Suicidality and Aggressive Behaviors in Migrants: Results From an Observational Study

Background: Suicide and aggression are significant public health concerns, particularly in vulnerable populations such as migrants. Emotional dysregulation, compounded by acculturation stress and socio-cultural challenges, may underlie both suicidality and aggression in migrants. However, little is known about the clinical profiles and predictors of these behaviors in psychiatric inpatient settings. Methods: We retrospectively analyzed 268 migrant patients admitted to a psychiatric unit in Italy between 2004 and 2019. Sociodemographic, cultural, and clinical information, including psychiatric diagnoses, acculturation stress, and clinical status, were collected. Logistic regression models were used to identify predictors of suicidality and aggression. Results: Suicide attempts were reported in 22.4% of patients and were associated with acculturation stress, with higher levels on suicidality and guilt at the BPRS, and with lower functioning. Aggressive behaviors were observed in 22.5% of patients and were linked to young age, low educational level, unstable legal status, low Italian proficiency, and high levels of hostility and motor hyperactivity. We found only a minimal overlap (3.7%) between suicidality and aggression. At the logistic regression analyses, suicidality was predicted by severe psychiatric symptoms and impaired psychosocial functioning, while aggression was predicted by hostility and low guilt. Conclusions: This study demonstrates that, among migrant patients, both self-harm and aggressive behaviors are modifiable expressions of emotional dysregulation rather than inherent traits of migration. Our findings emphasize the need for culturally sensitive, trauma-informed interventions addressing acculturation stress and emotional dysregulation. Tailored approaches can improve psychiatric outcomes and foster resilience in migrant populations.