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Suicidal gestures in teenage girls: SOS of a youth in distress – Liberation

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We knew that the year 2021, and even the end of 2020, had been marked, among young people, by an increase in suicidal acts and suicide attempts, that some specialists had linked to the effects of confinement and the health crisis in general. New data, obtained by Release, indicate that the phenomenon is mainly caused by adolescent girls and young women.

The higher prevalence of suicide attempts among young women has been known for years (even if it is not found in “completed” suicides, that is to say those with a fatal outcome, where the ratio is reversed) (1). But the figures that we obtained, from three converging indicators, indicate a phenomenon unprecedented in its scale, and for which explanations are still lacking.

22% increase among young women in 2021

Release obtained from Public Health France the evolution, by sex, of emergency room admissions for suicidal acts (GS). These data are not complete for 2021: they stop at week 43 (end of October), but they are striking. Among girls under 15 years of age, emergency room admissions for suicidal acts have increased sharply, increasing over the first 43 weeks of 2021 by more than 40% compared to the average admissions over the same period over the previous three years. . The number of admissions for boys under 15 over the first 43 weeks of 2021 is perfectly stable compared to the last three years.

Same phenomenon in the 15-29 age group. Among adolescent girls and young women, there is an increase of 22% in 2021 compared to the previous three years, against a virtual stability (+ 1%) for men. We did not obtain more precise data making it possible to know the distribution of this increase within this age group, and whether it was more situated in the youngest age group.

In these age categories, the volume of suicidal acts is structurally much higher in women. For those under 15, the number of emergency room admissions for young girls (between 3,300 and 4,000 per year for the years 2018-2020) is usually almost twice that of boys (between 2,000 and 2 500). The same goes for 15-29 year olds: the statistics indicated each year between 2018 and 2020 a volume of “usual” admissions twice as high for women (between 13,000 and 15,000) than for men (between 7,000 and 8 000).

“Multifactorial causes”

“In adolescence, among the perpetrators of suicide attempts, we always have an over-representation of girls compared to boys, explain to Release Angela Consoli, specialist in child and adolescent psychiatry at the Parisian hospital of Pitié-Salpêtrière, and member of the Scientific Council. Girls have more recourse, in the expression of their psychological suffering or their distress, to suicide attempts, often with means which are less life-threatening, taking medication, whereas for suicides which are said to have been completed. ”, That is to say followed by a death, it is more boys and men. These are multifactorial, biological, hormonal, socio-cultural causes. So there is, in what we observe there, a form of continuity. “

The very sharp increase in admissions for suicidal acts among adolescents and young women in 2021 has therefore come on top of a greater prevalence of this behavior, which is amplified.

The other indicators confirm the phenomenon, according to Fabrice Jollant, professor of psychiatry (GHU Paris psychiatry and neurosciences): “I worked on two types of French data, calls to poison control centers for attempted suicide until November 2021, and on the other hand hospitalizations for attempted suicide until August 2021 inclusive, he explains. These data both point in the same direction: namely an increase in suicide attempts among adolescent girls, but not among adolescents or in other age groups, this only since the start of the 2020 school year. “

“Very violent modalities”

Fabrice Jollant had analyzed with the resuscitator Dominique Vodovar the calls for suicide attempts in the eight French poison control centers (CAPs). The two doctors had concluded that there had been an increase in 12-24 year olds since September 2020. A phenomenon described as “new” and “Disturbing” by Professor Jollant. The data, which were analyzed within the association of CAPs, are the subject of a future publication, but Libé had access to the main lines: “By taking the figures from January to November (December not being consolidated in 2021) of each year from 2018 to 2020 inclusive, we observed a slow but regular decrease in suicidal attempts and gestures among 12-24 year olds, around 3% per year, Explain Dominique Vodovar. In 2021, there was an increase of nearly 45% among 12-24 year olds compared to the previous three years, with a total of suicidal acts and attempted suicides which rose from a little over 6,000 to almost 9,000. This increase seems to be increasing until March 2021 before the installation of a high plateau. “ And, here too, the increase is mainly driven by the very strong growth in suicide attempts and suicidal acts among women. The increase recorded in the first eleven months of 2021 compared to the average of the previous three years is more than 50% for women, against around 10% for boys. The imbalance according to sex in the calls of young people to the CAP is even more marked than that observed in the admissions to the emergency room or to the hospital for suicidal acts. The sex ratio was thus 3.5 over the years 2018-2020. It rose to 4.8 in 2021. This is explained according to Dominique Vodovar, by the fact that “Women more frequently use means such as drugs than men, in whom suicide attempts or suicidal gestures are carried out more by violent methods”.

The dynamic is the same for hospitalizations for self-inflicted acts. Fabrice Jollant and Catherine Quantin (Dijon University Hospital) had shown in a article on the first months of the pandemic a decrease in all age groups and for both sexes (except the elderly), compared to 2019. The start of the 2020 school year has reversed this trend among young people, and especially among girls. In another article currently being published, the researchers thus highlight, at the national level, a 27% increase in hospitalizations for self-inflicted acts since September 2020 among adolescents aged 10 to 19. “While rates are stable among adolescents aged 10-19 and young adults aged 20-29 (men and women), and even as the decline continues among middle-aged adults”, explains Fabrice Jollant.

If we do not have data at the national level on the means employed, Professor Nicolas Georgieff, child psychiatrist and head of the child and adolescent psychiatry center at Le Vinatier psychiatric hospital in Lyon, also reports on ” an evolution of operating methods among adolescent girls: “We have observed in young women serious suicide attempts and proven suicides with very violent methods that were not previously observed in girls, such as hanging and defenestration.”

“Undersized sectors”

Asked about the causes of the phenomenon, Fabrice Jollant argues that “The explanation for such a rise in teenage suicide attempts is not yet clear at all”, while recalling: “It is important to keep in mind that, apart from the pandemic, there is a peak among adolescent girls (but not boys) around 15-17 years old.” Evoking the impact of the health crisis, Angèle Consoli puts forward hypotheses: “Perhaps the girls were also more affected by this societal stress, by this insecurity, by the reduction of social or family ties and reference points.. There was an exposure to death, anguish, disease. Maybe they are more sensitive to it than boys. But it should not be deduced from this either that the boys, over the period, did not experience more suffering. It would be necessary to have the data by sex concerning the psychic distress and the depressions. Maybe the boys are just as depressed, but let that distress express itself in another way. These are just assumptions. We will have to study different risk factors and determinants. ” The certainty is that the phenomenon is highly worrying: “And vsWhat is worrying today is that it is continuing. Overall, since the fall of 2020, there has been this massive increase in depressions, anxiety disorders and suicidal gestures among young people. And it is an increase and a demand for care that we have difficulty in dealing with. ”

At Le Vinatier psychiatric hospital in Lyon, the massive increase in emergency room arrivals has made it necessary to review the emergency and post-emergency reception systems, testifies Nicolas Georgieff. “We noticed that our reception facilities were undersized and that they also had to evolve in qualitative terms, that a real psychiatric competence is needed from the emergencies. We imagined a crisis system by setting up a day hospital to respond intensively over a short period. It works to date, it avoids longer hospitalizations. But child psychiatry has never been so in demand since the start of the crisis and, at the same time, the number of child psychiatrists has collapsed. “

(1) In 2017, according to the CepiDC causes of death database, there were 223 suicides among adolescents and young men aged 15 to 24, compared to 89 among adolescents and young women.

Methodological note: the figures used in this article were communicated to CheckNews by Public Health France. They come from the system Health surveillance of emergencies and deaths (Sursaud), of which more than 600 emergency services are members. They were extracted at constant establishments, that is to say that the figures from January 1, 2018 to October 31, 2021 were produced by the same emergency services (which limits the statistical biases due to the opening or the closure of services). If during a week, for a given population, the number of suicidal acts was between 1 and 4, SPF replaced it, in its data by “Less than 5”, And this “For questions of statistical confidentiality”, the agency tells us. To facilitate treatment, we considered that this amounted to the fact that there had been no suicidal gesture that week for this population. For certain suicidal acts, age or sex were not indicated: we also excluded these suicidal acts from the calculation. Our figures, in absolute values, are therefore lower than reality.

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