Investigating Predictive Factors of Suicidal Re-attempts in Adolescents and Young Adults After a First Suicide Attempt, a Prospective Cohort Study. Study Protocol of the SURAYA Project

Abstract

IntroductionSuicide is the fourth leading cause of death in youth. Previous suicide attempts are among the strongest predictors of future suicide re-attempt. However, the lack of data and understanding of suicidal re-attempt behaviors in this population makes suicide risk assessment complex and challenging in clinical practice. The primary objective of this study is to determine the rate of suicide re-attempts in youth admitted to the emergency department after a first suicide attempt. The secondary objectives are to explore the clinical, socio-demographic, and biological risk factors that may be associated with re-attempted suicide in adolescents and young adults.MethodsWe have developed a single-center prospective and naturalistic study that will follow a cohort of 200 young people aged 16 to 25 years admitted for a first suicide attempt to the emergency department of Lyon, France. The primary outcome measure will be the incidence rate of new suicide attempts during 3 months of follow-up. Secondary outcomes to investigate predictors of suicide attempts will include several socio-demographic, clinical and biological assessments: blood and hair cortisol levels, plasma pro- and mature Brain-Derived Neurotrophic Factor (BDNF) isoforms proportion, previous infection with toxoplasma gondii, and C-Reactive Protein (CRP), orosomucoid, fibrinogen, interleukin (IL)-6 inflammatory markers.DiscussionTo our knowledge, the present study is the first prospective study specifically designed to assess the risk of re-attempting suicide and to investigate the multidimensional predictive factors associated with re-attempting suicide in youth after a first suicide attempt. The results of this study will provide a unique opportunity to better understand whether youth are an at-risk group for suicide re-attempts, and will help us identify predictive factors of suicide re-attempt risk that could be translated into clinical settings to improve psychiatric care in this population.Clinical Trial RegistrationClinicalTrials.gov, identifier: NCT03538197, first registered on 05/29/2018. The first patient was enrolled 05/22/2018.

The Impact of the COVID-19 Pandemic on Self-Harm Attempts Observed in a Hospital Emergency Department

“…No correlation was identified between relationship status and drug use across the two periods under study, although such a relationship is evident in the context of psychiatric history and treatment. Current evidence suggests that confinement in isolation and uncertainty can have negative consequences, leading to an increase in mental health problems such as anxiety and depression [9,11,19,20,25]. In contrast, a study conducted in the Czech Republic found that the happiness and quality of life of individuals during the peak of the pandemic was higher than that measured one year before the pandemic.…”

“…Presently, there are concerns about estimating the impact of the COVID-19 pandemic on the mental health of the population [10,11,22]. The COVID-19 pandemic has had a severe impact on the mental health of the population.…”

“…A positive correlation exists between social isolation and suicide, with social support being deemed a protective factor [12]. Suicidal actions are often triggered in crisis situations, such as financial hardships, familial disputes, chronic diseases, romantic separations, bereavement, or instances of abuse [11]. Contrary to expectations, a study has shown that educational attainment is not an effective means of equipping individuals with life skills [13].…”

“…Studies have shown that the risk of suicide escalates in the six months following a self-harm attempt, with the initial month being the most critical. Consequently, it is imperative to provide post-discharge follow-up care to avert future attempts [10,11]. This underscores the necessity to highlight the significance of prevention and promotion, a requirement for programs that educate about emotional health, and the availability of therapeutic tools that can deter short-term suicide attempts and prevent the loss of numerous lives in the long term [5].…”

“…Research has indicated a 25% surge in instances of depression and anxiety during the pandemic's initial year [1]. However, there is a paucity of research investigating whether this increase has precipitated a rise in suicide attempts [5,11,19,29]. Consequently, this study's primary objective is to delineate and contrast cases of attempted suicide and their attributes pre-and post-COVID-19 pandemic within a tertiary hospital's emergency department.…”