Protective Factors Against Elderly Suicide (ProFAES)

Methodical Search of Protective Factors During Interview of Suicidal Elderly Patients: Effect on the Proposed Care

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

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

Study Overview

• Status: Terminated
• Conditions: Suicide, Attempted; Suicide Gesture
• Intervention / Treatment: Behavioral: Post-suicidal crisis interview

Detailed Description

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

• Study Type: Observational
• Enrollment (Actual): 15

Contacts and Locations

Study Locations

• France
  • La Rochelle, France
    • Groupe Hospitalier de la Rochelle Ré Aunis

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 65 years and older (Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

Patients will be screened in the psychiatric, geriatric and emergency departments of la Rochelle and Rochefort secondary hospitals

Description

Inclusion Criteria:

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

Exclusion Criteria:

• Cognitive disorders
• Refusal to participate

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Suicide attempt or ideas; Elderly patients who attempted suicide or who emitted suicidal ideas	Behavioral: Post-suicidal crisis interview; Protective factor exploration during post-suicidal crisis interview

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Number of outpatients (with a low to moderate risk of suicidal recurrence)	Based on risk, emergency and hazard, patients are classified as being at low, moderate and high risk of suicidal recurrence. Patients with low to moderate risk of suicidal recurrence are either inpatient or outpatient.	7 days

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Number of patients considering themselves to be in good health	Score > 0 at Health Status questionnaire (SF36) item 1	7 days
Number of patients considering that their physical or mental state did not alter their social life	Score > 50 at Health Status questionnaire (SF36) items 6 or 10	7 days
Number of patients maintaining autonomy	Score = 0 at Instrumental Activities of Daily Living scale	7 days
Number of patients with religious practice	Binary answer from patients (yes/no I have a religious practice)	7 days
Number of patients with a sense of success and self-esteem	Binary answer from patients (yes/no I have a a sense of success and self-esteem)	7 days
Number of patients considering their family environment to be satisfactory	Binary answer from patients (yes/no I am satisfied with my family environment)	7 days
Number of patients with at least one environmental protection factor	Friendly network, associative investment, volunteering, specialized care, recreation, positive image from the entourage, presence of a third party, housekeeper, postman, pet, shopping facilities, doctor, pharmacy ...	7 days
Number of patients with social protection factors	Easy access to Health facilities, sufficient financial income	7 days
Number of patients able to adapt to difficult situations	score ≤ 12 at Neo Personality Inventory vulnerability item	7 days
Number of patients with extraversion capabilities	score ≥ 20 at Neo Personality Inventory extraversion item	7 days
Number of patients with openness to others	score ≥ 20 at Neo Personality Inventory Openness to feelings item	7 days
Number of patients considering that their health has improved	Patients will be asked if they feel that their health has improved, has not changed or has worsened	3 months

Collaborators and Investigators

• Sponsor: Groupe Hospitalier de la Rochelle Ré Aunis
• Investigators: Study Director: Karine REISS, MD, Groupe Hospitalier de la Rochelle Ré Aunis

Publications and helpful links

General Publications

• Richard-Devantoy S, Jollant F. [Suicide in the elderly: age-related specificities?]. Sante Ment Que. 2012 Autumn;37(2):151-73. doi: 10.7202/1014949ar. French.
• Conwell Y, Thompson C. Suicidal behavior in elders. Psychiatr Clin North Am. 2008 Jun;31(2):333-56. doi: 10.1016/j.psc.2008.01.004.
• Casadebaig F, Ruffin D, Philippe A. [Suicide in the elderly at home and in retirement homes in France]. Rev Epidemiol Sante Publique. 2003 Feb;51(1 Pt 1):55-64. French.

Helpful Links

• Epidemiology of suicide in France

Study record dates

Study Major Dates

• Study Start (Actual): February 16, 2018
• Primary Completion (Actual): February 16, 2019
• Study Completion (Actual): May 27, 2019

Study Registration Dates

• First Submitted: May 19, 2017
• First Submitted That Met QC Criteria: May 19, 2017
• First Posted (Actual): May 22, 2017

Study Record Updates

• Last Update Posted (Actual): July 5, 2019
• Last Update Submitted That Met QC Criteria: July 2, 2019
• Last Verified: July 1, 2019

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Behavioral Symptoms; Self-Injurious Behavior; Suicide; Suicide, Attempted
• Other Study ID Numbers: 2015/P08/079

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Study Data/Documents

1. Consensus conference report

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No