RESUMEN

Nearly 5% of the general population experiences a suicidal crisis every year in France. It is essential for any caregiver to learn to recognize it and intervene appropriately. This crisis most often occurs in a context of stress combined with individual vulnerability factors that causes the individual to lose their balance. The clinical presentation for suicidal crisis vary from one subject to another. It is usually fluctuating and temporary. The subject does not want to die; he wants to stop suffering. The suicidal act is the dreaded but not systematic outcome of the suicidal crisis. Here we will set out the general principles of the assessment of the suicidal crisis.

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RESUMEN

In the vast majority of cases, people who commit suicide do so alone. Exceptionally, suicides can be carried out by mutual agreement between two or more people. These are called suicide pacts. The motivations and operating methods of these rare acts are multiple.

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RESUMEN

Background: Preceding suicide attempts strongly predict future suicidal acts. However, whether attempting suicide per se increases the risk remains undetermined. We longitudinally investigated among patients with mood disorders whether after a suicide attempt future attempts occur during milder depressive states, indicating a possible lowered threshold for acting. Methods: We used 5-year follow-up data from 581 patients of the Jorvi Bipolar Study, Vantaa Depression Study, and Vantaa Primary Care Depression Study cohorts. Lifetime suicide attempts were investigated at baseline and during the follow-up. At follow-up interviews, life-chart data on the course of the mood disorder were generated and suicide attempts timed. By using individual-level data and multilevel modeling, we investigated at each incident attempt the association between the lifetime ordinal number of the attempt and the major depressive episode (MDE) status (full MDE, partial remission, or remission). Results: A total of 197 suicide attempts occurred among 90 patients, most during MDEs. When the dependencies between observations and individual liabilities were modeled, no association was found between the number of past suicide attempts at the time of each attempt and partial remissions. No association between adjusted inter-suicide attempt times and the number of past attempts emerged during follow-up. No indication for direct risk-increasing effects was found. Conclusion: Among mood disorder patients, repeated suicide attempts do not tend to occur during milder depressive states than in the preceding attempts. Previous suicide attempts may indicate underlying diathesis, future risk being principally set by the course of the disorder itself.

RESUMEN

Nonsuicidal self-injury (NSSI) and suicidal behaviour (SB) are both important issues in adolescent health care. The fact that they frequently coexist means that it is important to consider the nature of the link between them and the ways they are understood. Suicide and self-injury share the same risk factors. Integrated models envisage NSSI as a gateway enabling teenagers to acquire a capability for suicide. The act short-circuits the thought process and the intention to die underlying the act appears difficult to assess.

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RESUMEN

Migration is an experience with a creative and dynamic potential, but it can also serve to further isolate people. Migrant adolescents and ethnic minorities with a migrant background are particularly vulnerable to suicidal ideation and suicidal behaviour. International studies show a significant prevalence of suicide attempts among migrants and their children. Intergenerational conflicts and the family environment, for example poor communication and lack of parental support, are risk factors for suicidal behaviour in migrant adolescents. The valorisation of the culture of origin could contribute to the feeling of 'cultural continuity' which is a protective factor of the suicidal risk.

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