lundi 29 septembre 2014

RECHERCHE FRANCE : Parution Article : tentative de suicide et suicide et soin de santé primaire

Attempted and completed suicide in primary care: Not what we expected? Journal of Affective Disorders, Volume 170, 1 January 2015, Pages 150-154Journal of Affective Disorders 170 (2015) 150- 154

Auteurs : N. Younes a, b, M. Melchior c, d, C. Turbelin e, f, T. Blanchon e, f, T Hanslik e, f, g, C Chan Chee h
  • a EA 40-47 Université Versailles Saint-Quentin-en-Yvelines, F-78047 Guyancourt, France
  • b Academic Unit of Psychiatry, Versailles Hospital, 177 Rue de Versailles, F-78157 Le Chesnay, France
  • c INSERM, UMR_S 1136, Pierre Louis Institute for Epidemiology and Public Health, Department of Social Epidemiology, F-75013 Paris, France
  • d Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Pierre Louise Institute of Epidemiology and Public Health, F-75013 Paris, France
  • e INSERM, U707, F-75012, Paris, France
  • f UPMC University Paris 06, UMR-S U707, F-75012, Paris, France
  • g Université Versailles Saint Quentin en Yvelines, F-78000, Versailles, France
  • h French Institute for Public Health Surveillance, Saint Maurice, France
 Abstract
  • Background

    General Practitioners (GPs) play a central role in suicide prevention. This study aims to compare the characteristics of individuals who attempt suicide to those who complete suicide in a same primary care setting.

    Methods

    We compared the characteristics and GP׳s management of all patients with attempted (N=498, SA) or completed suicide (N=141, SC) reported to the GPs׳ French Sentinelles surveillance system (2009–2013).

    Results

    Compared to patients who attempted suicide, those who completed suicide were more likely to be male, older and to have used a more lethal method; for men they were less likely to have a history of previous suicide attempt and prior contacts with their GP. In terms of GPs׳ management, we found no differences between the SA and SC groups in the identification of psychological difficulties and in the care, but GPs were more likely to provide psychological support to the SA group. During the last consultation, the SC group expressed suicidal ideas more frequently than the SA group (26.7% vs. 14.8%, p<0.01), only for women.

    Limitations

    The network may have missed cases and selected more serious SA.

    Conclusions

    Individuals who commit suicide differ from those who attempt suicide in terms of demographic characteristics and by sex, of history of suicide attempt, previous contact and expressed suicidal ideas. We show that GPs do not act more intensively with patients who will commit suicide, as if they do not foresee them. Current prevention programs particularly in primary care should be tailored.
     
http://www.sciencedirect.com/science/article/pii/S0165032714005266

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