Clinical trial NCT03162744: Protective Factors Against Elderly Suicide
Official title: Methodical Search of Protective Factors During Interview of Suicidal Elderly Patients: Effect on the Proposed Care
Study type: OBSERVATIONAL
Overall status: TERMINATED
Conditions: Suicide, Attempted
Suicide Gesture
Lead sponsor: Groupe Hospitalier de la Rochelle Ré Aunis
Sponsor class: OTHER
First posted: 2017-05-22
Enrollment: 15
Sex: ALL
Minimum age (years): 65
Standard ages: OLDER_ADULT
Accepts healthy volunteers: no
Observational model: CASE_ONLY
Time perspective: CROSS_SECTIONAL
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Patients will be screened in the psychiatric, geriatric and emergency departments of la Rochelle and Rochefort secondary hospitals

Brief summary: Suicidal intentionality is generally stronger among the elderly, suicidal acts are more violent and are combined with a greater physical fragility. The suicide of an older adult is a situation that often leads to helplessness feelings.

Analysis of the literature reveals two types of major interventions in order to reduce suicide rate: reducing risk factors and increasing protective factors. Risk factors are well documented, particularly from studies using psychological autopsies. However, protective factors are much less studied for the elderly. Yet the identification of relevant and available protective mechanisms in a suicidal crisis is essential to effectively guide nurses and health professionals in therapeutic commitment and intervention.

Detailed description: France has a suicide rate (16.2 per 100 000 inhabitants) well above the European average rate (10.2 per 100 000 inhabitants). The Poitou-Charentes region is in a situation of excess mortality by suicide compared to France (+ 25%). While the ratio of suicide attempts per suicide is about 200/1 before 25 years, it is estimated to be 4/1 after 65 years, or even 1/1 in elderly men. In France, suicide attempts are not systematically recorded and the frequency of suicidal ideation is poorly understood. The consensus conference on suicidal crisis highlights a number of clinical points specific to the elderly population (suicidal ideas are not always clearly expressed or unidentified, there are various manifestations of the psychic crisis, greater vulnerability of this population), but the complexity of interactions between suicidal risk factors limits our predictive capabilities of suicidal intention in an elderly person. Analysis of the literature reveals two types of major interventions in order to reduce the suicide rate: those aimed at reducing risk factors and those aimed at increasing protective factors. The objective of our research is to determine the effect of protective factor methodical search on post-crisis patient care.

Eligibility criteria: Inclusion Criteria:

* Attempted suicide and / or suicidal ideas
* Informed and agreed to participate

Exclusion Criteria:

* Cognitive disorders
* Refusal to participate

Primary outcomes:
measure: Number of outpatients (with a low to moderate risk of suicidal recurrence)
timeFrame: 7 days
Secondary outcomes:
measure: Number of patients considering themselves to be in good health
timeFrame: 7 days
measure: Number of patients considering that their physical or mental state did not alter their social life
timeFrame: 7 days
measure: Number of patients maintaining autonomy
timeFrame: 7 days
measure: Number of patients with religious practice
timeFrame: 7 days
measure: Number of patients with a sense of success and self-esteem
timeFrame: 7 days
measure: Number of patients considering their family environment to be satisfactory
timeFrame: 7 days
measure: Number of patients with at least one environmental protection factor
timeFrame: 7 days
measure: Number of patients with social protection factors
timeFrame: 7 days
measure: Number of patients able to adapt to difficult situations
timeFrame: 7 days
measure: Number of patients with extraversion capabilities
timeFrame: 7 days
measure: Number of patients with openness to others
timeFrame: 7 days
measure: Number of patients considering that their health has improved
timeFrame: 3 months
Other outcomes:
Locations:
city: La Rochelle
country: France
facility: Groupe Hospitalier de la Rochelle Ré Aunis
Study officials:
affiliation: Groupe Hospitalier de la Rochelle Ré Aunis
name: Karine REISS, MD
role: STUDY_DIRECTOR
References:
citation: Richard-Devantoy S, Jollant F. [Suicide in the elderly: age-related specificities?]. Sante Ment Que. 2012 Autumn;37(2):151-73. doi: 10.7202/1014949ar. French.
citation: Conwell Y, Thompson C. Suicidal behavior in elders. Psychiatr Clin North Am. 2008 Jun;31(2):333-56. doi: 10.1016/j.psc.2008.01.004.
citation: Casadebaig F, Ruffin D, Philippe A. [Suicide in the elderly at home and in retirement homes in France]. Rev Epidemiol Sante Publique. 2003 Feb;51(1 Pt 1):55-64. French.