[Suicidal behavior prevention for children under age 13: A systematic review]. / Prévention des conduites suicidaires de l'enfant de moins de 13ans : une revue de la littérature.

OBJECTIVE: Our objective was to review international literature on suicidal behavior prevention for children under age 13. METHODS: We gathered all relevant articles on suicide prevention for children under 13. We researched all publications in the French and English languages in PubMed (MEDLINE), PsychINFO and SUDOC databases published until February 2014, with the keywords "child", "child preschool", "prevention and control", "suicide", and "suicide attempted". Publications were included if they described suicidal behavior prevention programs (suicide prevention programs, attempted-suicide prevention programs, suicidal ideation screening programs), and if the studies concerned children under age 13. We also included references cited in the articles if they were not already present in our searches but met inclusion criteria. Studies were excluded if they analyzed populations of children and adolescents without sub-analysis for children under age 13. RESULTS: A total of 350 potentially relevant articles were identified, 33 of which met the inclusion criteria, including 4 retrieved from articles' bibliography. Preventive measures against suicidal behavior for children under 13 exist and include: social programs, maltreatment prevention, curriculum-based suicide prevention programs, suicide screening in schools, gatekeepers, reduction of access of lethal means of suicide, suicide screening by primary care, and post-suicide intervention programs. Overall, the evidence was limited by methodological concerns, particularly a lack of RCTs. However, positive effects were found: school-based suicide prevention programs and gatekeepers increased knowledge about suicide and how to seek help, post-suicide programs helped to reduce psychological distress in the short term. One study showed a decreased risk of attempted-suicide after entry into the child welfare system. CONCLUSION: There are promising interventions but there is not enough scientific evidence to support any efficient preventive measure against suicidal behavior for children under 13, whether primary, secondary, tertiary or post-intervention. More research is needed.

The WHO START study: suicidal behaviors across different areas of the world.

BACKGROUND: The World Health Organization (WHO) study entitled Suicide Trends in At-Risk Territories (START) is an international multisite initiative that aims to stimulate suicide research and prevention across different areas of the globe. A central component of the study is the development of registration systems for fatal and nonfatal suicidal behaviors. AIMS: This paper provides an overview of the data collected on suicidal behaviors from the participating locations in the START study. METHOD: Descriptive statistics on the data are presented in terms of age, sex, and method. RESULTS: A greater proportion of suicide deaths occurred among males. In all areas except the Philippines more females than males engaged in nonfatal suicidal behaviors. Compared to Australia, Italy, New Zealand, the Philippines, and Hong Kong SAR, in the Pacific Islands suicide most often occurs in younger age groups. Results indicate notable variations between countries in choice of method. A greater proportion of suicides occurred by hanging in Pacific Islands, while inhalation of carbon monoxide, use of firearms, ingestion of chemicals and poisons, and drug overdose were the most frequent methods of choice in other areas. CONCLUSION: The information drawn from this study demonstrates the enormous variation in suicidal behavior across the areas involved in the START Study. Further research is needed to assess the reliability of the established data-recording systems for suicidal behaviors. The baseline data established in START may allow the development of suicide prevention initiatives sensitive to variation in the profile of suicide across different locations.

Association of D2 dopamine receptor and alcohol dehydrogenase 2 genes with Polynesian alcoholics.

Alleles of the D2 dopamine receptor (DRD2) and the alcohol dehydrogenase 2 (ADH2) genes were determined in 69 French Polynesian alcoholic patients and 57 controls matched for racial origin. Three racial groups were studied: pure Polynesians (PP), Polynesians mixed with Caucasian (PCA) ancestry and Polynesians mixed with Chinese (PCH) ancestry. DRD2 A1 allele frequencies in the alcoholics compared to their controls in these groups were: PP,.26 vs.32 (P =. 69); PCA,.44 vs.35 (P =.46); PCH,.40 vs 0.39 (P =.88). ADH2 1 allele frequencies in alcoholics compared to their controls groups were: PP, .56 vs.62 (P =.66); PCA,.75 vs.56 (P =.09); PCH,.78 vs.32 (P =.009). In the PCA group, the combination of the DRD2 A1 genotypes and the ADH2 1 homozygotes was strongly associated with alcoholism (P =. 0027). This preliminary study shows the importance of ascertaining racial ancestry in molecular genetic association studies. Moreover, it suggests that a combination of genes are involved in susceptibility to the development of alcoholism.

Mortalidad en pacientes con Lupus Eritematoso Sistémico e infecciones. Asociación con neutropenia y fiebre / Mortality in patients whith systemic lupus erythematosus and infections. Associated with neutropenic and fever

Con el objetivo de analizar la mortalidad y sus principales causas se evaluó a los pacientes con Lupus Eritematoso Sistémico (ACR82) que presenta-ron infecciones durante un período de estudio de 12 años. Se evaluaron en particular aquellos con neutropenia y fiebre. Ocurrieron 442 episodios de infecciones en 216 pacientes. 21 pacientes (10 por ciento) presentaron N y F en 28 episodios. La edad promedio fue de 35.6ñ9.6, el tiempo medio de evolución del LES fue de 5.8+- 2 (2 m.-25 a.). El lupus estuvo activo en el 93 por ciento) de los pacientes. El grado de actividad fue de 10.5ñ5.9 en neutropenicos febriles (N y F) vs 5.06.t4.7 en no-neutropenicos febriles (no-N y F) (p-< 0.0001). El tratamiento con ciclofósfamida i.v. se asoció con el desarrollo de neu-tropenia y fiebre (p<- 0.0002). El promedio de neutrofilos fue de 408/mm ñ185.6 (200-806). La duración media de la neutropenia fue de 10.9 días (245 días). Durante el episodio infeccioso fallecieron 38 pacientes (17.6 por ciento), 12/21 con N y F: (57 por ciento) y 26/195 (13 por ciento) no -N y F (p-< 0.00001). Las causas mas frecuentes de muerte fueron: infecciones en 21/38 casos (55.26 por ciento) , el compro-miso multiorgánico del lupus en 6 (16 por ciento), tromboembolismo pulmonar en 5 pasos (13 por ciento) . Predominó la mortalidad por infecciones en los pacientes con N y F (66.6 por ciento) vs. los no-N y F (50 por ciento) pero sin diferencia estadísticamente significativa. (AU)

Mortalidad en pacientes con Lupus Eritematoso Sistémico e infecciones. Asociación con neutropenia y fiebre / Mortality in patients whith systemic lupus erythematosus and infections. Associated with neutropenic and fever

Con el objetivo de analizar la mortalidad y sus principales causas se evaluó a los pacientes con Lupus Eritematoso Sistémico (ACR82) que presenta-ron infecciones durante un período de estudio de 12 años. Se evaluaron en particular aquellos con neutropenia y fiebre. Ocurrieron 442 episodios de infecciones en 216 pacientes. 21 pacientes (10 por ciento) presentaron N y F en 28 episodios. La edad promedio fue de 35.6ñ9.6, el tiempo medio de evolución del LES fue de 5.8+- 2 (2 m.-25 a.). El lupus estuvo activo en el 93 por ciento) de los pacientes. El grado de actividad fue de 10.5ñ5.9 en neutropenicos febriles (N y F) vs 5.06.t4.7 en no-neutropenicos febriles (no-N y F) (p-< 0.0001). El tratamiento con ciclofósfamida i.v. se asoció con el desarrollo de neu-tropenia y fiebre (p<- 0.0002). El promedio de neutrofilos fue de 408/mm ñ185.6 (200-806). La duración media de la neutropenia fue de 10.9 días (245 días). Durante el episodio infeccioso fallecieron 38 pacientes (17.6 por ciento), 12/21 con N y F: (57 por ciento) y 26/195 (13 por ciento) no -N y F (p-< 0.00001). Las causas mas frecuentes de muerte fueron: infecciones en 21/38 casos (55.26 por ciento) , el compro-miso multiorgánico del lupus en 6 (16 por ciento), tromboembolismo pulmonar en 5 pasos (13 por ciento) . Predominó la mortalidad por infecciones en los pacientes con N y F (66.6 por ciento) vs. los no-N y F (50 por ciento) pero sin diferencia estadísticamente significativa.

No association between dopamine D1, D2, and D3 receptor genes and manic-depressive illness.

BACKGROUND: The dopaminergic receptor genes are candidate genes for manic-depressive illness (MDI). To test this putative involvement we used a case-control study on samples from the native population of the northwest part of France. METHODS: Fifty patients for D1 and D2, 61 patients for D3, and 86-223 controls were tested. RESULTS: No significant association was found between allelic frequencies or genotype counts and MDI, even when the data were pooled with those from published studies. CONCLUSIONS: Single mutations of either of the studied receptor genes are not major determinants of MDI.

Manic depressive illness and tyrosine hydroxylase gene: linkage heterogeneity and association.

Several studies have implicated the tyrosine hydroxylase (TH) locus within the 11p15 region in susceptibility to manic depressive illness (MDI). This possibility was further investigated by both parametric (lod score) and nonparametric (affected-pedigree-member and a case-control study) methods of analysis in 11 French MDI families and in a sample of 200 unrelated subjects. Both types of analyses corroborate the implication of this locus, and positive lod scores were obtained in two families, which most likely reflects genetic heterogeneity. Statistical analyses were also performed including available data from published reports. These analyses, which allowed for genetic heterogeneity, substantiated our findings. The combined maximum lod score for all the families studied was 3.68 at theta = 0.00 (number of families: 36) assuming heterogeneity (alpha = 15%, P = 0.01). Taken together these results converge to suggest that the risk factors for MDI lie in the 11p15 region with TH being the most likely candidate gene.

Suicidal behaviors and the tryptophan hydroxylase gene.

BACKGROUND: To determine whether the tryptophan hydroxylase gene (ie, the gene that codes for the rate-limiting enzyme in the metabolic pathway of serotonin) may be a susceptibility factor for suicidal behavior. METHODS: Genotypic and allelic frequencies at a polymorphic Ava II restriction site were revealed with the use of the complementary DNA tryptophan hydroxylase probe C2-38 in 62 suicide attempters. The psychiatric characteristics of these suicide attempters were determined using the Schedule for Affective Disorders and Schizophrenia-Lifetime version with modification for the study of anxiety disorders, and these characteristics were compared with those in 52 healthy controls. RESULTS: No association between tryptophan hydroxylase and suicidal behavior was detected. CONCLUSION: The tryptophan hydroxylase gene was not a susceptibility factor for suicidal behaviors in the group of suicide attempters in this study.

[Clinical study of 5 families with bipolar disorder]. / Etude clinique de cinq familles de bipolaires.

Five pedigrees of bipolar patients with at least two bipolar subjects on two generations have been identified in psychiatric departments of Nantes, Montpellier and Challans for linkage studies. In each pedigree, it was found one or more patients suffering from other conditions, like Borderline personality, Anorexia-bulimia, Mental retardation with dysmorphia, and Panic disorders. Mood disorders spectrum and therapeutic implications are discussed.