Loneliness and Occurrence of Suicide Attempts and Suicidal Ideas (SOLSTIS)

Suicide is a major health problem that causes annually a million death worldwide. Loneliness is known to be associated with suicidal ideation in minors and to be related with suicidal risk in elderly people. However little is known about this association in a middle-aged population. Loneliness is a modifiable factor with suitable psychotherapeutic measures, it is essential to improve the scientific and medical knowledge about the link between this feeling and suicide risk in a population of depressed patients in middle age. The main objective is the study of the relationship between loneliness and the occurrence of suicidal behavior (SB) in major depressed adult population over 12 months. The secondary objectives are: Identification of risk factors (clinical, neuropsychological and biological) of the occurrence of SB within a clinical population and their interaction; Identification of predictive factors (clinical, neuropsychological, biological) therapeutic response to antidepressant in the context of depression.

This project is based on clinical, neuropsychological and biological data routinely collected in the Department of Emergency Psychiatry and Post Acute Care. This is a one year follow-up prospective study. Over three years, 600 depressed patients will be recruited. First visit (inclusion): clinical, biological and neuropsychological assessment Follow up visits (3, 6 and 12 months): clinical assessment only

frequency of suicide attempts during the 12 months follow-up depending on the intensity of the feeling of loneliness evaluated by the loneliness scale of the University of Laval (ESUL)

comorbid psychiatric disorders of Axis I assessed by the Mini International Neuropsychiatric Interview (MINI)

intensity of the depression assessed by the physician with the Inventory of Depressive Symptomatology, clinician rating (IDSC-30) and with the Montgomery-Asberg depression rating scale (MADRS) and assessed by the patient with the Beck Depression Inventory (BDI) scale.

Features of SB (number and methods of suicide attempts, nature of the precipitating factor, motivation, lethality, level of impulsiveness or premeditation) by the Columbia-Suicide Severity Rating Scale (CSSRS), the Risk Rescue Rating Scale (RRRS) and the Suicidal Intent Scales (SIS).

levels of thyroid-stimulating hormone (TSH), triiodothyronine(T3), and thyroxine(T4) in a blood sample collected at inclusion

Inclusion criteria: Main diagnosis of major depressive disorder according to Diagnostic and Statistical Manual of Mental DisordersIV (DSM IV) Having signed informed consent Able to understand nature, aims, and methodology oh the study Exclusion criteria: Participation in another clinical trial Patient on protective measures (guardianship or trusteeship)