Analysis of Suicidal Behavior Among Children and Adolescents in the Auvergne-Rhone-Alpes Region During the Covid 19 Pandemic Period

Official title

Clinical and Socioeconomic Characteristics of Suicidal Behaviour in Children and Adolescents During the Covid19 Pandemic Period in Auvergne-Rhône-Alpes. Prospective Quantitative and Qualitative Study

Overview

In 2020, the world is hit by a global health crisis due to a pandemic following the appearance of Sars-cov-2 or "covid-19". This pandemic was accompanied by a constant fear of contamination and death, relayed by the media. In France, the government proposed in response to the arrival of this virus on French territory. This policy was implemented in different ways over 3 distinct periods: strict containment at the start of the epidemic, then a "lighter" one, and finally a period of social restrictions without between these periods. This policy had a direct and rapid impact on the population's daily routines. Children and adolescents, are more susceptible to psychological trauma, as stress has a direct and psychic development. Studies have shown deleterious impact of the French health situation on the paediatric population. They point to an increase of psychological disorders such as depression and anxiety in the under -20s population, and an increase in suicidal gestures over the 2020-2021 period, with rates remaining higher than in previous years. Suicide is the 2nd leading cause of death in the population aged 15-24. Studies continue to focus on the incidence of suicidal gestures of suicidal gestures and psychological disorders, and few of them examine the factors linked to the increase in these incidences, the traumatic impact or the story of the trajectory. Similarly, the few studies focus only on the population aged 12 and over, and in some cases, do not distinguish between age groups (15-24 or under 20). Investigators believe that the various periods of social restrictions and eco-anxiety caused by the pandemic may have influenced suicidal behaviour in this population. The main objective of this study is to investigate the clinical and socio-economic characteristics of the pediatric population who experienced suicidal behaviors in the Auvergne Rhone Alpes region during the covid 19 pandemic.

Interventions

• Other Aggregated data collection
  The demographic and diagnostic characteristics will be collected in aggregate form nafrom digital services departments or medical information departments of participating hospitals.
• Other Data collection and qualitative interview
  The psychopathological and socioeconomic characteristics will be collected. For subjects who agreed, they will participate in interviews and/or focus groups. Parent's subjects who agreed will be part of focus groups too.

Primary outcome measures

• Demographic and diagnostic characteristics [Time frame: Baseline]

Secondary outcome measures (6)

• Number of patients aged 8-17 and 11month admitted to pediatric emergency [Time frame: Baseline]
• Psychopathological and socio-economic characteristics [Time frame: Baseline]
• Scores to CRIES [Time frame: Up to 3 months]
• CAS scale [Time frame: Up to 3 months]
• Qualitative interview [Time frame: Up to 3 months]
• Results to focus groups (parent's subjects, group 1b) [Time frame: Up to 3 months]

Eligibility criteria

Inclusion criteria

• The population (subjects and controls) will be divided into age categories:

• Pre-adolescents (≥ 8 years and < 11 years)
• Adolescents (≥ 11 years and < 15 years)
• Older adolescents (≥ 15 years and < 18 years)

Subjects with suicidal behavior during the health crisis (Group 1):

• Age > 8 years and < 18 years during the period 2020 to 2022.
• Admitted to pediatric emergency departments or hospitalized in a care unit (CHU, general hospitals) in the AURA region during 2020, 2021, and/or 2022 for suicidal behavior (defined as suicidal ideation and/or suicide attempt and/or self-harm/self-poisoning with suicidal intent).

Subjects with suicidal behavior during the health crisis with qualitative interviews (Group 1b):

• Age > 8 years and < 18 years during the period 2020 to 2022.
• Admitted to pediatric emergency departments or hospitalized in a care unit (CHU, general hospitals) in the AURA region during 2020, 2021, and/or 2022 for suicidal behavior (defined as suicidal ideation and/or suicide attempt and/or self-harm/self-poisoning with suicidal intent).
• Randomly selected from the population of Group 1.
• For whom the parent(s) and/or the subject have signed informed consent.

Controls with suicidal behavior before the health crisis (Group 2):

• Age > 8 years and < 18 years during the period 2018 to 2019.
• Admitted to pediatric emergency departments or hospitalized in a care unit (CHU, general hospitals) in the AURA region during 2018 and/or 2019 for suicidal behavior (defined as suicidal ideation and/or suicide attempt and/or self-harm/self-poisoning with suicidal intent).

Exclusion criteria

\- Subjects with Suicidal Behavior during the Health Crisis with and without Qualitative Interviews (Group 1 and 1b):

• Admitted to pediatric emergency services or hospitalized in a healthcare facility (university hospital center, general hospital) in the AURA region for a psychiatric reason other than suicidal behavior during the period from 2020 to 2022.

Controls with Suicidal Behavior before the Health Crisis (Group 2):

• Admitted to pediatric emergency services or hospitalized in a healthcare facility (university hospital center, general hospital) in the AURA region for a psychiatric reason other than suicidal behavior during the period from 2018 to 2019.
• Intercurrent illness with a life expectancy of less than 24 hours.

For Group 1:

• Pregnant, postpartum, or breastfeeding women.
• Persons deprived of liberty by judicial or administrative decision.
• Adults subject to a legal protection measure (guardianship, curatorship).
• Persons not affiliated with a social security scheme or beneficiaries of a similar scheme.
• Persons who do not understand and do not speak French.

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Allocation

Non-randomized

Model

Single group

Masking

Open label

Primary purpose

Health services research

Study locations

France · 4 centers

• Hospices Civils de Lyon - Hôpital Femme Mère Enfant- Service de pédopsychiatrie de l'enfan — Bron
• CHU de Clermont-Ferrand - Service de psychiatrie de l'enfant et de l'adolescent — Clermont-Ferrand
• CHU de Grenoble - Service de psychiatrie de l'enfant et de l'adolescent — Grenoble
• CHU de Saint-Etienne - Urgences psychiatriques — Saint-Etienne

Identifiers

NCT: NCT07302295 · 69HCL22_1175 · 2023-A02237-38

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗