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Suicidal behavior is a major public health issue and there are currently no specific treatments for it.
However, lithium, the reference treatment for bipolar disorder, have been shown to be effective in preventing suicidal risk.
Apart from drug treatments, lithium is present in our environment and its levels varies from one individual to another, depending, especially, on diet.
Knowing that patients with a mood disorder generally have a poor lifestyle and a less rich and varied diet than the general population, variations in basal lithium levels can be expected in these patients.
This study aims to assess the rate of depressed patients (unipolar or bipolar) with basal plasma lithium levels above 0.1 µeq/L.
It also aims to :
To do so, 158 patients currently suffering from a major depressive disorder and who have not received any lithium treatment over the last year, will be included and divided in two groups :
Following a clinical assessment, a blood sample will be collected from each participant to measure basal plasma lithium levels.
Study participation will be done in one day.
The investigators expect :
This knowledge will eventually make it possible to develop prevention and management strategies.
More appropriate prevention and management strategies better adapted to patients at risk of suicide.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Suicide attempters/ideations | Patients currently suffering from a major depressive disorder and reporting at least one suicidal event (suicide attempt or hospitalization for suicidal ideation) over the last 12 months. |
| |
| Affective controls | Patients currently suffering from a major depressive disorder and reporting no suicidal event (suicide attempt or hospitalization for suicidal ideation) over the last 12 months. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Blood sample | Biological | Blood sample for the determination of plasma lithium levels |
|
| Measure | Description | Time Frame |
|---|---|---|
| Patients rate with lithium levels above 0.1 µeq/L | Rate of patients with basal plasma lithium levels, assessed at baseline, above the threshold of 0.1 µeq/L | Baseline |
| Measure | Description | Time Frame |
|---|---|---|
| Basal plasma lithium levels | Basal plasma lithium levels (µeq/L) assessed in all participants at baseline. | Baseline |
| Current suicidal ideation | Severity of current suicidal ideation, assessed with the Columbia Suicide Severity Rating Scale. The ideation severity subscale ranges from 1 to 5 (higher score indicating more severe ideation). The ideation intensity subscale includes 5 questions each ranging from 1 to 5 (higher score indication more intense ideation). The suicidal behavior subscale includes 4 yes/no questions. The suicidal behavior lethality subscale inquires about the level of actual or potential medical damage. |
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Inclusion Criteria:
Exclusion Criteria:
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Patients currently suffering from a major depressive disorder, with ot without a history of suicidal event over the last 12 months, seen in consultation or hospitalization in the Psychiatric Emergencies and Post Acute Care of Montpellier Univeristy Hospital.
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Bénédicte NOBILE, Pharma D, PhD | Contact | +33467338581 | b-nobile@chu-montpellier.fr |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| CHU Montpellier | Recruiting | Montpellier | France |
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| ID | Term |
|---|---|
| D003865 | Depressive Disorder, Major |
| D001714 | Bipolar Disorder |
| D003863 | Depression |
| D013405 | Suicide |
| ID | Term |
|---|---|
| D003866 | Depressive Disorder |
| D019964 | Mood Disorders |
| D001523 | Mental Disorders |
| D000068105 | Bipolar and Related Disorders |
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| ID | Term |
|---|---|
| D001800 | Blood Specimen Collection |
| ID | Term |
|---|---|
| D013048 | Specimen Handling |
| D019411 | Clinical Laboratory Techniques |
| D019937 | Diagnostic Techniques and Procedures |
| D003933 | Diagnosis |
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| Baseline |
| Impulsiveness level | Impulsiveness assessed with the Barratt Impulsiveness Scale (BIS). The total score ranges from 30 to 120 with a higher score indicating an increased impulsive behavior. | Baseline |
| Aggression level | Aggression assessed with the 12 items Aggression Questionnaire (AQ-12). The questionnaire is divided in 4 subscales of 3 items (physical aggression, verbal aggression, anger, hostility) for each, the score ranges from 3 to 18 with a higher score indicating an increased aggressive behavior | Baseline |
| Bipolar disorder characteristics | For patients with bipolar disorder (BD): type of BD, age of onset, rapid cycling over lifetime, number of manic/hypomanic/depressive episodes over lifetime and the last year. | Baseline |
| Emotional lability | Emotional lability assessed with the Affective Lability Scale (ALS). The questionnaire is divided in 3 subscales (anxiety/depression, depression/elation and anger). For each subscale, higher score indicates an increased affective lability. | Baseline |
| Suicide attempt characteristics | For patients with a suicide attempt in the year prior to inclusion : number of actual, aborted and interrupted suicide attempts, number of violent and serious attempts. | Baseline |
| D001526 |
| Behavioral Symptoms |
| D001519 | Behavior |
| D016728 | Self-Injurious Behavior |
| D011677 | Punctures |
| D013514 | Surgical Procedures, Operative |
| D008919 | Investigative Techniques |