Evaluation of the Links Between Sleep Disorders and the Risk of Suicide Attempt

Study Overview
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Brief Summary
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Several studies have demonstrated an association between sleep disorders such as insomnia and nightmares to suicidal ideations and behaviors. Nevertheless, some of these studies are methodologically questionable especially in the exploration of sleep disorders. Furthermore, confounding factors such as depressive symptomatology are not controlled and the measurement of suicidal behavior has often been taken into account as a historical measure, not as a current event, which introduces uncertainties and a lack of precision regarding the temporality of the phenomena. Today, while the links between sleep disorders and suicidal risk are well known, we have a lack of information on the importance and the role of sleep disorders as a precipitating factor. Indeed, few studies have evaluated the temporal link between sleep disorders and suicidal acts. The objective of this study is to evaluate the links between acute and chronic sleep disorders and the risk of suicide attempt

Detailed Description
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Pilot, prospective, monocentric case-control study. There are 2 groups of subjects : group of patients who have made a suicide attempt control group with only suicidal ideas First visit V1 is performed within the first 72 hours of hospitalization. A re-assessment is scheduled 1 month after (V2). At V1, collected parameters are : chronic sleep disorders, chronotype, specific sleep disorders in posttraumatic stress disorder, nightmares and the distress associated, childhood trauma, cognitive dysfunction, suicidal ideation and psychopathologic assessment. At V2, we assess evolution of sleep disturbances and suicidal ideation.

Official Title
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Evaluation of the Links Between Sleep Disorders and the Risk of Suicide Attempt

Conditions
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Attempted Suicide

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria Criterion specific to the studying group : - Subjects hospitalized and whose indication of hospitalization is a suicide attempt by voluntary drug intoxication or phlebotomy during the last 72 hours, without any history of attempted suicide Criterion specific to the control group: - Subjects hospitalized since less than 72 hours, and whose indication of hospitalization is the presence of suicidal ideas, without any history of attempted suicide Exclusion Criteria: Pregnant of lactating women Diagnosed dementia pathology Proven intellectual disability Patient whose physical or mental state does not allow the passing of the tests of the study Under protective measures (guardianship/supervision) Refusal to participate in the study Diagnosed with chronic or severe psychiatric illness (psychotic disorder, bipolarity)

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| case group : realized a suicide attempt<br>adults having realized a suicide attempt and without histories of suicide attempt. | |
| control group : only suicidal ideas<br>adults having suicidal ideas without suicidal acting out and without histories of suicide attempt. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Sleep disorders intensity by the Insomnia Severity Index (ISI) | ISI score in the last 2 weeks between a group of suicide attempts and a group with suicidal thoughts suicidal The Insomnia Severity Index has seven questions. The seven answers are added up to get a total score. | at the 48 hours after the hospitalization; at the maximum within 72 hours. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Correlation between Beck Suicide Intent Scale (BSIS) score and ISI score | Correlation between Beck Suicide Intent Scale (BSIS) score and ISI score The Suicide Intent Scale (SIS) wconsists of 15 questions which are scaled from 0-2, which take into account both the logistics of the suicide attempt as well as the intent. The scale has high reliability and validity. Completed suicides ranked higher in the severity of the logistics than attempted suicides (it was impossible to measure intent for the completed suicides), and those with multiple attempts had higher scores than those who only attempted suicide once | Baseline (visit inclusion) and at one month ago | 
| Evolution of ISI score | Assess the evolution of sleep disturbances for each group by ISI Score | At one month +/- 15 days ant at 3 months +/-3 weeks | 
| Chronotype classification by MCTQ | Exploratory descriptive measures in the 2 groups | at the 48 hours after the hospitalization; at the maximum within 72 hours;at 3 months +/-3 weeks | 
| Pittsburg Sleep Quality Index (PSQI) score | PSQI score between the groups PSQI is a self-report questionnaire that assesses sleep quality over a 1-month time interval. The measure consists of 19 individual items, creating 7 components that produce one global score, and takes 5-10 minutes to complete. | at the 48 hours after the hospitalization; at the maximum within 72 hours,at 3 months +/-3 weeks | 
| Childhood Trauma Questionnaire (CTQ) score | CTQ score between the groups The Childhood Trauma Questionnaire was developed as a screening tool for histories of abut and neglect. The self-report includes a 28-item test that measures 5 types of maltreatment - emotional, physical, and sexual abuse, and emotional and physical neglect. | at the 48 hours after the hospitalization; at the maximum within 72 hours. | 
| Montréal Cognitive Assessment (MocA) | cognitive assessment by Moca test | at the 48 hours after the hospitalization; at the maximum within 72 hours. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Suicide, Suicidal ideation, Sleep disorder