contribution of psychological autopsy to the understanding of suicidal behaviors in french overseas territories

Conditions: Suicide; Mental Disorders; Prognostic Factors

Summary: the mains objectives of our project are to coordinate the monitoring of suicides and to identify common or specific suicide risk factors in four overseas drom-com (french polynesia, la reunion, french guiana and martinique) by comparing to a site in mainland france (amiens). a mixed approach (quantitative and qualitative) will be used, based on semi-directed interviews of the psychological autopsy type.

epidemiological studies on suicide are rare in overseas france. nevertheless, studies conducted independently in new caledonia (nc) and french guiana were able to highlight a high prevalence of suicides in minority indigenous populations (kanaks and amerindians). these data therefore suggest a socio-cultural variability of suicides within the different territories. psychological autopsies (used in nc) are an innovative approach that has already proven worldwilde its effectiveness in researching socio-cultural factors and prevalence of mental disorders in suicide subjects (inserm). however, the qualitative analysis of psychological autopsies, even if it is very complete, is limited to known factors of suicide risk. given the ethnic specificities of suicidal behavior and the socio-cultural richness of each overseas territory, an exploratory anthropologic approach will make it possible to complete identification of risk factors for suicide or combinations of these specific factors (profiles). our project will improve the data collection of suicide cases with the implementation of a network in each site (public health department, emergency units, coroner offices, gp, associations, families...). then interview with proxies of subjects deceased by suicide will allow psychological autopsy (questionnaires scid to detect mental disorders, life trajectories, to detect life events and their burden, anthropologic for socio-cultural aspects and psycholinguistic analysis). the total duration of the project will be 24 months with the recruitment of a maximum of 30 cases per site. duration of the inclusion period will be 23 months, duration of follow-up per participant 1 month. the follow-up interview will be carried out one month after the inclusion interview. it will make it possible to establish a post-vention of suicide among the bereaved and an evaluation of the impact of the psychological autopsy interviews and the life trajectories of the bereaved.

Eligibility criteria:
inclusion criteria: * persons close of the deceased * persons who knew about his/her childhood * age 18 or over * interviewed for the study between 2 and 11 months after the suicide exclusion criteria: * people with neuropsychiatric disorders that may affect the quality of the information collected, cognitive (memory and expression) and judgmental functions * people who refuses to participate * persons referred to articles l.1121-6, l.1121-7, l. 1121-8 l.1121-1-2 of the french public health code.

Keywords: suicide psychological autopsies epidemiology risk factors psycholinguistic approach french overseas territories