title: [Poor self-esteem is correlated with suicide intent, independently from the severity of depression].
abstract: BACKGROUND
  Suicide is a major Public Health concern, and low self-esteem might represent a major risk factor. Our main objective was to assess the correlation between self-esteem and suicide intent. More specifically, we aimed to examine the relationship between the different dimensions of self-esteem (total, general, familial, professional and social) and suicide intent. We also sought the role of depression in the relationship of self-esteem to suicide intent.
  
  
  METHODS
  This retrospective cross-sectional study was conducted at a suicide prevention department at the CMME (Sainte-Anne Hospital, Paris, France). We included patients aged 15 and older and admitted for suicide attempt over a 3-year period from January 2008 to December 2010. Self-esteem was assessed with the Coopersmith's Self-Esteem Inventory (SEI) scale that takes into account several domains of self-esteem. Subjects scoring over 5 points on the lie scale were excluded. Our primary endpoint was the correlation between self-esteem and suicide intent. Our secondary endpoint was the same correlation adjusted for depression severity (using the Hamilton scale). Suicide intent was estimated using Beck's Suicide Intentionality Scale (SIS). We examined the Pearson's correlation coefficients between self-esteem and suicide intent. These analyses were adjusted for the severity of depressive symptoms assessed with the Hamilton Depression Rating Scale (17 items).
  
  
  RESULTS
  Overall, 132 patients were included. Suicide intent was correlated with total self-esteem (r=-0.227, P=0.009), social self-esteem (r=-0.331, P<0.001) and familial self-esteem (r=-0.260, P=0.003). These results remained significant after adjusting for the level of depression for total score (r=-0.181, P=0.038), and the social (r=-0.282, P=0.001) and familial (r=-0.237, P=0.006) dimensions.
  
  
  CONCLUSIONS
  Self-esteem (and especially social and familial dimensions) is likely to be associated with suicide intent, at least in part independently of the severity of depression, in a population of subjects hospitalized for suicide attempt. This correlation was strongest with social self-esteem. The main limitation of this monocentric study is the lack of representative sample. Nevertheless, this result paves the way for future strategies of suicide prevention, especially those dealing with poor self-esteem.
authors.affiliation: Clinique des maladies mentales et de l'encéphale (CMME), hôpital Sainte-Anne, 1, rue Cabanis, 75014 Paris, France. Electronic address: clemence.perrot_86@hotmail.fr.
authors.forename: C
authors.initials: C
authors.lastname: Perrot
authors.affiliation: Clinique des maladies mentales et de l'encéphale (CMME), hôpital Sainte-Anne, 1, rue Cabanis, 75014 Paris, France.
authors.forename: L
authors.initials: L
authors.lastname: Vera
authors.affiliation: Clinique des maladies mentales et de l'encéphale (CMME), hôpital Sainte-Anne, 1, rue Cabanis, 75014 Paris, France; Centre de psychiatrie et neuroscience, Inserm UMR894, 2, ter rue d'Alésia, 75014 Paris, France; Université Paris-Descartes, 12, rue de l'École-de-Médecine, 75006 Paris, France.
authors.forename: P
authors.initials: P
authors.lastname: Gorwood
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D003863:Depression / Q000523:psychology*; D023381:Endpoint Determination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D012649:Self Concept; D059020:Suicidal Ideation; D055815:Young Adult; D000092864:Suicide Prevention
keywords: Depression; Dépression; Estime de soi; Intentionnalité suicidaire; Prevention; Prévention; Risque suicidaire; Self-esteem; Suicide intent; Suicide risk