1
|
Goueslard K, Quantin C, Jollant F. Self-harm and suicide death in the three years following hospitalization for intentional self-harm in adolescents and young adults: A nationwide study. Psychiatry Res 2024; 334:115807. [PMID: 38387165 DOI: 10.1016/j.psychres.2024.115807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 02/11/2024] [Accepted: 02/17/2024] [Indexed: 02/24/2024]
Abstract
Self-harm is frequent in youths. This study aimed to assess the risk of self-harm and mortality over a three-year period following self-harm hospitalization. Data were extracted from national databases in France. All patients aged 12 to 24 years and hospitalized for self-harm in 2013-2014 were included and compared to age- and sex-matched individuals with no self-harm hospitalization during this period. Cox proportional hazards regression models were used. Overall, 34,533 individuals were hospitalized for self-harm in 2013-2014 (70.8 % females, 79.6 % self-poisoning), with a peak among females aged 14-16. Comparison with 103,599 matched controls showed significantly higher rates of past self-harm, somatic and psychiatric disorders, and dispensed drugs in youth hospitalized for self-harm. During follow-up, they significantly more often repeated self-harm (20.9 vs. 0.1 %), died from any cause (0.6 vs 0.03 %) and from suicide (0.2 vs 0.01 %), particularly during the first year. The choice of a violent self-harm means at inclusion increased the risk of suicide during follow-up. Psychiatric disorders were a significant risk factor for all outcomes. In conclusion, at least one in five youths will self-harm, and one in two hundred will die in the three years following hospitalization for self-harm. Reinforced follow-up care is necessary in this population.
Collapse
Affiliation(s)
- Karine Goueslard
- Service de Biostatistiques et d'Information Médicale (DIM), CHU Dijon Bourgogne, France
| | - Catherine Quantin
- Service de Biostatistiques et d'Information Médicale (DIM), CHU Dijon Bourgogne, France; Université de Bourgogne, CIC 1432, Module Épidémiologie Clinique, F21000 Dijon, France; Inserm, CESP, 94807, Villejuif, France
| | - Fabrice Jollant
- Department of psychiatry, Faculty of Medicine, Université Paris Saclay, Le Kremlin-Bicêtre, France; Department of psychiatry, Hôpital Bicêtre, APHP, Le Kremlin-Bicêtre, France; Department of psychiatry, CHU Nîmes, Nîmes, France; McGill Group for Suicide Studies, Department of psychiatry, McGill University, Montréal, Québec, Canada; Moods Research Team, INSERM UMR-1178, CESP, Le Kremlin-Bicêtre, France.
| |
Collapse
|
2
|
Gifuni AJ, Pereira F, Chakravarty MM, Lepage M, Chase HW, Geoffroy MC, Lacourse E, Phillips ML, Turecki G, Renaud J, Jollant F. Perception of social inclusion/exclusion and response inhibition in adolescents with past suicide attempt: a multidomain task-based fMRI study. Mol Psychiatry 2024:10.1038/s41380-024-02485-w. [PMID: 38424142 DOI: 10.1038/s41380-024-02485-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 02/07/2024] [Accepted: 02/12/2024] [Indexed: 03/02/2024]
Abstract
The occurrence of suicidal behaviors increases during adolescence. Hypersensitivity to negative social signals and deficits in cognitive control are putative mechanisms of suicidal behaviors, which necessitate confirmation in youths. Multidomain functional neuroimaging could enhance the identification of patients at suicidal risk beyond standard clinical measures. Three groups of adolescents (N = 96; 78% females, age = 11.6-18.1) were included: patients with depressive disorders and previous suicide attempts (SA, n = 29); patient controls with depressive disorders but without any suicide attempt history (PC, n = 35); and healthy controls (HC, n = 32). We scanned participants with 3T-MRI during social inclusion/exclusion (Cyberball Game) and response inhibition (Go-NoGo) tasks. Neural activation was indexed by the blood-oxygenation-level dependent (BOLD) of the hemodynamic response during three conditions in the Cyberball Game ("Control condition", "Social Inclusion", and "Social Exclusion"), and two conditions in Go-NoGo task ("Go" and "NoGo" blocks). ANCOVA-style analysis identified group effects across three whole-brain contrasts: 1) NoGo vs. Go, 2) Social inclusion vs. control condition, 3) Social exclusion vs. control condition. We found that SA had lower activation in the left insula during social inclusion vs. control condition compared to PC and HC. Moreover, SA compared to PC had higher activity in the right middle prefrontal gyrus during social exclusion vs. control condition, and in bilateral precentral gyri during NoGo vs. Go conditions. Task-related behavioral and self-report measures (Self-reported emotional reactivity in the Cyberball Game, response times and number of errors in the Go-NoGo Task) did not discriminate groups. In conclusion, adolescent suicidal behaviors are likely associated with neural alterations related to the processing of social perception and response inhibition. Further research, involving prospective designs and diverse cohorts of patients, is necessary to explore the potential of neuroimaging as a tool in understanding the emergence and progression of suicidal behaviors.
Collapse
Affiliation(s)
- Anthony J Gifuni
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montréal, Canada
- Department of Psychiatry, McGill University, Montréal, Canada
- Manulife Centre for Breakthroughs in Teen Depression and Suicide Prevention, Montréal, Canada
| | - Fabricio Pereira
- MOODS Team, INSERM 1018, CESP (Centre de Recherche en Epidémiologie et Santé des Populations), Université Paris-Saclay, Faculté de Médecine Paris-Saclay, Le Kremlin Bicêtre, France
- Service de psychiatrie, CHU Nîmes, Nîmes, France
- MIPA, University of Nîmes, Nîmes, France
| | | | - Martin Lepage
- Department of Psychiatry, McGill University, Montréal, Canada
| | - Henri W Chase
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Marie-Claude Geoffroy
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montréal, Canada
- Department of Psychiatry, McGill University, Montréal, Canada
- Department of Educational and Counselling Psychology, McGill University, Montréal, Canada
| | - Eric Lacourse
- Department of Sociology, Université de Montréal, Montréal, Canada
| | - Mary L Phillips
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Gustavo Turecki
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montréal, Canada
- Department of Psychiatry, McGill University, Montréal, Canada
| | - Johanne Renaud
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montréal, Canada
- Department of Psychiatry, McGill University, Montréal, Canada
- Manulife Centre for Breakthroughs in Teen Depression and Suicide Prevention, Montréal, Canada
| | - Fabrice Jollant
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montréal, Canada.
- Department of Psychiatry, McGill University, Montréal, Canada.
- MOODS Team, INSERM 1018, CESP (Centre de Recherche en Epidémiologie et Santé des Populations), Université Paris-Saclay, Faculté de Médecine Paris-Saclay, Le Kremlin Bicêtre, France.
- Service de psychiatrie, CHU Nîmes, Nîmes, France.
- Université Paris-Saclay, Faculté de médecine, Le Kremlin-Bicêtre, France.
- Service de psychiatrie, Hôpital Bicêtre, APHP, Le Kremlin-Bicêtre, France.
| |
Collapse
|
3
|
Jollant F, Demattei C, Fabbro P, Abbar M. Clinical predictive factors and trajectories of suicidal remission over 6 weeks following intravenous ketamine for suicidal ideation. J Affect Disord 2024; 347:1-7. [PMID: 37981038 DOI: 10.1016/j.jad.2023.11.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 10/27/2023] [Accepted: 11/13/2023] [Indexed: 11/21/2023]
Abstract
BACKGROUND Ketamine is efficient for short-term reduction of suicidal ideas. Predictive factors and outcome trajectories are poorly characterized. METHODS Secondary analyses were conducted on the KETIS study (Abbar et al. BMJ 2022): 156 suicidal patients were randomized to two intravenous infusions of racemic ketamine (0.5 mg/kg) or placebo. Response or remission was assessed over six weeks based on the Beck Scale for Suicidal Ideation (SSI). We calculated i) predictive values of 12 baseline variables on remission ii) outcome courses, and iii) positive (PPV) and negative predictive values. RESULTS In multivariate analyses, bipolar disorder, lower patient-rated suicidal ideas, and higher physical pain were predictive of suicidal remission at day 3. No clinical factor predicted remission at week 6. Twenty and 24 different clinical courses were identified in early (day 3) and later (week 6) follow-up, respectively, including around 40 % sustained remission, 50 % fluctuating course and 10 % no response. Suicidal remissions at day 1 and day 3 were highly predictive of remissions at day 3 and week 6 (PPV = 96.8 and 92.6 %). LIMITATIONS SSI may not be adapted for rapid variations and repeated measures. CONCLUSIONS Clinical factors were poorly predictive of remission. Fluctuations in suicidal ideas were frequent, even after ketamine (although less than placebo), necessitating vigilance and multimodal care. Remission at day 1 after one infusion was highly predictive of future remission. The benefits of a second infusion will have to be tested.
Collapse
Affiliation(s)
- Fabrice Jollant
- Department of Psychiatry, CHU Nîmes, Univ Montpellier, Nîmes, France; Faculty of Medicine, Paris-Saclay University, Le Kremlin Bicêtre, France; Department of Psychiatry, Bicêtre Hospital, AP-HP, Le Kremlin Bicêtre, France; Moods Research Team, Inserm 1018, CESP, Le Kremlin-Bicêtre, France; Department of Psychiatry, McGill Group for Suicide Studies, McGill University, Montreal, Canada.
| | - Christophe Demattei
- Department of Biostatistics, Epidemiology, Public Health and Innovation in Methodology (BESPIM) CHU Nîmes, Univ Montpellier, Nîmes, France
| | - Pascale Fabbro
- Department of Biostatistics, Epidemiology, Public Health and Innovation in Methodology (BESPIM) CHU Nîmes, Univ Montpellier, Nîmes, France
| | - Mocrane Abbar
- Department of Psychiatry, CHU Nîmes, Univ Montpellier, Nîmes, France
| |
Collapse
|
4
|
Richard O, Piot MA, Jollant F. Short-term effects of a simulation-based training program on suicide risk assessment and intervention for first-year psychiatry residents. Encephale 2024:S0013-7006(24)00007-1. [PMID: 38311482 DOI: 10.1016/j.encep.2023.11.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 11/03/2023] [Accepted: 11/08/2023] [Indexed: 02/06/2024]
Abstract
OBJECTIVES Adequate training of mental health professionals in suicide risk assessment and intervention is crucial. Simulation-based education is a relevant method to acquire competences for challenging health interventions. Here, we aimed to evaluate the effects of a simulation-based training program on first-year psychiatry residents' skills, knowledge, attitudes and satisfaction. METHODS We conducted pre- and immediately post-training assessments in 153 psychiatry residents during their first or second postgraduate semester in Paris, France, in 2020 and 2021. The simulation-based training occurred a few weeks after a two-hour theoretical lecture on suicidal behaviors. It consisted of a full-day training of small groups (n=5 to 9) with six scenarios played by professional actors and facilitated by two trained psychiatrists, and a 45-60minute debriefing session after each simulation. Educational objectives focused on basic aspects of patient-psychiatrist relation, the investigation of suicidal ideation, and basic interventions in various contexts (outpatient consultation, emergency room, telephone) and patient profiles. Outcome measures included the Suicide Intervention Response Inventory (SIRI-2), a short questionnaire on basic knowledge, a self-confidence four-item scale, and a satisfaction questionnaire. RESULTS There were significant improvements in skills, basic knowledge, and self-confidence from pre- to post-training. Trainees also expressed a high level of satisfaction, an appreciation for this innovative pedagogy and a wish for more similar training. CONCLUSIONS This practical training program based on simulation improved self-confidence, knowledge and skills in suicide risk assessment and intervention in the short-term among first year psychiatry residents. Results from this study are therefore promising. Longitudinal studies are, however, needed to evaluate the persistence of changes over time, positive changes in care in real settings and health benefits for patients. In a time of easily accessible and rapidly growing factual medical knowledge, of necessary need for skilled professionals and of growing demand in mental health care, the development of simulation training in psychiatry should be a pedagogical and a public health priority.
Collapse
Affiliation(s)
- Océane Richard
- Université Paris-Cité, AP-HP, Academic Hospital Necker-Enfants Malades, Department of child and adolescent psychiatry, Reference center for autism and learning disorders, Paris, France
| | - Marie-Aude Piot
- Université Paris-Cité, AP-HP, Academic Hospital Necker-Enfants Malades, Department of child and adolescent psychiatry, Reference center for autism and learning disorders, Paris, France; Ilumens, Simulation Center, Paris, France; Paris-Saclay University, UVSQ, INSERM 1018, CESP, Villejuif, France
| | - Fabrice Jollant
- Department of Psychiatry, School of Medicine, Paris-Saclay University, le Kremlin-Bicêtre, France; Department of Psychiatry, Academic hospital Bicêtre, AP-HP, Le Kremlin-Bicêtre, France; Department of Psychiatry, CHU Nîmes, Nîmes, France; McGill University, McGill Group for Suicide Studies, Montreal, Canada; Moods Team, INSERM UMR-1178, CESP, Le Kremlin-Bicêtre, France.
| |
Collapse
|
5
|
Goueslard K, Jollant F, Cottenet J, Bechraoui-Quantin S, Rozenberg P, Simon E, Quantin C. Author reply. BJOG 2024; 131:118-120. [PMID: 37712741 DOI: 10.1111/1471-0528.17660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 08/13/2023] [Indexed: 09/16/2023]
Affiliation(s)
- Karine Goueslard
- Biostatistics and Bioinformatics (DIM), University Hospital, Dijon, France
- Université Bourgogne Franche-Comté, Dijon, France
| | - Fabrice Jollant
- Department of Psychiatry, Paris-Saclay University and Academic Hospital (CHU) Bicêtre, Le Kremlin-Bicêtre, France
- Department of Psychiatry, Nîmes Academic Hospital (CHU), Nîmes, France
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
- MOODS Research Team, CESP, Inserm, Le Kremlin-Bicêtre, France
| | - Jonathan Cottenet
- Biostatistics and Bioinformatics (DIM), University Hospital, Dijon, France
- Université Bourgogne Franche-Comté, Dijon, France
| | - Sonia Bechraoui-Quantin
- Biostatistics and Bioinformatics (DIM), University Hospital, Dijon, France
- Université Bourgogne Franche-Comté, Dijon, France
- Gynecology, Obstetrics and Fetal Medicine, University Hospital, Dijon, France
| | - Patrick Rozenberg
- Department of Obstetrics and Gynecology, Hôpital Intercommunal de Poissy, Université Versailles Saint-Quentin, Poissy, France
| | - Emmanuel Simon
- Gynecology, Obstetrics and Fetal Medicine, University Hospital, Dijon, France
| | - Catherine Quantin
- Biostatistics and Bioinformatics (DIM), University Hospital, Dijon, France
- Université Bourgogne Franche-Comté, Dijon, France
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, High-Dimensional Biostatistics for Drug Safety and Genomics, CESP, Villejuif, France
| |
Collapse
|
6
|
Nguyen TML, Jollant F, Tritschler L, Colle R, Corruble E, Gardier AM. [Ketamine and suicidal behavior: Contribution of animal models of aggression-impulsivity to understanding its mechanism of action]. Ann Pharm Fr 2024; 82:3-14. [PMID: 37890717 DOI: 10.1016/j.pharma.2023.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 10/16/2023] [Accepted: 10/19/2023] [Indexed: 10/29/2023]
Abstract
More than two-thirds of suicides occur during a major depressive episode. Acting out prevention measures and therapeutic options to manage the suicidal crisis are limited. The impulsive-aggressive dimensions are vulnerability factors associated with suicide in patients suffering from a characterized depressive episode: this can be a dimension involved in animals. Impulsive and aggressive rodent models can help analyze, at least in part, the neurobiology of suicide and the beneficial effects of treatments. Ketamine, a glutamatergic antagonist, by rapidly improving the symptoms of depressive episodes, would help reduce suicidal thoughts in the short term. Animal models share with humans impulsive and aggressive endophenotypes modulated by the serotonergic system (5-HTB receptor, MAO-A enzyme), neuroinflammation or the hypothalamic-pituitary-adrenal axis and stress. Significant effects of ketamine on these endophenotypes remain to be demonstrated.
Collapse
Affiliation(s)
- Thi Mai Loan Nguyen
- Inserm CESP/UMR 1018, équipe MOODS, faculté de pharmacie, université Paris-Saclay, 91400 Orsay, France
| | - Fabrice Jollant
- Inserm CESP/UMR 1018, équipe MOODS, faculté de médecine, université Paris-Saclay, 94270 Le Kremin-Bicêtre, France; Service hospitalo-universitaire de psychiatrie, hôpital de Bicêtre, hôpitaux universitaires Paris-Saclay, Assistance publique-Hôpitaux de Paris (AP-HP), 94275 Le Kremlin-Bicêtre, France; Pôle de psychiatrie, CHU de Nîmes, Nîmes, France; Département de psychiatrie, Université McGill et Groupe McGill d'études sur le suicide, Montréal, Canada
| | - Laurent Tritschler
- Inserm CESP/UMR 1018, équipe MOODS, faculté de pharmacie, université Paris-Saclay, 91400 Orsay, France
| | - Romain Colle
- Inserm CESP/UMR 1018, équipe MOODS, faculté de médecine, université Paris-Saclay, 94270 Le Kremin-Bicêtre, France; Service hospitalo-universitaire de psychiatrie, hôpital de Bicêtre, hôpitaux universitaires Paris-Saclay, Assistance publique-Hôpitaux de Paris (AP-HP), 94275 Le Kremlin-Bicêtre, France
| | - Emmanuelle Corruble
- Inserm CESP/UMR 1018, équipe MOODS, faculté de médecine, université Paris-Saclay, 94270 Le Kremin-Bicêtre, France; Service hospitalo-universitaire de psychiatrie, hôpital de Bicêtre, hôpitaux universitaires Paris-Saclay, Assistance publique-Hôpitaux de Paris (AP-HP), 94275 Le Kremlin-Bicêtre, France
| | - Alain M Gardier
- Inserm CESP/UMR 1018, équipe MOODS, faculté de pharmacie, université Paris-Saclay, 91400 Orsay, France.
| |
Collapse
|
7
|
Gifuni AJ, Spodenkiewicz M, Laurent G, MacNeil S, Jollant F, Renaud J. Symptoms characteristics of personality disorders associated with suicidal ideation and behaviors in a clinical sample of adolescents with a depressive disorder. Front Psychiatry 2023; 14:1269744. [PMID: 38146283 PMCID: PMC10749562 DOI: 10.3389/fpsyt.2023.1269744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Accepted: 11/16/2023] [Indexed: 12/27/2023] Open
Abstract
Introduction Pathological personality traits have repeatedly been identified as important risk factors for suicidal ideation and behaviors. Moreover, impulsive-aggressive traits, have shown a consistent association with suicidal behaviors across the lifespan. Adolescence represents a critical period for the emergence of different personality traits, mood disorders, and suicidal behaviors, but the relationship between these variables remain poorly understood. Methods These variables were examined in a cross-sectional case-control design involving three groups: 30 adolescents with a depressive disorder and past suicide attempt (Mean Age = 16.2, Females = 26), 38 adolescents with a depressive disorder but without past suicide attempt (Mean age = 16.0, Females = 29), and 34 healthy adolescent controls (Mean age = 15.2, Females = 22). Suicidal ideations were indexed using Suicidal Behavior Questionnaire (SBQ-R), psychiatric disorder assessed using a semi-structured questionnaire (K-SADS-PL), depressive symptoms with the Beck Depressive Inventory (BDI), symptoms characteristics of personality disorders with the Scheduled Clinical Interview for the DSM-IV (SCID-II) screening questionnaire, and impulsivity with the Barratt Impulsivesness Scale (BIS). Results Findings showed that impulsivity (F = 11.0, p < 0.0001) and antisocial symptoms characteristics of personality disorders (p < 0.001, d = 0.70) displayed the most robust association with adolescent suicide attempts. Borderline symptoms characteristics of personality disorders did not discriminate attempters from non-attempters but presented high correlations with suicidal ideation and depression severity. In an item-wise analysis, suicide attempt status was uniquely correlated with symptoms characteristics of an antisocial personality disorder. Suicide attempt status also correlated with non-suicidal self-injury and a chronic feeling of emptiness. Discussion The caveats of this cross-sectional study include the stability of symptoms characteristics of personality disorders in adolescence and the limited sample size. In sum, suicidal behaviors were characteristically correlated with increased impulsivity and antisocial symptoms characteristics of personality disorders, but other symptoms characteristics of personality disorders were relevant to adolescent depression and suicidal ideation. Understanding the emergence of symptoms characteristics of personality disorders and suicidal behaviors in a developmental context can ultimately inform not only the neurobiological origin of suicidal behaviors, but also provide new avenues for early detection and intervention.
Collapse
Affiliation(s)
- Anthony Joseph Gifuni
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montreal, QC, Canada
- Department of Psychiatry, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Michel Spodenkiewicz
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montreal, QC, Canada
- INSERM UMR-1178, Moods Team, CESP, Le Kremlin-Bicêtre, France
- Department of Psychology, Concordia University, Montreal, QC, Canada
| | - Geneviève Laurent
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montreal, QC, Canada
| | - Sasha MacNeil
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montreal, QC, Canada
- Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Fabrice Jollant
- Department of Psychology, Concordia University, Montreal, QC, Canada
| | - Johanne Renaud
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montreal, QC, Canada
- Division of Child Psychiatry, Department of Psychiatry, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| |
Collapse
|
8
|
Richard O, Jollant F, Billon G, Attoe C, Vodovar D, Piot MA. Simulation training in suicide risk assessment and intervention: a systematic review and meta-analysis. Med Educ Online 2023; 28:2199469. [PMID: 37073473 PMCID: PMC10120456 DOI: 10.1080/10872981.2023.2199469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
PURPOSE Suicide is a major cause of preventable death worldwide. Adequate training in risk assessment and intervention is key to suicide prevention. The use of simulation (role plays, simulated patients, virtual reality…) for practical training is a promising tool in mental health. The purpose of this study was to assess the effectiveness of simulation training in suicide risk assessment and intervention for healthcare professionals and gatekeepers. METHODS We conducted a systematic review in Medline and PsycINFO up to 31 July 2021 of randomized controlled trials (RCTs), non-randomized controlled trials, and pre/post-test studies. RCTs were furthermore included in a meta-analysis. We assessed the methodological quality of all studies with the Medical Education Research Study Quality Instrument, and the Cochrane Risk of Bias tool 2.0 for RCTs. Primary outcomes were changes in Kirkpatrick criteria: attitudes, skills, knowledge, behaviors, and patient outcomes. RESULTS We included 96 articles representing 43,656 participants. Most pre/post-test (n = 65) and non-randomized controlled (n = 14) studies showed significant improvement in attitudes, skills, knowledge, and behaviors. The meta-analysis of 11 RCTs showed positive changes in attitudes immediately after training and at 2-4 months post-training; in self-perceived skills at 6 months post-training; but not in factual knowledge. Studies assessing benefits for patients are still limited. CONCLUSIONS The heterogeneity of methodological designs, interventions, and trained populations combined with a limited number of RCTs and studies on patients' outcomes limit the strength of the evidence. However, preliminary findings suggest that simulation is promising for practical training in suicidal crisis intervention and should be further studied.
Collapse
Affiliation(s)
- Océane Richard
- Department of child and adolescent psychiatry,Université Paris Cité, AP-HP, Academic Hospital Necker-Enfants Malades, Reference center for autism and learning disorders, Paris, France
| | - Fabrice Jollant
- Department of psychiatry, CHU Bicêtre, APHP, Le Kremlin-Bicêtre, France; Department of psychiatry, CHU Nimes, Nimes, France; Department of Psychiatry, School of Medicine, Paris-Saclay University, le Kremlin-Bicêtre, France; McGill University, McGill Group for Suicide Studies, Montreal, Canada; Moods Team, INSERM UMR-1178, CESP, Le Kremlin-Bicêtre, France
| | - Grégoire Billon
- Mental helath simulation center, Maudsley Learning, South London and Maudsley NHS Foundation Trust, London, UK
| | - Chris Attoe
- Mental helath simulation center, Maudsley Learning, South London and Maudsley NHS Foundation Trust, London, UK
| | - Dominique Vodovar
- Université Paris Cité, UFR de médecine, 75010 Paris; UMRS 1144, Faculté de pharmacie, 75006 Paris; Centre AntiPoison de Paris, Paris
| | - Marie-Aude Piot
- Department of child and adolescent psychiatry, Université Paris Cité, AP-HP, Academic Hospital Necker-Enfants Malades Reference center for autism and learning disorders; Ilumens, Simulation Center; Paris-Saclay University, Paris, France
- CONTACT Marie-Aude Piot Department of child and adolescent psychiatry, Academic Hospital Necker-Enfants Malades, 149 rue de Sèvres, 75015, Paris, France
| |
Collapse
|
9
|
Tournier M, Bénard-Laribière A, Jollant F, Hucteau E, Diop PY, Jarne-Munoz A, Pariente A, Oger E, Bezin J. Risk of suicide attempt and suicide associated with benzodiazepine: A nationwide case crossover study. Acta Psychiatr Scand 2023; 148:233-241. [PMID: 37339778 DOI: 10.1111/acps.13582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 04/27/2023] [Accepted: 05/06/2023] [Indexed: 06/22/2023]
Abstract
BACKGROUND Previous studies that found an association between benzodiazepines and suicidal behaviours were confounded by indication bias. AIMS To limit this bias, a case crossover study (CCO) was conducted to estimate the risk of suicide attempt and suicide associated with benzodiazepines. METHOD Patients ≥16 years, with hospitalised suicide attempt or suicide between 2013 and 2016, and at least one benzodiazepine dispensing within the 120 days before their act were selected in the nationwide French reimbursement healthcare system databases (SNDS). For each patient, frequency of benzodiazepine dispensing was compared between a risk period (days -30 to -1 before the event) and two matched reference periods (days -120 to -91, and -90 to -61). RESULTS A total of 111,550 individuals who attempted suicide and 12,312 suicide victims were included, of who, respectively, 77,474 and 7958 had recent psychiatric history. Benzodiazepine dispensing appeared higher in the 30-day risk period than in reference ones. The comparison yielded adjusted odds ratios of 1.74 for hospitalised suicide attempt (95% confidence interval 1.69-1.78) and 1.45 for suicide (1.34-1.57) in individuals with recent psychiatric history, and of 2.77 (2.69-2.86) and 1.80 (1.65-1.97) for individuals without. CONCLUSION This nationwide study supports an association between recent benzodiazepine use and both suicide attempt and suicide. These results strengthen the need for screening for suicidal risk carefully before initiation and during treatment when prescribing benzodiazepines. REGISTRATION NO EUPAS48070 (http://www.ENCEPP.eu).
Collapse
Affiliation(s)
- Marie Tournier
- University of Bordeaux, INSERM, BPH, Team AHeaD, U1219, Bordeaux, France
- Hospital Charles Perrens, Bordeaux, France
| | | | - Fabrice Jollant
- Moods Research Team, INSERM UMR-1178, CESP, Le Kremlin-Bicêtre, France
- Department of Psychiatry, School of Medicine, University Paris-Saclay & Academic Hospital (CHU) Bicêtre, APHP, Le Kremlin-Bicêtre, France
| | - Emilie Hucteau
- University of Bordeaux, INSERM, BPH, Team AHeaD, U1219, Bordeaux, France
| | - Papa-Yatma Diop
- University of Bordeaux, INSERM, BPH, Team AHeaD, U1219, Bordeaux, France
| | - Ana Jarne-Munoz
- University of Bordeaux, INSERM, BPH, Team AHeaD, U1219, Bordeaux, France
| | - Antoine Pariente
- University of Bordeaux, INSERM, BPH, Team AHeaD, U1219, Bordeaux, France
- CHU de Bordeaux, Clinical Pharmacology Unit, INSERM, U1219, Bordeaux, France
| | - Emmanuel Oger
- EA 7449 REPERES (Pharmacoepidemiology and Health Services Research), Rennes 1 University, Rennes, France
| | - Julien Bezin
- University of Bordeaux, INSERM, BPH, Team AHeaD, U1219, Bordeaux, France
- CHU de Bordeaux, Clinical Pharmacology Unit, INSERM, U1219, Bordeaux, France
| |
Collapse
|
10
|
Duriez P, Goueslard K, Treasure J, Quantin C, Jollant F. Risk of non-fatal self-harm and premature mortality in the three years following hospitalization in adolescents and young adults with an eating disorder: A nationwide population-based study. Int J Eat Disord 2023; 56:1534-1543. [PMID: 37092760 DOI: 10.1002/eat.23974] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 04/07/2023] [Accepted: 04/08/2023] [Indexed: 04/25/2023]
Abstract
INTRODUCTION Eating disorders (ED) are associated with high rates of suicide attempts and premature mortality. However, data in large samples of adolescents and young adults are limited. This study aims to assess the risk of self-harm and premature mortality in young people hospitalized with an ED. METHODS Individuals aged 12 to 25 years old hospitalized in 2013-2014 in France with anorexia nervosa and/or bulimia nervosa as a primary or associated diagnosis were identified from French national health records. They were compared to two control groups with no mental disorders, and with any other mental disorder than ED. The main outcomes were any hospitalization for deliberate self-harm and mortality in the 3 years following hospitalization. Logistic regression models were used. RESULTS This study included 5, 452 patients hospitalized with an ED, 14,967 controls with no mental disorder, and 14,242 controls with a mental disorder other than an ED. During the three-year follow-up, 13.0% were hospitalized for deliberate self-harm (vs. 0.2 and 22.0%, respectively) and 0.8% died (vs. 0.03 and 0.4%). After adjustment, hospitalization with an ED was associated with more self-harm hospitalizations (hazard ratio [HR] = 46.0, 95% confidence interval [32.3-65.3]) and higher all-cause mortality (HR = 12.6 [4.3-37.3]) relative to youths without any mental disorder; less self-harm hospitalizations (HR = 0.5 [0.5-0.6]) but higher mortality (HR = 1.6 [1.0-2.4]) when compared to youths with any other mental disorder. CONCLUSION Young patients hospitalized with an ED are at high risk of self-harm and premature mortality. It is urgent to evaluate and implement the best strategies for post-discharge care and follow-up. PUBLIC SIGNIFICANCE We found that the risk of being hospitalized for a suicide attempt is 46 times higher and mortality 13 times higher than the general population in adolescents and young adults during the 3 years following hospitalization with an eating disorder. Eating disorders are also associated with a 1.5 higher risk of premature mortality relative to other mental disorders. This risk is particularly high in the 6 months following hospitalization. It is therefore crucial to implement careful post-discharge follow-up in patients hospitalized for eating disorders.
Collapse
Affiliation(s)
- Philibert Duriez
- CMME, Sainte-Anne Hospital, GHU Paris Psychiatrie et Neurosciences, Paris, France
- UMR_S1266, Institut de Psychiatrie et Neurosciences de Paris (IPNP), Inserm, Paris, France
- Faculty of Medicine, Université de Paris, Paris, France
| | - Karine Goueslard
- Service de Biostatistiques et d'Information Médicale (DIM), CHRU Dijon, Dijon, France
| | - Janet Treasure
- Psychology and Neuroscience, Section of Eating Disorders, Institute of Psychiatry, London, UK
| | - Catherine Quantin
- CIC 1432, INSERM, Dijon, France
- Clinical Epidemiology Clinical Trials Unit, Clinical Investigation Center, CHU Dijon, Dijon, France
- Biostatistics, Biomathematics, Pharmacoepidemiology and Infectious Diseases (B2PHI), Inserm, UVSQ, Institut Pasteur, Université Paris-Saclay, Paris, France
| | - Fabrice Jollant
- Faculty of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France
- Department of Psychiatry, CHU Bicêtre, Le Kremlin-Bicêtre, France
- Department of Psychiatry, CHU de Nîmes, Nîmes, France
- Department of Psychiatry, Faculty of Medicine, and McGill Group For Suicide Studies, McGill University, Montréal, Québec, Canada
- Team MOODS, Centre de recherche en Épidémiologie et Santé des Populations (CESP), Inserm, Université Paris-Saclay, Le Kremlin-Bicêtre, France
| |
Collapse
|
11
|
Nguyen TML, Jollant F, Tritschler L, Colle R, Corruble E, Gardier AM. Pharmacological Mechanism of Ketamine in Suicidal Behavior Based on Animal Models of Aggressiveness and Impulsivity: A Narrative Review. Pharmaceuticals (Basel) 2023; 16:ph16040634. [PMID: 37111391 PMCID: PMC10146327 DOI: 10.3390/ph16040634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 04/12/2023] [Accepted: 04/14/2023] [Indexed: 04/29/2023] Open
Abstract
Around 700,000 people die from suicide each year in the world. Approximately 90% of suicides have a history of mental illness, and more than two-thirds occur during a major depressive episode. Specific therapeutic options to manage the suicidal crisis are limited and measures to prevent acting out also remain limited. Drugs shown to reduce the risk of suicide (antidepressants, lithium, or clozapine) necessitate a long delay of onset. To date, no treatment is indicated for the treatment of suicidality. Ketamine, a glutamate NMDA receptor antagonist, is a fast-acting antidepressant with significant effects on suicidal ideation in the short term, while its effects on suicidal acts still need to be demonstrated. In the present article, we reviewed the literature on preclinical studies in order to identify the potential anti-suicidal pharmacological targets of ketamine. Impulsive-aggressive traits are one of the vulnerability factors common to suicide in patients with unipolar and bipolar depression. Preclinical studies in rodent models with impulsivity, aggressiveness, and anhedonia may help to analyze, at least in part, suicide neurobiology, as well as the beneficial effects of ketamine/esketamine on reducing suicidal ideations and preventing suicidal acts. The present review focuses on disruptions in the serotonergic system (5-HTB receptor, MAO-A enzyme), neuroinflammation, and/or the HPA axis in rodent models with an impulsive/aggressive phenotype, because these traits are critical risk factors for suicide in humans. Ketamine can modulate these endophenotypes of suicide in human as well as in animal models. The main pharmacological properties of ketamine are then summarized. Finally, numerous questions arose regarding the mechanisms by which ketamine may prevent an impulsive-aggressive phenotype in rodents and suicidal ideations in humans. Animal models of anxiety/depression are important tools to better understand the pathophysiology of depressed patients, and in helping develop novel and fast antidepressant drugs with anti-suicidal properties and clinical utility.
Collapse
Affiliation(s)
- Thi Mai Loan Nguyen
- Université Paris-Saclay, Faculté de Pharmacie, Inserm CESP/UMR 1018, MOODS Team, F-91400 Orsay, France
| | - Fabrice Jollant
- Université Paris-Saclay, Faculté de Médecine, Inserm CESP/UMR 1018, MOODS Team, F-94270 Le Kremin-Bicêtre, France
- Service Hospitalo-Universitaire de Psychiatrie, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Paris-Saclay, Hôpital de Bicêtre, F-94275 Le Kremlin Bicêtre, France
- Pôle de Psychiatrie, CHU Nîmes, 30900 Nîmes, France
- Department of Psychiatry, McGill University and McGill Group for Suicide Studies, Montréal, QC H3A 0G4, Canada
| | - Laurent Tritschler
- Université Paris-Saclay, Faculté de Pharmacie, Inserm CESP/UMR 1018, MOODS Team, F-91400 Orsay, France
| | - Romain Colle
- Université Paris-Saclay, Faculté de Médecine, Inserm CESP/UMR 1018, MOODS Team, F-94270 Le Kremin-Bicêtre, France
- Service Hospitalo-Universitaire de Psychiatrie, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Paris-Saclay, Hôpital de Bicêtre, F-94275 Le Kremlin Bicêtre, France
| | - Emmanuelle Corruble
- Université Paris-Saclay, Faculté de Médecine, Inserm CESP/UMR 1018, MOODS Team, F-94270 Le Kremin-Bicêtre, France
- Service Hospitalo-Universitaire de Psychiatrie, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Paris-Saclay, Hôpital de Bicêtre, F-94275 Le Kremlin Bicêtre, France
| | - Alain M Gardier
- Université Paris-Saclay, Faculté de Pharmacie, Inserm CESP/UMR 1018, MOODS Team, F-91400 Orsay, France
| |
Collapse
|
12
|
Chauvet-Gelinier JC, Cottenet J, Guillaume M, Endomba FT, Jollant F, Quantin C. Risk of hospitalization for self-harm among adults hospitalized with SARS-CoV-2 in France: A nationwide retrospective cohort study. Psychiatry Res 2023; 324:115214. [PMID: 37084571 PMCID: PMC10105376 DOI: 10.1016/j.psychres.2023.115214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 04/04/2023] [Accepted: 04/14/2023] [Indexed: 04/23/2023]
Abstract
While much work has shown a link between the global SARS-CoV-2 pandemic and poor mental health, little is known about a possible association between hospitalization with SARS-CoV-2 infection and subsequent hospitalization for self-harm. Analyses performed on the French national hospital database between March 2020-March 2021 in 10,084,551 inpatients showed that hospitalization with SARS-CoV-2 infection was not associated with hospitalization for self-harm in the following year. However, hospitalization with SARS-Cov-2 was related to an increased risk of self-harm in patients with a suicidal episode at the inclusion (aHR=1.56[1.14-2.15]), suggesting an effect of SARS-CoV-2 in patients with a recent history of self-harm.
Collapse
Affiliation(s)
| | - Jonathan Cottenet
- Biostatistics and Bioinformatics (DIM), University Hospital, CHU Dijon Bourgogne, INSERM, Université de Bourgogne, CIC 1432, Module Épidémiologie Clinique, F21000 Dijon, France
| | | | | | - Fabrice Jollant
- Faculty of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France; Departement of psychiatry, CHU Bicêtre, APHP, Le Kremlin-Bicêtre, France; Department of psychiatry, CHU Nîmes, Nîmes, France; McGill Group for Suicide Studies, Department of psychiatry, McGill University, Montréal, QC, Canada.; Moods Research Team, INSERM UMR-1178, CESP, Le Kremlin-Bicêtre, France
| | - Catherine Quantin
- Biostatistics and Bioinformatics (DIM), University Hospital, CHU Dijon Bourgogne, INSERM, Université de Bourgogne, CIC 1432, Module Épidémiologie Clinique, F21000 Dijon, France; Université Paris-Saclay, UVSQ, Inserm, CESP, 94807, Villejuif, France.
| |
Collapse
|
13
|
Laanani M, Weill A, Jollant F, Zureik M, Dray-Spira R. Suicidal risk associated with finasteride versus dutasteride among men treated for benign prostatic hyperplasia: nationwide cohort study. Sci Rep 2023; 13:5308. [PMID: 37002313 PMCID: PMC10066399 DOI: 10.1038/s41598-023-32356-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 03/26/2023] [Indexed: 04/03/2023] Open
Abstract
Finasteride, a 5α-reductase inhibitor used in benign prostatic hyperplasia and androgenetic alopecia, has been associated with an increased suicidal risk, whereas it is unclear whether such risk is similar to that for another 5α-reductase inhibitor, dutasteride. We aimed to assess the risk of suicidal behaviours with finasteride relative to dutasteride. A nationwide cohort study was conducted using the French National Health Data System (SNDS). Men aged 50 years or older initiating finasteride 5 mg or dutasteride 0.5 mg in France between 01-01-2012 and 30-06-2016 were included and followed until outcome (suicide death identified from death certificate or self-harm hospitalisation), treatment discontinuation or switch, death, or 31-12-2016. Self-harm by violent means or resulting in admission to an intensive care unit were also examined. Cox proportional hazards models controlled for age and psychiatric and non-psychiatric conditions by inverse probability of treatment weighting (IPTW). Analyses were stratified according to psychiatric history. The study compared 69,786 finasteride new users to 217,577 dutasteride new users (median age: 72.0 years [Q1-Q3 = 64.5-80.2] vs. 71.1 [Q1-Q3 = 65.0-79.2]). During follow-up, 18 suicide deaths (0.57/1000 person-years) and 34 self-harm hospitalisations (1.08/1000) occurred among finasteride users versus 47 deaths (0.43/1000) and 87 hospitalisations (0.79/1000) among dutasteride users. Overall, finasteride was not associated with an increased risk of any suicidal outcome (IPTW-adjusted Hazard Ratio = 1.21 [95% Confidence Interval .87-1.67]), suicide death or self-harm hospitalisation. However, among individuals with a history of mood disorders, finasteride was associated with an increased risk of any suicidal outcome (25 versus 46 events; HR = 1.64 [95% CI 1.00-2.68]), suicide death (8 versus 10 events; HR = 2.71 [95% CI 1.07-6.91]), self-harm by violent means (6 versus 6 events; HR = 3.11 [95% CI 1.01-9.61]), and self-harm with admission to an intensive care unit (7 versus 5 events; HR = 3.97 [95% CI 1.26-12.5]). None of these risks was significantly increased among individuals without a psychiatric history. These findings do not support an increased risk of suicide with finasteride used in the treatment of benign prostatic hyperplasia. However, an increased risk cannot be excluded among men with a history of mood disorder, but this result based on a limited number of events should be interpreted with caution.
Collapse
Affiliation(s)
- Moussa Laanani
- Epiphare (French National Medicines Agency ANSM and French National Health Insurance CNAM), Saint-Denis, France.
- French National Health Insurance (CNAM), Paris, France.
| | - Alain Weill
- Epiphare (French National Medicines Agency ANSM and French National Health Insurance CNAM), Saint-Denis, France
| | - Fabrice Jollant
- Université Paris-Saclay & CHU Bicêtre, AP-HP, Le Kremlin-Bicêtre, France
- Nîmes University Hospital (CHU), Nîmes, France
- Department of psychiatry, McGill Group for Suicide Studies, McGill University, Montréal, Canada
- Moods Team, INSERM UMR-1018, CESP, Le Kremlin-Bicêtre, France
| | - Mahmoud Zureik
- Epiphare (French National Medicines Agency ANSM and French National Health Insurance CNAM), Saint-Denis, France
| | - Rosemary Dray-Spira
- Epiphare (French National Medicines Agency ANSM and French National Health Insurance CNAM), Saint-Denis, France
| |
Collapse
|
14
|
Campos AI, Van Velzen LS, Veltman DJ, Pozzi E, Ambrogi S, Ballard ED, Banaj N, Başgöze Z, Bellow S, Benedetti F, Bollettini I, Brosch K, Canales-Rodríguez EJ, Clarke-Rubright EK, Colic L, Connolly CG, Courtet P, Cullen KR, Dannlowski U, Dauvermann MR, Davey CG, Deverdun J, Dohm K, Erwin-Grabner T, Goya-Maldonado R, Fani N, Fortea L, Fuentes-Claramonte P, Gonul AS, Gotlib IH, Grotegerd D, Harris MA, Harrison BJ, Haswell CC, Hawkins EL, Hill D, Hirano Y, Ho TC, Jollant F, Jovanovic T, Kircher T, Klimes-Dougan B, le Bars E, Lochner C, McIntosh AM, Meinert S, Mekawi Y, Melloni E, Mitchell P, Morey RA, Nakagawa A, Nenadić I, Olié E, Pereira F, Phillips RD, Piras F, Poletti S, Pomarol-Clotet E, Radua J, Ressler KJ, Roberts G, Rodriguez-Cano E, Sacchet MD, Salvador R, Sandu AL, Shimizu E, Singh A, Spalletta G, Steele JD, Stein DJ, Stein F, Stevens JS, Teresi GI, Uyar-Demir A, van der Wee NJ, van der Werff SJ, van Rooij SJ, Vecchio D, Verdolini N, Vieta E, Waiter GD, Whalley H, Whittle SL, Yang TT, Zarate CA, Thompson PM, Jahanshad N, van Harmelen AL, Blumberg HP, Schmaal L, Rentería ME. Concurrent validity and reliability of suicide risk assessment instruments: A meta-analysis of 20 instruments across 27 international cohorts. Neuropsychology 2023; 37:315-329. [PMID: 37011159 PMCID: PMC10132776 DOI: 10.1037/neu0000850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
Abstract
OBJECTIVE A major limitation of current suicide research is the lack of power to identify robust correlates of suicidal thoughts or behavior. Variation in suicide risk assessment instruments used across cohorts may represent a limitation to pooling data in international consortia. METHOD Here, we examine this issue through two approaches: (a) an extensive literature search on the reliability and concurrent validity of the most commonly used instruments and (b) by pooling data (N ∼ 6,000 participants) from cohorts from the Enhancing NeuroImaging Genetics Through Meta-Analysis (ENIGMA) Major Depressive Disorder and ENIGMA-Suicidal Thoughts and Behaviour working groups, to assess the concurrent validity of instruments currently used for assessing suicidal thoughts or behavior. RESULTS We observed moderate-to-high correlations between measures, consistent with the wide range (κ range: 0.15-0.97; r range: 0.21-0.94) reported in the literature. Two common multi-item instruments, the Columbia Suicide Severity Rating Scale and the Beck Scale for Suicidal Ideation were highly correlated with each other (r = 0.83). Sensitivity analyses identified sources of heterogeneity such as the time frame of the instrument and whether it relies on self-report or a clinical interview. Finally, construct-specific analyses suggest that suicide ideation items from common psychiatric questionnaires are most concordant with the suicide ideation construct of multi-item instruments. CONCLUSIONS Our findings suggest that multi-item instruments provide valuable information on different aspects of suicidal thoughts or behavior but share a modest core factor with single suicidal ideation items. Retrospective, multisite collaborations including distinct instruments should be feasible provided they harmonize across instruments or focus on specific constructs of suicidality. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
Collapse
Affiliation(s)
- Adrian I. Campos
- Department of Genetics & Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
- School of Biomedical Sciences, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Laura S. Van Velzen
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia
| | - Dick J. Veltman
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Elena Pozzi
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia
| | - Sonia Ambrogi
- Laboratory of Neuropsychiatry, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Elizabeth D. Ballard
- Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - Nerisa Banaj
- Laboratory of Neuropsychiatry, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Zeynep Başgöze
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA
| | - Sophie Bellow
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Francesco Benedetti
- IRCCS San Raffaele Scientific Institute, Milan, Italy
- Università Vita-Salute San Raffaele, Milan, Italy
| | - Irene Bollettini
- IRCCS San Raffaele Scientific Institute, Milan, Italy
- Università Vita-Salute San Raffaele, Milan, Italy
| | - Katharina Brosch
- Department of Psychiatry and Psychotherapy and CMBB, University of Marburg, Marburg, Germany
| | - Erick J. Canales-Rodríguez
- FIDMAG Germanes Hospitalaries research Foundation, Barcelona, Spain
- CIBERSAM, Barcelona, Spain
- Signal Processing Laboratory (LTS5), EPFL, Lausanne, Switzerland
| | | | - Lejla Colic
- Department of Psychiatry and Psychotherapy, University Hospital Jena, Jena, Germany
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- German Center for Mental Health, Halle-Jena-Magdeburg, Germany
| | - Colm G. Connolly
- Magnetic Resonance Imaging Facility and Department of Biomedical Sciences, Florida State University, Tallahassee, FL, USA
| | - Philippe Courtet
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France
- IGF, University of Montpellier, CNRS, INSERM, Montpellier, France
| | - Kathryn R. Cullen
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA
| | - Udo Dannlowski
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Maria R. Dauvermann
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- King’s College London, London, United Kingdom
| | - Christopher G. Davey
- Department of Psychiatry, The University of Melbourne & Melbourne Health, Melbourne, VIC, Australia
| | - Jeremy Deverdun
- Institut d'Imagerie Fonctionnelle Humaine, I2FH, Montpellier University Hospital Center, Gui de Chauliac Hospital, University of Montpellier, Montpellier, France
| | - Katharina Dohm
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Tracy Erwin-Grabner
- Laboratory of Systems Neuroscience and Imaging in Psychiatry (SNIP-Lab), Department of Psychiatry and Psychotherapy, University Medical Center Goettingen (UMG), Georg-August University, Von-Siebold-Str. 5, 37075 Goettingen, Germany
| | - Roberto Goya-Maldonado
- Laboratory of Systems Neuroscience and Imaging in Psychiatry (SNIP-Lab), Department of Psychiatry and Psychotherapy, University Medical Center Goettingen (UMG), Georg-August University, Von-Siebold-Str. 5, 37075 Goettingen, Germany
| | - Negar Fani
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Lydia Fortea
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CIBERSAM, Barcelona, Spain
- Institute of Neurosciences, University of Barcelona, Barcelona, Spain
| | | | - Ali Saffet Gonul
- SoCAT Lab, Department of Psychiatry, School of Medicine, Ege University, Izmir, Turkey
- Department of Neuroscience, Institute of Health Sciences, Ege University, Izmir, Turkey
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Mercer University Macon, GA, USA
| | - Ian H. Gotlib
- Department of Psychology, Stanford University, Stanford, CA, USA
| | - Dominik Grotegerd
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Mathew A. Harris
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Ben J. Harrison
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne, Melbourne, VIC, Australia
| | - Courtney C. Haswell
- Brain Imaging and Analysis Center, Duke University School of Medicine. Durham, NC, USA
| | - Emma L. Hawkins
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Dawson Hill
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA
| | - Yoshiyuki Hirano
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Suita, Japan
| | - Tiffany C. Ho
- Department of Psychiatry and Behavioral Sciences, Division of Child and Adolescent Psychiatry, Weill Institute for Neurosciences, University of California, San Francisco (UCSF) School of Medicine, San Francisco, CA, USA
- Department of Psychology, Stanford University, Stanford, CA
- Department of Psychiatry and Behavioral Sciences and Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA
| | - Fabrice Jollant
- Université de Paris, Paris, France
- GHU Paris Psychiatrie et Neurosciences, France
- McGill university, McGill Group for Suicide Studies, Montréal, Canada
- CHU Nîmes, department of psychiatrie, France
- Universitätsklinikum Jena, Germany
| | - Tanja Jovanovic
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, USA
| | - Tilo Kircher
- Department of Psychiatry and Psychotherapy and CMBB, University of Marburg, Marburg, Germany
| | | | - Emmanuelle le Bars
- Institut d'Imagerie Fonctionnelle Humaine, I2FH, Montpellier University Hospital Center, Gui de Chauliac Hospital, University of Montpellier, Montpellier, France
- Department of Neuroradiology, Montpellier University Hospital, Gui de Chauliac Hospital, Montpellier, France
| | - Christine Lochner
- SAMRC Unit on Risk & Resilience in Mental Disorders, Dept of Psychiatry, Stellenbosch University, South Africa
| | - Andrew M. McIntosh
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Susanne Meinert
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Yara Mekawi
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Elisa Melloni
- IRCCS San Raffaele Scientific Institute, Milan, Italy
- Università Vita-Salute San Raffaele, Milan, Italy
| | - Philip Mitchell
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - Rajendra A. Morey
- Brain Imaging and Analysis Center, Duke University School of Medicine. Durham, NC, USA
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine. Durham, NC, USA
| | - Akiko Nakagawa
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Suita, Japan
| | - Igor Nenadić
- Department of Psychiatry and Psychotherapy and CMBB, University of Marburg, Marburg, Germany
| | - Emilie Olié
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France
- IGF, University of Montpellier, CNRS, INSERM, Montpellier, France
| | - Fabricio Pereira
- Departments of Radiology and Psychiatry, University Hospital Center of Nîmes, France
- MIPA, University of Nîmes, France
| | - Rachel D. Phillips
- Brain Imaging and Analysis Center, Duke University School of Medicine. Durham, NC, USA
| | - Fabrizio Piras
- Laboratory of Neuropsychiatry, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Sara Poletti
- IRCCS San Raffaele Scientific Institute, Milan, Italy
- Università Vita-Salute San Raffaele, Milan, Italy
| | - Edith Pomarol-Clotet
- FIDMAG Germanes Hospitalaries research Foundation, Barcelona, Spain
- CIBERSAM, Barcelona, Spain
| | - Joaquim Radua
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CIBERSAM, Barcelona, Spain
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- Centre for Psychiatric Research and Education, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Kerry J. Ressler
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
- McLean Hospital, Harvard Medical School, Boston, MA, USA
| | - Gloria Roberts
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - Elena Rodriguez-Cano
- FIDMAG Germanes Hospitalaries research Foundation, Barcelona, Spain
- Benito Menni CASM, Sant Boi de Llobregat, Spain
| | - Matthew D. Sacchet
- Center for Depression, Anxiety, and Stress Research, McLean Hospital, Harvard Medical School, Belmont, MA, USA
| | - Raymond Salvador
- FIDMAG Germanes Hospitalaries research Foundation, Barcelona, Spain
- CIBERSAM, Barcelona, Spain
| | - Anca-Larisa Sandu
- Aberdeen Biomedical Imaging Centre, Institute of Medical Sciences, University of Aberdeen, Aberdeen, UK
| | - Eiji Shimizu
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Suita, Japan
| | - Aditya Singh
- Laboratory of Systems Neuroscience and Imaging in Psychiatry (SNIP-Lab), Department of Psychiatry and Psychotherapy, University Medical Center Goettingen (UMG), Georg-August University, Von-Siebold-Str. 5, 37075 Goettingen, Germany
| | - Gianfranco Spalletta
- Laboratory of Neuropsychiatry, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy
- Division of Neuropsychiatry, Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, U.S.A
| | - J. Douglas Steele
- Division of Imaging Science and Technology, Medical School, University of Dundee, Dundee, UK
| | - Dan J. Stein
- SAMRC Unit on Risk & Resilience in Mental Disorders, Dept of Psychiatry & Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Frederike Stein
- Department of Psychiatry and Psychotherapy and CMBB, University of Marburg, Marburg, Germany
| | - Jennifer S. Stevens
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Giana I. Teresi
- Department of Psychology, Stanford University, Stanford, CA, USA
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Aslihan Uyar-Demir
- SoCAT Lab, Department of Psychiatry, School of Medicine, Ege University, Izmir, Turkey
| | - Nic J. van der Wee
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
- ResearchTheme Neuroscience and Leiden Institute for Brain and Cognition, Leiden University Medical Center, Leiden, The Netherlands
| | | | - Sanne J.H. van Rooij
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Daniela Vecchio
- Laboratory of Neuropsychiatry, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Norma Verdolini
- Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Eduard Vieta
- Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Gordon D. Waiter
- Aberdeen Biomedical Imaging Centre, Institute of Medical Sciences, University of Aberdeen, Aberdeen, UK
| | - Heather Whalley
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Sarah L. Whittle
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne, Melbourne, VIC, Australia
| | - Tony T. Yang
- Department of Psychiatry and Behavioral Sciences, Division of Child and Adolescent Psychiatry, Weill Institute for Neurosciences, University of California, San Francisco (UCSF) School of Medicine, San Francisco, CA, USA
| | - Carlos A. Zarate
- Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - Paul M. Thompson
- Imaging Genetics Center, Mark & Mary Stevens Neuroimaging & Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Neda Jahanshad
- Imaging Genetics Center, Mark & Mary Stevens Neuroimaging & Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Anne-Laura van Harmelen
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Social Security and Resilience Programme, Education and Child Studies, Leiden University, Leiden, the Netherlands
| | - Hilary P. Blumberg
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- Department of Radiology and Biomedical Imaging, Yale School of Medicine
- Child Study Center, Yale School of Medicine
| | - Lianne Schmaal
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia
| | - Miguel E. Rentería
- Department of Genetics & Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
- School of Biomedical Sciences, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| |
Collapse
|
15
|
Danyeli LV, Sen ZD, Colic L, Kurzweil L, Gensberger-Reigl S, Macharadze T, Götting F, Refisch A, Liebe T, Chand T, Kretzschmar M, Wagner G, Opel N, Jollant F, Speck O, Munk MHJ, Li M, Walter M. Correction: Association of the delayed changes in glutamate levels and functional connectivity with the immediate network effects of S-ketamine. Transl Psychiatry 2023; 13:73. [PMID: 36854748 PMCID: PMC9974949 DOI: 10.1038/s41398-023-02377-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2023] Open
Affiliation(s)
- Lena Vera Danyeli
- grid.275559.90000 0000 8517 6224Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany ,Clinical Affective Neuroimaging Laboratory (CANLAB), Magdeburg, Germany ,grid.10392.390000 0001 2190 1447Department of Psychiatry and Psychotherapy, University Tübingen, Tübingen, Germany
| | - Zümrüt Duygu Sen
- grid.275559.90000 0000 8517 6224Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany ,Clinical Affective Neuroimaging Laboratory (CANLAB), Magdeburg, Germany ,grid.10392.390000 0001 2190 1447Department of Psychiatry and Psychotherapy, University Tübingen, Tübingen, Germany ,Center for Intervention and Research on adaptive and maladaptive brain Circuits underlying mental health (C-I-R-C), Jena-Magdeburg-Halle, Germany
| | - Lejla Colic
- grid.275559.90000 0000 8517 6224Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany ,Clinical Affective Neuroimaging Laboratory (CANLAB), Magdeburg, Germany ,Center for Intervention and Research on adaptive and maladaptive brain Circuits underlying mental health (C-I-R-C), Jena-Magdeburg-Halle, Germany ,German Center for Mental Health (DZPG), Site Halle-Jena-Magdeburg, Germany
| | - Lisa Kurzweil
- grid.5330.50000 0001 2107 3311Food Chemistry, Department of Chemistry and Pharmacy, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Sabrina Gensberger-Reigl
- grid.5330.50000 0001 2107 3311Food Chemistry, Department of Chemistry and Pharmacy, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Tamar Macharadze
- grid.5807.a0000 0001 1018 4307Department of Anesthesiology and Intensive Care Medicine, Medical Faculty, Otto-von-Guericke-Universität Magdeburg, Magdeburg, Germany ,grid.418723.b0000 0001 2109 6265Department Systems Physiology of Learning, Leibniz Institute for Neurobiology, Magdeburg, Germany ,grid.452320.20000 0004 0404 7236Center for Behavioral Brain Sciences, Magdeburg, Germany
| | - Florian Götting
- grid.275559.90000 0000 8517 6224Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany ,Clinical Affective Neuroimaging Laboratory (CANLAB), Magdeburg, Germany
| | - Alexander Refisch
- grid.275559.90000 0000 8517 6224Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Thomas Liebe
- grid.275559.90000 0000 8517 6224Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany ,Clinical Affective Neuroimaging Laboratory (CANLAB), Magdeburg, Germany
| | - Tara Chand
- grid.275559.90000 0000 8517 6224Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany ,Clinical Affective Neuroimaging Laboratory (CANLAB), Magdeburg, Germany ,grid.10392.390000 0001 2190 1447Department of Psychiatry and Psychotherapy, University Tübingen, Tübingen, Germany ,grid.9613.d0000 0001 1939 2794Department of Clinical Psychology, Friedrich Schiller University, Jena, Germany
| | - Moritz Kretzschmar
- grid.5807.a0000 0001 1018 4307Department of Anesthesiology and Intensive Care Medicine, Medical Faculty, Otto-von-Guericke-Universität Magdeburg, Magdeburg, Germany
| | - Gerd Wagner
- grid.275559.90000 0000 8517 6224Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany ,Center for Intervention and Research on adaptive and maladaptive brain Circuits underlying mental health (C-I-R-C), Jena-Magdeburg-Halle, Germany
| | - Nils Opel
- grid.275559.90000 0000 8517 6224Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany ,Center for Intervention and Research on adaptive and maladaptive brain Circuits underlying mental health (C-I-R-C), Jena-Magdeburg-Halle, Germany ,German Center for Mental Health (DZPG), Site Halle-Jena-Magdeburg, Germany
| | - Fabrice Jollant
- grid.275559.90000 0000 8517 6224Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany ,grid.460789.40000 0004 4910 6535School of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France ,grid.413784.d0000 0001 2181 7253Department of psychiatry, CHU Bicêtre, APHP, Le Kremlin-Bicêtre, France ,grid.463845.80000 0004 0638 6872Inserm, CESP, MOODS team, Le Kremlin-Bicêtre, France ,grid.411165.60000 0004 0593 8241Department of psychiatry, CHU Nîmes, Nîmes, France ,grid.14709.3b0000 0004 1936 8649Department of Psychiatry, McGill University, Montreal, Canada
| | - Oliver Speck
- Center for Intervention and Research on adaptive and maladaptive brain Circuits underlying mental health (C-I-R-C), Jena-Magdeburg-Halle, Germany ,German Center for Mental Health (DZPG), Site Halle-Jena-Magdeburg, Germany ,grid.452320.20000 0004 0404 7236Center for Behavioral Brain Sciences, Magdeburg, Germany ,grid.418723.b0000 0001 2109 6265Department of Behavioral Neurology, Leibniz Institute for Neurobiology, Magdeburg, Germany ,grid.5807.a0000 0001 1018 4307Department of Biomedical Magnetic Resonance, Otto von Guericke University, Magdeburg, Germany
| | - Matthias H. J. Munk
- grid.10392.390000 0001 2190 1447Department of Psychiatry and Psychotherapy, University Tübingen, Tübingen, Germany ,grid.6546.10000 0001 0940 1669Systems Neurophysiology, Department of Biology, Darmstadt University of Technology, Darmstadt, Germany
| | - Meng Li
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany. .,Clinical Affective Neuroimaging Laboratory (CANLAB), Magdeburg, Germany. .,Center for Intervention and Research on adaptive and maladaptive brain Circuits underlying mental health (C-I-R-C), Jena-Magdeburg-Halle, Germany.
| | - Martin Walter
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany. .,Clinical Affective Neuroimaging Laboratory (CANLAB), Magdeburg, Germany. .,Department of Psychiatry and Psychotherapy, University Tübingen, Tübingen, Germany. .,Center for Intervention and Research on adaptive and maladaptive brain Circuits underlying mental health (C-I-R-C), Jena-Magdeburg-Halle, Germany. .,German Center for Mental Health (DZPG), Site Halle-Jena-Magdeburg, Germany. .,Center for Behavioral Brain Sciences, Magdeburg, Germany. .,Department of Behavioral Neurology, Leibniz Institute for Neurobiology, Magdeburg, Germany. .,Max Planck Institute for Biological Cybernetics, Tübingen, Germany.
| |
Collapse
|
16
|
Goueslard K, Jollant F, Cottenet J, Bechraoui-Quantin S, Rozenberg P, Simon E, Quantin C. Hospitalisation for non-lethal self-harm and premature mortality in the 3 years following adolescent pregnancy: Population-based nationwide cohort study. BJOG 2023. [PMID: 36808811 DOI: 10.1111/1471-0528.17432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 02/10/2023] [Accepted: 02/13/2023] [Indexed: 02/22/2023]
Abstract
OBJECTIVE To evaluate the risk of non-lethal self-harm and mortality related to adolescent pregnancy. DESIGN Nationwide population-based retrospective cohort. SETTING Data were extracted from the French national health data system. POPULATION We included all adolescents aged 12-18 years with an International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10) code for pregnancy in 2013-2014. METHODS Pregnant adolescents were compared with age-matched non-pregnant adolescents and with first-time pregnant women aged 19-25 years. MAIN OUTCOME MEASURES Any hospitalisation for non-lethal self-harm and mortality during a 3-year follow-up period. Adjustment variables were age, a history of hospitalisation for physical diseases, psychiatric disorders, self-harm and reimbursed psychotropic drugs. Cox proportional hazards regression models were used. RESULTS In 2013-2014, 35 449 adolescent pregnancies were recorded in France. After adjustment, pregnant adolescents had an increased risk of subsequent hospitalisation for non-lethal self-harm in comparison with both non-pregnant adolescents (n = 70 898) (1.3% vs 0.2%, HR 3.06, 95% CI 2.57-3.66) and pregnant young women (n = 233 406) (0.5%, HR 2.41, 95% CI 2.14-2.71). Rates of hospitalisation for non-lethal self-harm were lower during pregnancy and higher between 12 and 8 months pre-delivery, 3-7 months postpartum and in the month following abortion. Mortality was significantly higher in pregnant adolescents (0.7‰) versus pregnant young women (0.4‰, HR 1.74, 95% CI 1.12-2.72), but not versus non-pregnant adolescents (0.4‰, HR 1.61, 95% CI 0.92-2.83). CONCLUSIONS Adolescent pregnancy is associated with an increased risk of hospitalisation for non-lethal self-harm and premature death. Careful psychological evaluation and support should be systematically implemented for adolescents who are pregnant.
Collapse
Affiliation(s)
- Karine Goueslard
- Biostatistics and Bioinformatics (DIM), University Hospital, Bourgogne Franche-Comté University, Dijon, France
| | - Fabrice Jollant
- Department of Psychiatry, Paris-Saclay University and Academic Hospital (CHU) Bicêtre, Le Kremlin-Bicêtre, France.,Department of Psychiatry, Nîmes Academic Hospital (CHU), Nîmes, France.,Department of Psychiatry, McGill University, Montreal, Quebec, Canada.,MOODS Research Team, Centre de recherche en Epidémiologie et santé des populations (CESP), Institut national de la santé et de la recherche médicale (Inserm), Le Kremlin-Bicêtre, France
| | - Jonathan Cottenet
- Biostatistics and Bioinformatics (DIM), University Hospital, Bourgogne Franche-Comté University, Dijon, France
| | - Sonia Bechraoui-Quantin
- Biostatistics and Bioinformatics (DIM), University Hospital, Bourgogne Franche-Comté University, Dijon, France.,Gynecology, Obstetrics and Fetal Medicine, University Hospital, Dijon, France
| | - Patrick Rozenberg
- Department of Obstetrics and Gynecology, Hôpital Intercommunal de Poissy, Université Versailles Saint-Quentin, Poissy, France
| | - Emmanuel Simon
- Gynecology, Obstetrics and Fetal Medicine, University Hospital, Dijon, France
| | - Catherine Quantin
- Biostatistics and Bioinformatics (DIM), University Hospital, Bourgogne Franche-Comté University, Dijon, France.,Inserm, High-Dimensional Biostatistics for Drug Safety and Genomics, CESP, Université Paris-Saclay, Université Versailles Saint-Quentin, Université Paris-Sud, Villejuif, France
| |
Collapse
|
17
|
Jollant F, Colle R, Nguyen TML, Corruble E, Gardier AM, Walter M, Abbar M, Wagner G. Ketamine and esketamine in suicidal thoughts and behaviors: a systematic review. Ther Adv Psychopharmacol 2023; 13:20451253231151327. [PMID: 36776623 PMCID: PMC9912570 DOI: 10.1177/20451253231151327] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 01/01/2023] [Indexed: 02/10/2023] Open
Abstract
BACKGROUND More than 2% of the general population experience suicidal ideas each year and a large number of them will attempt suicide. Evidence-based therapeutic options to manage suicidal crisis are currently limited. OBJECTIVES The aim of this study was to overview the findings on the use of ketamine and esketamine for the treatment of suicidal ideas and acts. DESIGN Systematic review. DATA SOURCES AND METHODS PubMed, article references, and Clinicaltrials.gov up to June 30, 2022. Meta-analyses published within the last 2 years were also reviewed. RESULTS We identified 12 randomized controlled trials with reduction of suicidal ideation as the primary objective and 14 trials as secondary objectives. Intravenous racemic ketamine was superior to control drugs (placebo or midazolam) within the first 72 h, in spite of large placebo effects. Adverse events were minor and transient. In contrast, intranasal esketamine did not differ from placebo in large-scale studies. Limitations, clinical considerations, and opportunities for future research include the following points: large placebo effects when studying suicidal ideation reduction; small concerns about blinding quality due to dissociative effects; no studies on the risk/prevention of suicidal acts and mortality; lack of studies beyond affective disorders; no studies in adolescents and older people; lack of knowledge of long-term side effects, notably liability for abuse; no robust predictive markers; limited understanding of the mechanisms of ketamine on suicidal ideas; need for improved assessment of suicidal ideation in clinical trials; need for studies in outpatient settings, emergency room, and liaison consultation; need for research on ketamine administration; limited knowledge on the positive and negative effects of concomitant treatments. CONCLUSION Overall, there is compelling evidence for a favorable short-term benefit-risk balance with intravenous racemic ketamine but not intranasal esketamine. The place of ketamine will have to be defined within a multimodal care strategy for suicidal patients. Caution remains necessary for clinical use, and pharmacovigilance will be essential.
Collapse
Affiliation(s)
- Fabrice Jollant
- Service de Psychiatrie, CHU Bicêtre, APHP, 78 Rue du Général Leclerc, 94270 Le Kremlin-Bicêtre, France.,Faculty of Medicine, University Paris-Saclay, Le Kremlin-Bicêtre, France.,MOODS Team, Inserm 1018, Centre de Recherche en Epidémiologie et Santé des Populations (CESP), Le Kremlin-Bicêtre, France.,Department of Psychiatry, CHU Nîmes, Univ Montpellier, Nîmes, France.,Department of Psychiatry & McGill Group for Suicide Studies, McGill University, Montréal, QC, Canada
| | - Romain Colle
- Faculty of Medicine, University Paris-Saclay, Le Kremlin-Bicêtre, France.,Department of Psychiatry, CHU Bicêtre, APHP, Le Kremlin-Bicêtre, France.,MOODS Team, Inserm 1018, Centre de Recherche en Epidémiologie et Santé des Populations (CESP), Le Kremlin-Bicêtre, France
| | - Thi Mai Loan Nguyen
- Faculty of Pharmacy, University Paris-Saclay, Orsay, France.,MOODS Team, Inserm 1018, Centre de Recherche en Epidémiologie et Santé des Populations (CESP), Le Kremlin-Bicêtre, France
| | - Emmanuelle Corruble
- Faculty of Medicine, University Paris-Saclay, Le Kremlin-Bicêtre, France.,Department of Psychiatry, CHU Bicêtre, APHP, Le Kremlin-Bicêtre, France.,MOODS Team, Inserm 1018, Centre de Recherche en Epidémiologie et Santé des Populations (CESP), Le Kremlin-Bicêtre, France
| | - Alain M Gardier
- Faculty of Pharmacy, University Paris-Saclay, Orsay, France.,MOODS Team, Inserm 1018, Centre de Recherche en Epidémiologie et Santé des Populations (CESP), Le Kremlin-Bicêtre, France
| | - Martin Walter
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany.,Clinical Affective Neuroimaging Laboratory (CANLAB), Magdeburg, Germany.,Center for Behavioral Brain Sciences, Magdeburg, Germany.,Department of Psychiatry and Psychotherapy, University Tübingen, Tübingen, Germany.,German Center for Mental Health (DZPG), site Jena Magdeburg Halle, Germany.,Center for Intervention and Research on adaptive and maladaptive Brain Circuits underlying Mental Health (C-I-R-C), site Jena Magdeburg Halle, Germany
| | - Mocrane Abbar
- Department of Psychiatry, CHU Nîmes, Univ Montpellier, Nîmes, France
| | - Gerd Wagner
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany.,Network for Suicide Prevention in Thuringia (NeST), Jena, Germany.,Center for Intervention and Research on adaptive and maladaptive Brain Circuits underlying Mental Health (C-I-R-C), site Jena Magdeburg Halle, Germany
| |
Collapse
|
18
|
van Velzen LS, Dauvermann MR, Colic L, Villa LM, Savage HS, Toenders YJ, Zhu AH, Bright JK, Campos AI, Salminen LE, Ambrogi S, Ayesa-Arriola R, Banaj N, Başgöze Z, Bauer J, Blair K, Blair RJ, Brosch K, Cheng Y, Colle R, Connolly CG, Corruble E, Couvy-Duchesne B, Crespo-Facorro B, Cullen KR, Dannlowski U, Davey CG, Dohm K, Fullerton JM, Gonul AS, Gotlib IH, Grotegerd D, Hahn T, Harrison BJ, He M, Hickie IB, Ho TC, Iorfino F, Jansen A, Jollant F, Kircher T, Klimes-Dougan B, Klug M, Leehr EJ, Lippard ETC, McLaughlin KA, Meinert S, Miller AB, Mitchell PB, Mwangi B, Nenadić I, Ojha A, Overs BJ, Pfarr JK, Piras F, Ringwald KG, Roberts G, Romer G, Sanches M, Sheridan MA, Soares JC, Spalletta G, Stein F, Teresi GI, Tordesillas-Gutiérrez D, Uyar-Demir A, van der Wee NJA, van der Werff SJ, Vermeiren RRJM, Winter A, Wu MJ, Yang TT, Thompson PM, Rentería ME, Jahanshad N, Blumberg HP, van Harmelen AL, Schmaal L. Structural brain alterations associated with suicidal thoughts and behaviors in young people: results from 21 international studies from the ENIGMA Suicidal Thoughts and Behaviours consortium. Mol Psychiatry 2022; 27:4550-4560. [PMID: 36071108 PMCID: PMC9734039 DOI: 10.1038/s41380-022-01734-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 06/24/2022] [Accepted: 08/05/2022] [Indexed: 12/14/2022]
Abstract
Identifying brain alterations associated with suicidal thoughts and behaviors (STBs) in young people is critical to understanding their development and improving early intervention and prevention. The ENIGMA Suicidal Thoughts and Behaviours (ENIGMA-STB) consortium analyzed neuroimaging data harmonized across sites to examine brain morphology associated with STBs in youth. We performed analyses in three separate stages, in samples ranging from most to least homogeneous in terms of suicide assessment instrument and mental disorder. First, in a sample of 577 young people with mood disorders, in which STBs were assessed with the Columbia Suicide Severity Rating Scale (C-SSRS). Second, in a sample of young people with mood disorders, in which STB were assessed using different instruments, MRI metrics were compared among healthy controls without STBs (HC; N = 519), clinical controls with a mood disorder but without STBs (CC; N = 246) and young people with current suicidal ideation (N = 223). In separate analyses, MRI metrics were compared among HCs (N = 253), CCs (N = 217), and suicide attempters (N = 64). Third, in a larger transdiagnostic sample with various assessment instruments (HC = 606; CC = 419; Ideation = 289; HC = 253; CC = 432; Attempt=91). In the homogeneous C-SSRS sample, surface area of the frontal pole was lower in young people with mood disorders and a history of actual suicide attempts (N = 163) than those without a lifetime suicide attempt (N = 323; FDR-p = 0.035, Cohen's d = 0.34). No associations with suicidal ideation were found. When examining more heterogeneous samples, we did not observe significant associations. Lower frontal pole surface area may represent a vulnerability for a (non-interrupted and non-aborted) suicide attempt; however, more research is needed to understand the nature of its relationship to suicide risk.
Collapse
Grants
- UG3 MH111929 NIMH NIH HHS
- R37 MH101495 NIMH NIH HHS
- R01 MH103291 NIMH NIH HHS
- P41 RR008079 NCRR NIH HHS
- UL1 TR001872 NCATS NIH HHS
- UL1 TR001863 NCATS NIH HHS
- R61 MH111929 NIMH NIH HHS
- RC1 MH088366 NIMH NIH HHS
- R01 MH117601 NIMH NIH HHS
- K23 MH090421 NIMH NIH HHS
- R21 AA027884 NIAAA NIH HHS
- K01 MH106805 NIMH NIH HHS
- R61 AT009864 NCCIH NIH HHS
- R01 MH069747 NIMH NIH HHS
- K01 AA027573 NIAAA NIH HHS
- R01 MH070902 NIMH NIH HHS
- K01 MH117442 NIMH NIH HHS
- R01 MH085734 NIMH NIH HHS
- R21 AT009173 NCCIH NIH HHS
- MQ Brighter Futures Award MQBFC/2 and the U.S. National Institute of Mental Health under Award Number R01MH117601. National Suicide Prevention Research Fund, managed by Suicide Prevention Australia
- MQ Brighter Futures Award MQBFC/2. Interdisziplinäres Zentrum für Klinische Forschung, UKJ
- Italian Ministry of Health grant RC17-18-19-20-21/A
- Instituto de Salud Carlos III through the projects PI14/00639, PI14/00918 and PI17/01056 (Co-funded by European Regional Development Fund/European Social Fund "Investing in your future") and Fundación Instituto de Investigación Marqués de Valdecilla (NCT0235832 and NCT02534363)
- National Institute of Mental Health (K23MH090421), the National Alliance for Research on Schizophrenia and Depression, the University of Minnesota Graduate School, the Minnesota Medical Foundation, and the Biotechnology Research Center (P41 RR008079 to the Center for Magnetic Resonance Research), University of Minnesota, and the Deborah E. Powell Center for Women’s Health Seed Grant, University of Minnesota
- Medical Leader Foundation of Yunnan Province (L2019011) and Famous Doctors Project of Yunnan Province Plan (YNWR-MY-2018-041)
- CJ Martin Fellowship (NHMRC app 1161356). “Investissements d’avenir” ANR-10-IAIHU-06
- German Research Foundation (DFG, grant FOR2107-DA1151/5-1 and DA1151/5-2 to UD, and DFG grants HA7070/2-2, HA7070/3, HA7070/4 to TH)
- Australian National Health and Medical Research Council of Australia (NHMRC) Project Grants 1024570 NHMRC Career Development Fellowships (1061757)
- Medical Faculty Münster, Innovative Medizinische Forschung (Grant IMF KO 1218 06)
- Australian National Medical and Health Research Council (Program Grant 1037196 and Investigator Grant 1177991 to PBM, Project Grant 1066177 to JMF), the Lansdowne Foundation, Good Talk and the Keith Pettigrew Family Bequest (PM) Janette Mary O’Neil Research Fellowship. IHG is supported in part by R37MH101495
- Australian National Health and Medical Research Council of Australia (NHMRC) Project Grants 1064643 (principal investigator, BJH) NHMRC Career Development Fellowships (1124472)
- National Institute of Mental Health (K01MH106805). Klingenstein Third Generation Foundation, the National Institute of Mental Health (K01MH117442), the Stanford Maternal Child Health Research Institute, and the Stanford Center for Cognitive and Neurobiological Imaging. TCH receives partial support from the Ray and Dagmar Dolby Family Fund
- German Research Foundation (DFG, grant FOR2107-JA 1890/7-1 and JA 1890/7-2 to AJ, and DFG, grant FOR2107-KI588/14-1 and FOR2107-KI588/14-2 to TK)
- NIAAA (K01AA027573, R21AA027884) and the American Foundation for Suicide Prevention
- National Institute of Mental Health (R01-MH103291)
- National Center for Complementary and Integrative Health (NCCIH) R21AT009173 and R61AT009864 National Center for Advancing Translational Sciences (CTSI), National Institutes of Health, through UCSF-CTSI UL1TR001872 American Foundation for Suicide Prevention (AFSP) SRG-1-141-18 UCSF Research Evaluation and Allocation Committee (REAC) and J. Jacobson Fund to TTY; by the National Institute of Mental Health (NIMH) R01MH085734 and the Brain and Behavior Research Foundation (formerly NARSAD)
- MQ Brighter Futures Award MQBFC/2 R61MH111929RC1MH088366, R01MH070902, R01MH069747, American Foundation for Suicide Prevention, International Bipolar Foundation, Brain and Behavior Research Foundation, For the Love of Travis Foundation and Women’s Health Research at Yale
- MQ Brighter Futures Award MQBFC/2 Social Safety and Resilience programme of Leiden University
- MQ Brighter Futures Award MQBFC/2 National Institute of Mental Health under Award Number R01MH117601 NHMRC Career Development Fellowship (1140764)
Collapse
Affiliation(s)
- Laura S van Velzen
- Orygen, Parkville, VIC, Australia.
- Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia.
| | - Maria R Dauvermann
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, UK
- McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Lejla Colic
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
- German Center for Mental Health, Halle-Jena-Magdeburg, Germany
| | - Luca M Villa
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Hannah S Savage
- Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne, Melbourne, VIC, Australia
| | - Yara J Toenders
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia
| | - Alyssa H Zhu
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - Joanna K Bright
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
- Social Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Adrián I Campos
- Department of Genetics & Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
- School of Biomedical Sciences, Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
- Institute for Molecular Bioscience, The University of Queensland, St Lucia, QLD, Australia
| | - Lauren E Salminen
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - Sonia Ambrogi
- Laboratory of Neuropsychiatry, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Rosa Ayesa-Arriola
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain
- Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Sevilla, Spain
| | - Nerisa Banaj
- Laboratory of Neuropsychiatry, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Zeynep Başgöze
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Jochen Bauer
- University Clinic for Radiology, University of Münster, Münster, Germany
| | - Karina Blair
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, USA
| | - Robert James Blair
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, USA
| | - Katharina Brosch
- Department of Psychiatry and Psychotherapy, Marburg University, Marburg, Germany
- CMBB, Marburg, Germany
| | - Yuqi Cheng
- Department of Psychiatry, First Affiliated Hospital of Kunming Medical College, Kunming, China
- Yunnan Province Clinical Research Center for Psychiatry, Kunming, China
| | - Romain Colle
- MOODS Team, CESP, INSERM U1018, Faculté de Médecine, Univ Paris-Saclay, Le Kremlin Bicêtre, 94275, France
- Service Hospitalo-Universitaire de Psychiatrie de Bicêtre, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, Hôpital de Bicêtre, Le Kremlin Bicêtre, F-94275, France
| | - Colm G Connolly
- Department of Biomedical Sciences, Florida State University, Tallahassee, FL, USA
| | - Emmanuelle Corruble
- MOODS Team, CESP, INSERM U1018, Faculté de Médecine, Univ Paris-Saclay, Le Kremlin Bicêtre, 94275, France
- Service Hospitalo-Universitaire de Psychiatrie de Bicêtre, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, Hôpital de Bicêtre, Le Kremlin Bicêtre, F-94275, France
| | - Baptiste Couvy-Duchesne
- Institute for Molecular Bioscience, The University of Queensland, St Lucia, QLD, Australia
- Paris Brain Institute (ICM), Inserm (U1127), CNRS (UMR 7225), Sorbonne University, Inria Paris (Aramis project-team), Paris, France
| | - Benedicto Crespo-Facorro
- Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Sevilla, Spain
- Virgen del Rocío University Hospital, IBiS, CSIC, University of Sevilla, Sevilla, Spain
| | - Kathryn R Cullen
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Udo Dannlowski
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Christopher G Davey
- Department of Psychiatry, The University of Melbourne, Melbourne, VIC, Australia
| | - Katharina Dohm
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Janice M Fullerton
- Neuroscience Research Australia, Randwick, NSW, Australia
- School of Medical Sciences, University of New South Wales, Kensington, NSW, Australia
| | - Ali Saffet Gonul
- SoCAT Lab, Department of Psychiatry, School of Medicine, Ege University, Izmir, Turkey
| | - Ian H Gotlib
- Department of Psychology, Stanford University, Stanford, CA, USA
| | - Dominik Grotegerd
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Tim Hahn
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Ben J Harrison
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne, Melbourne, VIC, Australia
| | - Mengxin He
- Department of Psychiatry, First Affiliated Hospital of Kunming Medical College, Kunming, China
| | - Ian B Hickie
- Brain and Mind Centre, University of Sydney, Camperdown, NSW, Australia
| | - Tiffany C Ho
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA, USA
- Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - Frank Iorfino
- Brain and Mind Centre, University of Sydney, Camperdown, NSW, Australia
| | - Andreas Jansen
- Department of Psychiatry and Psychotherapy, Marburg University, Marburg, Germany
- CMBB, Marburg, Germany
- Core-Facility Brainimaging, Faculty of Medicine, University of Marburg, Marburg, Germany
| | - Fabrice Jollant
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
- MOODS Team, CESP, INSERM U1018, Faculté de Médecine, Univ Paris-Saclay, Le Kremlin Bicêtre, 94275, France
- Université de Paris & GHU Paris Psychiatrie et Neurosciences, Paris, France
- McGill University, Department of Psychiatry, Montréal, QC, Canada
- Academic Hospital (CHU), Nîmes, France
| | - Tilo Kircher
- Department of Psychiatry and Psychotherapy, Marburg University, Marburg, Germany
- CMBB, Marburg, Germany
| | | | - Melissa Klug
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Elisabeth J Leehr
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Elizabeth T C Lippard
- Department of Psychiatry and Behavioral Sciences, Dell Medical School, University of Texas at Austin, Austin, TX, USA
- Institute of Early Life Adversity Research, Dell Medical School, University of Texas at Austin, Austin, TX, USA
- Waggoner Center for Alcohol and Addiction Research, University of Texas at Austin, Austin, TX, USA
- Mulva Clinic for Neuroscience, Dell Medical School, University of Texas at Austin, Austin, TX, USA
| | | | - Susanne Meinert
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
- Institute for Translational Neuroscience, University of Münster, Münster, Germany
| | - Adam Bryant Miller
- Mental Health Risk and Resilience Research Program, RTI International, Research Triangle Park, NC, USA
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Philip B Mitchell
- School of Psychiatry, University of New South Wales, Kensington, NSW, Australia
| | - Benson Mwangi
- Center Of Excellence On Mood Disorders, The University of Texas-Health Science Center at Houston, Houston, TX, USA
- Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences at McGovern Medical School, The University of Texas - Health Science Center at Houston, Houston, TX, USA
| | - Igor Nenadić
- Department of Psychiatry and Psychotherapy, Marburg University, Marburg, Germany
- CMBB, Marburg, Germany
| | - Amar Ojha
- Center for Neuroscience, University of Pittsburgh, Pittsburgh, PA, USA
- Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Julia-Katharina Pfarr
- Department of Psychiatry and Psychotherapy, Marburg University, Marburg, Germany
- CMBB, Marburg, Germany
| | - Fabrizio Piras
- Laboratory of Neuropsychiatry, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Kai G Ringwald
- Department of Psychiatry and Psychotherapy, Marburg University, Marburg, Germany
- CMBB, Marburg, Germany
| | - Gloria Roberts
- School of Psychiatry, University of New South Wales, Kensington, NSW, Australia
| | - Georg Romer
- Department of Child & Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Münster, Münster, Germany
| | - Marsal Sanches
- Center Of Excellence On Mood Disorders, The University of Texas-Health Science Center at Houston, Houston, TX, USA
- Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences at McGovern Medical School, The University of Texas - Health Science Center at Houston, Houston, TX, USA
| | - Margaret A Sheridan
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jair C Soares
- Center Of Excellence On Mood Disorders, The University of Texas-Health Science Center at Houston, Houston, TX, USA
- Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences at McGovern Medical School, The University of Texas - Health Science Center at Houston, Houston, TX, USA
| | - Gianfranco Spalletta
- Laboratory of Neuropsychiatry, IRCCS Santa Lucia Foundation, Rome, Italy
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Frederike Stein
- Department of Psychiatry and Psychotherapy, Marburg University, Marburg, Germany
- CMBB, Marburg, Germany
| | - Giana I Teresi
- Department of Psychology, Stanford University, Stanford, CA, USA
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Diana Tordesillas-Gutiérrez
- Department of Radiology, IDIVAL, Marqués de Valdecilla University Hospital, Santander, Spain
- Advanced Computing and e-Science, Instituto de Física de Cantabria (UC-CSIC), Santander, Spain
| | - Aslihan Uyar-Demir
- SoCAT Lab, Department of Psychiatry, School of Medicine, Ege University, Izmir, Turkey
| | - Nic J A van der Wee
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
- Leiden Institute for Brain and Cognition, Leiden University, Leiden, The Netherlands
| | - Steven J van der Werff
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
- Leiden Institute for Brain and Cognition, Leiden University, Leiden, The Netherlands
- Leids Universitair Behandel- en Expertise Centrum, Leiden, The Netherlands
| | - Robert R J M Vermeiren
- Child and Adolescent Psychiatry Leiden University Medical Center, Leiden, The Netherlands
- Youz: Child and Adolescent Psychiatry, Leiden, The Netherlands
| | - Alexandra Winter
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Mon-Ju Wu
- Center Of Excellence On Mood Disorders, The University of Texas-Health Science Center at Houston, Houston, TX, USA
- Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences at McGovern Medical School, The University of Texas - Health Science Center at Houston, Houston, TX, USA
| | - Tony T Yang
- Department of Psychiatry and Behavioral Sciences, Division of Child and Adolescent Psychiatry, Weill Institute for Neurosciences, UCSF, San Francisco, CA, USA
| | - Paul M Thompson
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - Miguel E Rentería
- Department of Genetics & Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
- School of Biomedical Sciences, Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
| | - Neda Jahanshad
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - Hilary P Blumberg
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA
- Child Study Center, Yale School of Medicine, New Haven, CT, USA
| | - Anne-Laura van Harmelen
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Leiden Institute for Brain and Cognition, Leiden University, Leiden, The Netherlands
- Social Security and Resilience Programme, Education and Child Studies, Leiden University, Leiden, The Netherlands
| | - Lianne Schmaal
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia
| |
Collapse
|
19
|
Jollant F. Suicide prevention in France put to the test by COVID-19. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac129.528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Each year, nearly 9,000 people die from suicide in France, and more than 150,000 attempt suicide. In spite of a decrease for the last 30 years, rates of suicide in France remain higher than the European mean. Since 2018, a national suicide prevention strategy of the Ministry of Health has been in place. In 2020, this new strategy has been exposed to the COVID-19 pandemic.
Methods
First, the different actions of the national suicide prevention strategy will be presented, followed by the results of the available data regarding the impact of COVID-19 on suicidal gestures. These data are 1) hospitalizations for self-harm (ICD-10 codes X60 to X-84) from the national health database; 2) calls to poison control centers and 3) visits to the emergency room for a suicide attempt. The latest figures available will be presented.
Results
The analysis of these data compared to 2019 highlights two main periods. Between March and December 2020, a significant decrease in suicide attempts was observed (8.5%), with a rapid drop during the first week of the first confinement in mid-March 2020, in women and men, and in all age groups except old-aged people. Since January 2021, a significant increase in suicide attempts has been observed among teenage girls, including high-lethality acts. Moreover, among the young and the elderly, the figures are now similar to 2019. Only numbers for middle-aged adults continue to decline.
Conclusions
The impact of the COVID-19 pandemic on suicide attempts appears to be variable over time, according to age and gender. The old-aged people and young people, especially adolescent girls seem to have suffered the most from this situation. It is still too early to know whether the new national suicide strategy has had any positive impact. However, the pandemic has highlighted certain weaknesses in the French system, in particular the lack of recent data on mortality by suicide, and the heavy dependence on a fragile mental health medical system.
Collapse
Affiliation(s)
- F Jollant
- Department of Psychiatry, Université Paris-Saclay and Bicêtre Academic , Paris, France
| |
Collapse
|
20
|
Sanchez MA, Fuchs B, Tubert-Bitter P, Mariet AS, Jollant F, Mayet A, Quantin C. Trends in psychotropic drug consumption among French military personnel during the COVID-19 epidemic. BMC Med 2022; 20:306. [PMID: 36100914 PMCID: PMC9470234 DOI: 10.1186/s12916-022-02497-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 07/25/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The coronavirus disease (COVID-19) pandemic may have had significant mental health consequences for military personnel, which is a population already exposed to psychological stress. To assess the potential impact of the COVID-19 pandemic, we analyzed the dispensing of three classes of psychotropic drugs (anxiolytics, hypnotics, and antidepressants) among French military personnel. METHODS A retrospective analysis was conducted using the individualized medico-administrative data of persons insured by the National Military Social Security Fund from the National Health Data System. All active French military personnel aged 18-64 who received outpatient care and to whom drugs were dispensed between January 1, 2019, and April 30, 2021, were included from the French national health database. Rate ratios of dispensed anxiolytics, hypnotics and antidepressants (based on drug reimbursement) were estimated from negative binomial regressions before and after the start of the COVID-19 pandemic. RESULTS Three hundred eighty-one thousand seven hundred eleven individuals were included. Overall, 45,148 military personnel were reimbursed for anxiolytics, 10,637 for hypnotics, and 4328 for antidepressants. Drugs were dispensed at a higher rate in 2020 and 2021 than in 2019. There was a notable peak at the beginning of the first lockdown followed by a decrease limited to the duration of the first lockdown. During the first lockdown only, there were temporary phenomena including a brief increase in drug dispensing during the first week followed by a decrease during the rest of lockdown, possibly corresponding to a stocking-up effect. For the study period overall, while there was a significant downward trend in psychotropic drug dispensing before the occurrence of COVID-19 (p < 0.001), the pandemic period was associated with an increase in dispensed anxiolytics (rate ratio, 1.03; 95% CI, 1.02-1.04, p < 0.05), hypnotics (rate ratio, 1.13; 95% CI, 1.11-1.16, p < 0.001) and antidepressants (rate ratio, 1.12; 95% CI, 1.10-1.13, p < 0.001) in the military population. CONCLUSIONS The COVID-19 pandemic has probably had a significant impact on the mental health of French military personnel, as suggested by the trends in dispensed psychotropic drugs. The implementation of mental health prevention measures should be investigated for this population.
Collapse
Affiliation(s)
- Marc-Antoine Sanchez
- Information Systems and Digital Department, French Military Health Service, Saint-Mandé, France.,Université Paris-Saclay, UVSQ, Université Paris-Sud, Inserm, High-Dimensional Biostatistics for Drug Safety and Genomics, CESP, Villejuif, France
| | - Basile Fuchs
- Centre Hospitalo-Universitaire Cochin, Paris, Assistance Publique Des Hôpitaux de Paris, Paris, France
| | - Pascale Tubert-Bitter
- Université Paris-Saclay, UVSQ, Université Paris-Sud, Inserm, High-Dimensional Biostatistics for Drug Safety and Genomics, CESP, Villejuif, France
| | - Anne-Sophie Mariet
- Service de Biostatistiques Et d'Information Médicale (DIM), CHU Dijon Bourgogne, INSERM, Université de Bourgogne, CIC 1432, Module Épidémiologie Clinique, 21000, Dijon, France
| | - Fabrice Jollant
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany.,Université de Paris, Paris, France & GHU Paris Psychiatrie Et Neurosciences, Hôpital Sainte-Anne, CMME, Paris, France.,McGill Group for Suicide Studies, McGill University, Montréal, Canada.,Nîmes Academic Hospital (CHU), Nîmes, France.,Moods Team, INSERM UMR-1018, CESP, Le Kremlin-Bicêtre, France
| | - Aurélie Mayet
- French Armed Forces Center for Epidemiology and Public Health (CESPA), French Military Health Service, Marseille, France.,INSERM-IRD-Aix-Marseille université - SESSTIM, Marseille, France
| | - Catherine Quantin
- Université Paris-Saclay, UVSQ, Université Paris-Sud, Inserm, High-Dimensional Biostatistics for Drug Safety and Genomics, CESP, Villejuif, France. .,Service de Biostatistiques Et d'Information Médicale (DIM), CHU Dijon Bourgogne, INSERM, Université de Bourgogne, CIC 1432, Module Épidémiologie Clinique, 21000, Dijon, France.
| |
Collapse
|
21
|
Jollant F, Blanc-Brisset I, Cellier M, Ambar Akkaoui M, Tran VC, Hamel JF, Piot MA, Nourredine M, Nisse P, Hawton K, Descatha A, Vodovar D. Temporal trends in calls for suicide attempts to poison control centers in France during the COVID-19 pandemic: a nationwide study. Eur J Epidemiol 2022; 37:901-913. [PMID: 36040638 PMCID: PMC9425826 DOI: 10.1007/s10654-022-00907-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 07/26/2022] [Indexed: 11/30/2022]
Abstract
Concerns have been raised about early vs. later impacts of the COVID-19 pandemic on suicidal behavior. However, data remain sparse to date. We investigated all calls for intentional drug or other toxic ingestions to the eight Poison Control Centers in France between 1st January 2018 and 31st May 2022. Data were extracted from the French National Database of Poisonings. Calls during the study period were analyzed using time trends and time series analyses with SARIMA models (based on the first two years). Breakpoints were determined using Chow test. These analyses were performed together with examination of age groups (≤ 11, 12–24, 25–64, ≥ 65 years) and gender effects when possible. Over the studied period, 66,589 calls for suicide attempts were received. Overall, there was a downward trend from 2018, which slowed down in October 2019 and was followed by an increase from November 2020. Number of calls observed during the COVID period were above what was expected. However, important differences were found according to age and gender. The increase in calls from mid-2020 was particularly observed in young females, while middle-aged adults showed a persisting decrease. An increase in older-aged people was observed from mid-2019 and persisted during the pandemic. The pandemic may therefore have exacerbated a pre-existing fragile situation in adolescents and old-aged people. This study emphasizes the rapidly evolving situation regarding suicidal behaviour during the pandemic, the possibility of age and gender differences in impact, and the value of having access to real-time information to monitor suicidal acts.
Collapse
Affiliation(s)
- Fabrice Jollant
- Universitätsklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Jena, Philosophenweg 3, 07743, Jena, Germany. .,Nîmes Academic Hospital (CHU), Nîmes, France. .,School of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France. .,CHU Bicêtre, APHP, Le Kremlin-Bicêtre, France. .,McGill Group for Suicide Studies, McGill University, Montréal, Canada. .,Moods Team, INSERM UMR-1178, CESP, Le Kremlin-Bicêtre, France.
| | | | - Morgane Cellier
- CHU Angers, Poison Control Center - Clinical Data Center, Angers, France.,UNIV Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail)-UMR S1085 SFR ICAT, Angers, France
| | - Marine Ambar Akkaoui
- Département de Psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, Paris, France
| | - Viet Chi Tran
- Laboratoire d'analyses et de Mathématiques Appliquées (LAMA), Gustave Eiffel University, Paris Est Creteil University, CNRS, Marne-la-Vallée, France
| | - Jean-François Hamel
- UNIV Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail)-UMR S1085 SFR ICAT, Angers, France.,Biostatistics and Methodology Department, CHU Angers, Angers, France
| | - Marie-Aude Piot
- Institut Mutualiste Montsouris & Université Paris Cité, Paris, France.,Epidemiological and Public Health Research Centre (CESP) - UMR 1018- UVSQ, Villejuif, France
| | - Mikail Nourredine
- Service Hospitalo-Universitaire de Pharmacotoxicologie de Lyon, Hospices Civils de Lyon, Lyon, France.,Service de Recherche et Épidémiologie Clinique, Hospices Civils de Lyon, Lyon, France.,Laboratoire d'Évaluation et Modélisation des Effets Thérapeutiques, UMR CNRS 5558, Lyon, France
| | | | | | - Keith Hawton
- Centre for Suicide Research, University of Oxford, Oxford, UK
| | - Alexis Descatha
- CHU Angers, Poison Control Center - Clinical Data Center, Angers, France.,UNIV Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail)-UMR S1085 SFR ICAT, Angers, France
| | - Dominique Vodovar
- Paris Academic Hospital (APHP), Poison Control Center & Université Paris Cité, Paris, France.,UMRS-1144, Faculty of Medicine, Paris, France
| |
Collapse
|
22
|
Chauvet-Gelinier JC, Roussot A, Vergès B, Petit JM, Jollant F, Quantin C. Hospitalizations for Anorexia Nervosa during the COVID-19 Pandemic in France: A Nationwide Population-Based Study. J Clin Med 2022; 11:jcm11164787. [PMID: 36013026 PMCID: PMC9409983 DOI: 10.3390/jcm11164787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 08/04/2022] [Indexed: 11/16/2022] Open
Abstract
The COVID-19 pandemic has had a detrimental impact on mental health, including on food-related behaviors. However, little is known about the effect of the pandemic on anorexia nervosa (AN). We sought to assess an association between the COVID-19 pandemic and a potential increase in hospitalizations for AN in France. We compared the number of hospitalizations with a diagnosis of AN during the 21-month period following the onset of the pandemic with the 21-month period before the pandemic using Poisson regression models. We identified a significant increase in hospitalizations for girls aged 10 to 19 years (+45.9%, RR = 1.46[1.43−1.49]; p < 0.0001), and for young women aged 20 to 29 (+7.0%; RR = 1.07[1.04−1.11]; p < 0.0001). Regarding markers of severity, there was an increase in hospitalizations for AN associated with a self-harm diagnosis between the two periods. Multivariate analysis revealed that the risk of being admitted for self-harm with AN increased significantly during the pandemic period among patients aged 20−29 years (aOR = 1.39[1.06−1.81]; p < 0.05 vs. aOR = 1.15[0.87−1.53]; NS), whereas it remained high in patients aged 10 to 19 years (aOR = 2.40[1.89−3.05]; p < 0.0001 vs. aOR = 3.12[2.48−3.98]; p < 0.0001). Furthermore, our results suggest that the pandemic may have had a particular effect on the mental health of young women with AN, with both a sharp increase in hospitalizations and a high risk of self-harming behaviors.
Collapse
Affiliation(s)
- Jean-Christophe Chauvet-Gelinier
- Department of Psychiatry, Dijon University Hospital, 21000 Dijon, France
- INSERM, LNC-UMR 1231, University of Burgundy, 21078 Dijon, France
| | - Adrien Roussot
- Biostatistics and Bioinformatics (DIM), Dijon University Hospital, 21000 Dijon, France
| | - Bruno Vergès
- INSERM, LNC-UMR 1231, University of Burgundy, 21078 Dijon, France
- Department of Endocrinology, Diabetes and Metabolic Disorders, Dijon University Hospital, 21000 Dijon, France
| | - Jean-Michel Petit
- INSERM, LNC-UMR 1231, University of Burgundy, 21078 Dijon, France
- Department of Endocrinology, Diabetes and Metabolic Disorders, Dijon University Hospital, 21000 Dijon, France
| | - Fabrice Jollant
- Department of Psychiatry and Psychotherapy, Jena University Hospital, 07743 Jena, Germany
- GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, CMME, 75014 Paris, France
- McGill Group for Suicide Studies, McGill University, Montreal, QC H3A 0G4, Canada
- Nîmes Academic Hospital (CHU), 30900 Nîmes, France
- Moods Team, INSERM, UMR-1178, CESP, 94276 Le Kremlin-Bicêtre, France
| | - Catherine Quantin
- Biostatistics and Bioinformatics (DIM), Dijon University Hospital, 21000 Dijon, France
- INSERM, CIC 1432, Clinical Investigation Center, Clinical Epidemiology/Clinical Trials Unit, Dijon University Hospital, 21000 Dijon, France
- INSERM, CESP, UVSQ, Université Paris-Saclay, 94807 Villejuif, France
- Correspondence: ; Tel.: +33-38029-3629
| |
Collapse
|
23
|
Gasnier M, Choucha W, Radiguer F, Faulet T, Chappell K, Bougarel A, Kondarjian C, Thorey P, Baldacci A, Ballerini M, Ait Tayeb AEK, Herrero H, Hardy-Leger I, Meyrignac O, Morin L, Lecoq AL, Pham T, Noel N, Jollant F, Montani D, Monnet X, Becquemont L, Corruble E, Colle R. Comorbidity of long COVID and psychiatric disorders after a hospitalisation for COVID-19: a cross-sectional study. J Neurol Neurosurg Psychiatry 2022; 93:jnnp-2021-328516. [PMID: 35953265 DOI: 10.1136/jnnp-2021-328516] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 06/07/2022] [Indexed: 01/09/2023]
Abstract
OBJECTIVES Long COVID is a major public health issue. Whether long COVID is comorbid with psychiatric disorders remains unclear. Here, we investigate the association between long COVID, psychiatric symptoms and psychiatric disorders. DESIGN Cross-sectional. SETTINGS Bicêtre Hospital, France, secondary care. PARTICIPANTS One hundred seventy-seven patients admitted in intensive care unit during acute phase and/or reporting long COVID complaints were assessed 4 months after hospitalisation for an acute COVID. MAIN OUTCOME MEASURES Eight long COVID complaints were investigated: fatigue, respiratory and cognitive complaints, muscle weakness, pain, headache, paraesthesia and anosmia. The number of complaints, the presence/absence of each COVID-19 complaint as well as lung CT scan abnormalities and objective cognitive impairment) were considered. Self-reported psychiatric symptoms were assessed with questionnaires. Experienced psychiatrists assessed Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition-based diagnoses of psychiatric disorders. RESULTS One hundred and fifteen (65%) patients had at least one long COVID complaint. The number of long COVID complaints was associated with psychiatric symptoms. The number of long COVID complaints was higher in patients with psychiatric disorders (mean (m) (SD)=2.47 (1.30), p<0.05), new-onset psychiatric disorders (m (SD)=2.41 (1.32), p<0.05) and significant suicide risk (m (SD)=2.67 (1.32), p<0.05) than in patients without any psychiatric disorder (m (SD)=1.43 (1.48)). Respiratory complaints were associated with a higher risk of psychiatric disorder and new-onset psychiatric disorder, and cognitive complaints were associated with a higher risk of psychiatric disorder. CONCLUSIONS Long COVID is associated with psychiatric disorders, new-onset psychiatric disorders and suicide risk. Psychiatric disorders and suicide risk should be systematically assessed in patients with long COVID.
Collapse
Affiliation(s)
- Matthieu Gasnier
- Service Hospitalo-Universitaire de Psychiatrie de Bicêtre, Mood Center Paris Saclay, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Saclay, Hôpital de Bicêtre, Le Kremlin Bicêtre, France
- MOODS Team, INSERM 1018, CESP (Centre de Recherche en Epidémiologie et Santé des Populations), Université Paris-Saclay, Faculté de Médecine Paris-Saclay, Le Kremlin Bicêtre, France
| | - Walid Choucha
- Service Hospitalo-Universitaire de Psychiatrie de Bicêtre, Mood Center Paris Saclay, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Saclay, Hôpital de Bicêtre, Le Kremlin Bicêtre, France
- MOODS Team, INSERM 1018, CESP (Centre de Recherche en Epidémiologie et Santé des Populations), Université Paris-Saclay, Faculté de Médecine Paris-Saclay, Le Kremlin Bicêtre, France
| | - Francois Radiguer
- Service de réanimation chirurgicale, Hôpital de Bicêtre, Le Kremlin-Bicêtre, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Theo Faulet
- Service Hospitalo-Universitaire de Psychiatrie de Bicêtre, Mood Center Paris Saclay, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Saclay, Hôpital de Bicêtre, Le Kremlin Bicêtre, France
- MOODS Team, INSERM 1018, CESP (Centre de Recherche en Epidémiologie et Santé des Populations), Université Paris-Saclay, Faculté de Médecine Paris-Saclay, Le Kremlin Bicêtre, France
| | - Kenneth Chappell
- Service Hospitalo-Universitaire de Psychiatrie de Bicêtre, Mood Center Paris Saclay, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Saclay, Hôpital de Bicêtre, Le Kremlin Bicêtre, France
- MOODS Team, INSERM 1018, CESP (Centre de Recherche en Epidémiologie et Santé des Populations), Université Paris-Saclay, Faculté de Médecine Paris-Saclay, Le Kremlin Bicêtre, France
| | - Aurore Bougarel
- Service Hospitalo-Universitaire de Psychiatrie de Bicêtre, Mood Center Paris Saclay, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Saclay, Hôpital de Bicêtre, Le Kremlin Bicêtre, France
| | - Christian Kondarjian
- Service Hospitalo-Universitaire de Psychiatrie de Bicêtre, Mood Center Paris Saclay, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Saclay, Hôpital de Bicêtre, Le Kremlin Bicêtre, France
| | - Paul Thorey
- Service Hospitalo-Universitaire de Psychiatrie de Bicêtre, Mood Center Paris Saclay, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Saclay, Hôpital de Bicêtre, Le Kremlin Bicêtre, France
| | - Antoine Baldacci
- Service Hospitalo-Universitaire de Psychiatrie de Bicêtre, Mood Center Paris Saclay, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Saclay, Hôpital de Bicêtre, Le Kremlin Bicêtre, France
| | - Maryne Ballerini
- Service Hospitalo-Universitaire de Psychiatrie de Bicêtre, Mood Center Paris Saclay, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Saclay, Hôpital de Bicêtre, Le Kremlin Bicêtre, France
| | - Abd El Kader Ait Tayeb
- Service Hospitalo-Universitaire de Psychiatrie de Bicêtre, Mood Center Paris Saclay, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Saclay, Hôpital de Bicêtre, Le Kremlin Bicêtre, France
- MOODS Team, INSERM 1018, CESP (Centre de Recherche en Epidémiologie et Santé des Populations), Université Paris-Saclay, Faculté de Médecine Paris-Saclay, Le Kremlin Bicêtre, France
| | - Hugo Herrero
- Service Hospitalo-Universitaire de Psychiatrie de Bicêtre, Mood Center Paris Saclay, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Saclay, Hôpital de Bicêtre, Le Kremlin Bicêtre, France
- MOODS Team, INSERM 1018, CESP (Centre de Recherche en Epidémiologie et Santé des Populations), Université Paris-Saclay, Faculté de Médecine Paris-Saclay, Le Kremlin Bicêtre, France
| | - Isabelle Hardy-Leger
- Service de médecine interne et immunologie clinique, Hôpital de Bicêtre, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Olivier Meyrignac
- Service de radiologie diagnostique et interventionnelle, Hôpital de Bicêtre, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Luc Morin
- Service de réanimation pédiatrique et médecine néonatale, Hôpital de Bicêtre, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Anne-Lise Lecoq
- Centre de Recherche Clinique, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, Hôpital de Bicêtre, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Tài Pham
- Service de médecine intensive-réanimation, hôpital de Bicêtre, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Nicolas Noel
- Service de médecine interne et immunologie clinique, Hôpital de Bicêtre, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Fabrice Jollant
- Service Hospitalo-Universitaire de Psychiatrie de Bicêtre, Mood Center Paris Saclay, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Saclay, Hôpital de Bicêtre, Le Kremlin Bicêtre, France
- MOODS Team, INSERM 1018, CESP (Centre de Recherche en Epidémiologie et Santé des Populations), Université Paris-Saclay, Faculté de Médecine Paris-Saclay, Le Kremlin Bicêtre, France
| | - David Montani
- Service de pneumologie et soins intensifs respiratoires, Hopital Bicêtre, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Xavier Monnet
- Service de pneumologie et soins intensifs respiratoires, Hopital Bicêtre, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Laurent Becquemont
- MOODS Team, INSERM 1018, CESP (Centre de Recherche en Epidémiologie et Santé des Populations), Université Paris-Saclay, Faculté de Médecine Paris-Saclay, Le Kremlin Bicêtre, France
- Centre de Recherche Clinique, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, Hôpital de Bicêtre, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Emmanuelle Corruble
- Service Hospitalo-Universitaire de Psychiatrie de Bicêtre, Mood Center Paris Saclay, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Saclay, Hôpital de Bicêtre, Le Kremlin Bicêtre, France
- MOODS Team, INSERM 1018, CESP (Centre de Recherche en Epidémiologie et Santé des Populations), Université Paris-Saclay, Faculté de Médecine Paris-Saclay, Le Kremlin Bicêtre, France
| | - Romain Colle
- Service Hospitalo-Universitaire de Psychiatrie de Bicêtre, Mood Center Paris Saclay, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Saclay, Hôpital de Bicêtre, Le Kremlin Bicêtre, France
- MOODS Team, INSERM 1018, CESP (Centre de Recherche en Epidémiologie et Santé des Populations), Université Paris-Saclay, Faculté de Médecine Paris-Saclay, Le Kremlin Bicêtre, France
| |
Collapse
|
24
|
Jollant F, Roussot A, Corruble E, Chauvet-Gelinier JC, Falissard B, Mikaeloff Y, Quantin C. Prolonged impact of the COVID-19 pandemic on self-harm hospitalizations in France: A nationwide retrospective observational study. Eur Psychiatry 2022; 65:e35. [PMID: 35694827 PMCID: PMC9251820 DOI: 10.1192/j.eurpsy.2022.26] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Background The first wave of the COVID-19 pandemic in France was associated with a reduced number of hospitalizations for self-harm, with the exception of older people. The on-going pandemic may have both sustained and delayed effects. Methods Data were extracted from the French national hospital database (PMSI), a nationwide exhaustive database. The number of self-harm hospitalizations (ICD-10 codes X60–84) between September 1, 2020 and August 31, 2021 (N = 85,679) was compared to 2019 (N = 88,782) using Poisson regression models. Results There was a decrease in the total number of self-harm hospitalizations during the studied period versus 2019 (−3.5%; Relative Risk [RR] [95% Confidence Intervals] = 0.97 [0.96–0.97]; p < 0.0001). However, sex and age effects were identified. While adults aged 30–59-years-old showed a decrease (monthly decreases: −12.6 to −15.0%), we found an increase in adolescent girls (+27.7%, RR = 1.28 [1.25–1.31]; p < 0.0001), notably since January 2021. Moreover, the numbers were similar to 2019 in adolescent boys, in youths aged 20–29 years, and in people aged 70 and more. Hospitalizations in intensive care units decreased (−6.7%, RR = 0.93 [0.91–0.96]; p < 0.0001) and deaths at hospital following self-harm remained stable (+0.6%, Hazard Ratio = 0.99 [0.91–1.08], p = 0.79). Conclusions During this second stage, the number of self-harm hospitalizations remained at a lower level than in the prepandemic period. However, significant variations over time, age, and sex were observed. Young people (notably adolescent girls) appear to have particularly suffered from the persistence of the pandemic, while older people did not show any decrease since the beginning. Vigilance and continuing prevention are warranted.
Collapse
Affiliation(s)
- F Jollant
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Germany.,CHU Nîmes, Nîmes, France.,Université Paris Cité, Paris, France & GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, CMME, Paris, France.,McGill Group for suicide studies, McGill University, Montréal, Canada.,Moods Team, INSERM UMR-1178, CESP, Le Kremlin-Bicêtre, France
| | - A Roussot
- Biostatistics and Bioinformatics (DIM), University Hospital, BP 77908, 21079 Dijon, France; Bourgogne Franche-Comté University, Dijon, France
| | - E Corruble
- Moods Team, INSERM UMR-1178, CESP, Le Kremlin-Bicêtre, France.,Psychiatry department, Bicêtre Hospital, GHU Paris-Saclay; APHP, Université Paris-Saclay, France
| | - J C Chauvet-Gelinier
- Service de Psychiatrie et d'Addictologie, Centre Hospitalier Universitaire, Dijon, France.,Laboratoire de Psychopathologie et Psychologie Médicale, EA 4452, IFR Santé STIC 100, Université de Bourgogne-Franche-Comté, Dijon, France
| | - B Falissard
- Université Paris-Saclay, UVSQ, Inserm, Developmental psychiatry, CESP, Villejuif, France
| | - Y Mikaeloff
- Pediatrics department, GHU Paris-Saclay; Université Paris-Saclay, UVSQ, Inserm, Developmental psychiatry, CESP, Villejuif, France
| | - C Quantin
- Biostatistics and Bioinformatics (DIM), University Hospital, BP 77908, 21079 Dijon, France; Bourgogne Franche-Comté University, Dijon, France.,Inserm, CIC 1432, Dijon, France; Dijon University Hospital, Clinical Investigation Center, clinical epidemiology/clinical trials unit, Dijon, France.,Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, High-Dimensional Biostatistics for Drug Safety and Genomics, CESP, Villejuif, France
| |
Collapse
|
25
|
Jollant F, Goueslard K, Hawton K, Quantin C. Self-harm, somatic disorders and mortality in the 3 years following a hospitalisation in psychiatry in adolescents and young adults. Evid Based Mental Health 2022; 25:177-184. [DOI: 10.1136/ebmental-2021-300409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 03/02/2022] [Indexed: 11/04/2022]
Abstract
BackgroundThere is limited recent information regarding the risk of self-harm, somatic disorders and premature mortality following discharge from psychiatric hospital in young people.ObjectiveTo measure these risks in young people discharged from a psychiatric hospital as compared with both non-affected controls and non-hospitalised affected controls.MethodsData were extracted from the French national health records. Cases were compared with two control groups. Cases: all individuals aged 12–24 years, hospitalised in psychiatry in France in 2013–2014. Non-affected controls: matched for age and sex with cases, not hospitalised in psychiatry and no identification of a mental disorder in 2008–2014. Affected controls: unmatched youths identified with a mental disorder between 2008 and 2014, never hospitalised in psychiatry. Follow-up of 3 years. Logistic regression analyses were conducted with these confounding variables: age, sex, past hospitalisation for self-harm, past somatic disorder diagnosis.FindingsThe studied population comprised 73 300 hospitalised patients (53.6% males), 219 900 non-affected controls and 9 683 affected controls. All rates and adjusted risks were increased in hospitalised patients versus both non-affected and affected controls regarding a subsequent hospitalisation for self-harm (HR=105.5, 95% CIs (89.5 to 124.4) and HR=1.5, 95% CI (1.4 to 1.6)), a somatic disorder diagnosis (HR=4.1, 95% CI (3.9–4.1) and HR=1.4, 95% CI (1.3–1.5)), all-cause mortality (HR=13.3, 95% CI (10.6–16.7) and HR=2.2, 95% CI (1.5–3.0)) and suicide (HR=9.2, 95% CI (4.3–19.8) and HR=1.7, 95% CI (1.0–2.9)).ConclusionsThe first 3 years following psychiatric hospital admission of young people is a period of high risk for self-harm, somatic disorders and premature mortality.Clinical implicationsAttention to these negative outcomes urgently needs to be incorporated in aftercare policies.
Collapse
|
26
|
Abstract
BACKGROUND A few previous studies suggest that a large number of individuals do not present at hospital following a suicide attempt, complicating recurrence prevention and prevalence estimation. METHODS Data were extracted from a regular phone survey in representative samples of the French population aged 18-75 years old. Five surveys between 2000 and 2017 collected data about the occurrence of a previous suicide attempt and subsequent care contacts. A total of 102,729 individuals were surveyed. Among them, 6,500 (6.4%) reported a lifetime history of suicide attempt. RESULTS Following their last suicide attempt, 39.3% reported they did not present to hospital (53.4% in 18-24 year-olds), with limited changes in rates with time. Risk factors for non-presentation were being male [adjusted odds ratio = 1.3, 95% confidence interval (1.1-1.5)], living with someone [1.2 (1.0-1.4)], being a non-smoker [1.4 (1.2-1.6)], and being younger at time of attempt [0.97 (0.96-0.98) per year]. Of those who did not present to hospital, only 37.7% reported visiting a doctor or a psychiatrist/psychologist after their act v. 67.1% in those who presented to hospital (as a second health contact). In both cases, half disclosed their act to someone else. Prevalence rates of suicide attempts reported in community were 4.6 times higher than those in hospital administrative databases. CONCLUSIONS This survey at a national level confirmed that a large proportion of individuals does not go to the hospital and does not meet any health care professionals following a suicidal act. Assessment of unmet needs is necessary.
Collapse
Affiliation(s)
- Fabrice Jollant
- Department of psychiatry, University of Paris (Paris-Descartes University), Paris, France
- GHU Paris Psychiatrie et Neurosciences, Sainte-Anne Hospital, Paris, France
- McGill Group for Suicide Studies, McGill University, Montréal, Canada
- CHU de Nîmes, Nîmes, France
| | - Keith Hawton
- Department of Psychiatry, Centre for Suicide Research, University of Oxford, Warneford Hospital, Oxford, UK
| | - Guillaume Vaiva
- Department of Psychiatry, University of Lille, Lille, France
- Academic Hospital (CHU) of Lille, Lille, France
- SCA Laboratory CNRS-UMR 91-93, Lille, France
| | - Christine Chan-Chee
- National Agency of Public Health (Santé Publique France), Saint-Maurice, France
| | - Enguerrand du Roscoat
- National Agency of Public Health (Santé Publique France), Saint-Maurice, France
- LAPPS, EA 4386, Université Paris Ouest Nanterre-La Défense, Nanterre, France
| | - Christophe Leon
- National Agency of Public Health (Santé Publique France), Saint-Maurice, France
| |
Collapse
|
27
|
Abbar M, Demattei C, El-Hage W, Llorca PM, Samalin L, Demaricourt P, Gaillard R, Courtet P, Vaiva G, Gorwood P, Fabbro P, Jollant F. Ketamine for the acute treatment of severe suicidal ideation: double blind, randomised placebo controlled trial. BMJ 2022; 376:e067194. [PMID: 35110300 PMCID: PMC8808464 DOI: 10.1136/bmj-2021-067194] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To confirm the rapid onset anti-suicidal benefits of ketamine in the short term and at six weeks, overall and according to diagnostic group. DESIGN Prospective, double blind, superiority, randomised placebo controlled trial. SETTING Seven French teaching hospitals between 13 April 2015 and 12 March 2019. ELIGIBILITY CRITERIA FOR PARTICIPANTS Aged 18 or older with current suicidal ideation, admitted to hospital voluntarily. Exclusion criteria included a history of schizophrenia or other psychotic disorders, substance dependence, and contraindications for ketamine. PARTICIPANTS 156 participants were recruited and randomised to placebo (n=83) or ketamine (n=73), stratified by centre and diagnosis: bipolar, depressive, or other disorders. INTERVENTION Two 40 minute intravenous infusions of ketamine (0.5 mg/kg) or placebo (saline) were administered at baseline and 24 hours, in addition to usual treatment. MAIN OUTCOME MEASURES The primary outcome was the rate of patients in full suicidal remission at day 3, according to the scale for suicidal ideation total score ≤3. Analyses were conducted on an intention-to-treat basis. RESULTS More participants receiving ketamine reached full remission of suicidal ideas at day 3 than those receiving placebo: 46 (63.0%) of 83 participants in the ketamine arm and 25 (31.6%) of 73 in the placebo arm (odds ratio 3.7 (95% confidence interval 1.9 to 7.3), P<0.001). This effect differed according to the diagnosis (treatment: P<0.001; interaction: P=0.02): bipolar (odds ratio 14.1 (95% confidence interval 3.0 to 92.2), P<0.001), depressive (1.3 (0.3 to 5.2), P=0.6), or other disorders (3.7 (0.9 to 17.3, P=0.07)). Side effects were limited. No manic or psychotic symptom was seen. Moreover, a mediating effect of mental pain was found. At week 6, remission in the ketamine arm remained high, although non-significantly versus placebo (69.5% v 56.3%; odds ratio 0.8 (95% confidence interval 0.3 to 2.5), P=0.7). CONCLUSIONS The findings indicate that ketamine is rapid, safe in the short term, and has persistent benefits for acute care in suicidal patients. Comorbid mental disorders appear to be important moderators. An analgesic effect on mental pain might explain the anti-suicidal effects of ketamine. TRIAL REGISTRATION ClinicalTrials.gov NCT02299440.
Collapse
Affiliation(s)
- Mocrane Abbar
- Department of Psychiatry, Academic Hospital (CHU) Nîmes, University of Montpellier, Nîmes, France
| | - Christophe Demattei
- Department of Biostatistics, Epidemiology, Public Health and Innovation in Methodology, CHU Nîmes, University of Montpellier, Nîmes, France
| | - Wissam El-Hage
- CHRU Tours, Research Unit (UMR) 1253, iBrain, University of Tours, National Institute for Health and Medical Research (INSERM), Tours, France
| | - Pierre-Michel Llorca
- Department of Psychiatry, CHU Clermont-Ferrand, University of Clermont Auvergne, UMR 6602, Institute Pascal, Clermont-Ferrand, France
| | - Ludovic Samalin
- Department of Psychiatry, CHU Clermont-Ferrand, University of Clermont Auvergne, UMR 6602, Institute Pascal, Clermont-Ferrand, France
| | - Pierre Demaricourt
- School of Medicine, University of Paris and Sainte-Anne Hospital, Paris, France
| | - Raphael Gaillard
- School of Medicine, University of Paris and Sainte-Anne Hospital, Paris, France
| | - Philippe Courtet
- INSERM, Centre for Epidemiological and Clinical Research in Psychiatry (PSNREC), University of Montpellier, CHU Montpellier, Montpellier, France
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France
| | - Guillaume Vaiva
- Department of Psychiatry, CHU Lille, Lille, France
- University of Lille, INSERM U1172 - LilNCog - Lille Neuroscience and Cognition, Lille, France
| | - Philip Gorwood
- School of Medicine, University of Paris and Sainte-Anne Hospital, Paris, France
| | - Pascale Fabbro
- Department of Biostatistics, Epidemiology, Public Health and Innovation in Methodology, CHU Nîmes, University of Montpellier, Nîmes, France
| | - Fabrice Jollant
- Department of Psychiatry, Academic Hospital (CHU) Nîmes, University of Montpellier, Nîmes, France
- School of Medicine, University of Paris and Sainte-Anne Hospital, Paris, France
- Department of Psychiatry, McGill University, McGill Group for Suicide Studies, Montreal, QC, Canada
- Moods Team, INSERM, UMR-1178, Epidemiology and Population Health Research Centre (CESP), Le Kremlin-Bicêtre, France
- Department of Psychiatry and Psychotherapy, University Hospital Jena, Jena, Germany
| |
Collapse
|
28
|
Goueslard K, Jollant F, Petit JM, Quantin C. Self-harm hospitalization following bariatric surgery in adolescents and young adults. Clin Nutr 2021; 41:238-245. [PMID: 34915275 DOI: 10.1016/j.clnu.2021.11.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 11/02/2021] [Accepted: 11/25/2021] [Indexed: 11/03/2022]
Abstract
BACKGROUND While bariatric surgery has demonstrated physical and psychological benefits, a risk of suicide and non-fatal self-harm has also been shown. The aim of this study was to compared the rate of hospitalization for self-harm during a three-year observational follow-up period between adolescents/young adults who underwent bariatric surgery in France in 2013-2014 and two control groups. METHODS All individuals aged 12-25 years old who underwent bariatric surgery in France between January 1st, 2013, and December 31st, 2014, were identified with a validated algorithm from the French national hospital database, and compared to a healthy sample of the general population matched for age and gender. Information relative to hospitalizations, including for self-harm (ICD-10 codes X60-84), were extracted i) between 2008 and the surgery, and ii) for a three-year follow-up period. A second unmatched control group with obesity but no bariatric surgery was also identified. Survival analyses with adjustments for confounding variables were used. RESULTS In 2013-2014, 1984 youths had bariatric surgery in France. During follow-up, 1.5% were hospitalized for self-harm vs. 0.3% for controls (p < 0.0001). After adjustment, subsequent hospitalization for self-harm was associated with bariatric surgery (HR 3.64, 95% CI 1.70-7.81), prior psychiatric disorders (HR 7.76, 95% CI 3.76-16.01), and prior self-harm (HR 4.43, 95% CI 1.75-11.24). When compared to non-operated youths with obesity, bariatric surgery was not associated with self-harm while prior mental disorders and self-harm were. Mortality reached 0.3% after surgery. CONCLUSIONS Bariatric surgery is associated with an increased risk of self-harm, mainly in relation to preexisting psychological conditions. Vigilance and appropriate care are thus warranted in vulnerable individuals.
Collapse
Affiliation(s)
- K Goueslard
- Biostatistics and Bioinformatics (DIM), University Hospital, Dijon, France
| | - F Jollant
- Department of Psychiatry and Psychotherapy, University Hospital Jena, Jena, Germany; Nîmes Academic Hospital (CHU), Nîmes, France; University of Paris, Faculty of Health, Medicine School, Paris, France; GHU Paris Psychiatrie et Neurosciences, Sainte-Anne Hospital, CMME, Paris, France; McGill Group for Suicide Studies, McGill University, Montréal, Canada; Moods Team, INSERM UMR-1178, CESP, Le Kremlin-Bicêtre, France
| | - J M Petit
- Centre de Recherche INSERM Unité 866, Univ. Bourgogne Franche-Comté, F-21000, Dijon, France; Services de diabétologie et endocrinologie, CHRU Dijon, Dijon, F-21000, France
| | - C Quantin
- Biostatistics and Bioinformatics (DIM), University Hospital, Dijon, France; Inserm, CIC 1432, Dijon, France; Dijon University Hospital, Clinical Investigation Center, Clinical Epidemiology/ Clinical Trials Unit, Dijon, France; Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, High-Dimensional Biostatistics for Drug Safety and Genomics, CESP, Villejuif, France.
| |
Collapse
|
29
|
Loiseau M, Cottenet J, Bechraoui-Quantin S, Gilard-Pioc S, Mikaeloff Y, Jollant F, François-Purssell I, Jud A, Quantin C. Physical abuse of young children during the COVID-19 pandemic: Alarming increase in the relative frequency of hospitalizations during the lockdown period. Child Abuse Negl 2021; 122:105299. [PMID: 34488053 PMCID: PMC8435815 DOI: 10.1016/j.chiabu.2021.105299] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 08/11/2021] [Accepted: 08/19/2021] [Indexed: 05/16/2023]
Abstract
BACKGROUND In France, the COVID-19 pandemic led to a general lockdown from mid-March to mid-May 2020, forcing families to remain confined. We hypothesized that children may have been victims of more physical abuse during the lockdown, involving an increase in the relative frequency of hospitalization. METHODS Using the national administrative database on all admissions to public and private hospitals (PMSI), we selected all children aged 0-5 years hospitalized and identified physically abused children based on ICD-10 codes. We included 844,227 children hospitalized in March-April 2017-2020, of whom 476 (0.056%) were admitted for physical abuse. Relative frequency of hospitalization for physical abuse observed in March to April 2020 were compared with those from the same months in the three previous years (2017-2019). FINDINGS Even if absolute number of children exposed to physical abuse did not fluctuate significantly, we found a significant increase in the relative frequency of young children hospitalized for physical abuse from 2017 (0.053%) to 2020 (0.073%). Compared with the 2017-2019 period, and considering the observed decrease in the number of overall hospital admissions during the first lockdown, the number of children exposed to physical violence was 40% superior to what would be expected. INTERPRETATION The sharp increase in the relative frequency of hospitalizations for physical abuse in children aged 0-5 years in France is alarming. As only the most severe cases were brought to the hospital for treatment during the lockdown, our figures probably only represent the tip of the iceberg of a general increase of violence against young children.
Collapse
Affiliation(s)
| | - Jonathan Cottenet
- Biostatistics and Bioinformatics (DIM), University Hospital, Dijon, France
| | | | | | - Yann Mikaeloff
- Unité de Rééducation Neurologique Infantile (URNI), DMU Santé de l'enfant et de l'adolescent (SEA), Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris (AP-HP): Equipe "Psychiatrie du développement", CESP, INSERM: Université Paris-Saclay, France
| | - Fabrice Jollant
- Université de Paris, Paris, France; GHU Paris psychiatrie et neurosciences, Paris, France; Department of Psychiatry, McGill University, Montréal, Canada; Chu Nîmes, France
| | | | - Andreas Jud
- Child and Adolescent Psychiatry/Psychotherapy, University Hospital, School of Social Work, Lucerne University of Applied Sciences and Arts, Ulm, Germany
| | - Catherine Quantin
- Biostatistics and Bioinformatics (DIM), University Hospital, Dijon, France; Inserm, CIC 1432, Dijon University Hospital, Clinical Investigation Center, Clinical Epidemiology/Clinical Trials Unit, Dijon, France; Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, High-Dimensional Biostatistics for Drug Safety and Genomics, CESP, Villejuif, France.
| |
Collapse
|
30
|
Abstract
A quantitative assessment of publications in suicidology has not been conducted yet. Web of Science was used to identify publications on suicidal behavior between 1989 and 2018. 41,276 items were retrieved. Over 30 years, the number of annual publications has been multiplied by 6. Psychiatry and psychology were the dominant research areas. Three-quarters of all publications were produced by high-income countries. A significant gap between male and female researchers persisted over time. Reported funding was largely public with a significant share from the private sector. Overall, suicidology appears as a dynamic field of research. This study also underlines two priorities: bridging the gender gap and encourage research in low- and middle-income countries where 80% of suicides occur.
Collapse
|
31
|
Jollant F, Roussot A, Corruble E, Chauvet-Gelinier JC, Falissard B, Mikaeloff Y, Quantin C. Hospitalization for self-harm during the early months of the COVID-19 pandemic in France: A nationwide retrospective observational cohort study. Lancet Reg Health Eur 2021; 6:100102. [PMID: 34557830 PMCID: PMC8454825 DOI: 10.1016/j.lanepe.2021.100102] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Background Little is known to date about the impact of COVID-19 pandemic on self-harm. Methods The number of hospitalizations for self-harm (ICD-10 codes X60-X84) in France from 1st January to 31st August 2020 (including a two-month confinement) was compared to the same periods in 2017-2019. Statistical methods comprised Poisson regression, Cox regression and Student's t-test, plus Spearman's correlation test relating to spatial analysis of hospitalizations. Outcomes There were 53,583 self-harm hospitalizations in France during January to August 2020. Compared to the same period in 2019, this represents an overall 8·5% decrease (Relative Risk [95% Confidence Interval] = 0·91 [0·90-0·93]).This decrease started in the first week of confinement and persisted until the end of August. Similarly, decrease was found in both women (RR=0·90 [0·88-0·92]) and men (RR=0·94 [0·91-0·95]), and in all age groups, except 65 years and older. Regarding self-harm hospitalizations by means category, increases were found for firearm (RR=1·20 [1·03-1·40]) and for jumping from heights (RR=1·10 [1·01-1·21]). There was a trend for more hospitalizations in intensive care (RR=1·03 [0·99-1·07]). The number of deaths at discharge from hospital also increased (Hazard Ratio = 1·19 [1·09-1·31]). Self-harm hospitalizations were weakly correlated with the rates of hospitalization for COVID-19 across administrative departments (Spearman's rho =-0·21; p = 0·03), but not with overall hospitalizations. Interpretation The COVID-19 pandemic had varied effects on self-harm hospitalizations during the early months in France. Active suicide prevention strategies should be maintained. Funding French National Research Agency.
Collapse
Affiliation(s)
- Fabrice Jollant
- Université de Paris, Paris, France.,GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, CMME, Paris, France.,McGill Group for suicide studies, McGill University, Montréal, Canada.,Nîmes academic hospital (CHU), Nîmes, France.,Moods Team, INSERM UMR-1178, CESP, Le Kremlin-Bicêtre, France
| | - Adrien Roussot
- Biostatistics and Bioinformatics (DIM), University Hospital, BP 77908, 21079 Dijon, France; Bourgogne Franche-Comté University, Dijon, France
| | - Emmanuelle Corruble
- Moods Team, INSERM UMR-1178, CESP, Le Kremlin-Bicêtre, France.,Psychiatry department, Bicêtre Hospital, GHU Paris-Saclay; APHP, Université Paris-Saclay, France
| | - Jean-Christophe Chauvet-Gelinier
- Service de Psychiatrie et d'Addictologie, Centre Hospitalier Universitaire, Dijon, France.,Laboratoire de Psychopathologie et Psychologie Médicale, EA 4452, IFR Santé STIC 100, Université de Bourgogne-Franche-Comté, Dijon, France
| | - Bruno Falissard
- Université Paris-Saclay, UVSQ, Inserm, Developmental psychiatry, CESP, Villejuif, France
| | - Yann Mikaeloff
- Pediatricsdepartment, GHU Paris-Saclay; Université Paris-Saclay, UVSQ, Inserm, Developmental psychiatry, CESP, Villejuif, France
| | - Catherine Quantin
- Biostatistics and Bioinformatics (DIM), University Hospital, BP 77908, 21079 Dijon, France; Bourgogne Franche-Comté University, Dijon, France.,Inserm, CIC 1432, Dijon, France; Dijon University Hospital, Clinical Investigation Center, clinical epidemiology/clinical trials unit, Dijon, France.,Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, High-Dimensional Biostatistics for Drug Safety and Genomics, CESP, Villejuif, France
| |
Collapse
|
32
|
Piot MA, Dechartres A, Attoe C, Romeo M, Jollant F, Billon G, Cross S, Lemogne C, Layat Burn C, Michelet D, Guerrier G, Tesniere A, Rethans JJ, Falissard B. Effectiveness of simulation in psychiatry for nursing students, nurses and nurse practitioners: A systematic review and meta-analysis. J Adv Nurs 2021; 78:332-347. [PMID: 34378236 DOI: 10.1111/jan.14986] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 05/24/2021] [Accepted: 07/15/2021] [Indexed: 11/30/2022]
Abstract
AIMS Mental disorders constitute one of the main causes of disease and disability worldwide. While nurses are often at the frontline of mental health care, they have limited access to dedicated psychiatric training opportunities. Simulation training may foster the development of the appropriate competencies required when supporting people with mental disorders. To evaluate the effectiveness of simulation training in psychiatry for nursing students, nurses and nurse practitioners. DESIGN Systematic review and meta-analysis. DATA SOURCES Eight electronic databases, trial registries, key journals and reference lists of selected studies were searched from inception to August 20, 2020 without language restriction. REVIEW METHODS We included randomized and non-randomized controlled studies and single group pre/post studies. Cochrane Risk of Bias tool 2.0 was used for randomized controlled study appraisal, and the Medical Education Research Study Quality instrument was completed for all other studies. Meta-analysis was restricted to randomized controlled studies. The other studies were synthesized narratively. The main outcomes were based on Kirkpatrick levels. RESULTS A total of 118 studies (6738 participants) were found. Interventions included simulated patients (n = 55), role-plays (n = 40), virtual reality (n = 12), manikins (n = 9) and voice simulations (n = 9). Meta-analyses based on 11 randomized controlled studies found a significant large effect size on skills at immediate post-test for simulation compared with active control; and a small and medium effect size on learners' attitudes for simulation compared with inactive control, at immediate post-test and at three-month follow-up respectively. Three quarters of non-randomized controlled studies and pre/post-tests assessing attitudes and skills showed significant differences, and three quarters of participants in randomized controlled studies and pre/post-tests showed significant differences in behaviours. Among the few studies assessing people with mental health outcomes, almost all reported significant differences. CONCLUSION These findings support the effectiveness of simulation training in psychiatric nursing throughout professional development grades, despite heterogeneity in methods and simulation interventions.
Collapse
Affiliation(s)
- Marie-Aude Piot
- Université de Paris, Institute Mutualiste Montsouris, Department of Psychiatry, Paris-Saclay University, UVSQ, INSERM 1018, CESP, Ilumens, Simulation Center, Paris, France
| | - Agnès Dechartres
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP. Hôpital Pitié Salpêtrière, Département de Santé Publique, Centre de Pharmacoépidémiologie de l'AP-HP (Cephepi), F75013, Paris, France
| | - Chris Attoe
- Maudsley Simulation, South London & Maudsley NHS Foundation Trust, London, UK
| | - Marie Romeo
- Université de Paris, Institute Mutualiste Montsouris, Department of Psychiatry, Paris-Saclay University, UVSQ, INSERM 1018, CESP, Ilumens, Simulation Center, Paris, France
| | - Fabrice Jollant
- Université de Paris, GHU Paris Psychiatrie et Neurosciences, Sainte-Anne Hospital, Department of Psychiatry, Moods Team, INSERM UMR-1178, CESP, Paris, France.,Nîmes academic hospital (CHU), Nîmes, France.,Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Grégoire Billon
- Maudsley Simulation, South London & Maudsley NHS Foundation Trust, London, UK
| | - Sean Cross
- Maudsley Simulation, South London & Maudsley NHS Foundation Trust, London, UK
| | - Cédric Lemogne
- Université de Paris, AP-HP, Hôpital Hôtel-Dieu, DMU Psychiatrie et Addictologie, Service de Psychiatrie de l'adulte, INSERM, Institut de Psychiatrie et Neurosciences de Paris (IPNP), UMR_S1266, Paris, France
| | - Carine Layat Burn
- Department of Orthopaedic Surgery, La Providence Hospital, Neuchâtel, Switzerland.,Department of Psychotherapy, Berger Psychotherapeutic Centre, Neuchâtel, Switzerland
| | - Daphné Michelet
- Department of Pediatric Anesthesia, CHU of Reims Hôpital Maison Blanche, Reims, France
| | - Gilles Guerrier
- Université de Paris, AP-HP, Cochin Hospital, Anaesthesiology Department, Ilumens, Simulation Center, Paris, France
| | - Antoine Tesniere
- Université de Paris, AP-HP, Cochin Hospital, Anaesthesiology Department, Ilumens, Simulation Center, Paris, France
| | - Jan-Joost Rethans
- Skillslab, Faculty of Health, Medicine & Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Bruno Falissard
- Public Health Department, School of Medicine, University Paris Saclay, INSERM 1018, CESP, Villejuif, Ile-de-France, France
| |
Collapse
|
33
|
Gifuni AJ, Chakravarty MM, Lepage M, Ho TC, Geoffroy MC, Lacourse E, Gotlib IH, Turecki G, Renaud J, Jollant F. Brain cortical and subcortical morphology in adolescents with depression and a history of suicide attempt. J Psychiatry Neurosci 2021; 46:E347-E357. [PMID: 33961355 PMCID: PMC8327980 DOI: 10.1503/jpn.200198] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Suicidal behaviours are a major source of mortality and morbidity among adolescents. Given the maturational changes that occur in cortical and subcortical structures during adolescence, we tested whether atypical brain structural measurements were associated with a history of suicide attempt. METHODS We assessed 3 groups of adolescents (n = 92; 79% female, mean age 15.9 years, range 11.6-18.1 years): patients with a depressive disorder and a history of suicide attempt (n = 28); patient controls, who had a depressive disorder but no history of suicide attempt (n = 34); and healthy controls (n = 30). We derived regional cortical thickness and surface area, and subcortical volumes, from T1-weighted anatomic MRI scans acquired at 3 T. RESULTS We found significant group differences in surface area in the prefrontal, temporal and parietal regions, as well as in the volume of several subcortical nuclei (pFDR ≤ 0.05), but not in cortical thickness. Post hoc analyses indicated that morphological alterations primarily differentiated patients with a history of suicide attempt from healthy controls, but not from patient controls. However, patients with a history of suicide attempt exhibited positive correlations between age and cortical thickness in the temporal cortices and right insula, and between age and right putamen volume (i.e., thicker regional cortex and larger subcortical volumes with age). These correlations were negative in both patient controls and healthy controls (i.e., thinner regional cortex and smaller subcortical volumes). LIMITATIONS Sample sizes, cross-sectional findings and psychiatric heterogeneity were limitations of this study. CONCLUSION Macroscopic structural differences in several brain regions differentiated adolescents with a history of suicide attempt from healthy controls, but not from patient controls. However, adolescents with a history of suicide attempt may present with atypical maturation of specific cortical and subcortical regions that might contribute to the risk of suicidal behaviour.
Collapse
Affiliation(s)
- Anthony J Gifuni
- From the McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montréal, Canada (Gifuni, Geoffroy, Turecki, Renaud, Jollant); the Department of Psychiatry, McGill University, Montréal, Canada (Gifuni, Chakravarty, Lepage, Turecki, Renaud, Jollant); the Manulife Centre for Breakthroughs in Teen Depression and Suicide Prevention, Montréal, Canada (Gifuni, Renaud); the Department of Psychology, Stanford University, Stanford, USA (Gifuni, Gotlib); the Department of Psychiatry & Behavioral Sciences and Weill Institute for Neurosciences, University of California at San Francisco, San Francisco, USA (Ho); the Department of Educational and Counselling Psychology, McGill University, Montréal, Canada (Geoffroy); the Department of Sociology, Université de Montréal, Montréal, Canada (Lacourse); the Université de Paris, Paris, France (Jollant); the GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, Paris, France (Jollant); and the Academic Hospital (CHU) Nîmes, Nîmes, France (Jollant)
| | - M Mallar Chakravarty
- From the McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montréal, Canada (Gifuni, Geoffroy, Turecki, Renaud, Jollant); the Department of Psychiatry, McGill University, Montréal, Canada (Gifuni, Chakravarty, Lepage, Turecki, Renaud, Jollant); the Manulife Centre for Breakthroughs in Teen Depression and Suicide Prevention, Montréal, Canada (Gifuni, Renaud); the Department of Psychology, Stanford University, Stanford, USA (Gifuni, Gotlib); the Department of Psychiatry & Behavioral Sciences and Weill Institute for Neurosciences, University of California at San Francisco, San Francisco, USA (Ho); the Department of Educational and Counselling Psychology, McGill University, Montréal, Canada (Geoffroy); the Department of Sociology, Université de Montréal, Montréal, Canada (Lacourse); the Université de Paris, Paris, France (Jollant); the GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, Paris, France (Jollant); and the Academic Hospital (CHU) Nîmes, Nîmes, France (Jollant)
| | - Martin Lepage
- From the McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montréal, Canada (Gifuni, Geoffroy, Turecki, Renaud, Jollant); the Department of Psychiatry, McGill University, Montréal, Canada (Gifuni, Chakravarty, Lepage, Turecki, Renaud, Jollant); the Manulife Centre for Breakthroughs in Teen Depression and Suicide Prevention, Montréal, Canada (Gifuni, Renaud); the Department of Psychology, Stanford University, Stanford, USA (Gifuni, Gotlib); the Department of Psychiatry & Behavioral Sciences and Weill Institute for Neurosciences, University of California at San Francisco, San Francisco, USA (Ho); the Department of Educational and Counselling Psychology, McGill University, Montréal, Canada (Geoffroy); the Department of Sociology, Université de Montréal, Montréal, Canada (Lacourse); the Université de Paris, Paris, France (Jollant); the GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, Paris, France (Jollant); and the Academic Hospital (CHU) Nîmes, Nîmes, France (Jollant)
| | - Tiffany C Ho
- From the McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montréal, Canada (Gifuni, Geoffroy, Turecki, Renaud, Jollant); the Department of Psychiatry, McGill University, Montréal, Canada (Gifuni, Chakravarty, Lepage, Turecki, Renaud, Jollant); the Manulife Centre for Breakthroughs in Teen Depression and Suicide Prevention, Montréal, Canada (Gifuni, Renaud); the Department of Psychology, Stanford University, Stanford, USA (Gifuni, Gotlib); the Department of Psychiatry & Behavioral Sciences and Weill Institute for Neurosciences, University of California at San Francisco, San Francisco, USA (Ho); the Department of Educational and Counselling Psychology, McGill University, Montréal, Canada (Geoffroy); the Department of Sociology, Université de Montréal, Montréal, Canada (Lacourse); the Université de Paris, Paris, France (Jollant); the GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, Paris, France (Jollant); and the Academic Hospital (CHU) Nîmes, Nîmes, France (Jollant)
| | - Marie-Claude Geoffroy
- From the McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montréal, Canada (Gifuni, Geoffroy, Turecki, Renaud, Jollant); the Department of Psychiatry, McGill University, Montréal, Canada (Gifuni, Chakravarty, Lepage, Turecki, Renaud, Jollant); the Manulife Centre for Breakthroughs in Teen Depression and Suicide Prevention, Montréal, Canada (Gifuni, Renaud); the Department of Psychology, Stanford University, Stanford, USA (Gifuni, Gotlib); the Department of Psychiatry & Behavioral Sciences and Weill Institute for Neurosciences, University of California at San Francisco, San Francisco, USA (Ho); the Department of Educational and Counselling Psychology, McGill University, Montréal, Canada (Geoffroy); the Department of Sociology, Université de Montréal, Montréal, Canada (Lacourse); the Université de Paris, Paris, France (Jollant); the GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, Paris, France (Jollant); and the Academic Hospital (CHU) Nîmes, Nîmes, France (Jollant)
| | - Eric Lacourse
- From the McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montréal, Canada (Gifuni, Geoffroy, Turecki, Renaud, Jollant); the Department of Psychiatry, McGill University, Montréal, Canada (Gifuni, Chakravarty, Lepage, Turecki, Renaud, Jollant); the Manulife Centre for Breakthroughs in Teen Depression and Suicide Prevention, Montréal, Canada (Gifuni, Renaud); the Department of Psychology, Stanford University, Stanford, USA (Gifuni, Gotlib); the Department of Psychiatry & Behavioral Sciences and Weill Institute for Neurosciences, University of California at San Francisco, San Francisco, USA (Ho); the Department of Educational and Counselling Psychology, McGill University, Montréal, Canada (Geoffroy); the Department of Sociology, Université de Montréal, Montréal, Canada (Lacourse); the Université de Paris, Paris, France (Jollant); the GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, Paris, France (Jollant); and the Academic Hospital (CHU) Nîmes, Nîmes, France (Jollant)
| | - Ian H Gotlib
- From the McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montréal, Canada (Gifuni, Geoffroy, Turecki, Renaud, Jollant); the Department of Psychiatry, McGill University, Montréal, Canada (Gifuni, Chakravarty, Lepage, Turecki, Renaud, Jollant); the Manulife Centre for Breakthroughs in Teen Depression and Suicide Prevention, Montréal, Canada (Gifuni, Renaud); the Department of Psychology, Stanford University, Stanford, USA (Gifuni, Gotlib); the Department of Psychiatry & Behavioral Sciences and Weill Institute for Neurosciences, University of California at San Francisco, San Francisco, USA (Ho); the Department of Educational and Counselling Psychology, McGill University, Montréal, Canada (Geoffroy); the Department of Sociology, Université de Montréal, Montréal, Canada (Lacourse); the Université de Paris, Paris, France (Jollant); the GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, Paris, France (Jollant); and the Academic Hospital (CHU) Nîmes, Nîmes, France (Jollant)
| | - Gustavo Turecki
- From the McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montréal, Canada (Gifuni, Geoffroy, Turecki, Renaud, Jollant); the Department of Psychiatry, McGill University, Montréal, Canada (Gifuni, Chakravarty, Lepage, Turecki, Renaud, Jollant); the Manulife Centre for Breakthroughs in Teen Depression and Suicide Prevention, Montréal, Canada (Gifuni, Renaud); the Department of Psychology, Stanford University, Stanford, USA (Gifuni, Gotlib); the Department of Psychiatry & Behavioral Sciences and Weill Institute for Neurosciences, University of California at San Francisco, San Francisco, USA (Ho); the Department of Educational and Counselling Psychology, McGill University, Montréal, Canada (Geoffroy); the Department of Sociology, Université de Montréal, Montréal, Canada (Lacourse); the Université de Paris, Paris, France (Jollant); the GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, Paris, France (Jollant); and the Academic Hospital (CHU) Nîmes, Nîmes, France (Jollant)
| | - Johanne Renaud
- From the McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montréal, Canada (Gifuni, Geoffroy, Turecki, Renaud, Jollant); the Department of Psychiatry, McGill University, Montréal, Canada (Gifuni, Chakravarty, Lepage, Turecki, Renaud, Jollant); the Manulife Centre for Breakthroughs in Teen Depression and Suicide Prevention, Montréal, Canada (Gifuni, Renaud); the Department of Psychology, Stanford University, Stanford, USA (Gifuni, Gotlib); the Department of Psychiatry & Behavioral Sciences and Weill Institute for Neurosciences, University of California at San Francisco, San Francisco, USA (Ho); the Department of Educational and Counselling Psychology, McGill University, Montréal, Canada (Geoffroy); the Department of Sociology, Université de Montréal, Montréal, Canada (Lacourse); the Université de Paris, Paris, France (Jollant); the GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, Paris, France (Jollant); and the Academic Hospital (CHU) Nîmes, Nîmes, France (Jollant)
| | - Fabrice Jollant
- From the McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montréal, Canada (Gifuni, Geoffroy, Turecki, Renaud, Jollant); the Department of Psychiatry, McGill University, Montréal, Canada (Gifuni, Chakravarty, Lepage, Turecki, Renaud, Jollant); the Manulife Centre for Breakthroughs in Teen Depression and Suicide Prevention, Montréal, Canada (Gifuni, Renaud); the Department of Psychology, Stanford University, Stanford, USA (Gifuni, Gotlib); the Department of Psychiatry & Behavioral Sciences and Weill Institute for Neurosciences, University of California at San Francisco, San Francisco, USA (Ho); the Department of Educational and Counselling Psychology, McGill University, Montréal, Canada (Geoffroy); the Department of Sociology, Université de Montréal, Montréal, Canada (Lacourse); the Université de Paris, Paris, France (Jollant); the GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, Paris, France (Jollant); and the Academic Hospital (CHU) Nîmes, Nîmes, France (Jollant)
| |
Collapse
|
34
|
Abstract
Nearly 5% of the general population experiences a suicidal crisis every year in France. It is essential for any caregiver to learn to recognize it and intervene appropriately. This crisis most often occurs in a context of stress combined with individual vulnerability factors that causes the individual to lose their balance. The clinical presentation for suicidal crisis vary from one subject to another. It is usually fluctuating and temporary. The subject does not want to die; he wants to stop suffering. The suicidal act is the dreaded but not systematic outcome of the suicidal crisis. Here we will set out the general principles of the assessment of the suicidal crisis.
Collapse
Affiliation(s)
- Fabrice Jollant
- Groupe hospitalier universitaire Paris psychiatrie & neurosciences, hôpital Sainte-Anne, 1, rue Cabanis, 75014 Paris, France; McGill University, Department of Psychiatry, McGill Group for Suicide Studies, Douglas Institute, 845, rue Sherbrooke Ouest, Montréal, QC H3A 0G4, Canada; Département de psychiatrie, CHU de Nîmes, place du Pr-Robert-Debré, 30029 Nîmes cedex 9, France.
| |
Collapse
|
35
|
Lutz PE, Almeida D, Filliol D, Jollant F, Kieffer BL, Turecki G. Increased functional coupling of the mu opioid receptor in the anterior insula of depressed individuals. Neuropsychopharmacology 2021; 46:920-927. [PMID: 33531622 PMCID: PMC8115105 DOI: 10.1038/s41386-021-00974-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Accepted: 01/14/2021] [Indexed: 12/20/2022]
Abstract
The mu opioid receptor (MOR) is a G protein-coupled receptor that plays an essential role in reward and hedonic processes, and that has been implicated in disorders such as depression and addiction. Over the last decade, several brain imaging studies in depressed patients have consistently found that dysregulation of MOR function occurs in particular in the anterior insular cortex, an important brain site for the perception of internal states and emotional regulation. To investigate molecular mechanisms that may underlie these effects, here we assessed genetic polymorphisms, expression, and functional G-protein coupling of MOR in a large post-mortem cohort (N = 95) composed of depressed individuals who died by suicide, and healthy controls. Results indicated that depression, but not comorbid substance use disorder or acute opiate consumption, was associated with increased MOR activity. This effect was partly explained by a specific increase in expression of the inhibitory alpha G-protein subunit GNAI2. Consistent with previous neuroimaging studies, our findings support the notion that enhanced endogenous opioidergic tone in the anterior insula may buffer negative affective states in depressed individuals, a mechanism that could potentially contribute to the antidepressant efficacy of emerging opioid-based medications.
Collapse
Affiliation(s)
- Pierre-Eric Lutz
- McGill Group for Suicide Studies, Douglas Mental Health Research Centre, McGill University, 6875 LaSalle Boulevard, Verdun, Montréal, QC, Canada. .,Centre National de la Recherche Scientifique, Université de Strasbourg, Fédération de Médecine Translationnelle de Strasbourg, Institut des Neurosciences Cellulaires et Intégratives UPR3212, Strasbourg, France.
| | - Daniel Almeida
- grid.14709.3b0000 0004 1936 8649McGill Group for Suicide Studies, Douglas Mental Health Research Centre, McGill University, 6875 LaSalle Boulevard, Verdun, Montréal, QC Canada
| | - Dominique Filliol
- grid.420255.40000 0004 0638 2716Translational Medicine and Neurogenetics, Institut de Génétique et de Biologie Moléculaire et Cellulaire, INSERM U-964, CNRS UMR-7104, Université de Strasbourg, Illkirch, France
| | - Fabrice Jollant
- grid.14709.3b0000 0004 1936 8649McGill Group for Suicide Studies, Douglas Mental Health Research Centre, McGill University, 6875 LaSalle Boulevard, Verdun, Montréal, QC Canada ,grid.508487.60000 0004 7885 7602Université de Paris, Paris, France ,grid.411165.60000 0004 0593 8241CHU Nîmes, Nîmes, France ,Present Address: Clinique des Maladies Mentales et de l’Encéphale (CMME), CH Sainte-Anne, GHU Paris, Psychiatrie et Neurosciences, Paris, France
| | - Brigitte L. Kieffer
- grid.420255.40000 0004 0638 2716Translational Medicine and Neurogenetics, Institut de Génétique et de Biologie Moléculaire et Cellulaire, INSERM U-964, CNRS UMR-7104, Université de Strasbourg, Illkirch, France ,grid.14709.3b0000 0004 1936 8649Douglas Mental Health Research Centre, Department of Psychiatry, McGill University, Montréal, QC H4H 1R3 Canada ,grid.412220.70000 0001 2177 138XPresent Address: INSERM U1114, Department of Psychiatry, University Hospital of Strasbourg, Strasbourg, France
| | - Gustavo Turecki
- McGill Group for Suicide Studies, Douglas Mental Health Research Centre, McGill University, 6875 LaSalle Boulevard, Verdun, Montréal, QC, Canada.
| |
Collapse
|
36
|
Wagner G, Li M, Sacchet MD, Richard-Devantoy S, Turecki G, Bär KJ, Gotlib IH, Walter M, Jollant F. Functional network alterations differently associated with suicidal ideas and acts in depressed patients: an indirect support to the transition model. Transl Psychiatry 2021; 11:100. [PMID: 33542184 PMCID: PMC7862288 DOI: 10.1038/s41398-021-01232-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 01/08/2021] [Accepted: 01/18/2021] [Indexed: 02/08/2023] Open
Abstract
The transition from suicidal ideas to a suicide act is an important topic of research for the identification of those patients at risk of acting out. We investigated here whether specific brain activity and connectivity measures at rest may be differently associated with suicidal thoughts and behaviors. A large sample of acutely depressed patients with major depressive disorder was recruited in three different centers (Montreal/Canada, Stanford/USA, and Jena/Germany), covering four different phenotypes: patients with a past history of suicide attempt (n = 53), patients with current suicidal ideas but no past history of suicide attempt (n = 40), patients without current suicidal ideation nor past suicide attempts (n = 42), and healthy comparison subjects (n = 107). 3-T resting-state functional magnetic resonance imaging (fMRI) measures of the amplitude of low-frequency fluctuation (ALFF) and degree centrality (DC) were obtained and examined in a whole-brain data-driven analysis. Past suicide attempt was associated with a double cortico-subcortical dissociation in ALFF values. Decreased ALFF and DC values mainly in a frontoparietal network and increased ALFF values in some subcortical regions (hippocampus and thalamus) distinguished suicide attempters from suicide ideators, patient controls, and healthy controls. No clear neural differences were identified in relation to suicidal ideas. Suicide attempters appear to be a distinct subgroup of patients with widespread brain alterations in functional activity and connectivity that could represent factors of vulnerability. Our results also indirectly support at the neurobiological level the relevance of the transition model described at the psychological and clinical levels. The brain bases of suicidal ideas occurrence in depressed individuals needs further investigations.
Collapse
Affiliation(s)
- Gerd Wagner
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Philosophenweg 3, 07743, Jena, Germany.
| | - Meng Li
- grid.275559.90000 0000 8517 6224Department of Psychiatry and Psychotherapy, Jena University Hospital, Philosophenweg 3, 07743 Jena, Germany
| | - Matthew D. Sacchet
- grid.240206.20000 0000 8795 072XCenter for Depression, Anxiety, and Stress Research, McLean Hospital, Harvard Medical School, Belmont, MA USA
| | - Stéphane Richard-Devantoy
- grid.412078.80000 0001 2353 5268McGill group for Suicide Studies, McGill University & Douglas Mental Health University Institute, Montréal, QC Canada
| | - Gustavo Turecki
- grid.412078.80000 0001 2353 5268McGill group for Suicide Studies, McGill University & Douglas Mental Health University Institute, Montréal, QC Canada
| | - Karl-Jürgen Bär
- grid.275559.90000 0000 8517 6224Department of Gerontopsychiatry and Psychosomatics, Jena University Hospital, Jena, Germany
| | - Ian H. Gotlib
- grid.168010.e0000000419368956Department of Psychology, Stanford University, Stanford, CA USA
| | - Martin Walter
- grid.275559.90000 0000 8517 6224Department of Psychiatry and Psychotherapy, Jena University Hospital, Philosophenweg 3, 07743 Jena, Germany
| | - Fabrice Jollant
- grid.412078.80000 0001 2353 5268McGill group for Suicide Studies, McGill University & Douglas Mental Health University Institute, Montréal, QC Canada ,Université de Paris, Faculté de médecine, Paris, France ,grid.414435.30000 0001 2200 9055GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, Paris, France ,grid.411165.60000 0004 0593 8241Psychiatry Department, CHU Nîmes, Nîmes, France ,grid.7429.80000000121866389Equipe Moods, INSERM, UMR-1178 Paris, France
| |
Collapse
|
37
|
Perrain R, Dardennes R, Jollant F. Risky decision-making in suicide attempters, and the choice of a violent suicidal means: an updated meta-analysis. J Affect Disord 2021; 280:241-249. [PMID: 33220560 DOI: 10.1016/j.jad.2020.11.052] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 10/02/2020] [Accepted: 11/08/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Studies showed disadvantageous decision-making in suicide attempters. The present meta-analysis aims to examine the stability of these findings and related questions. METHODS EMBASE and Pubmed databases were searched for studies published between 01/01/2000 and 01/01/2020 with an additional search through bibliographical references. English or French articles published in peer-reviewed journals, reporting quantitative task-based measures of decision-making in suicide attempters were included: 3,582 records were identified, 33 full-text articles screened, and 21 articles finally included. RESULTS All studies were conducted in mood disorders; 18 used the Iowa Gambling Task (IGT) and 3 the Cambridge Gamble Task (CGT). With the IGT, suicide attempters showed riskier choices than patient controls (Hedges' g=-0.28 95%CI (-0.44 - -0.12)) and healthy controls (g=-0.54 (-0.83 - -0.25)) with no significant difference between control groups. The difference between suicide attempters and patient controls was not related to age group, mood disorder type, author, or research center while an effect of time of publication was found (p=0.006). Poorer performance was also found in suicide attempters compared to patient controls when using the CGT (g=-0.57 95%CI (-0.82 - -0.31)). Suicide attempters who used a violent means showed poorer IGT performance than those who used a non-violent means (3 studies). LIMITATION Limited number of studies outside mood disorders. No data to calculate a gender effect. CONCLUSION The present meta-analysis confirmed riskier decision-making in suicide attempters. Although group differences appear to be of modest effect size in general, they were particularly marked in the subgroup of those who used a violent suicidal means.
Collapse
Affiliation(s)
- Rebecca Perrain
- Université de Paris, Paris, France; GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, CMME, Paris, France
| | - Roland Dardennes
- Université de Paris, Paris, France; GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, CMME, Paris, France
| | - Fabrice Jollant
- Université de Paris, Paris, France; GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, CMME, Paris, France; McGill Group for suicide studies, McGill University, Montréal, Canada; Nîmes academic hospital (CHU), Nîmes, France; Equipe Moods, INSERM UMR-1178, Paris, France.
| |
Collapse
|
38
|
Astraud LP, Jollant F. [Thirty years of research in suicidology in France: A bibliometric study]. Encephale 2020; 47:195-202. [PMID: 33046236 DOI: 10.1016/j.encep.2020.06.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Revised: 05/13/2020] [Accepted: 06/06/2020] [Indexed: 01/16/2023]
Abstract
OBJECTIVES To study the quantitative evolution of research in suicidology in France for 30 years. METHODS Analysis of the Web of Science database; identification of publications between 1989 and 2018 with at least one author with an affiliation in France and focusing on suicidal behavior and self-inflicted acts. RESULTS In total, 1188 publications were identified. Over 30 years, the number of publications has been multiplied by 8.8 (particularly since 2005), a growth higher than those published in psychiatry and science in France, and in suicidology worldwide. France has contributed 3.3% of global publications since 2014 (ranks 8th in the world, recently outnumbered by South Korea and China) and 10.6% of European publications (ranks 3rd after the United Kingdom and Germany). The number of international co-publications has risen sharply over the last 30 years (44.9% between 2014 and 2018), notably with the USA, Canada and Spain. Use of English has increased from 37 to 78% of publications. Inserm, and the Universities and Academic hospitals of Paris and Montpellier are among the first institutions in terms of number of publications. Twenty-one of the 30 most published authors are men. The mention of the origin of the financing of the publications is increasing but remains limited. CONCLUSION Suicidology has been a dynamic field of research in France for the last fifteen years, with a growing international visibility, but there is also room for improvement. An effort remains to be made to improve women's place in these publications.
Collapse
Affiliation(s)
- L-P Astraud
- Université de Paris (ex-Université Paris-Descartes), Paris, France
| | - F Jollant
- Université de Paris (ex-Université Paris-Descartes), Paris, France; GHU Paris psychiatrie et neurosciences, centre hospitalier Sainte-Anne, Paris, France; CHU de Nîmes, Nîmes, France; McGill Group for Suicide Studies, McGill University, Montréal (Québec), Canada.
| |
Collapse
|
39
|
Affiliation(s)
- F Jollant
- University of Paris (ex-Paris-Descartes University), Paris, France; GHU Paris psychiatrie et neurosciences, Sainte-Anne Hospital, Paris, France; McGill Group for Suicide Studies, Department of psychiatry, McGill University, Montréal, Canada; CHU de Nîmes, Nîmes, France.
| |
Collapse
|
40
|
Laanani M, Imbaud C, Tuppin P, Poulalhon C, Jollant F, Coste J, Rey G. Contacts with health services during the year prior to suicide death in France (2013-2015). Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
This study was designed to describe contacts with health services during the year before suicide death in France, and to compare the prevalent mental and physical conditions in these people to those of the general population.
Methods
Data were extracted from the French National Health Data System (SNDS), which comprises comprehensive claims data for inpatient and outpatient care linked to the national causes-of-death registry. Individuals, national health insurance general scheme beneficiaries (i.e. 76% of the population living in France), aged 15 years or older, who died from suicide in France in 2013-2015 were included. Medical consultations, emergency room visits, and hospitalisations during the year preceding death were collected. Conditions were identified, and standardised prevalence ratios (SPRs) were estimated to compare prevalence rates in suicide decedents with those of the general population.
Results
The study included 19,144 suicide decedents. Overall, 8.5% of suicide decedents consulted a physician or attended an emergency room on the day of death, 34.1% during the week before death, 60.9% during the month before death. Most contacts involved a general practitioner or an emergency room (46.2% of suicide decedents consulted a general practitioner during the month before death, 16.7% attended an emergency room). During the month preceding suicide, 24.4% of individuals were hospitalised at least once. Mental conditions (36.8% of cases) were 7.9-fold (SPR 95% CI: 7.7-8.1) more prevalent in suicide decedents than in the general population. The highest SPRs among physical conditions were for liver/pancreatic diseases (SPR=3.3, 95% CI: 3.1-3.6) and epilepsy (SPR=2.7, 95% CI: 2.4-3.0).
Conclusions
General practitioners and emergency departments have frequent contacts with suicide decedents during the last weeks before death and are at the forefront of suicide risk identification and prevention in individuals with mental, but also physical conditions.
Key messages
Mental and physical conditions are more common among suicide decedents than in the general population, and contacts with primary care services are frequent in the last weeks prior to suicide. Primary care services (general practitioners and emergency rooms) should be targeted for suicide preventive interventions.
Collapse
Affiliation(s)
- M Laanani
- French Centre for Epidemiology on Medical Causes of Death, CépiDc-Inserm, Le Kremlin-Bicêtre, France
- Strategy and Research Department, French National Health Insurance, Paris, France
| | - C Imbaud
- French Centre for Epidemiology on Medical Causes of Death, CépiDc-Inserm, Le Kremlin-Bicêtre, France
| | - P Tuppin
- Strategy and Research Department, French National Health Insurance, Paris, France
| | - C Poulalhon
- Centre of Research in Epidemiology and Statistics, Inserm, Villejuif, France
| | - F Jollant
- Université de Paris, Paris, France
- GHU Paris Psychiatrie et Neurosciences, Sainte-Anne hospital, Paris, France
- McGill Group for suicide studies, McGill University, Montréal, Canada
| | - J Coste
- Université de Paris, Paris, France
- Biostatistics and Epidemiology unit, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
- French National Public Health Agency, Saint-Maurice, France
| | - G Rey
- French Centre for Epidemiology on Medical Causes of Death, CépiDc-Inserm, Le Kremlin-Bicêtre, France
| |
Collapse
|
41
|
Laanani M, Imbaud C, Tuppin P, Poulalhon C, Jollant F, Coste J, Rey G. Contacts with Health Services During the Year Prior to Suicide Death and Prevalent Conditions A Nationwide Study. J Affect Disord 2020; 274:174-182. [PMID: 32469801 DOI: 10.1016/j.jad.2020.05.071] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 05/12/2020] [Accepted: 05/14/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND This study was designed to describe contacts with health services during the year before suicide death in France, and prevalent mental and physical conditions. METHODS Data were extracted from the French National Health Data System (SNDS), which comprises comprehensive claims data for inpatient and outpatient care linked to the national causes-of-death registry. Individuals aged ≥15 years who died from suicide in France in 2013-2015 were included. Medical consultations, emergency room visits, and hospitalisations during the year preceding death were collected. Conditions were identified, and standardised prevalence ratios (SPRs) were estimated to compare prevalence rates in suicide decedents with those of the general population. RESULTS The study included 19,144 individuals. Overall, 8.5% of suicide decedents consulted a physician or attended an emergency room on the day of death, 34.1% during the week before death, 60.9% during the month before death. Most contacts involved a general practitioner or an emergency room. During the month preceding suicide, 24.4% of individuals were hospitalised at least once. Mental conditions (36.8% of cases) were 7.9-fold more prevalent in suicide decedents than in the general population. The highest SPRs among physical conditions were for liver/pancreatic diseases (SPR=3.3) and epilepsy (SPR=2.7). LIMITATIONS The study population was restricted to national health insurance general scheme beneficiaries (76% of the population living in France). CONCLUSIONS Suicide decedents have frequent contacts with general practitioners and emergency departments during the last weeks before death. Improving suicide risk identification and prevention in these somatic healthcare settings is needed.
Collapse
Affiliation(s)
- Moussa Laanani
- Centre for Epidemiology on Medical Causes of Death (CépiDc-Inserm), Le Kremlin-Bicêtre, France; Strategy and Research Department, French National Health Insurance, Paris, France.
| | - Claire Imbaud
- Centre for Epidemiology on Medical Causes of Death (CépiDc-Inserm), Le Kremlin-Bicêtre, France
| | - Philippe Tuppin
- Strategy and Research Department, French National Health Insurance, Paris, France
| | - Claire Poulalhon
- Centre of Research in Epidemiology and Statistics, Inserm, Villejuif, France
| | - Fabrice Jollant
- Université de Paris, Paris, France; GHU Paris Psychiatrie et Neurosciences, Sainte-Anne hospital, Paris, France; McGill Group for suicide studies, McGill University, Montréal, Canada; Nîmes university hospital (CHU), Nîmes, France
| | - Joël Coste
- Université de Paris, Paris, France; Assistance Publique-Hôpitaux de Paris, Biostatistics and Epidemiology unit, Cochin Hospital, Paris, France; French National Public Health Agency, Saint-Maurice, France
| | - Grégoire Rey
- Centre for Epidemiology on Medical Causes of Death (CépiDc-Inserm), Le Kremlin-Bicêtre, France
| |
Collapse
|
42
|
Petit JM, Goueslard K, Chauvet-Gelinier JC, Bouillet B, Vergès B, Jollant F, Quantin C. Association between hospital admission for ketoacidosis and subsequent suicide attempt in young adults with type 1 diabetes. Diabetologia 2020; 63:1745-1752. [PMID: 32642808 DOI: 10.1007/s00125-020-05206-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 05/14/2020] [Indexed: 01/22/2023]
Abstract
AIMS/HYPOTHESIS The aim of this study was to examine the associations between hospitalisation for diabetic ketoacidosis and subsequent hospitalisation for suicide attempt in young adults with type 1 diabetes. METHODS This nationwide historical cohort study included hospital data on all young people hospitalised in France for type 1 diabetes in 2008. Epidemiological follow-up focused on hospitalisations (medical and psychiatric hospital data) from the index hospitalisation to 2017. Survival analyses were done using a Cox proportional hazards regression model to explore the association between hospitalisation for ketoacidosis and subsequent hospitalisation for a suicide attempt. RESULTS In 2008, 16,431 people aged 18-35 years had a hospitalisation mentioning type 1 diabetes. Among them, 1539 (9.4%) had at least one hospitalisation for ketoacidosis between 2008 and 2010. At 9 years, 7.2% of the group hospitalised for ketoacidosis had been hospitalised for a suicide attempt vs only 2.5% in the group not hospitalised for ketoacidosis. The association between hospitalisation for ketoacidosis and suicide attempt decreased over time and was no longer significant after 5 years. CONCLUSIONS/INTERPRETATION We found that young adults admitted to hospital for diabetic ketoacidosis have an increased risk of being admitted to hospital for a subsequent suicide attempt. The risk of a suicide attempt was the highest in the 12 months following the ketoacidosis episode. Our findings support the recommendation that screening for depression and suicide risk should be part of the routine clinical assessment of individuals with type 1 diabetes and ketoacidosis.
Collapse
Affiliation(s)
- Jean-Michel Petit
- Inserm Unit, LNC-UMR 1231, University of Burgundy, Dijon, France.
- Department of Endocrinology, Diabetes and Metabolic Disorders, Dijon University Hospital, 14 rue Gaffarel, BP 77908, 21079, Dijon Cedex, France.
| | - Karine Goueslard
- Biostatistics and Bioinformatics (DIM), Dijon University Hospital, Dijon, France
- University of Burgundy and Franche-Comte, Dijon, France, Inserm, CIC 1432, Dijon, France
- Dijon University Hospital, Clinical Investigation Center, Clinical Epidemiology/Clinical Trials Unit, Dijon, France
| | | | - Benjamin Bouillet
- Inserm Unit, LNC-UMR 1231, University of Burgundy, Dijon, France
- Department of Endocrinology, Diabetes and Metabolic Disorders, Dijon University Hospital, 14 rue Gaffarel, BP 77908, 21079, Dijon Cedex, France
| | - Bruno Vergès
- Inserm Unit, LNC-UMR 1231, University of Burgundy, Dijon, France
- Department of Endocrinology, Diabetes and Metabolic Disorders, Dijon University Hospital, 14 rue Gaffarel, BP 77908, 21079, Dijon Cedex, France
| | - Fabrice Jollant
- Paris-Descartes University and Sainte-Anne Hospital, Paris, France
| | - Catherine Quantin
- Biostatistics and Bioinformatics (DIM), Dijon University Hospital, Dijon, France
- University of Burgundy and Franche-Comte, Dijon, France, Inserm, CIC 1432, Dijon, France
- Dijon University Hospital, Clinical Investigation Center, Clinical Epidemiology/Clinical Trials Unit, Dijon, France
| |
Collapse
|
43
|
Piot MA, Dechartres A, Attoe C, Jollant F, Lemogne C, Layat Burn C, Rethans JJ, Michelet D, Cross S, Billon G, Guerrier G, Tesniere A, Falissard B. Simulation in psychiatry for medical doctors: A systematic review and meta-analysis. Med Educ 2020; 54:696-708. [PMID: 32242966 DOI: 10.1111/medu.14166] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 03/14/2020] [Accepted: 03/23/2020] [Indexed: 05/06/2023]
Abstract
CONTEXT Most medical doctors are likely to work with patients experiencing mental health conditions. However, educational opportunities for medical doctors to achieve professional development in the field of psychiatry are often limited. Simulation training in psychiatry may be a useful tool to foster this development. OBJECTIVES The purpose of this study was to assess the effectiveness of simulation training in psychiatry for medical students, postgraduate trainees and medical doctors. METHODS For this systematic review and meta-analysis, we searched eight electronic databases and trial registries up to 31 August 2018. We manually searched key journals and the reference lists of selected studies. We included randomised and non-randomised controlled studies and single group pre- and post-test studies. Our main outcomes were based on Kirkpatrick levels. We included data only from randomised controlled trials (RCTs) using random-effects models. RESULTS From 46 571 studies identified, we selected 163 studies and combined 27 RCTs. Interventions included simulation by role-play (n = 69), simulated patients (n = 72), virtual reality (n = 22), manikin (n = 5) and voice simulation (n = 2). Meta-analysis found significant differences at immediate post-tests for simulation compared with active and inactive control groups for attitudes (standardised mean difference [SMD] = 0.52, 95% confidence interval [CI] 0.31-0.73 [I2 = 0.0%] and SMD = 0.28, 95% CI 0.04-0.53 [I2 = 52.0%], respectively), skills (SMD = 1.37, 95% CI 0.56-2.18 [I2 = 93.0%] and SMD = 1.49, 95% CI 0.39-2.58 [I2 = 93.0%], respectively), knowledge (SMD = 1.22, 95% CI 0.57-1.88 [I2 = 0.0%] and SMD = 0.72, 95% CI 0.14-1.30 [I2 = 80.0%], respectively), and behaviours (SMD = 1.07, 95% CI 0.49-1.65 [I2 = 68.0%] and SMD = 0.45, 95% CI 0.11-0.79 [I2 = 41.0%], respectively). Significant differences in terms of patient benefit and doctors' behaviours and skills were found at the 3-month follow-up. CONCLUSIONS Despite heterogeneity in methods and simulation interventions, our findings demonstrate the effectiveness of simulation training in psychiatry training.
Collapse
Affiliation(s)
- Marie-Aude Piot
- Epidemiological and Public Health Research Centre, Villejuif, France
- University of Paris, Faculty of Health, Medicine School, Paris, France
- Department of Psychiatry, Institute Mutualiste Montsouris, Paris, France
- Health Care Simulation Center iLumens, University of Paris, France
| | - Agnès Dechartres
- Sorbonne Université, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP.Sorbonne Université, Hôpital Pitié Salpêtrière, Département de Santé Publique, Paris, France
| | - Chris Attoe
- Maudsley Simulation, South London and Maudsley NHS Foundation Trust, London, UK
| | - Fabrice Jollant
- University of Paris, Faculty of Health, Medicine School, Paris, France
- Department of Psychiatry, GHU Paris Psychiatry and Neurosciences, Sainte-Anne Hospital Center, Paris, France
- Department of Psychiatry, Nîmes Academic Hospital (CHU), Nîmes, France
- Department of Psychiatry, McGill University, Montréal, Québec, Canada
| | - Cédric Lemogne
- University of Paris, Faculty of Health, Medicine School, Paris, France
- University of Paris, INSERM, Institute of Psychiatry and Neurosciences of Paris (IPNP), Paris, France
- AP-HP.Centre-University of Paris, European Georges-Pompidou Hospital, Department of Psychiatry, Paris, France
| | - Carine Layat Burn
- Department of Orthopaedic Surgery, La Providence Hospital, Neuchâtel, Switzerland
- Department of Psychotherapy, Berger Psychotherapeutic Centre, Neuchâtel, Switzerland
| | - Jan-Joost Rethans
- Institute for Education and Skills Lab, Faculty of Health, Medicine and Life Sciences, Maastricht University, the Netherlands
| | - Daphne Michelet
- Health Care Simulation Center iLumens, University of Paris, France
- Department of Pediatric Anesthesia, CHU of Reims Hôpital Maison Blanche, Reims, France
| | - Sean Cross
- Maudsley Simulation, South London and Maudsley NHS Foundation Trust, London, UK
| | - Gregoire Billon
- Maudsley Simulation, South London and Maudsley NHS Foundation Trust, London, UK
| | - Gilles Guerrier
- University of Paris, Faculty of Health, Medicine School, Paris, France
- Health Care Simulation Center iLumens, University of Paris, France
- Department of Anaesthesiology, Cochin Hospital, AP-HP, Paris, France
| | - Antoine Tesniere
- University of Paris, Faculty of Health, Medicine School, Paris, France
- Health Care Simulation Center iLumens, University of Paris, France
| | - Bruno Falissard
- Epidemiological and Public Health Research Centre, Villejuif, France
- Department of Public health, School of Medecine, University Paris Saclay, Villejuif, France
| |
Collapse
|
44
|
Abstract
Suicide is a major public health concern, especially for older adults, who have higher rates of completed suicide than any other age group in most countries of the world. However, understanding suicidal behaviour remains a challenging task particularly among the elders who have been poorly studied. Decision making has been recently found to be altered in suicide attempters under 65.To test wether decision making would be a neuropsychological trait of vulnerability to suicidal behaviours, the authors used the Iowa Gambling Task to investigate normothymic non demented elders with a history of suicidal behaviour (N = 35) and compared it to decision making in non suicide attempters with a past history of depression (N = 52) and comparison subjects (N = 43). The data also were compared to those of similar groups of younger normothymic subjects. Moreover, the old suicidal patients were assessed according to the age at the onset of suicidal behaviour (before or after 60).Old suicide attempters did not significantly differ from the other aged groups and according to the age of first suicidal behaviour. Old suicide attempters presented better performances than that of younger suicidal patients.Vulnerability to suicidal behaviour in older people may proceed from cognitive processes which are different from the ones involved in suicidal vulnerability of younger subjects. These results are preliminary and further studies are needed to explore vulnerability cognitive patterns to suicide among elders.
Collapse
|
45
|
Duriez P, Goueslard K, Quantin C, Jollant F. Étude de l’association entre les troubles des conduites alimentaires et le risque suicidaire chez les adolescents et jeunes adultes. Rev Epidemiol Sante Publique 2020. [DOI: 10.1016/j.respe.2020.01.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
|
46
|
Jollant F. [Current modeling of suicidal behavior : crisis, transition, and vulnerability]. Rev Prat 2020; 70:38-41. [PMID: 32877026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Current modeling of suicidal behavior: crisis, transition, and vulnerability. Suicidal behavior is multifactorial and polymorphic. Modeling - although simplifying - is necessary. This article presents three interactive processes: the suicidal crisis, the transition from ideas to action, and the suicidal vulnerability. The suicidal crisis is a state of rupture of the psychic balance, often occurring in response to an event of social and interpersonal character, and leading the individual to the significant thoughts that only suicide is the solution to one's own problems. This crisis is particularly marked by an unbearable psychic pain whose cessation is the goal of most suicidal gestures. The acting out occurs in less than a quarter of people with suicidal ideas. The mechanisms responsible for the emergence of suicidal ideation appear partly different from those allowing the transition to a suicidal act. Suicidal risk in a context of psychosocial stress is increased by the existence of vulnerability factors, whose complex nature is developmental, genetic, cognitive, and temperamental, among others.
Collapse
Affiliation(s)
- Fabrice Jollant
- Université de Paris (Paris-Descartes), Paris, France. GHU Paris psychiatrie et neurosciences, site hôpital Sainte-Anne, pôle CMME, Paris, France Université McGill, Groupe McGill de recherche sur le suicide, Montréal (Québec), Canada
| |
Collapse
|
47
|
Jollant F. [Suicide: 10 key messages]. Rev Prat 2020; 70:62. [PMID: 32877032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- Fabrice Jollant
- Université de Paris (Paris-Descartes), Paris, France. GHU Paris psychiatrie et neurosciences, site hôpital Sainte-Anne, pôle CMME, Paris, France Université McGill, Groupe McGill de recherche sur le suicide, Montréal (Québec), Canada
| |
Collapse
|
48
|
Dardennes R, Jollant F. [Novel insight into suicidal behavior]. Rev Prat 2020; 70:59-61. [PMID: 32877031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Novel insight into suicidal behavior. This article presents four short examples of new insights into suicidal acts and innovative treatments. These include the results of cognitive neuroscience studies that have identified hypersensitivity to rejection, exclusion, and injustice signals in suicide attempters, as well as persisting trend for risky choices and insufficient cognitive control. These processes may be future therapeutic targets. Moreover, several studies showed on early suicidal trajectories, as well as residual epigenetic scars, as a result of childhood abuse. The people who were victims of these events may require specific intervention. In addition, artificial intelligence is a source of hope to account for the etiological and phenotypic complexity of suicidal behavior, and to establish more precise algorithms of medical decision-making. Ethical issues are raised at the same time. Finally, ketamine is today an innovative treatment (pending authorization) for the rapid reduction of suicidal ideation and a more effective crisis management.
Collapse
Affiliation(s)
- Roland Dardennes
- Université de Paris (Paris-Descartes), Paris, France. GHU Paris psychiatrie et neurosciences, site hôpital Sainte-Anne, pôle CMME, Paris, France Université McGill, Groupe McGill de recherche sur le suicide, Montréal (Québec), Canada
| | - Fabrice Jollant
- Université de Paris (Paris-Descartes), Paris, France. GHU Paris psychiatrie et neurosciences, site hôpital Sainte-Anne, pôle CMME, Paris, France Université McGill, Groupe McGill de recherche sur le suicide, Montréal (Québec), Canada
| |
Collapse
|
49
|
Jollant F, Voegeli G, Kordsmeier NC, Carbajal JM, Richard-Devantoy S, Turecki G, Cáceda R. A visual analog scale to measure psychological and physical pain: A preliminary validation of the PPP-VAS in two independent samples of depressed patients. Prog Neuropsychopharmacol Biol Psychiatry 2019; 90:55-61. [PMID: 30391308 PMCID: PMC6463884 DOI: 10.1016/j.pnpbp.2018.10.018] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 09/25/2018] [Accepted: 10/30/2018] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Psychological pain lies at the heart of human experience. However, it may also be abnormally intense and/or prolonged in pathological states, with negative outcomes. A simple and reliable measure of psychological pain for clinical use would be useful. In this study, we present a preliminary validation of a simple visual analog scale jointly measuring psychological and physical pain. METHODS Two samples of adult (non elderly) depressed patients and healthy controls were independently recruited in two locations in Canada and the USA (N = 46/48 and 200/20, respectively). Six dimensions were successively scored on a paper visual analog scale measuring current, mean and worst pain over the last 15 days, for physical then psychological pain. RESULTS All physical and psychological pain dimensions discriminated depressed from non-depressed subjects. Among depressed patients, psychological pain scores were higher than physical pain scores for a given period of assessment. Moreover, correlations between dimensions from the same pain category (physical or psychological) were higher than between different pain categories. Psychological pain was mainly correlated with depression and hopelessness scales while physical pain was mainly correlated with anxiety scales. Secondary analyses showed that psychological (and some physical) pain measures were correlated with suicidal ideas in one location, but no difference in pain scores was found between patients with vs. without a history of suicidal acts in both samples. Childhood trauma positively correlated with several pain dimensions. CONCLUSION The PPP-VAS appears to be a valid tool in terms of discriminative capacities and convergent-divergent validities. Validation in different samples, including adolescents and elderly, and in various psychiatric and medical conditions will have to be conducted, in addition to the assessment of concurrent and predictive validities, and the confirmation of sensitivity to change. The role of psychological pain in the suicidal process needs to be further elucidated.
Collapse
Affiliation(s)
- Fabrice Jollant
- Université Paris Descartes, Sorbonne Paris Cité, Paris, France; CH Sainte-Anne, Clinique des Maladies Mentales et de l'Encéphale (CMME), Paris, France,; McGill University, Department of Psychiatry & Douglas Mental Health University Institute, McGill Group for Suicide Studies, Montréal, Québec, Canada.
| | - Géraldine Voegeli
- Université Paris Descartes, Sorbonne Paris Cité, Paris, France, & CH Sainte-Anne, Clinique des Maladies Mentales et de l’ Encéphale (CMME), Paris, France
| | | | | | - Stéphane Richard-Devantoy
- McGill University, Department of Psychiatry & Douglas Mental Health University Institute, McGill Group for Suicide Studies, Montréal (Québec), Canada
| | - Gustavo Turecki
- McGill University, Department of Psychiatry & Douglas Mental Health University Institute, McGill Group for Suicide Studies, Montréal (Québec), Canada
| | - Ricardo Cáceda
- Department of Psychiatry, Stony Brook University, Stony Brook, NY, USA
| |
Collapse
|
50
|
Goueslard K, Petit JM, Cottenet J, Chauvet-Gelinier JC, Jollant F, Quantin C. Risque augmenté de ré-hospitalisation chez les personnes atteintes de diabète de type 1 et de schizophrénie. Rev Epidemiol Sante Publique 2019. [DOI: 10.1016/j.respe.2019.01.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|