| Summary: | Abstract Suicide attempts are a critical concern among first-episode, drug-naïve (FEDN) patients with major depressive disorder (MDD). This cross-sectional study investigated the prevalence and correlates of suicide attempts in 1,701 working-age Chinese adults (18–59 years) with FEDN MDD. Sociodemographic data, clinical assessments, and biochemical data were obtained. Overall, 20.2% of participants reported lifetime suicide attempts. Multiple logistic regression identified four independent correlates: Hamilton Anxiety Scale (HAMA), clinical global impression of severity scale (CGI-s), systolic blood pressure, and thyroid peroxidase antibody levels. Additional analysis revealed significant pro-atherogenic lipid profile alterations in suicide attempters. Receiver operating characteristic curve analysis highlighted the high discriminative ability of HAMA and CGI-s for identifying suicide attempts. These findings underscore the importance of integrating psychological, cardiovascular, and metabolic markers in routine suicide risk evaluation for working-age FEDN MDD patients. Incorporating anxiety, blood pressure, lipid metabolism, and thyroid autoantibody assessment may enhance early detection and inform targeted interventions.
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