Protective Factors Against Elderly Suicide

Suicide, Attempted Clinical Trial

— ProFAES  

Official title:

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

Clinical Trial Details — Status: Terminated

Administrative data

• NCT number: NCT03162744
• Other study ID #: 2015/P08/079
• Status: Terminated
• Start date: February 16, 2018
• Est. completion date: May 27, 2019

Study information

• Verified date: July 2019
• Source: Groupe Hospitalier de la Rochelle Ré Aunis
• Contact: n/a
• Is FDA regulated: No
• Study type: Observational

Clinical Trial Summary

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.

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.

Recruitment information / eligibility

• Status: Terminated
• Enrollment: 15
• Est. completion date: May 27, 2019
• Est. primary completion date: February 16, 2019
• Accepts healthy volunteers: No
• Gender: All
• Age group: 65 Years and older

Eligibility

Inclusion Criteria:

• Attempted suicide and / or suicidal ideas

• Informed and agreed to participate

Exclusion Criteria:

• Cognitive disorders

• Refusal to participate

Related Conditions & MeSH terms

• Suicide
• Suicide Gesture
• Suicide, Attempted

Intervention

Behavioral:
• Post-suicidal crisis interview
Protective factor exploration during post-suicidal crisis interview

Locations

Country	Name	City	State
France	Groupe Hospitalier de la Rochelle Ré Aunis	La Rochelle

Sponsors (1)

Lead Sponsor	Collaborator
Groupe Hospitalier de la Rochelle Ré Aunis

Country where clinical trial is conducted

France, 

References & Publications (3)

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. — View Citation

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. Review. — View Citation

Richard-Devantoy S, Jollant F. [Suicide in the elderly: age-related specificities?]. Sante Ment Que. 2012 Autumn;37(2):151-73. French. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	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	Number of patients considering themselves to be in good health	Score > 0 at Health Status questionnaire (SF36) item 1	7 days
Secondary	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
Secondary	Number of patients maintaining autonomy	Score = 0 at Instrumental Activities of Daily Living scale	7 days
Secondary	Number of patients with religious practice	Binary answer from patients (yes/no I have a religious practice)	7 days
Secondary	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
Secondary	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
Secondary	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
Secondary	Number of patients with social protection factors	Easy access to Health facilities, sufficient financial income	7 days
Secondary	Number of patients able to adapt to difficult situations	score = 12 at Neo Personality Inventory vulnerability item	7 days
Secondary	Number of patients with extraversion capabilities	score = 20 at Neo Personality Inventory extraversion item	7 days
Secondary	Number of patients with openness to others	score = 20 at Neo Personality Inventory Openness to feelings item	7 days
Secondary	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

External Links

•   Epidemiology of suicide in France