Contribution of Psychological Autopsy to the Understanding of Suicidal Behaviors in French Overseas Territories (AUTOPSOM)

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.

Study Overview

• Status: Recruiting
• Conditions: Mental Disorders; Suicide; Prognostic Factors
• Intervention / Treatment: Other: other

Detailed Description

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 (Estimated): 150

Contacts and Locations

• Study Contact: Name: SEBASTIEN CAVALINI; Phone Number: +596 596 592 696; Email: sebastien.cavalini@chu-martinique.fr
• Study Contact Backup: Name: VERONIQUE ERDUAL; Phone Number: +596 596 553 554; Email: veronique.erdual@chu-martinique.fr

Study Locations

• Martinique
  • France
    • Fort-De-France, France, Martinique, 97261
      • Recruiting
      • Centre Hospitalier Universitaire de Martinique - Hôpital Pierre ZOBDA QUITMAN
      • Contact: SEBASTIEN CAVALINI; Phone Number: +596 596 592 696; Email: sebastien.cavalini@chu-martinique.fr

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes

• Sampling Method: Non-Probability Sample

Study Population

The study population corresponds to the relatives of a person who died by suicide.

The deceased had been living for at least two years in one of the five study territories and information on cause of death information was obtained from potential sources on suicide victims.

Description

Inclusion Criteria:

• Persons close of the deceased
• Persons who knew about his/her childhood
• Age 18 or over
• Interviewed for the study between 2 and 11 months after the suicide

Exclusion Criteria:

• People with neuropsychiatric disorders that may affect the quality of the information collected, cognitive (memory and expression) and judgmental functions
• People who refuses to participate
• Persons referred to articles L.1121-6, L.1121-7, L. 1121-8 L.1121-1-2 of the French Public Health Code.

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
person close to the deceased; Relatives will be invited to participate in two semi-structured research interviews in the form of a storytelling interview with an interviewer. All interviews will be conducted after obtaining the participants' non-objection. The interviews will be recorded and, once transcribed, will be analysed.	Other: other; 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.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Existence 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.	1 month

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
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.	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.	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.	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.	6 month

Collaborators and Investigators

• Sponsor: University Hospital Center of Martinique
• Collaborators: Department for Research, Studies, Evaluation and Statistics, French Health and Social Affairs Ministry, France; French National Institute for Health and Medical Research, MOODS Unit; Clinical research and Innovation Office, Martinique; SOS KRIZ, Martinique; Amiens University Hospital, France; Suicide Prevention Resource Center, French Guiana; Cayenne Hospital Center, French Guiana; University Hospital, La Réunion; Tahiti Hospital Center, French Polynesia; Regional Health Agency, Martinique; Regional Health Agency, French Guiana; Regional Health Agency, La Somme; Regional Health Agency, La Réunion
• Investigators: Principal Investigator: STEPHANE AMADEO, Pr, University hospital, Martinique

Publications and helpful links

General Publications

• Guidère M, Jehel L. (2020) Psycholinguistique et Santé mentale : de l'évaluation à la prévention.Journal of Applied Research in Human & Social Sciences, 2020, 1.
• Hawton K, Appleby L, Platt S, Foster T, Cooper J, Malmberg A, Simkin S. The psychological autopsy approach to studying suicide: a review of methodological issues. J Affect Disord. 1998 Sep;50(2-3):269-76. doi: 10.1016/s0165-0327(98)00033-0.
• First MB, Spitzer RL, Gibbon M, Williams JBW. (1995) The Structured Clinical Interview for DSM-III-R Personality Disorders (SCID-II). Part I: Description. J Personal Disord; 9: 2-16.
• Seguin M, Lesage A, Chawky N, Guy A, Daigle F, Girard G, Turecki G. Suicide cases in New Brunswick from April 2002 to May 2003: the importance of better recognizing substance and mood disorder comorbidity. Can J Psychiatry. 2006 Aug;51(9):581-6. doi: 10.1177/070674370605100906.
• Robert M, Séguin M, O'Connor K. (2010) The evolution of the study of life trajectories in social sciences over the past five years: A state of the art review. Advances in Mental Health, 9(2), 190-205.
• Seguin M, Beauchamp G, Robert M, DiMambro M, Turecki G. Developmental model of suicide trajectories. Br J Psychiatry. 2014 Aug;205(2):120-6. doi: 10.1192/bjp.bp.113.139949. Epub 2014 May 8.

Study record dates

Study Major Dates

• Study Start (Actual): January 25, 2024
• Primary Completion (Estimated): February 1, 2025
• Study Completion (Estimated): April 1, 2025

Study Registration Dates

• First Submitted: March 7, 2023
• First Submitted That Met QC Criteria: March 7, 2023
• First Posted (Actual): March 17, 2023

Study Record Updates

• Last Update Posted (Actual): September 26, 2024
• Last Update Submitted That Met QC Criteria: September 24, 2024
• Last Verified: September 1, 2024

More Information

Terms related to this study

• Keywords: risk factors; epidemiology; Suicide; Psychological autopsies; psycholinguistic approach; French overseas territories
• Additional Relevant MeSH Terms: Behavioral Symptoms; Self-Injurious Behavior; Mental Disorders; Suicide
• Other Study ID Numbers: 22_RIPH3_14; 2022-A02413-40 (Other Identifier: French National Medicines and Health Products safety Agency)

Plan for Individual participant data (IPD)

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

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No