The mains objectives of our project are to coordinate the monitoring of suicides and to identify common or specific suicide risk factors in four overseas DROM-COM (French Polynesia, La Reunion, French Guiana and Martinique) by comparing to a site in mainland France (Amiens). A mixed approach (quantitative and qualitative) will be used, based on semi-directed interviews of the psychological autopsy type.
Epidemiological studies on suicide are rare in Overseas France. Nevertheless, studies conducted independently in New Caledonia (NC) and French Guiana were able to highlight a high prevalence of suicides in minority indigenous populations (Kanaks and Amerindians). These data therefore suggest a socio-cultural variability of suicides within the different territories. Psychological autopsies (used in NC) are an innovative approach that has already proven worldwilde its effectiveness in researching socio-cultural factors and prevalence of mental disorders in suicide subjects (Inserm). However, the qualitative analysis of psychological autopsies, even if it is very complete, is limited to known factors of suicide risk. Given the ethnic specificities of suicidal behavior and the socio-cultural richness of each overseas territory, an exploratory anthropologic approach will make it possible to complete identification of risk factors for suicide or combinations of these specific factors (profiles). Our project will improve the data collection of suicide cases with the implementation of a network in each site (Public Health Department, Emergency units, Coroner offices, GP, associations, families…). Then interview with proxies of subjects deceased by suicide will allow psychological autopsy (questionnaires SCID to detect mental disorders, Life Trajectories, to detect life events and their burden, Anthropologic for socio-cultural aspects and Psycholinguistic analysis). The total duration of the project will be 24 months with the recruitment of a maximum of 30 cases per site. Duration of the inclusion period will be 23 months, duration of follow-up per participant 1 month. The follow-up interview will be carried out one month after the inclusion interview. It will make it possible to establish a post-vention of suicide among the bereaved and an evaluation of the impact of the psychological autopsy interviews and the life trajectories of the bereaved.
Study Type
OBSERVATIONAL
Enrollment
150
The interviewers will collect data from relatives using questionnaires and evaluation grids based on an identification form, a Life Trajectory questionnaire, an anthropological evaluation grid, a retrospective psychiatric diagnosis questionnaire (SCID), a socio-demographic questionnaire, a questionnaire on suicide risks and a questionnaire on emotional state.
Centre Hospitalier Universitaire de Martinique - Hôpital Pierre ZOBDA QUITMAN
Fort-de-France, France, Martinique
RECRUITINGExistence of risk factors and mental disorders evaluated by Structured Clinical Interview for Diagnostic (SCID)
Number and percentage of mental disorders presented by the deceased and identified on the basis of data collected during DSM 5 diagnostic interviews.
Time frame: 1 month
Assessment and comparison of risk factors and mental disorders
The number of risk factors identified and the number of mental disorders detected will be compared between the overseas territories and the Somme department.
Time frame: 1 month
Existence or not of violence in childhood or during life among suicide cases
The variables related to childhood violence will be presented with the number of subjects "n" expressed as a percentage.
Time frame: 1 month
Score of adversity by the Life Trajectory Questionnaire
Once the interviews have been completed, the recordings will be transcribed semi-automatically via the HappyScribe® online platform. The resulting verbatim recordings will then be used as data for psycholinguistic and anthropological analyses. The qualitative data will then be transformed into quantitative data following the methodology developed by Brown and Harris, in which a panel of experts (researchers from our team and clinicians) assigns an overall rating for each five-year period, according to the severity of the burden of adversity carried by the person. This rating, from 1 to 6, makes it possible to determine the burden of adversity in the development of the individual (detailed description Séguin et al, 2007). It is the ratings of adversity that will form the curve of these trajectories.
Time frame: 6 month
Existence of language, social and anthropological elements associated with suicide risk factors
an audio-recording will record responses to semi-structured interview using anthropological approach. After transcription, the qualitative data gained from these questions will be analyzed using thematic analysis to understand the main themes (Representations of mental illness and suicidal commitment. Religious beliefs and cultural practices. Use of traditional methods to treat mental illness). A part of the transcription will also be analyzed using psycholinguistic approach. The words will be defined according to their frequency of occurrence and the most frequent grouped according to several "reference universes" associated with central notions (e.g. feeling, sensation, behavior, time, family, crisis, suicide, etc.). The visualization of the reference universes will summarize the frequency and proximity of key words and will make it possible to obtain a cognitive and mental representation of the speech.
Time frame: 6 month
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