Serious Suicide AttemptSuiciDevNCT05450354
Associated Psychiatric Disorders in Children Hospitalized for a Serious Suicide Attempt
An observational study of Serious Suicide Attempt, run by Assistance Publique - Hôpitaux de Paris at 1 site in France.
Trial summary
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. It is recognized that suicide attempts are mostly encountered in individuals with a psychiatric disorder. Read more about this study
- Who is it for?
- Ages 9 years and older
- Conditions the study is for
- Serious Suicide Attempt
- What is being tested?
- Questionnaires and Questionnaire
- How many people
- 200 participants
- Where
- 1 siteFrance
- Study dates
- 1 Aug 2022to Aug 2028
- Phase
- Observational
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 9 years and older
- All sexes
- No healthy volunteers
- Child, Adult, Older adult
Study population: Alive patients who made a serious suicide attempt between the ages of 9 and 15 inclusive and after January 1, 2016. And 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.
Who may be able to join
- Patients:
- 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:
- At least one of the parents of a patient meeting the inclusion criteria.
- 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.
Who cannot join
- Insufficient command of French to answer the questionnaires.
- Incomplete file of patients whose hospitalization is no longer in progress.
- Medical impossibility to pass the questionnaires.
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
France1 site, 1 recruiting
- Recruiting
Hôpital Necker-Enfants Malades
Paris, 75015
Mélisande Sansen, MD, 1 44 49 45 61 ext. +33, melisande.sansen@aphp.fr
Julie Lévy-Bencheton, MD
About this study
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.
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.
Read more
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.
Read the detailed description
In 2016, the French national institute of statistics and economic studies (INSEE) indicates about the death of children aged 5 to 14 in France, that 4.2% of deaths at this age (n=26) are due to suicide, with a possible sub- assessment of suicide in this age group because a certain number of deaths are attributed to accidents.
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
- Serious Suicide Attempt
- Being tested
- Questionnaires, Questionnaire
- Keywords
- Serious suicide attempt in children, Neurodevelopment, Psycho-emotional development, psychopathological characteristics, Attachment disorders, Disorganized attachment
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
QuestionnairesOther
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.
QuestionnaireOther
Determination of attachment style : Adolescent Relationship Scale Questionnaire (ARSQ). The questionnaire will be completed only once.
| Study group | Role | What they receive |
|---|---|---|
| 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. Receives: Other: Questionnaires; Other: Questionnaire | |
| 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. Receives: Other: Questionnaire |
What is being measured
The primary outcome is the main question the study is designed to answer.
Description of the distribution of scores of the Autism-Tics, ADHD and Other Comorbidities Inventory (A-TAC) assessing neurodevelopment
A-TAC is a hetero-questionnaire of 96 "gate items" used for basic screening and identification of proxies to diagnoses, organized in different modules, and 163 additional items tapping into more specific symptoms including 72 items (4/module) addressing psychosocial dysfunction and subjective suffering associated with that particular problem area, the age at onset and whether the problems are present or in remission. 3 answers are possible/item (yes, scored 1; yes to some extent, 0,5; no, 0). For each module in which at least one item is answered in the affirmative, the parents tell about whether or not the endorsed symptoms had led to (1) dysfunction at school, among peers, or at home, and (2) suffering on the part of the child. A "problem load score" is calculated as the sum of these 2 items (from 0 to 2), with a theoretically defined cut-off for problems "significant" at ≥ 1, indicating that one of the problem questions is fully endorsed or that both are endorsed "to some extent".
Measured: Day 0
Secondary outcomes (10)
Evaluation of neurodevelopment by a dimensional scale (K-SADS-PL-5)
Kiddie Schedule for Affective Disorders and Schizophrenia, Present and Lifetime version (K-SADS-PL-5) : Semi-structured diagnostic interview to assess mental disorders in children and adolescents (6-18 years). It includes a dimensional and categorical assessment of the symptoms of current and past episodes of psychopathology, in order to make one or more diagnoses according to the DSM-5 criteria. For each category related to DMS-5 diagnosis, there are 4 possible answers for the most severe past episode (0: no information; 1: no diagnosis; 2: likely diagnosis, 3: clear diagnosis) and 5 possible answers for the actual episode (0: no information; 1: no diagnosis; 2: likely diagnosis, 3: clear diagnosis; 4: in partial remission).
Measured: Day 0
Evaluation of neurodevelopment by a dimensional scale (SRS)
Social Responsiveness Scale (SRS) : 65-item hetero-questionnaires for children and adolescents from 4 to 18 years old concerning social awareness, cognition, communication and motivation, repetitive behaviors and restricted interests. Each item on the scale inquires about an observed aspect of reciprocal social behaviour that is rated on a scale from "0" (never true) to "3" (almost always true).
Measured: Day 0
Evaluation of neurodevelopment by a dimensional scale (CCC-2)
Children's Communication Checklist (CCC-2) : 70-item hetero-questionnaire for children and adolescents from 4 to 16 years old which evaluates the structure of language, pragmatic difficulties and non-linguistic aspects of autistic behaviors (social relations and centers of interest). It does not allow the diagnosis of autism spectrum disorder. It quantifies the strengths and weaknesses of children's communication from 0 ("less than once a week") to 3 ("every day").
Measured: Day 0
Evaluation of neurodevelopment by a dimensional scale (CONNERS-3)
CONNERS-3 : 108-item hetero-questionnaire to assess the presence of symptoms of inattention, hyperactivity, impulsivity and other frequently associated disorders in children and adolescents aged 6 to 18. Symptoms are rated on a Likert scale with severity ratings from 0 (not at all/never) to 3 (very much/ very frequently).
Measured: Day 0
Evaluation of neurodevelopment by a dimensional scale (DUNN)
Sensory Profile 2 (DUNN) : hetero-questionnaire of 86 items evaluating the behavioral reactions of the child in response to sensory stimuli as well as their repercussions on occupational performance in children and adolescents from 3 to 15 years old. There are 5 possible answers for each item (always, scored as 1; frequently, scored as 2; sometimes, scored as 3; rarely scored as 4; and never scored as 5).
Measured: Day 0
Correlation between neurodevelopmental particularities and the age of suicide attempt
Study of the correlation between the presence of neurodevelopmental particularities assessed by the dimensional scales (K-SADS-PL-5, A-TAC, SRS, CCC-2, CONNERS-3, DUNN) and the age of suicide attempt.
Measured: Day 0
Presence of psychotic symptoms
Description of scale scores to assess the presence of psychotic symptoms in children who have made a serious suicide attempt.
Prodromal Questionnaire French Version (F PQ16) : self-administered 16-item questionnaire for individuals under 35 years of age assessing the presence of attenuated psychotic symptoms. The cut-off for a significant presence of psychotic symptoms is ≥ 4 of the 16 items.
Measured: Day 0
Description of associated mood disorders in children who have made a serious suicide attempt
Child Depression Inventory (CDI) : Self-questionnaire of 27 items which measures the intensity of depression in children and adolescents from 7 to 17 years old. Each item is rated from 0 (normal behavior for age or absent) to 2 (severe). The addition of the items gives a total between 0 and 54. The higher the score, the more severe the depression symptomatology is.
Revised Children's Manifest Anxiety Scale (RCMAS) : Self-administered 37-item questionnaire assessing the level and nature of anxiety in children and adolescents aged 9 to 19, not allowing diagnosis of the various anxiety disorders in children. The total anxiety score can range from 0 to 28. The cut-off point for pathological anxiety is more than two standard deviations around the mean (T>70).
Measured: Day 0
Description of sleep characteristics in children who have made a serious suicide attempt
Children's Sleep Habits Questionnaire (CSHQ): 33-items hetero-questionnaire to assess sleep habits in children aged 4 to 10, validated in adolescents up to 17 years old. There are 3 possible answers for each item (rarely, scored as 1; sometimes, scored as 2; and regularly scored as 3).
Measured: Day 0
Description of the distribution of scores of the Adolescent Relationship Scale Questionnaire (ARSQ) assessing the style of attachment
Self-questionnaire of 17 items rated 1 = Not at all like me, at 5=Totally like me, allowing to distinguish the 4 different attachment styles (secure, preoccupied, ambivalent, disorganized). The results of patients who made a serious suicide attempt will be compared with those of patients who made non-serious suicide attempts.
Measured: Day 0
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted8 Jul 2022
- Study start1 Aug 2022
- Primary completionAug 2028 (estimated)
- Study completionAug 2028 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (22)Papers the sponsor has linked to this study.
- Other trials for Serious Suicide AttemptStudies of the same condition, open and under way.
- More trials run by Assistance Publique - Hôpitaux de ParisThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Case-control
- Time perspective
- Cross-sectional
- Enrolment
- 200 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Assistance Publique - Hôpitaux de Paris
- Sponsor type
- University, hospital or other
- Collaborators
- URC-CIC Paris Descartes Necker Cochin
- Responsible party
- Sponsor
- Investigators
- Mélisande Sansen, MD, Principal investigator, Assistance Publique - Hôpitaux de ParisPauline Chaste, MD, PhD, Study director, Assistance Publique - Hôpitaux de Paris
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT05450354
- Sponsor's protocol ID
- APHP220360
- Other IDs
- 2022-A00462-41
- Acronym
- SuiciDev
- Status last verified
- Oct 2024
- First submitted
- 3 Jun 2022
- Last updated
- 12 Sep 2025
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Skovgaard AM. Mental health problems and psychopathology in infancy and early childhood. An epidemiological study. Dan Med Bull. 2010 Oct;57(10):B4193.
PubMed 21040689https://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.
PubMed 25656458Scharfe 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.
PubMed 946536Prior 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.
PubMed 16530587Liotti G. A model of dissociation based on attachment theory and research. J Trauma Dissociation. 2006;7(4):55-73. doi: 10.1300/J229v07n04_04.
PubMed 17182493Liotti 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.
PubMed 27245812Leary 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.
PubMed 11212184Guedeney 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.
PubMed 20159199Guédeney 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
Study at a glance
From the registry record, last updated by the sponsor on 12 Sep 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Associated Psychiatric Disorders in Children Hospitalized for a Serious Suicide Attempt
- ClinicalTrials.gov ID
- NCT05450354
- Acronym / sponsor ID
- SuiciDev / APHP220360
- Conditions
- Serious Suicide Attempt
- Keywords
- Serious suicide attempt in children, Neurodevelopment, Psycho-emotional development, psychopathological characteristics, Attachment disorders, Disorganized attachment
- Study type
- Observational
- Recruitment status
- Recruiting
- Enrolment
- 200 participants (estimated)
- Lead sponsor
- Assistance Publique - Hôpitaux de ParisUniversity, hospital or other
- Collaborators
- URC-CIC Paris Descartes Necker Cochin
- Study start
- 1 Aug 2022 (actual)
- Primary completion
- Aug 2028 (estimated)
- Study completion
- Aug 2028 (estimated)
- First posted
- 8 Jul 2022 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
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.
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.
Detailed description
In 2016, the French national institute of statistics and economic studies (INSEE) indicates about the death of children aged 5 to 14 in France, that 4.2% of deaths at this age (n=26) are due to suicide, with a possible sub- assessment of suicide in this age group because a certain number of deaths are attributed to accidents.
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.
Study design
- Observational model
- Case-control
- Time perspective
- Cross-sectional
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Patients | – | Other: Questionnaires, Other: QuestionnaireAlive 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. |
| Control patients | – | Other: QuestionnairePatients 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. |
Who may qualify
- Ages
- 9 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child, Adult, Older adult
- Study population
- Alive patients who made a serious suicide attempt between the ages of 9 and 15 inclusive and after January 1, 2016. And 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.
Key inclusion criteria (8 listed)
- Patients:
- 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.
Key exclusion criteria (3 listed)
- Insufficient command of French to answer the questionnaires.
- Incomplete file of patients whose hospitalization is no longer in progress.
- Medical impossibility to pass the questionnaires.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| QuestionnairesQuestionnaires 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. | Other | Patients |
| QuestionnaireDetermination of attachment style : Adolescent Relationship Scale Questionnaire (ARSQ). The questionnaire will be completed only once. | Other | Control patients, Patients |
Primary outcome
Description of the distribution of scores of the Autism-Tics, ADHD and Other Comorbidities Inventory (A-TAC) assessing neurodevelopment
Time frame: Day 0
A-TAC is a hetero-questionnaire of 96 "gate items" used for basic screening and identification of proxies to diagnoses, organized in different modules, and 163 additional items tapping into more specific symptoms including 72 items (4/module) addressing psychosocial dysfunction and subjective suffering associated with that particular problem area, the age at onset and whether the problems are present or in remission. 3 answers are possible/item (yes, scored 1; yes to some extent, 0,5; no, 0). For each module in which at least one item is answered in the affirmative, the parents tell about whether or not the endorsed symptoms had led to (1) dysfunction at school, among peers, or at home, and (2) suffering on the part of the child. A "problem load score" is calculated as the sum of these 2 items (from 0 to 2), with a theoretically defined cut-off for problems "significant" at ≥ 1, indicating that one of the problem questions is fully endorsed or that both are endorsed "to some extent".
10 secondary outcomes
Evaluation of neurodevelopment by a dimensional scale (K-SADS-PL-5)
Time frame: Day 0
Evaluation of neurodevelopment by a dimensional scale (SRS)
Time frame: Day 0
Evaluation of neurodevelopment by a dimensional scale (CCC-2)
Time frame: Day 0
Evaluation of neurodevelopment by a dimensional scale (CONNERS-3)
Time frame: Day 0
Evaluation of neurodevelopment by a dimensional scale (DUNN)
Time frame: Day 0
Correlation between neurodevelopmental particularities and the age of suicide attempt
Time frame: Day 0
Presence of psychotic symptoms
Time frame: Day 0
Description of associated mood disorders in children who have made a serious suicide attempt
Time frame: Day 0
Description of sleep characteristics in children who have made a serious suicide attempt
Time frame: Day 0
Description of the distribution of scores of the Adolescent Relationship Scale Questionnaire (ARSQ) assessing the style of attachment
Time frame: Day 0
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 12 Sep 2025.
- Background: PubMed 21040689Skovgaard AM. Mental health problems and psychopathology in infancy and early childhood. An epidemiological study. Dan Med Bull. 2010 Oct;57(10):B4193.
- Backgroundhttps://www.who.int/fr/news-room/fact-sheets/detail/suicide
- Background: PubMed 25656458Stordeur 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.
- BackgroundScharfe E., Reliability and Validity of an Interview Assessment of Attachment Representations in a Clinical Sample of Adolescents 2002
- Background: PubMed 946536Rosen 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.
- BackgroundPrior V, Glaser D. Comprendre l'attachement et les troubles de l'attachement : théorie, preuve et pratique. Bruxelles : De Boeck ; 2010
- BackgroundNational Center for Injury Prevention and Control-blank template
- Background: PubMed 16530587Lyons-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.
- Background: PubMed 17182493Liotti G. A model of dissociation based on attachment theory and research. J Trauma Dissociation. 2006;7(4):55-73. doi: 10.1300/J229v07n04_04.
- BackgroundLiotti G. Disorganized/disoriented attachment in the etiology of the dissociative disorders. Dissociation 1992
- Background: PubMed 27245812Levi-Belz Y, Beautrais A. Serious Suicide Attempts. Crisis. 2016 Jul;37(4):299-309. doi: 10.1027/0227-5910/a000386. Epub 2016 Jun 1.
- BackgroundLeary MR, Hoyle RH, éditeurs. Handbook of individual differences in social behavior. New York: Guilford Press; 2009
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Mélisande Sansen, MD principal investigator
Assistance Publique - Hôpitaux de Paris
Pauline Chaste, MD, PhD study director
Assistance Publique - Hôpitaux de Paris
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Serious Suicide Attempt, run by Assistance Publique - Hôpitaux de Paris at 1 site in France.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 8 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: looking for participants now, as of the sponsor's last update on 12 Sep 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in France. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Mélisande Sansen, MD (1 44 49 45 61 ext. +33, melisande.sansen@aphp.fr), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Description of the distribution of scores of the Autism-Tics, ADHD and Other Comorbidities Inventory (A-TAC) assessing neurodevelopment (time frame: Day 0). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT05450354, which also lists 22 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 12 Sep 2025.