Associated Psychiatric Disorders in Children Hospitalized for a Serious Suicide Attempt
NCT ID: NCT05450354
Last Updated: 2025-09-12
Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.
RECRUITING
200 participants
OBSERVATIONAL
2022-08-01
2028-08-31
Brief Summary
Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.
It is recognized that suicide attempts are mostly encountered in individuals with a psychiatric disorder. Serious suicide attempts, which probably better reflect the risk of completed suicide, are very poorly known and have been very little explored. They could be related to more specific and earlier psychiatric disorders or even concern children with developmental particularities that are insufficiently defined to fall under a categorical diagnosis, but which could be better understood with dimensional measurements. Better characterizing them would seem quite important given their high lethality. Indeed, a high lethality is found for half of the suicide attempts in children fewer than 12, contrasting with a moderate or low intentionality ; in children, the means used are often more violent and more lethal than in adolescents (over 12 years old): hanging, firearm, etc.
The Necker-Enfants Malades hospital has a pediatric neurosurgery department as well as a specialized multidisciplinary team to care for polytraumatized children in a regional "Trauma Center" type structure. As a result, most children and adolescents in Ile-de-France who have made a violent suicide attempt are sent to the Necker hospital. Once medico-surgically stabilized, these children and adolescents are assessed by the hospital's child psychiatry team. This regional recruitment makes it possible to have an epidemiological representativeness. From this population, the investigative team proposes to better characterize the developmental profile and psychiatric disorders of children who have made a serious suicide attempt.
The study also proposes to examine in detail the psycho-emotional development as well as the psychopathological characteristics of these children in order to shed light on these early and lethal acting out. The investigative team proposes in particular to use dimensional evaluations to analyze behavioral traits in more detail. To the knowledge of the child psychiatry department of the Necker Enfants Malades hospital, there is no such study to date.
In addition to the question of neurodevelopmental disorders, an ancillary study will make it possible to question attachment disorders in children who have made a serious suicide attempt.
In fact, a link between attachment disorders and suicidal ideation or attempted suicide has been shown in the literature.
Attachment disorders correspond to an early imbalance in the bond between a child and the primary caregiver, particularly before the age of 3. Attachment relationships that do not allow a solid bond between the young child and the person occupying the maternal function may not be pathological in themselves but would be risk factors for pathologies in adolescence and adulthood, and in particular a category of so-called disorganized attachment disorders in the occurrence of dissociative symptoms.
Related Clinical Trials
Explore similar clinical trials based on study characteristics and research focus.
Mixed-method Evaluation of a Parental Psychoeducation Programme in a Suicide Risk Prevention Group
NCT06576453
Analysis of Suicidal Behavior Among Children and Adolescents in the Auvergne-Rhone-Alpes Region During the Covid 19 Pandemic Period
NCT07302295
Therapeutic Evaluative Conditioning to Reduce Adolescents' Self-injurious Thoughts and Behaviors During and After Psychiatric Inpatient Hospitalization
NCT05796531
Suicide Prevention in Prepubertal Children
NCT04171089
Randomized Controlled and Prospective Trial of a Cohort of People Who Made a Suicide Attempt
NCT01176929
Detailed Description
Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.
Several studies agree on the increase in suicide attempts in children over the past 15 years. This trend has been aggravated by the COVID 19 pandemic. Indeed, several recent studies have reported deterioration in the mental health of children and adolescents since the start of the pandemic and an increase in the rate of suicidal ideation and suicide attempts in 2020. Among the factors that could explain this increase, we can cite the phenomena of social distancing and isolation.
It is recognized that suicide attempts are mostly encountered in individuals with a psychiatric disorder. Indeed, psychological autopsies indicate a prevalence of psychiatric disorders of more than 90% among people who died by suicide.
Nevertheless, serious suicide attempts, which probably better reflect the risk of completed suicide, are very poorly known and have been very little explored. They could be related to more specific and earlier psychiatric disorders or even concern children with developmental particularities that are insufficiently defined to fall under a categorical diagnosis, but which could be better understood with dimensional measurements. Better characterizing them would seem quite important given their high lethality. Indeed, a high lethality is found for half of the suicide attempts in children fewer than 12, contrasting with a moderate or low intentionality ; in children, the means used are often more violent and more lethal than in adolescents (over 12 years old): hanging, firearm, etc.
The Necker-Enfants Malades hospital has a pediatric neurosurgery department as well as a specialized multidisciplinary team to care for polytraumatized children in a regional "Trauma Center" type structure. As a result, most children and adolescents in Ile-de-France who have made a violent suicide attempt are sent to the Necker hospital. Once medico-surgically stabilized, these children and adolescents are assessed by the hospital's child psychiatry team. This regional recruitment makes it possible to have an epidemiological representativeness. From this population, the investigative team proposes to better characterize the developmental profile and psychiatric disorders of children who have made a serious suicide attempt.
The study also proposes to examine in detail the psycho-emotional development as well as the psychopathological characteristics of these children in order to shed light on these early and lethal acting out. The investigative team proposes in particular to use dimensional evaluations to analyze behavioral traits in more detail. To the knowledge of the child psychiatry department of the Necker Enfants Malades hospital, there is no such study to date.
In addition to the question of neurodevelopmental disorders, an ancillary study will make it possible to question attachment disorders in children who have made a serious suicide attempt.
In fact, a link between attachment disorders and suicidal ideation or attempted suicide has been shown in the literature.
Attachment disorders correspond to an early imbalance in the bond between a child and the primary caregiver, particularly before the age of 3. Attachment relationships that do not allow a solid bond between the young child and the person occupying the maternal function may not be pathological in themselves but would be risk factors for pathologies in adolescence and adulthood, and in particular a category of so-called disorganized attachment disorders in the occurrence of dissociative symptoms.
The adolescent relationship scale questionnaire (ARSQ), to determine attachment style, will be offered to children and adolescents who have made serious suicide attempts who will participate in the study as well as to a control group of children and adolescents.
Conditions
See the medical conditions and disease areas that this research is targeting or investigating.
Study Design
Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.
CASE_CONTROL
CROSS_SECTIONAL
Study Groups
Review each arm or cohort in the study, along with the interventions and objectives associated with them.
Patients
Alive patients between the ages of 9 and 15 included at the time of their hospitalization at the Necker Enfants Malades Hospital following a serious suicide attempt that took place after January 1, 2016 and at least one of the two parents of the patient, to answer to the study questionnaires.
Questionnaires
Questionnaires will be completed only once :
* Neurodevelopment in children: Kiddie Schedule for Affective Disorders and Schizophrenia, Present and Lifetime version (K-SADS-PL-5), the Social Responsiveness Scale (SRS), The Children's Communication Checklist-2 (CCC-2), The Autism-Tics, ADHD and Other Comorbidities Inventory (A-TAC), CONNERS-3, Sensory Profile 2 (DUNN)
* Psychopathological profile of the child by evaluating the presence of psychotic symptoms: K-SADS-PL-5, Prodromal Questionnaire (F PQ16)
* Presence of mood and anxiety disorders: Child Depression Inventory (CDI), Revised Children's Manifest Anxiety Scale (RCMAS)
* Presence of sleep disorders: Children's Sleep Habits Questionnaire (CSHQ). The K-SADS-PL-5 will only be completed by subjects who have attempted suicide after the start of the study; it requires a semi-structured interview of the child by a child psychiatrist and cannot be done remotely. The other scales will be completed by all included subjects.
Questionnaire
Determination of attachment style : Adolescent Relationship Scale Questionnaire (ARSQ). The questionnaire will be completed only once.
Control patients
Patients aged 9 to 15 years hospitalized at the Necker-Enfants Malades hospital at time of the study for a non-serious suicide attempt and at least one of the two parents of the patient.
Questionnaire
Determination of attachment style : Adolescent Relationship Scale Questionnaire (ARSQ). The questionnaire will be completed only once.
Interventions
Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.
Questionnaires
Questionnaires will be completed only once :
* Neurodevelopment in children: Kiddie Schedule for Affective Disorders and Schizophrenia, Present and Lifetime version (K-SADS-PL-5), the Social Responsiveness Scale (SRS), The Children's Communication Checklist-2 (CCC-2), The Autism-Tics, ADHD and Other Comorbidities Inventory (A-TAC), CONNERS-3, Sensory Profile 2 (DUNN)
* Psychopathological profile of the child by evaluating the presence of psychotic symptoms: K-SADS-PL-5, Prodromal Questionnaire (F PQ16)
* Presence of mood and anxiety disorders: Child Depression Inventory (CDI), Revised Children's Manifest Anxiety Scale (RCMAS)
* Presence of sleep disorders: Children's Sleep Habits Questionnaire (CSHQ). The K-SADS-PL-5 will only be completed by subjects who have attempted suicide after the start of the study; it requires a semi-structured interview of the child by a child psychiatrist and cannot be done remotely. The other scales will be completed by all included subjects.
Questionnaire
Determination of attachment style : Adolescent Relationship Scale Questionnaire (ARSQ). The questionnaire will be completed only once.
Eligibility Criteria
Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.
Inclusion Criteria
* Between the ages of 9 and 15 inclusive at the time of hospitalization at the Necker Enfants Malades Hospital following a serious suicide attempt that took place after January 1, 2016.
* Serious suicide attempt whose criteria are: hospitalization for more than 24 hours and one of the following criteria: care in a specialized service, surgery under general anesthesia, hospitalization in intensive care or continuous care or resuscitation unit, attempted suicide by methods involving a high risk of mortality: precipitation, hanging, firearm…
* Control patients aged 9 to 15 years old hospitalized at the Necker-Enfants Malades hospital at time of the study for a non-serious suicide attempt.
* Without intellectual disability (IQ\>70).
* Parents:
* All subjects (parent(s) and minor or adult children) informed and not objecting to participation in the study. Holders of parental authority of minor patients informed and not opposing the participation of their child in the study.
Exclusion Criteria
* Incomplete file of patients whose hospitalization is no longer in progress.
* Medical impossibility to pass the questionnaires.
9 Years
ALL
No
Sponsors
Meet the organizations funding or collaborating on the study and learn about their roles.
URC-CIC Paris Descartes Necker Cochin
OTHER
Assistance Publique - Hôpitaux de Paris
OTHER
Responsible Party
Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.
Principal Investigators
Learn about the lead researchers overseeing the trial and their institutional affiliations.
Mélisande Sansen, MD
Role: PRINCIPAL_INVESTIGATOR
Assistance Publique - Hôpitaux de Paris
Pauline Chaste, MD, PhD
Role: STUDY_DIRECTOR
Assistance Publique - Hôpitaux de Paris
Locations
Explore where the study is taking place and check the recruitment status at each participating site.
Hôpital Necker-Enfants Malades
Paris, , France
Countries
Review the countries where the study has at least one active or historical site.
Central Contacts
Reach out to these primary contacts for questions about participation or study logistics.
Facility Contacts
Find local site contact details for specific facilities participating in the trial.
References
Explore related publications, articles, or registry entries linked to this study.
Levy-Bencheton J, Chaste P, Sansen M. Link between neurodevelopmental disorders and suicidal risk in children. Encephale. 2025 Feb;51(1):39-45. doi: 10.1016/j.encep.2023.12.002. Epub 2024 Mar 23.
Skovgaard AM. Mental health problems and psychopathology in infancy and early childhood. An epidemiological study. Dan Med Bull. 2010 Oct;57(10):B4193.
https://www.who.int/fr/news-room/fact-sheets/detail/suicide
Stordeur C, Acquaviva E, Galdon L, Mercier JC, Titomanlio L, Delorme R. [Suicide attempts in children under 12 years of age]. Arch Pediatr. 2015 Mar;22(3):255-9. doi: 10.1016/j.arcped.2014.12.004. Epub 2015 Feb 2. French.
Scharfe E., Reliability and Validity of an Interview Assessment of Attachment Representations in a Clinical Sample of Adolescents 2002
Rosen DH. The serious suicide attempt. Five-year follow-up study of 886 patients. JAMA. 1976 May 10;235(19):2105-9. doi: 10.1001/jama.235.19.2105.
Prior V, Glaser D. Comprendre l'attachement et les troubles de l'attachement : théorie, preuve et pratique. Bruxelles : De Boeck ; 2010
National Center for Injury Prevention and Control-blank template
Lyons-Ruth K, Dutra L, Schuder MR, Bianchi I. From infant attachment disorganization to adult dissociation: relational adaptations or traumatic experiences? Psychiatr Clin North Am. 2006 Mar;29(1):63-86, viii. doi: 10.1016/j.psc.2005.10.011. No abstract available.
Liotti G. A model of dissociation based on attachment theory and research. J Trauma Dissociation. 2006;7(4):55-73. doi: 10.1300/J229v07n04_04.
Liotti G. Disorganized/disoriented attachment in the etiology of the dissociative disorders. Dissociation 1992
Levi-Belz Y, Beautrais A. Serious Suicide Attempts. Crisis. 2016 Jul;37(4):299-309. doi: 10.1027/0227-5910/a000386. Epub 2016 Jun 1.
Leary MR, Hoyle RH, éditeurs. Handbook of individual differences in social behavior. New York: Guilford Press; 2009
Hesse E, Main M. Disorganized infant, child, and adult attachment: collapse in behavioral and attentional strategies. J Am Psychoanal Assoc. 2000;48(4):1097-127; discussion 1175-87. doi: 10.1177/00030651000480041101.
Guedeney N, Fermanian J, Bifulco A. [Construct validation study of the Relationship Scales Questionnaire (RSQ) on an adult sample]. Encephale. 2010 Feb;36(1):69-76. doi: 10.1016/j.encep.2008.12.006. Epub 2009 Apr 7. French.
Guédeney N., S. Tereno b, J. Tissier c, A. Guédeney d, T. Greacen e, T. Saïas e, F. Tubach c, R. Dugravier f, B. Welniarz g , Groupe CAPEDP-A Transmission du traumatisme. La question de l'attachement désorganisé : de la théorie à la pratique ; 2012
Guédeney N, Guédeney A, Fonagy P. L'attachement : approche théorique : du bébé́ à la personne âgée: Elsevier Masson ; 2016
Conversy L, A Guedeney , Les trouble de l'attachement ; 2017
Beautrais AL. Suicide and serious suicide attempts in youth: a multiple-group comparison study. Am J Psychiatry. 2003 Jun;160(6):1093-9. doi: 10.1176/appi.ajp.160.6.1093.
Boris NW, Zeanah CH. Disturbances and disorders of attachment in infancy: an overview. Infant mental health journal 1999
Barach PM. Multiple personality disorder as an attachment disorder. Dissociation 1991
Ainsworth M, Patterns of attachment : a psychological study on the strange situation, 1978
Other Identifiers
Review additional registry numbers or institutional identifiers associated with this trial.
2022-A00462-41
Identifier Type: OTHER
Identifier Source: secondary_id
APHP220360
Identifier Type: -
Identifier Source: org_study_id
More Related Trials
Additional clinical trials that may be relevant based on similarity analysis.