The Mental Health of First Nations Children in Manitoba: A Population-Based Retrospective Cohort Study Using Linked Administrative Data: La santé mentale des enfants des Premières Nations au Manitoba : une étude de cohorte rétrospective dans la population, à l'aide de données administratives liées.

OBJECTIVE: First Nations children face a greater risk of experiencing mental disorders than other children from the general population because of family and societal factors, yet there is little research examining their mental health. This study compares diagnosed mental disorders and suicidal behaviours of First Nations children living on-reserve and off-reserve to all other children living in Manitoba. METHOD: The research team, which included First Nations and non-First Nations researchers, utilized population-based administrative data that linked de-identified individual-level records from the 2016 First Nations Research File to health and social information for children living in Manitoba. Adjusted rates and rate ratios of mental disorders and suicide behaviours were calculated using a generalized linear modelling approach to compare First Nations children (n = 40,574) and all other children (n = 197,109) and comparing First Nations children living on- and off-reserve. RESULTS: Compared with all other children, First Nations children had a higher prevalence of schizophrenia (adjusted rate ratio (aRR): 4.42, 95% confidence interval (CI), 3.36 to 5.82), attention-deficit hyperactivity disorder (ADHD; aRR: 1.21, 95% CI, 1.09 to 1.33), substance use disorders (aRR: 5.19; 95% CI, 4.25 to 6.33), hospitalizations for suicide attempts (aRR: 6.96; 95% CI, 4.36 to 11.13) and suicide deaths (aRR: 10.63; 95% CI, 7.08 to 15.95). The prevalence of ADHD and mood/anxiety disorders was significantly higher for First Nations children living off-reserve compared with on-reserve; in contrast, hospitalization rates for suicide attempts were twice as high on-reserve than off-reserve. When the comparison cohort was restricted to only other children in low-income areas, a higher prevalence of almost all disorders remained for First Nations children. CONCLUSION: Large disparities were found in mental health indicators between First Nations children and other children in Manitoba, demonstrating that considerable work is required to improve the mental well-being of First Nations children. Equitable access to culturally safe services is urgently needed and these services should be self-determined, planned, and implemented by First Nations people.

Pattern of encounters to emergency departments for suicidal attempts in France: Identification of high-risk days, months and holiday periods.

INTRODUCTION: Seasonal change in patterns of suicidal attempts is not well known in France and may differ from other western countries. We aimed to determine the peak times (days, months and holiday periods) of suicidal attempts in France. METHODS: We carried out a multicentre retrospective epidemiological study, using data from the Organization for Coordinated Monitoring of Emergencies (OSCOUR®) network. We aggregated daily data from January 1, 2010, to December 31, 2019. Variations in suicidal attempts on specific days were investigated by comparing their frequencies (ad hoc Z-scores). RESULTS: 114,805,488 ED encounters were recorded including 233,242 ED encounters regarding suicidal attempts. Men accounted for 45.7%. A significantly higher frequency of ED encounters for suicidal acts were found on Sundays in the months of May-June for both sexes and on New Year's Day for all genders and age groups. An increased risk was also noted on July 14th (National Day) and June 22nd (Summer Solstice). A protective effect was noted on the day after Valentine's Day, on Christmas Day and Christmas time (in particular December 24 and 26). CONCLUSION: Sundays, June, New Year's Day were at increased risk of suicidal attempts in France requiring a strengthening of prevention.

Living with Mental Illness.

Objective: The situation of patient's relatives is still not broadly studied in psychiatry. Their needs are often overlooked. Method: We developed a digital questionnaire concerning the patient's sociodemographic, disease-related, and family-related data and had the patient's therapist fill it out. The patients included (N = 1766) were persons hospitalized on a selected date. Results: One-third of patients had at least one relative with mental illness, prior treatment, or need for treatment. The main diagnoses in relatives were affective, substance use, and somatoform disorders, often in concordance with their index patient. Teenage patients had the most affected relatives. The therapists of the minors included were better informed about their familial situation, whereas the therapists of the 30-59-year-olds knew the least. Conclusions: The comparably lower rate of affected relatives in adults stems most likely from underassessment and needs further investigation.

Prevalence rate of ADHD in France: Review of the literature and results from ChiP-ARD study.

OBJECTIVES: Attention Deficit Hyperactivity Disorder (ADHD) is a frequent neurodevelopmental disorder whose first clinical description was published more than two centuries ago. Prevalence rates have been evaluated in many countries and meta-analyses conducted, but the data collected in France are scarce. METHODS: A review of the literature was conducted by retrieving the references from four electronic databases leading to the selection of four studies in children and four in adults. Meta-analyses of prevalence rates were performed on this published data as well as unpublished results from the ChiP-ARD study (Children and Parents with ADHD and Related Disorders), separately for children and adults. RESULTS: While the quality of most studies is questionable, the prevalence rates are close to those reported in international meta-analytic studies for children (3.68%), but are higher in adults (5.5%). CONCLUSIONS: Well-conducted studies in both general and special populations are needed (e.g., in patients with depression, anxiety, bipolar disorder, developmental disorders including autism spectrum disorder, behavioural or substance abuse, and incarcerated). Nevertheless, healthcare stakeholders can conservatively consider that .8 million children and 1.4 million adults in the metropolitan French general population are likely to have ADHD and suffer from its multiple consequences.

[Diagnostic criteria, epidemiology and assessment of patients with functional neurological disorders]. / Définitions, épidémiologie et démarche diagnostique clinique dans les troubles neurologiques fonctionnels.

Functional neurological disorders (FND) are symptoms that can affect a variety of functions including motor, sensory and cognitive. These symptoms are genuinely experienced by the patient and are related to a functional disorder rather than a structural one. There is little epidemiological data on these disorders, but their frequency is well established in clinical practice, it is the second most frequent reason for consultation in Neurology. Despite of the frequency of the disorder, general practitioners and specialists are insufficiently trained in the disease, and patients often suffer from stigmatization and/or unnecessary investigations. It is therefore important to be aware of the diagnostic approach to FND, which mostly relies on positive clinical signs. Psychiatric evaluation can help with the characterization of predisposing, precipitating and perpetuating factors of the symptoms (according to the 3P biopsychosocial model related to FND), and guide their management. Finally, diagnosis explanation is a crucial step in the management of the disease, which can in itself have a therapeutic effect, and allow the patient to adhere to the treatments.

2022 Recommendations of the AFU Lithiasis Committee: Epidemiology, stone analysis and composition.

The incidence of urinary lithiasis is rising steadily in industrialized countries, and its prevalence in the general population of France is estimated at 10%. Renal colic accounts for 1-2% of emergency department consultations. At a time when the new LASER stone fragmentation techniques available to urologists will lead to ever finer in situ pulverization of stones, the exact identification of the compounds that form the stone is essential for etiological diagnosis. Constitutional analysis by infrared spectrophotometry or X-ray diffraction is therefore recommended, to be complemented by morphological typing of the calculi. METHODOLOGY: These recommendations have been drawn up using two methods: the Recommendation for Clinical Practice (RPC) method and the ADAPTE method, depending on whether or not the issue was considered in the EAU recommendations (https://uroweb.org/guidelines/urolithiasis) [EAU 2022] and their adaptability to the French context.

[Bladder tumors in the Hérault department: Results of the Hérault tumor registry registration from1987 to 2019]. / Les tumeurs de la vessie dans le département de l'Hérault : résultats de l'enregistrement du registre des tumeurs de l'Hérault de1987 à 2019.

OBJECTIVES: The Hérault Tumor Registry (RTH) is a general registry qualified by the national committee of registries since 1987. The objective of this study is to present the evolution of the epidemiology of bladder cancer (stage≥T1) in the Hérault department based on data collected by the RTH over a period from 1987 to 2019. MATERIAL AND METHODS: We analyzed trends in bladder cancer incidence in Hérault between 1987 and 2019 by sex, age, and stage, as well as mortality trends between 1987 and 2017. For the years 2018-2019, which are the last two years validated by the registry, we described relative frequencies, sex ratio, mean and median age at diagnosis, cumulative risk, stages at diagnosis, pathology data, and primary treatments. Observed and net survival data are analyzed for those diagnosed between 01/01/2000 and 12/31/2015 with a point date of 06/30/2018. RESULTS: In 2018-2019, bladder cancer was the 7th most common cancer in Hérault (5th in men and 12th in women) with an incidence sex ratio of 3.9 men to one woman. The mean age at diagnosis was 75.3 years for men and 77.8 years for women. The probability of having bladder cancer before the age of 75 years was 1.68% for a man (1/59) and 0.34% for a woman (1/295). Urothelial carcinomas accounted for 90.7% of cancers. Between 1987 and 2019, bladder cancer incidence TSMs (worldwide standardized rates) decreased by 0.8% per year in men and remained stable in women. Mortality TSMs between 1987 and 2017 followed the same trends with a decrease of 2.2% per year in men and stability in women. For the 3304 bladder cancers diagnosed between 01/01/2000 and 12/31/2015, the observed 5-year survival was 38% (34% in women and 38% in men). CONCLUSIONS: Bladder cancer incidence and mortality rates have decreased slightly in men but remain stable in women in the Hérault. Registries collect only a limited number of variables for each patient. In 2018 the Hérault Registry Specialized in Onco-Urology (RHESOU) was created, to have comprehensive data.

Patterns of unintentional fatal drowning among children in North Tunisia : A 10-year study.

AIMS: This study aims to better understand patterns of unintentional fatal drowning among children in North Tunisia. METHODS: A cross-sectional retrospective study including all unintentional fatal drowning among children was conducted in the Legal and Forensic Medicine department in the Charles Nicolle Hospital, Tunis, between January 2010 and December 2019. Socio-demographic variables, as well as death circumstances, were documented for each victim and analyzed. RESULTS: A total of 200 casualties were included in this study. The highest rate of deaths was observed in the summer (N=44). Most of the victims were males and 55.5% were aged between 13 and 18 years. The drowning occurred in a canal or the sea in 33.5 % and 29.5 % of the cases respectively. The distribution of drowning sites varied significantly by season and place of living: drowning in the sea was more likely to occur in the summer and in urban areas (p < 0.05). In the first years of life, drowning occurred mostly in buckets and wells (N=9 and N=10, respectively) while between 7 and 18 years, it was more frequent in a canal or the sea. Swimming was the leading activity before death in 50% of the cases. CONCLUSIONS: Unintentional fatal drowning among children remains an underestimated major health problem in Tunisia especially in the population aged from 7 to 18 years. Effective prevention measures should be implemented nationwide, especially around seas and canals.

Facial fractures in post-revolution Tunisia as violence indicator: About 476 cases.

INTRODUCTION: On January 2011, Tunisia had known a revolution. To move from dictatorship to democraty project, the country suddenly fell into political instability, which was accompanied by a wave of social violence. Traumatology, and, particularly, maxilla-facial traumatology, is usually a reliable indicator of the degree of violence. AIM: The aim of this study was to establish the epidemiological profile of facial fractures during the various phases of political transition through which Tunisia has passed since revolution (2012-2016). PATIENTS AND METHODS: A retrospective cross-sectional study was conducted among all patients with facial fractures admitted to the department of Oral and Maxillo facial Surgery of University Hospital of Sahloul during five years (2012-2016). Fractures diagnosed late at the sequelae stage were excluded. Data of patients were recorded according to medical files, including cause of injury, age and gender, injury mechanisms and type of facial fracture. RESULTS: During the period of the study, a total of 476 patients were identified, with a sex-ratio of 7.2 to 1, patients ranged in age from 1 year to 76-years-old with a mean age of 27 years. Assaults were the most common cause of injury (39.1%). Mandible was fractured in 257 cases (54.2%) followed by zygoma (116 cases, 24.4%), nasal bone (99 cases, 20.8%) and Orbital walls (98 cases, 20.6%). DISCUSSION: The epidemiological profile of facial fractures in Tunisia has been changed since 2011. Facial fractures occur mainly after assaults, which are an indicator of increased social violence accompanying political instability present in our country.

[De novo or secondary metastatic prostate cancer management in France: Observational study from "sentinel multidisciplinary meeting" of the French Association of Urology]. / Prise en charge des cancers de la prostate métastatiques synchrones et métachrones en France : étude observationnelle à partir des « RCP sentinelles ¼ de l'AFU.

INTRODUCTION: Metastatic prostate cancer (mPCa) is an heterogeneous disease. Metachronous mPCa (MM) seems to have a better prognosis than synchronous mPCa (SM). However, it is difficult to analyze their specificities from national registries. Data from the so-called "sentinel multidisciplinary meeting" (SMDM) would represent a "real life" data collection. The objective of this national pilot study was to evaluate the concept of SMDM through the description and comparison of the diagnosis, management and follow-up of patients with synchronous or metachronous mPCa in 2018. METHODS: A survey covering clinical, biological, radiological data as well as treatment initiated and follow-up at 3 and 6 months was sent to the SMDM. All patients diagnosed with metastatic disease (SM or MM) between 01/01/2018 and 11/30/2018 were included. RESULTS: In total, 780 patients from 39 centers were included, 408 SM and 372 MM. SM were more symptomatic and had a higher metastatic burden than MM. PET were mostly performed in MM without a prior standard staging. SM patients received more chemotherapy than MM patients whereas new generation androgen deprivation therapy was mostly given to MM patients. At 6 months, there were no more significant difference in clinical presentation between the two groups. CONCLUSION: Specificities of SM and MM patients in terms of clinical presentation, metastatic burden and management were described, validating the concept of SMDM as a source of reliable informations.

[Epidemiology, diagnosis and extension]. / Épidémiologie, diagnostic et bilan d'extension.

Breast cancer is the most common cancer in women. The elderly, whose numbers have been increasing, constitute a population in their own right, because of the many co-morbidities they suffer from. The epidemiology of breast cancer, particularly in elderly women, is described here, as well as the diagnosis and the assessment of extension, which do not differ from the rest of the population.

Épidémiologie descriptive du risque suicidaire dans le système médical français de médecine générale.

OBJECTIVE: Suicide prevention certainly includes a better knowledge of suicide risk in primary care. A number of international publications have shown interest in assessing this risk, but mostly through specific consultant populations: young patients, old patients, anhedonic, depressive, etc. Our study analyses suicide risk prevalence in patients consulting in general medicine for any somatic or psychiatric reason, their pathology or their age. METHOD: This cross-sectional study was conducted with adult patients (827 subjects included) who were consulting a French generalist doctor panel randomly selected. They filled a validated self-questionnaire (aRSD) assessing their suicide risk in the 15 preceding days and providing professional and personal data. RESULTS: The totally operable 757 files (483 female; 274 male) show that close to a quarter of consultants (24.3%) presents with a positive suicide risk in the 15 days preceding their consultation and 6.3%, reveal a severe risk (aRSD ≥ 7) with ideas and impulses to commit the act. When the reason to consult is psychiatric, 64.6% of these consultants have aRSD positive. One time out of two, the risk is even severe. CONCLUSIONS: This data shows how important the suicide risk prevalence is in general medicine. It confirms the main role played by primary care patricians in acting to prevent suicide risk. This data also shows the contribution represented by a self-questionnaire that would rapidly assess the suicide intent while screening, it.

[Patterns of antidepressant dispensing among children and adolescents between 2015 and 2017 in the French region of Midi-Pyrenees]. / Profil de délivrance des antidépresseurs chez l'enfant et l'adolescent en Midi-Pyrénées entre 2015 et 2017.

BACKGROUND: In France, consumption of antidepressant drugs by children and teenagers has been on the rise, even though recommendations for use are limited due to their association with serious adverse reactions. The objective of this study was to describe the patterns of antidepressant drug dispensing among children and adolescents in the French region of Midi-Pyrenees. METHOD: The data regarding the Midi-Pyrenees region were extracted from the French Health Insurance Database (SNDS) using their ATC codes. The reimbursements for antidepressants, benzodiazepines and neuroleptics dispensed to patients from 6 to 17 years old between January 2015 and June 2017 were analyzed, after which data on the antidepressants themselves were selected. The population was divided into sub-groups according to age (children : 6 to 11 years old, teenagers: 12 to 17 years old). RESULTS: During the 30 months analyzed, 12,783 antidepressants were dispensed to 3506 patients. The antidepressants were primarily issued (90%) to teenagers. In terms of prevalence, 24.7% of the teenagers had amitriptyline delivered at least once, while 31.2% of them received sertraline at least once. Regarding total amount of antidepressant issuances, sertraline was first in both the child (26.9%) and the teenage (40.7%) populations. Benzodiazepine with an antidepressant was issued to 35.1% of the children and teenagers. CONCLUSIONS: Amitriptyline was the most widely dispensed antidepressant among children, and sertraline among teenagers. However, fluoxetine is recommended as the first-line treatment for depression affecting this population. A psychotropic drug prescription assistance website such as psychotropes.fr addressed to general practitioners might improve the implementation of recommendations and guidelines.

Interdisciplinary community-based participatory health research across the industrial region of the Étang de Berre : The EPSEAL Fos Crau study.

BACKGROUND: We conducted a community-based participatory environmental health study in three towns: two in the heart of Marseille's industrial zone (Fos-sur-Mer and Port-Saint-Louis-du-Rhône), and one on the periphery located about 30 km away (Saint-Martin-de-Crau). METHODS: We first conducted a cross-sectional survey of a random sample of residents in each of the three towns. We asked study participants to self-report a wide variety of health issues (Port-Saint-Louis: n = 272, Fos-sur-Mer: n = 543, Saint-Martin-de-Crau: n = 439). We then conducted focus groups with residents and other stakeholders to share preliminary data in order to propose areas of reflection and collaboratively produce contextually-situated knowledge of their health and environment. We directly standardized the prevalences (by age and gender) to the French metropolitan population to make our results more comparable. RESULTS: Study participants who lived closer to the core industrial zone (residents of Fos-sur-Mer and Port-Saint-Louis-du-Rhone) had higher prevalences of eye irritation, nose and throat problems, chronic skin problems and headaches than people who lived further away (residents of Saint-Martin-de-Crau). Residents also offered diverse qualitative insights about their environment and health experiences. DISCUSSION: We observed elevated prevalences of diseases that affected residents across the industrial zone (Fos-sur-Mer and Port-Saint-Louis-du-Rhône) compared to those living outside (Saint-Martin-de-Crau), and qualitative evidence of how residents made sense of their health experiences strengthening an understanding of their own empirical observations which helps to produce knowledge about health in an industrial context. The results of the workshops show an important benefit from the co-production of local knowledge. CONCLUSION: We encourage future researchers to do in-depth, community-based research to comprehensively describe the health of residents in other heavily polluted zones, product local knowledge and to help identify policy solutions, engender trust among the local people, and identify opportunities for intervention.

[Euthanasia and assisted suicide for psychiatric disorder]. / La pratique de l'euthanasie et du suicide assisté pour motif psychiatrique.

OBJECTIVES: Assisted death has been discussed for years in medicine. Ten countries have adopted legislation that authorises some form of euthanasia or assisted suicide, and the incidence and practices vary from country to country. Consideration of psychological pain linked to psychiatric disorders as a sufficient legal condition for enabling assisted death has added a new layer of complexity to the debate. Thus, Switzerland, Netherlands, Belgium and Luxembourg legalised assisted suicide or euthanasia for psychiatric reasons. In these cases, it is not a question of choosing death conditions but the occurrence of death. This manuscript is a narrative review of the literature about characteristics of patients with psychiatric disorders who requested assisted death in these countries. METHODS: Scientific manuscripts, reports and legal documents were reviewed. RESULTS: The incidence of assisted death for psychiatric reasons was low but has increased over the years. They represented 1.1 % of assisted deaths in Belgium (n=23) and 1.3 % in Netherlands (n=83) in 2017, and 4.5 % in Switzerland in 2014 when also considering dementia. The most frequent diagnoses were depressive and personality disorders. Patients were more often women than men, unlike suicide and middle aged. CONCLUSIONS: Authors who support these practices emphasise the right to die with dignity and the inequality of ruling out patients with psychiatric reasons, whereas they meet the legal requirements, and psychological pain is as severe as somatic pain. Some major issues are highlighted: the close relationship between mood symptoms and death wish, thinking biases and cognitive disturbances that limit the ability to decide, access and consent to medical care, the difficulty of assessing psychological pain, and the definitions of incurability or treatment refractoriness in psychiatry. To date, medical knowledge and assessment tools are not sufficient to define possible indications and offer the best support possible to these patients.

Vesico-vaginal fistula in Tunisia: Epidemiology and risk factors of treatment failure.

INTRODUCTION: Vesico-vaginal fistula (VVF) is a global healthcare problem that has a high prevalence in developing countries. The aim of this work is to study the epidemiological, clinical and therapeutic characteristics of VVF post-obstetric and gynecologic procedures in order to identify the predictive factors of surgical treatment failure. METHODS: Data were collected from 132 VVF patients in our institution between 1985 and 2017. VVF was classified according to Zmerli's classification. Patients underwent surgical treatment and were evaluated after a follow-up period of 6 months. Successful treatment was defined as the absence of urine leakage whereas recurrence was defined as the presence of urine leakage immediately after the surgery or after a period of dryness with a confirmed VVF. Risk factors of surgical treatment failure were identified. RESULTS: The average age of patients was 44 years. The patients were multiparous in 62% of cases. VVF was consecutive to hysterectomy in 62.1% of cases, and after childbirth in 34%. VVF was retro-trigonal in 99 cases (75%) and trigonal in 33 cases (25%). The average size of the fistula was 1cm (0.3-2cm). VVF repair was performed by vaginal approach in 68% of cases and abdominal approach in 32% of cases. Treatment failure was noted in 36 patients (27%). Predictive factors of treatment failure were: vaginal fibrosis (P<0.001); trigonal location of the fistula (P<0.001); large diameter of the VVF>1cm (P<0.001); and complex and complicated fistulas (P=0.02). CONCLUSION: Although Tunisia is a developing country, the main cause of VVF was not obstetrical. Treatment failure, noted in almost one third of cases, was, in our series, correlated with the quality of the vaginal tissue, the size and the location of the fistula, and its complexity. LEVEL OF PROOF: 4.

[Cancers of the external genital organs of male in Hérault: Results from the Hérault tumor register (RTH) over a period of 30 years (1987-2016)]. / Le cancer des organes génitaux externes de l'homme dans le département de l'Hérault: résultats de 30 ans d'enregistrement du registre des tumeurs de l'Hérault (1987­2016).

AIM: The objective of this study is to present the history of cancers of the external genital organs of male in Hérault using data from the Hérault tumor register (RTH) over a period of 30 years. PATIENTS AND METHODS: Using the RTH database, we studied the development of testicular germ cell tumors (TGCT) and penile cancer (PC) over 30 years, from 1987 to 2016. We analyzed the incidence and mortality data for these tumors. We compared these results to French, European and global data. RESULTS: In 30 years of registration we have recorded 725 cases of TGCT and 175 cases of PC. The age standardized incidence rate (ASR) of TGCT has doubled between 1987 and 2016 (4.2 per 100,000 in 1987 and 9.3 per 100,000 in 2016). It was multiplied by 2.63 in the population of patients aged 30 to 44. There is a decrease of the mortality rate with a ASR of 0.8 deaths per 100,000 in 1987, and 0.4/100 000 in 2016. The PC incidence ASR was stable between 1987 and 2016 (0.4-0.9/100,000). Mortality is stable with a ASR between 0.1 and 0.3 deaths per 100,000 between 1987 and 2016. CONCLUSION: The incidence of TGCT has increased sharply in the Hérault over the past 30 years, while a decrease in mortality has been observed. The proportion of seminomas is increasing; it has gone from 53 % to 60 % in 30 years in the Hérault. The incidence and mortality of PC shows a stability in the Hérault over the past 30 years.

[Renal cell carcinoma in the department of Hérault: Results over a 30 year period]. / Le cancer du rein dans le département de L'Hérault : résultats de 30 ans d'enregistrement.

OBJECTIVE: The objective of the study was to determine the specificities of renal cell carcinoma (RCC) in the department of Herault using the Herault Tumor Registry over 30 years. METHODS: Data of this study were obtained from the Herault cancer database. We analysed the evolution of RCC from 1987 to 2016, including the incidence, mortality, cancer pathology and staging at the moment of diagnosis. We compared our results with national and international data. RESULTS: We identified 3769 newly diagnosed RCC: 2628 in men (69,7%) and 1141 in women (30,3%). In 2016, RCC was the 8th most frequent cancer, both genders combined, the 7th most frequent cancer in men and the 11th in women. New cases of RCC increased by 4.2 in men and 3.3 in women over the study period. The number of localised forms increased by 9% over 20 years. In 2016, the probability of having a RCC before the age of 75 was of 2.11% for a man and of 0.62% for a woman. CONCLUSION: Over 30 years, the incidence rate of RCC increased in the department of Herault; however, mortality decreased over the same period. This analytical data should be improved by the development of the Registry of Herault Specialised in Onco-Urology (RHESOU). LEVEL OF EVIDENCE: 3.

[Suicide, a separate entity in psychiatry]. / Le suicide, une entité à part en psychiatrie.

Since ancient times, the subject of suicide has been recurrently discussed in societies. Whether it is a selfish or altruistic act, the ethical debate has always been intense. Today, the suicidal act is at the center of the public debate with the subject of euthanasia and assisted suicide. Philosophers, theologians, sociologists, doctors and jurists share their thoughts on this subject, which is still considered "taboo". Between suicide, suicidal ideas or suicidal crisis, the stakeholders are involved in the field of prevention and are mobilizing to propose innovative treatments.

[Epidemiology of suicide and suicide attempts]. / Épidémiologie du suicide et de ses tentatives.

France has recently recorded approximately 9,000 to 10,000 suicides and 200,000 suicide attempts per year with regional, age and gender disparities. Men commit suicide more than women, while women make more attempts than men.