title: Attempted and completed suicide in primary care: not what we expected?
abstract: BACKGROUND
  General Practitioners (GPs) play a central role in suicide prevention. This study aims to compare the characteristics of individuals who attempt suicide to those who complete suicide in a same primary care setting.
  
  
  METHODS
  We compared the characteristics and GP's management of all patients with attempted (N=498, SA) or completed suicide (N=141, SC) reported to the GPs'French Sentinelles surveillance system (2009-2013).
  
  
  RESULTS
  Compared to patients who attempted suicide, those who completed suicide were more likely to be male, older and to have used a more lethal method; for men they were less likely to have a history of previous suicide attempt and prior contacts with their GP. In terms of GPs' management, we found no differences between the SA and SC groups in the identification of psychological difficulties and in the care, but GPs were more likely to provide psychological support to the SA group. During the last consultation, the SC group expressed suicidal ideas more frequently than the SA group (26.7% vs. 14.8%, p<0.01), only for women.
  
  
  CONCLUSIONS
  The network may have missed cases and selected more serious SA.
  
  
  CONCLUSIONS
  Individuals who commit suicide differ from those who attempt suicide in terms of demographic characteristics and by sex, of history of suicide attempt, previous contact and expressed suicidal ideas. We show that GPs do not act more intensively with patients who will commit suicide, as if they do not foresee them. Current prevention programs particularly in primary care should be tailored.
authors.affiliation: EA 40-47 Université Versailles Saint-Quentin-en-Yvelines, F-78047 Guyancourt, France; Academic Unit of Psychiatry, Versailles Hospital, 177 Rue de Versailles, F-78157 Le Chesnay, France. Electronic address: nyounes@ch-versailles.fr.
authors.forename: N
authors.initials: N
authors.lastname: Younes
authors.affiliation: INSERM, UMR_S 1136, Pierre Louis Institute for Epidemiology and Public Health, Department of Social Epidemiology, F-75013 Paris, France; Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Pierre Louise Institute of Epidemiology and Public Health, F-75013 Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Melchior
authors.affiliation: INSERM, U707, F-75012, Paris, France; UPMC University Paris 06, UMR-S U707, F-75012, Paris, France.
authors.forename: C
authors.initials: C
authors.lastname: Turbelin
authors.affiliation: INSERM, U707, F-75012, Paris, France; UPMC University Paris 06, UMR-S U707, F-75012, Paris, France.
authors.forename: T
authors.initials: T
authors.lastname: Blanchon
authors.affiliation: INSERM, U707, F-75012, Paris, France; UPMC University Paris 06, UMR-S U707, F-75012, Paris, France; Université Versailles Saint Quentin en Yvelines, F-78000, Versailles, France.
authors.forename: T
authors.initials: T
authors.lastname: Hanslik
authors.affiliation: French Institute for Public Health Surveillance, Saint Maurice, France.
authors.forename: C Chan
authors.initials: CC
authors.lastname: Chee
mesh_terms: D000328:Adult; D011307:Drug Prescriptions; D005260:Female; D005602:France / Q000453:epidemiology; D058005:General Practitioners; D006801:Humans; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care; D012737:Sex Factors; D012959:Socioeconomic Factors; D013405:Suicide / Q000523:psychology / Q000706:statistics & numerical data; D013406:Suicide, Attempted / Q000517:prevention & control* / Q000523:psychology / Q000706:statistics & numerical data; D000092864:Suicide Prevention
keywords: Genders difference; Primary care; Suicidal attempts; Suicidal prevention; Suicides