Contribution of Psychological Autopsy to the Understanding of Suicidal Behaviors in French Overseas Territories

Study Overview
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Brief Summary
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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.

Detailed Description
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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.

Official Title
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Contribution of Psychological Autopsy to the Understanding of Suicidal Behaviors in French Overseas Territories

Conditions
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Suicide, Mental Disorders and Socio-health Profile of Suicided Persons

Intervention / Treatment
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* Other: other


Participation Criteria
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Eligibility Criteria
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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.

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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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| person close to the deceased<br>Relatives will be invited to participate in two semi-structured research interviews in the form of a storytelling interview with an interviewer. All interviews will be conducted after obtaining the participants' non-objection. The interviews will be recorded and, once transcribed, will be analysed. | Other: other<br>* The interviewers will collect data from relatives using questionnaires and evaluation grids based on an identification form, a Life Trajectory questionnaire, an anthropological evaluation grid, a retrospective psychiatric diagnosis questionnaire (SCID), a socio-demographic questionnaire, a questionnaire on suicide risks and a questionnaire on emotional state.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Risk factors identified and their frequency | From the data collected via SCID, mental disorders presented by the deceased will be identified. The variables will be presented in numbers and percentages | 1 month | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| comparison by territory | The risk factors identified and the mental disorders detected will be compared between the overseas sites and the Somme department. | 1 month | 
| Existence or not of violence in childhood or during life among suicide cases | The variables related to childhood violence will be presented with the number of subjects n expressed as a percentage. | 1 month | 
| Analysis of the Life Trajectory | Once the interviews have been completed, the recordings will be transcribed semi-automatically via the HappyScribe® online platform. The resulting verbatim recordings will then be used as data for psycholinguistic and psycholinguistic and anthropological analyses. The qualitative data will then be transformed into quantitative data following the methodology developed by Brown and Harris, in which a panel of experts (researchers from our team and clinicians) assigns an overall rating for each five-year period, according to the severity of the burden of adversity carried by the person. This rating, from 1 to 6, makes it possible to determine the burden of adversity in the development of the individual (detailed description Séguin et al, 2007). It is the ratings of adversity that will form the curve of these trajectories. | 6 month | 
| Qualitative analyses of psychological autopsies using anthropological and psycholinguistic approaches. |  | 6 month | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Suicide, Psychological autopsies, epidemiology, risk factors, psycholinguistic approach, French overseas territories