Évaluation par les professionnels de santé des facteurs de risques liés aux psychotraumatismes dans les trajectoires suicidaires des personnes âgées

Abstract

Among the many risk factors involved in the onset of a suicidal crisis is a history of psychic trauma, which in elderly, can be recent, old, or delayed (current expression of an old trauma). The links between traumatic experiences and psychological vulnerability are demonstrated and the correlations between Post-Traumatic Stress Episode (PTSD) and suicide risk are also well supported. Nevertheless, it seemed through our clinical experience, that the assessment in suicidal elderly people of traumatic experiences, de novo, old and delayed, was not systematic compared to other risks factors such as depression. A questionnaire was distributed to health professionals about how they assessed the main risk factors associated with suicide among the elderly on a 6-point Likert scale ranging from “Never” to “Systematically”. Questions also concerned their previous training in psychotrauma, their training needs and their feeling of being able to explore this traumatic history in their clinical interviews. One-hundred-and-fifty-six complete questionnaires were analyzed. Medical physicians (33%), nurses (38%), psychologists (17%) – mostly women (69%), with a median age of 42 years and a median professional experience of 13 years – participated in this study. The results show that when faced with an elderly person in a suicidal crisis, depression is not systematically sought (67%). Of those who rate depression, only 64% look for recent traumatic events, 38% for old ones, and 33% for delayed expressions. Few of them have been trained in psychotrauma (25%) but 90.3% feel the need to be trained. Sixty percent of them feel able to explore this theme. To conclude, to have more precise data on the prevalence of PTSD in elderly people in suicidal crisis, on the impact of traumatic events on the life trajectories of these individuals and to improve their care, the professionals who meet them must be trained in this topic.