Résumés
Résumé
La recherche a souligné l’importance des problématiques de santé mentale dans le suicide, en particulier lorsqu’il survient en milieu carcéral ou institutionnel. Par ailleurs, les études disponibles laissent entendre que certaines mesures de prévention du suicide en institution peuvent être efficaces. Il y a peu de connaissances à ce jour sur l’importance relative et les effets d’interaction possibles entre psychopathologie, réponse institutionnelle sous forme de traitement, genre et comportements suicidaires. La présente étude cherchait à mettre en évidence les patrons d’association entre ces facteurs à partir d’un échantillon de 3620 sujets résidant en milieu psycholégal, totalisant 25 778 observations dans le temps. Les analyses de modèles mixtes logistiques laissent supposer que le genre, la forme et la cible du traitement sont significativement associés aux conduites suicidaires. Spécifiquement, les individus de sexe masculin ayant peu accès au traitement et prenant part à des interventions visant surtout la réintégration sociale étaient davantage à risque de conduites suicidaires. La présence de schizophrénie sans trouble de personnalité concomitant était négativement associée aux comportements suicidaires. Ces résultats contribuent à clarifier les liens entre problèmes de santé mentale, traitement institutionnel et problématiques suicidaires.
Mots-clés :
- Suicide,
- institution,
- psychopathologie,
- traitement
Abstract
Previous research has highlighted the importance of mental health problems in suicide, particularly in the context of carceral or forensic institutionalization. Studies have suggested that specific measures for suicide prevention in institutions can be helpful, but there is little information on the relative importance and possible interactions between psychopathology, institutional treatment programs, gender, and the risk of suicidal behavior. The current study examined associations between these variables in a sample of 3,620 inmates in secure forensic mental health custody, with a total of 25,778 observations for the time under consideration. Linear logistic mixed models revealed that gender as well as the form and focus of treatment are significantly related to the occurrence of suicidal behavior. Males who had little access to treatment and were involved primarily in activities focused on social reintegration were at higher risk of suicidal behaviour. A diagnosis of schizophrenia without a co-occurring personality disorder was negatively related to suicidal conduct. These results contribute to clarifying the links between mental health, institution-based treatment, and suicidal behavior.
Keywords:
- Suicide,
- institution,
- psychopathology,
- treatment
Resumen
Las investigaciones han subrayado la importancia de las problemáticas de salud mental en el suicidio, particularmente cuando acontece en el medio de las cárceles o de las instituciones. Por otro lado, los estudios disponibles sugieren que algunas medidas de prevención del suicidio en el medio institucional pueden ser eficaces. Hasta el día de hoy, existen relativamente pocos conocimientos acerca de la importancia relativa y sobre los efectos de interacción posibles entre la psicopatología, la respuesta institucional bajo la forma de tratamiento, el género y los comportamientos suicidas. El presente estudio buscaba evidenciar los patrones de asociación entre estos factores, a partir de una muestra de 3620 sujetos, residentes en el medio psico-legal, con un total de 25 778 observaciones a lo largo del tiempo. Los análisis de modelos mixtos logísticos sugieren que el género, la forma y el foco del tratamiento, están asociados significativamente con las conductas suicidas. Específicamente, los individuos de sexo masculino que tienen poco acceso a los tratamientos y que participan en intervenciones cuyo objetivo es sobre todo la reintegración social tienen más riesgo de tener conductas suicidas. La presencia de la esquizofrenia sin trastorno concomitante de la personalidad está asociada negativamente con los comportamientos suicidas. Estos resultados contribuyen a poner en claro las relaciones entre los problemas de salud mental, los tratamientos institucionales y las problemáticas suicidas.
Palabras clave:
- Suicidio,
- institución,
- psicopatología,
- tratamiento
Parties annexes
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