ObjectiveFew studies on elders’ suicide and depression have integrated social and community factors in their explicative models. Most of the studied variables used are focused on individual and based on psychopathological models. The purpose of this study is to investigate the impact of socio-environmental factors on death ideations, using data from the European SHARE cohort.MethodSocial support components and death ideations have been studied, together with known individual risk factors, within a sample of 11,425 European participants in the SHARE study, aged over 64. The item evaluating death ideations was extracted from the EURO-D12 questionnaire.ResultsThe high prevalence of death ideations (6.9% for men and 13.0% for women) confirmed that elders’ death ideations, as it is known to be linked to suicidal behaviors, is a major public health issue. Bivariate analyses revealed a strong association between community participation and death ideations. This association was no longer significant while adjusting for depressive symptomatology. The logistic model identified that factors significantly associated with death ideations, when adjusted for the other factors were: having multiple depressive symptoms (OR = 1.64 per symptom) being aged, especially over 84 (OR = 1.58), being retired for fewer than five years (OR = 1.46), being widowed (OR = 1.35) and having a long-term illness (OR = 1.28).ConclusionsAlthough social and community participation is associated to death ideations, this link becomes non-significant in a regression model taking into account other factors. It is important to notice that depressive symptoms, which are obviously closely related to death ideations, take the greatest part in the association among all associated factors. Our results suggest that, consistently with the literature, while addressing death ideation or suicide prevention, professionals have to consider first the secondary prevention of depressive symptomatology. Strategies targeting social isolation and community participation should be considered as part of primary prevention policies.
BackgroundPsychological distress (PD) in students is under-investigated, since its prevalence can be high in certain subgroups of students and it has been seen to be associated with other mental health issues and academic achievement. In a sample of French college students, this study investigated factors associated with PD, and looked more closely at the impact of social and interpersonal variables.MethodsData were extracted from the 2010 French “National Health Barometer”. 946 students were interviewed. Mental health was assessed using the MH-5 five-item scale.ResultsThe PD rate in this sample was 13.8% (7.2% in males, 19.5% in females). Low income, nonsexual assault in the last 12 months, studying law and low social participation were associated with PD in multivariate analyses.ConclusionsFrench students show specific characteristics that are discussed in order to explain the relatively low rate of PD observed. The impact of loneliness and social isolation are a major focus for preventive policies based on community resources and early detection of the symptoms of PD.
BackgroundSeveral studies suggest that the number of risk factors rather than their nature is key to mental health disorders in childhood.Method and designThe objective of this multicentre randomized controlled parallel trial (PROBE methodology) is to assess the impact in a multi-risk French urban sample of a home-visiting program targeting child mental health and its major determinants. This paper describes the protocol of this study. In the study, pregnant women were eligible if they were: living in the intervention area; able to speak French, less than 26 years old; having their first child; less than 27 weeks of amenorrhea; and if at least one of the following criteria were true: less than twelve years of education, intending to bring up their child without the presence of the child’s father, and 3) low income. Participants were randomized into either the intervention or the control group. All had access to usual care in mother-child centres and community mental health services free of charge in every neighbourhood. Psychologists conducted all home visits, which were planned on a weekly basis from the 7th month of pregnancy and progressively decreasing in frequency until the child’s second birthday. Principle outcome measures included child mental health at 24 months and two major mediating variables for infant mental health: postnatal maternal depression and the quality of the caring environment. A total of 440 families were recruited, of which a subsample of 120 families received specific attachment and caregiver behaviour assessment. Assessment was conducted by an independent assessment team during home visits and, for the attachment study, in a specifically created Attachment Assessment laboratory.DiscussionThe CAPEDP study is the first large-scale randomised, controlled infant mental health promotion programme to take place in France. A major specificity of the program was that all home visits were conducted by specifically trained, supervised psychologists rather than nurses. Significant challenges included designing a mental health promotion programme targeting vulnerable families within one of the most generous but little assessed health and social care systems in the Western World.Trial registrationCurrent Clinical trial number is NCT00392847.
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