jeudi 19 janvier 2017

ETUDE RECHERCHE FRANCE Le lien entre dissociation et les tentatives de suicide et les automutilations non suicidaires


Raffaella Calati a, b, c, , , Ismaïl Bensassi a, c, Philippe Courtet a, b, ca INSERM U1061, La Colombière Hospital, University of Montpellier UM1, Montpellier, France
b FondaMental Foundation, Créteil, France
c Department of Emergency Psychiatry & Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France

Dissociative disorders (DD) are frequently associated with suicidal behaviors. We performed the first meta-analysis of studies comparing rates of suicide attempts (SA) and non-suicidal self-injury (NSSI) in psychiatric individuals with and without DD. We included: 1) studies comparing SA and NSSI rates in psychiatric individuals with and without DD; 2) studies comparing Dissociative Experiences Scale (DES) scores in both SA and NSSI psychiatric patients versus non SA and non NSSI ones. Cochrane Collaboration Review Manager Software and STROBE statement were used. Nineteen studies were included in the analyses. DD patients were more likely to report both previous SA and NSSI in comparison to non DD patients. Importantly, results remained highly significant in both outcomes but with no more heterogeneity when including studies using a DSM-based method to diagnose DD. Both SA and NSSI patients reported higher DES scores in comparison to non SA and non NSSI patients. The presence of DD diagnosis or higher DES scores seems to be related to both SA and NSSI in psychiatric patients. Hence, it may be reasonable to hypothesize the presence of a dissociative subtype in a subset of these patients, which should be considered as a transdiagnostic factor and should be carefully assessed.

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