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Molecular Genetics of Suicidal Behavior

Not Applicable
Conditions
Suicidal Behaviour
Interventions
Other: Clinical and neuropsychological assessment, Blood and saliva samples
Registration Number
NCT02858635
Lead Sponsor
University Hospital, Montpellier
Brief Summary

Suicide is a major health problem that causes annually a million death worldwide. In the stress-vulnerability model, suicidal behavior (SB) results from the interaction between an individual's predisposition and stressful condition. According to this model, individuals who carry a suicidal act when subjected to stress factors (environmental stress, depression, substance ...) are those which have a specific vulnerability.These vulnerabilities can be considered as clinical parameters (propensity to despair, aggressive and/or impulsive traits), neurobiological parameters (dysfunction of the serotonergic system, ...) and cognitive parameters (taking disadvantageous decision ...). Suicidal vulnerability is partly underpinned by genetic factors. The interest of current researches is to identify biomarkers that will improve the opportunities for early identification of subject with a risk for SB.

The four goals of this project are in the continuity of previous works team:

1. To determine whether combinations of the main serotonin-related genes may better contribute to the vulnerability to SB, than when they are considered independently.

2. To assess whether the associations between these genes and SB are modulated by childhood trauma, life events and stress response associated with these environmental factors.

3. To test the value of combined clinical, neuropsychological and genetic factor for suicide prevention, in a prospective study, in particularity impulsivity and gene gene interaction.

4. To investigate the association between events in real life (using ecological momentary assessment) and emotional response and suicidal ideation.

The investigators propose to use a multidisciplinary approach to answer these questions and, hence, be able to identify new prevention strategies for SB.

Detailed Description

Transversal study:

1500 patients with a personal history of suicide attempt will be recruited. Clinical, biological and neuropsychological assessments will be performed. The first objective of the study is to replicate the results already obtained regarding the association between serotonergic system genes and suicidal behaviour. The allele frequencies for different markers tested in suicidal and in control subjects with no history of suicidal behaviour will be compared. The patients that will be recruited will be compared to the control population already recruited for another project.

Prospective study: 554 patients hospitalized for a suicide attempt will will be evaluated, each 6 month, during the 2-years period of the study. Clinical, biological and neuropsychological assessments will be performed.

At the end of the inclusion visit, 60 participants will be assessed using ecological momentary assessment(ESM). They will be instructed to carry a smartphone with them for one week, and to record at each alarm signal daily life events, negative emotions, psychological pain, suicidal ideas, and specific attributions to these events. Participants will be signalled five times a day during the period. Subjects will be contacted by telephone halfway through the assessment period to monitor and encourage compliance.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
1982
Inclusion Criteria
  • personal history of suicide attempt
  • French Caucasian Western Europe and specifically have all four grandparents from a country in Western Europe (for genetics purposes)
  • able to understand nature, aims, and methodology oh the study
  • do not emphasize to leave during the time-study.
Exclusion Criteria
  • Pregnancy
  • Not able to speak, read and understand French
  • Patient on protective measures (guardianship or trusteeship)

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Suicide attemptersClinical and neuropsychological assessment, Blood and saliva samplesClinical and neuropsychological assessment. Blood and saliva samples in order to answer objectives study.
Primary Outcome Measures
NameTimeMethod
occurrence of suicide attemptup to 6 months

occurrence of a suicide attempt will be assessed by the Columbia History Form at each visit

Secondary Outcome Measures
NameTimeMethod
number of suicide attempt1 hour

assessed by clinical interview

lethality of suicide attempt1 hour

assessed by Risk-Rescue Rating Scale (RRRS)

psychological pain1 hour

assessed by Likert scale

type of suicide attempt1 hour

assessed by clinical interview

suicidal ideationup to 7 days

suicidal ideation will be assessed by scale for suicidal ideation (SSI) self-assessments (with a smartphone) by Likert scales, 5 times per day during 7 days.

aggressiveness1 hour

assessed by buss durkee hostility inventory (BDHI)

anger1 hour

assessed by State-Trait Anger Expression Inventory (STAXI scale)

Impulsivity1 hour

assessed by barratt impulsiveness scale (BIS scale)

Trial Locations

Locations (1)

University hospital of Montpellier

🇫🇷

Montpellier, France

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