L’objectif de notre travail était de dresser le profil sociodémographique et clinique des jeunes suicidants en population clinique et de tenter d’en relever les modifications entre 2005 et 2015.

Il s’agit d’une étude descriptive rétrospective incluant 159 suicidants référés au service de pédopsychiatrie de l’hôpital Razi, service de référence pour l’hospitalisation des enfants du nord et du centre du pays, entre janvier 2005 et décembre 2015.

L’âge moyen de notre population était de 12,8 ans (DS : 5,8–17) ans. Elle était constituée de 74,2 % de filles et 25,8 % de garçons. Le moyen médicamenteux constituait le moyen le plus fréquemment employé (68,6 %) suivi par les moyens physiques (20,1 %) et les produits toxiques (12,6 %). Il s’agissait essentiellement de tentatives de suicide non préméditées (83,1 %). Nos patients présentaient des antécédents personnels de tentative de suicide dans 25,8 % des cas. Des troubles psychiatriques caractérisés chez l’enfant, chez les parents, la notion de maltraitance et de désinsertion scolaire ont été retrouvés chez respectivement 48,4 %, 0,6 %, 37,1 % et 13,4 % des suicidants. L’étude chronologique a mis en évidence des modifications significatives à partir de 2013–2014, traduisant une tendance nouvelle : rajeunissement de la population de suicidants (p=0,012), davantage d’antécédents personnels de tentative de suicide (p=0,045), recours plus fréquent aux moyens violents (p=0,019) et proportion plus importante de tentatives réalisées en hiver (p=0,019).

Le profil clinique de ces patients se rapproche de la littérature. On note cependant une nouvelle tendance évolutive marquée par des passages à l’acte plus violents.

Suicide and suicide attempts represent a worldwide health priority. The aim of our study was to describe the epidemiological and clinical characteristics of young suicide attempters among a clinical population and to assess their potential evolution over a period of11 years.

We conducted a descriptive retrospective study among a clinical population of suicide attempters referred to the child psychiatric department of the Razi hospital, the inpatient reference department in the north and center of Tunisia, between January 2005 and December 2015. Based on the WHO definition we considered as suicide attempts, “any deliberate act, without any fatal outcome, aimed at performing a gesture of violence on one's own person or to ingest a toxic substance or drugs at a dose higher than the dose recognized as therapeutic”. We conducted collection of data from patient records based on a pre-established record with the following parameters: clinical study of patients including: socio-demographic data, clinical characteristics based on DSM 4 criteria and environmental factors including family history of psychiatric disorder, abuse, school difficulties and failure.

The sample was composed of 159 patients having a mean age of 12.8 years with extremes from 5.8 to 17 years. It was composed of 74.2% girls and 25.8% boys. Medical intoxication was the most common mean (68.6%) followed by physical means (20.1%) and toxic products ingestion (12.6%). The suicide attempts were mainly non-premeditated (83.1%). Our patients reported a previous suicide attempt in 25.8% of cases. Chronic somatic disorders were found among 24.5% of our sample. Psychiatric disorders among children, parents, abuse, and school failure were found in respectively 48.4%, 50.6%, 37.1% and 13.4% of suicidal patients. Psychiatric disorders were dominated by depressive disorders and oppositional defiant disorders associated with conduct disorder. The chronological study highlighted significant modifications starting from 2013/2014, reflecting a recent trend: a significant decrease in suicidal age was found since the year 2015: children under 10 years of age, who constituted 8.4 % (n=10) of suicides during the period from (n=119), accounted for 20 % (n=32) of the patients enumerated in the year 2015 (P=0.045). We also found that the percentage of suicidal attempts committed in winter was higher from 2013 than in previous years (P=0.019). We also noted a significant increase in 2014 in the proportion of patients with a personal history of suicidal attempt when compared to previous years (P=0.045). The use of physical means became more frequent from 2013 (P=0.019). This is confirmed by comparing the suicide attempts prior to and from 2014 (P=0.007) or by comparing the suiced attempts committed in 2015 to the ones committed during the previous ten years (P=0.007). Finally, there was a statistically significant distribution of serious organic effects (coma) as a function of years: such complications were more frequent in the course of suicidal attempts committed after 2013 (P=0.009).

Since 2013/2014 we found a recent trend characterized by more children among suicidals, more patients reporting a previous suicide attempt, more frequent use of physical means and a greater proportion of suicide attempts realized in winter. This raises the challenge for more research on the topic as well as new therapeutic interventions.