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To evaluate the impact of a specific nursing management (personalized and close, through consultation at the hospital, at home or by phone) monitoring in post-hospitalization, the suicide attempt of recurrence and suicidal crisis, in the year following a suicide attempt in patients suffering from a mood disorder (unipolar or bipolar) or reactive depression.
Main objective: To evaluate the impact of a specific nursing management (personalized and close, through consultation at the hospital, at home or by phone) monitoring in post-hospitalization, the suicide attempt of recurrence and suicidal crisis, in the year following a suicide attempt in patients suffering from a mood disorder (unipolar or bipolar) or reactive depression.
Secondary objectives:
Studying during the year following the suicide attempt index, the impact of this device on:
Studying patient compliance with intensive nursing monitoring program.
To study the role of the nurse to determine the factors that promote the construction of a therapeutic alliance.
Establish a mapping of needs and resources suicidal patient for nursing care in post-emergency.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Supported with intensive nursing follow | Experimental | Supported with intensive nursing follow post hospitalization the team of hospital output of the unit to 12 weeks after discharge. These interviews will be conducted at the hospital, at home or by phone and their pace will be adjusted according to the patient's condition. The expected duration of close outpatient follow-up is of maximum 3 months. |
|
| usual care | No Intervention | For control patients, monitoring will be identical to their usual care as part of their pathology. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Supported with intensive nursing follow post hospitalization | Other | Intensive nursing follow post - hospitalization |
|
| Measure | Description | Time Frame |
|---|---|---|
| Composite suicidal outcome including suicidal attempt recurrence or hospitalization for suicidal crisis or worsening of suicidal ideation | Composite endpoint including any of the following events:
| 12 months from EPAC (Emergency Psychiatry and Acute Care) discharge |
| Measure | Description | Time Frame |
|---|---|---|
| Suicide attempt recurrence | Occurrence of at least one suicide attempt, defined as medically documented or self-reported attempt or death by suicide | 12 months from EPAC discharge |
| Emergency hospitalization for suicidal crisis without attempt |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Grégory Mykolow | University Hospital, Montpellier | Principal Investigator |
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| ID | Term |
|---|---|
| D019964 | Mood Disorders |
| D000275 | Adjustment Disorders |
| ID | Term |
|---|---|
| D001523 | Mental Disorders |
| D000068099 | Trauma and Stressor Related Disorders |
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| ID | Term |
|---|---|
| D010166 | Palliative Care |
| ID | Term |
|---|---|
| D005791 | Patient Care |
| D013812 | Therapeutics |
| D006296 | Health Services |
| D005159 | Health Care Facilities Workforce and Services |
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Occurrence of at least one emergency hospitalization for suicidal crisis, defined as persistent and high-intensity suicidal ideations
| 12 months from EPAC discharge |
| Worsening of suicidal ideations | Increase ≥2 points on the C-SSRS severity score compared with EPAC discharge | 3 months, 6 months and 12 months after EPAC discharge |
| Frequency of suicidal ideation | Frequency of suicidal ideation measured with the C-SSRS (Columbia-Suicide Severity Rating Scale). | At inclusion, at EPAC discharge, and at 3 months, 6 months and12 months after EPAC discharge |
| Intensity of suicidal ideation | Intensity of suicidal ideation measured with the C-SSRS (Columbia-Suicide Severity Rating Scale). | At inclusion, at EPAC discharge, and at 3 months, 6 months and 12 months after EPAC discharge |
| Psychological pain | Psychological pain measured with Visual Analog Scale (VAS) | At inclusion, at EPAC discharge, and at 3 months, 6 months and 12 months after EPAC discharge |
| Number of unscheduled healthcare visits for suicidal ideation | At 3 months, 6 months and12 months after EPAC discharge |
| All-cause mortality and mortality by suicide | At 3 months, 6 months and12 months after EPAC discharge |
| Total duration of psychiatric hospitalization during the year following the suicide attempt | At 3 months, 6 months and12 months after EPAC discharge |
| Number of participants lost to follow-up at the end of the study | At 12 months after EPAC discharge |
| Patient quality of life | At inclusion, at 3 months, 6 months and12 months after EPAC discharge |
| Adherence to the therapeutic program proposed and/or prescribed in the service. | 12 months after EPAC discharge |