View clinical trials related to Suicidal.
Filter by:The study is a randomized trial comparing outcomes of active duty service members who present to the emergency department at risk for suicide and receive care from providers trained in crisis response planning versus those providing treatment as usual.
Suicide is a major public health problem. About 9,000 suicides per year are retrieved by year in France. Between 15,000 and 20,0000 suicide attempts give rise to contact with the healthcare system. Among young people aged 15 to 24 years old, suicide is the second main cause of death. In this way, suicide among adolescents is a major public health priority, due to its seriousness, its frequency, and its potentially preventable nature. The severity of suicide risk can be assessed by different scales, and the Columbia-Suicide Severity Rating Scale (C-SSRS) is the most widely used in the international literature for adolescents, assessing four dimensions: suicidal ideation, severity of ideation, suicidal behavior and lethality. The measurement of the seriousness of the suicide risk is therefore defined as the measurement of the importance of the direct and indirect negative consequences associated with this risk. It can be catch up in the four factors mentioned above. Anxiety is one of the central pillars influencing the suicidal risk of adolescents. Very few studies have identified operationalizable and generalizable risk factors for anxiety. However, in adolescents, one of the risk factors for anxiety seems particularly important, because it is a factor that is both generic (i.e., it can be found in different profiles of adolescents), related to the projection in the future (which characterizes this population), and relatively specific to this age group, while being operational through validated questionnaires. This important risk factor is the eco-anxiety, which corresponds to anxiety related to climate change. The theme of climate change is certainly a central social issue, but also an important public health issue. First, climate change raises direct risks to human health, and indirectly some risks for mental health. For instance, the direct consequences of a drought or natural disaster can cause material hardship that impacts indirectly mental health (Thoma et al., 2021). Secondly, climate change can also raise direct risk for mental health, and especially the eco-anxiety which is not the consequence of a direct risk from the environment on an individual, but rather constitutes mental distress related to the fear of such changes. Eco-anxiety can be identified and measured in a valid and reliable way thanks to a scale used in the international literature, the "Climate Anxiety Scale" (CAS), which was validated in 2020 with 22 items with 4 factors by Clayton and Karazsia (Clayton and Karazsia, 2020), and translated and validated in French in 2022 by Mouguiama-Daouda (Mouguiama-Daouda et al., 2022), retaining as the most appropriate model the version with the first 13 items. This scale is suitable for adolescents from the age of 12 years old. This 13-item scale is composed of two subscales that assess cognitive and emotional difficulties in response to climate change and functional impairment. Two subscales are added to this 13-item scale (and thus are part of the 22-item CAS also validated), which assess 1) direct or indirect personal experience of climate change, and 2) behavioral commitment and the tendency to deploy adaptive behavioral responses to climate change. The literature reports a correlation between eco-anxiety and depression (Mouguiama-Daouda et al., 2022). Indeed, depressive symptoms can influence how people worry about climate change. The correlation between eco-anxiety and anxiety is variable in the literature and has been studied using questionnaires focusing on generalized anxiety (Mouguiama-Daouda et al., 2022). Higher suicide rates have certainly been shown in populations affected by climate change (Dumont et al., 2020), related to the direct consequences of climate change, e.g., due to pollution, increased temperature or drought. However, to the knowledge of the investigators and despite the major public health impact in adolescents, no study has investigated the relationships between eco-anxiety and the severity of suicide risk. This study therefore seeks to examine the association between eco-anxiety in adolescents, assessed using the French version of the CAS, and the severity of suicide risk, assessed using the French version of the C-SSRS. We hypothesize that there would be a relationship between eco-anxiety and the severity of suicide risk in adolescents. Such results would allow both to refine the understanding of the risk of suicide, in its relationship with a central theme of society and public health, and to better identify and prevent behaviors at risk of suicide among adolescents.
There is still no consensus on how to manage suicidal behavior in youth with recurrent self-harm at times when the risk for suicide is imminent (1). Brief Admission (BA) has evolved as a promising crisis intervention for adults with self-harm (2). The characteristics of BA is different from other types of admission, being focused on prevention through increased autonomy and self-care, based on structured and voluntary brief self-referrals to hospital (3). As a result of a randomized controlled trial, BA is since January 2019, continuously offered to adults with self-harm at risk for suicide in Skåne (4). Parallel to this clinical trial, the method has been adapted to work in a psychiatric setting for adolescents. At present 24 adolescents have access to the method in Skåne. Clinical experiences from staff are promising, however, the lived experiences have not been collected in a standardized way. The aim of the present study is to gather information on how BA in its present, standardized form works for adolescents, their loved ones and staff working at the ward providing BA. This will be done through semi-structured interviews with: 1. Adolescents using BA and their loved ones 2. Staff working at the ward providing BA. Data will be analyzed with qualitative analysis (5, 6). The ultimate aim is to use these results to optimize the current standardized version of BA for adolescents in order to test in a randomized clinical trial.
Open enrollment study to collect data for the optimization of machine learning models for use in an app for the early detection of mental health and suicidal risk.