Positive Psychology in Suicidal Patients (POPS)

Suicide is a major health concern. Weeks following psychiatric admission are a highly suicide risk period for those having current suicidal ideation or attempt. Recently, a pilot study suggested the feasibility of positive psychology in patients in suicidal crisis. Notably, gratitude exercises suggested improvement in optimism and hopelessness, two dimensions associated to suicide. Moreover, gratitude has been associated to suicidal ideation and attempt, independently from depression. Thus, investigators want to conduct the first randomized controlled study in order to assess effectiveness of gratitude exercises (vs control task) in suicidal inpatients, on 1) psychological pain reduction 2) suicidal ideation, hopelessness, optimism, depressive symptomatology, and anxiety improvement.

Study design: monocentric randomized controlled study Methods: 206 inpatients (Department of Emergency Psychiatry and Post Acute Care), between 18 and 65 years-old, having attempted suicide before hospitalisation or having current active suicidal ideation at the time of the psychiatric hospitalisation. Patients suffering from schizophrenia are excluded. Randomization into two groups: Positive Psychology (i.e., gratitude journal) (n = 103) or Control Task (i.e., food journal) (n = 103), daily exercises during 7 days (in add-on from usual treatment). Clinical assessment: 1) at baseline (the day before the intervention beginning) (V0); 2) short daily self-assessments (immediately before and after the exercise); 3) the day following the last day of the intervention (V1). V0 : socio-demographic data, treatments, psychopathology, suicidal ideation,depressive and anxious symptomatology, psychological pain, optimism, hopelessness. Daily self-assessments: psychological pain, optimism, hopelessness V1 : treatments suicidal ideation,depressive and anxious symptomatology, psychological pain, optimism, hopelessness, intervention satisfaction.

Gratitude Journal (Emmons and Stern, 2013) Every evening, patients have to write down the things they feel grateful about.

Food journal (i.e. alimentary list): Patients have to write down the list of foods eaten during the day.

Psychological pain reduction, in gratitude vs control group, between the beginning and the end of the intervention, using a likert scale.

Psychological pain reduction, in gratitude vs control group, the beginning and the end of each exercise, using a likert scale.

Reduction of suicidal ideation intensity, in gratitude vs control group between the beginning and the end of the intervention using a Likert Scale and the Scale for Suicidal Ideation (SSI).

Reduction of hopelessness, in gratitude vs control group between the beginning and the end of the intervention, using a Likert Scale and the Beck Hopelessness Scale (BHS).

Reduction of hopelessness, in gratitude vs control group between the beginning and the end of the intervention, using a Likert Scale and the Life Orientation Test-Revised (LOT-R).

Reduction of depressive symptoms between the beginning and the end of the intervention, using the Beck Depression Inventory (BDI)

Reduction of anxious symptoms between the beginning and the end of the intervention, using the State Anxiety Inventory- State (SAI-State)

Reduction of suicidal ideation intensity, in gratitude vs control group between the beginning and the end of each exercise, using a Likert Scale.

Reduction of hopelessness, in gratitude vs control group between the beginning and the end of each exercise, using a Likert Scale.

Reduction of hopelessness, in gratitude vs control group between the beginning and the end of each exercise, using a Likert Scale.

Inclusion criteria: Being hospitalized for suicidal thoughts or suicide attempt (from less than a week) Having signed informed consent Be fluent in French Able to understand nature, aims and methodology of the study Exclusion criteria: Lifetime history of schizophrenia according to the Diagnostic and Statistical Manual of Mental Disorders - V (DSM-V) criteria Current eating disorder according to DSM-V criteria Patient on protective measures (guardianship or trusteeship) Deprived of liberty subject (judicial or administrative decision)