Prévention de la récidive suicidaire à l’adolescence par SMS ou autre media.

Résumé Prévenir la récidive suicidaire chez l’adolescent est l’une de nos préoccupations lorsque nous recevons un jeune patient dans les suites d’une tentative de suicide. En effet, la récidive suicidaire reste importante, comprise entre 14 % et 28 % dans l’année suivant la tentative de suicide étudiée. Dans ce but, les recommandations préconisent un suivi suffisamment long et valorisent le maintien du lien avec le service de soins, ce qui est loin d’être aisé auprès d’adolescents qui n’ont souvent aucune demande de soins. Cette communication présente tout d’abord brièvement trois études menées auprès d’adolescents suicidants. La première étude porte sur le poids de la récidive suicidaire sur le devenir des adolescents ; la deuxième porte sur l’impact de ne plus être joignable par les équipes de soins à un an d’une tentative de suicide et la troisième sur les modalités d’utilisation des média par les adolescents suicidants. Ces études convergent finalement vers une idée : l’intérêt de la mise en place d’un dispositif de veille en postvention. Enfin, le dispositif de veille MEDIACONNEX est présenté, dispositif basé sur l’envoi de messages par SMS ou tout autre média qui sera évalué à partir d’un essai contrôlé randomisé. Preventing suicidal recurrence in adolescence is one of our concerns when we receive a young patient in the aftermath of a suicide attempt. Indeed, suicidal recurrence remains significant, between 14 % and 28 % in the year following the suicide attempt studied. For the purpose, the French recommendations advocate a sufficiently long follow-up and value the maintenance of the link with the care service, which is sometimes difficult with adolescents who often have no demand for care. This paper presents three studies of suicidal adolescents, which have in common a convergence towards an idea: the interest to set up a monitoring system in postvention. Objectives (1) To describe psychosocial outcomes of SAers and the weight of recurrence on these outcomes; (2) to study the impact of losing contact with caregivers during the year following SA; and (3) to study how young SAers use means of communication, and perceive social support they receive and their health-related quality of life. Materials and methods Three researches were carried out on adolescent SAers at Nancy university hospital, one of them in association with Strasbourg university hospital. Overall, 309 SAers participated in the first study: they were evaluated at time of SA and 10 years after SA. The second study concerned the correlation between a loss of contact with caregivers and SA recurrence occurring between 1 to 10 years after the initial SA of 249 young patients. The third study focuses on how 58 SAers use means of communication, and perceive social support they receive and their health-related quality of life. Results As an adult, the psychosocial situation of young SAers is impaired, especially for those who have a recurrence of SA during the year after index SA. The risk of recurrence increases in the 10 years following index SA for early SAers (OR = 2.3; 95 % CI = 1.1–4.9), and in the year following index SA when contact has been lost with caregivers (HR = 2.8; 95 % CI = 1.4–5.5). SAers preferentially use SMS to “keep in touch” with relatives and they assess on a less positive note than peers their social support and health-related quality of life. Finally, they would agree to receive SMS messages from caregivers and underline the interest of including a support message. Conclusion and perspectives SA recurrence is associated with poorer psychosocial outcomes and with higher risk of SA over the longer term. A loss of contact with caregivers 1 year after SA of inclusion was also associated with recurrence. Communication devices focusing on keeping in touch with SAers have been developed for adults over the last decades. Therefore, we developed a monitoring device based on SMS sending in order to prevent SA recurrence which will be assessed through a randomized controlled clinical trial. [ABSTRACT FROM AUTHOR]