Conclusion
Repeated suicide attempts in the later episodes of depression appear to be a risk factor for suicide in severe depression. In contrast, controls made repeated attempts during the early course of depression.
The difference could not be considered to be secondary to a more severe course of depression, or due to a lack of treatment in the suicide group, but to a difference in suicidal behaviour itself.
The present study gives clinical evidence of a behavioural sensitisation or a kindling model of suicide attempt across the depressive episodes, independent of a
corresponding kindling of depression. Furthermore, this sensitisation appears to be related to a suicidal outcome as it was found in the suicide group only.