[Ten-year psychosocial outcome of 29 adolescent suicide-attempters].

OBJECTIVES: This study investigates the psychosocial outcome of adolescents admitted to the Nancy University Children's Hospital between the 1st January 1996 and 31st December 1996 following a suicide attempt, and the influence that the initial characteristics (personal, familial and social) of these patients can have on their long-term outcome. Defining prognostic factors for a long-term negative outcome in young suicide-attempters will enable us to focus our therapeutic approach on long-term prevention, as opposed to simple crisis management.

METHODS: Longitudinal study conducted in 2006 on the basis of self-questionnaires distributed to former patients and their parents. The self-questionnaires consisted of 39 questions: 22 questions requiring yes/no answers and 12 open questions, 11 of which required a quantitative or objective answer (for example, level of education, number of cigarettes consumed, etc.), and one of which required a subjective answer (concerning perceived improvements in care received), and five satisfaction scales graded from 1 to 10 for the different parameters considered, on which responders were asked to make a cross. The questions were grouped into three main categories: family life, professional status and education, and finally physical and mental health. Patients were also asked to answer a second self-questionnaire, the Center for Epidemiologic Studies-Depression scale (CES-D), which provides an objective assessment of psychological well-being. Composed of 20 items (16 presented in negative form and four in positive form), this test measures the frequency of symptoms experienced in the past week. Symptom frequency is graded from 0 to 3; possible scores therefore range from 0 to 60. In France for adults, the depression threshold is considered to be 17 in men and 23 in women. The data collected from the different self-questionnaires was then cross-matched with the personal, familial and social characteristics recorded in the former patients' medical and social case notes, taken at the time of their suicide attempt in 1996.

RESULTS: It was possible to trace 67.2% of the former patients and 67.4% of these answered the questionnaires, i.e. 45.3% of the initial population. The psychosocial outcome of the former patients in our study was quite encouraging, with over three quarters of former suicide-attempters stating they were happy in their personal lives, and more than half of the 65.5% actually working considering themselves to be satisfied or very satisfied with their professional lives. In addition, 66.7% of responders did not report any particular psychiatric problem. However, one patient completed suicide in the course of 1996. 17.2% of the former patients responding to the questionnaire reported a chronic psychiatric condition, sometimes accompanied by repeated suicide attempts, and 13.8% situated themselves somewhere in between. Learning difficulties and falling behind at school were evidenced as risk factors for recurrence, and personal psychiatric antecedents were evidenced as factors for poor psychosocial outcome. However, other factors, such as personal suicide attempt antecedents, were not evidenced as risk factors for poor psychosocial outcome.

CONCLUSION: The psychosocial outcome of the former patients in our study was quite encouraging. Suicide-attempters who relapsed, those who had had more school difficulties, and those who experienced a less favourable ten-year psychosocial outcome, had more personal psychiatric antecedents.