Suicide et délinquance juvénile : phénomènes distincts ou manifestations d’une même problématique ?

Cet article examine la relation entre suicide et délinquance chez les jeunes. Une revue des recherches suggère que les comportements suicidaires sont exceptionnellement fréquents chez les jeunes Québécois qui présentent des comportements délinquants ou perturbateurs. Ainsi, au moins 32 % des jeunes de 18 ans et moins décédés par suicide au Québec au cours des années 1995-96 avaient reçu des services des Centresjeunesse, organismes responsables de l'intervention auprès des jeunes contrevenants et des jeunes en besoin de protection. Parmi ces victimes, les jeunes contrevenants et les jeunes qui ont des troubles sévères du comportement, qui constituent environ 33 % de la clientèle des Centresjeunesse, avaient commis 69 % des suicides. L'examen des recherches récentes propose trois ensembles d'hypothèses pour tenter d'expliquer les taux élevés de comportements suicidaires chez ces jeunes, hypothèses portant respectivement sur 1) la psychopathologie et les trajectoires de vie, 2) l'impulsivité, l'agressivité et la réaction au stress et 3) l'impact à plus ou moins long terme des événements de vie négatifs. Certains facteurs organisationnels liés aux milieux d'intervention destinés aux jeunes délinquants sont aussi discutés. En conclusion, nous faisons des recommandations pour améliorer la prévention du suicide dans ces milieux.This article examines the relation between juvenile delinquency and suicide in adolescents. A review of the research suggests that suicidal behavior is extremely frequent among Quebec delinquent or severely disruptive adolescents. At least 32 % of Quebec adolescents who committed suicide in 1995 and 1996 had been involved with the "Centres jeunesse" (CJ), a governmental organization in charge of juvenile delinquents and youths in need of protection. Among those suicide victims, juvenile delinquents and severely disruptive adolescents, who represent 33 % of CJ customers, committed 69 % of all suicides. A review of recent research suggests three sets of hypotheses for explaining the high level of suicidal behaviors among délinquant and disruptive adolescents, in terms of 1) psychopathology and Life history, 2) impulsivity, aggressivity, and stress adjustment, and 3) the short and long term impacts of negative life events. Certain organizational factors of the intervention environments for delinquent and disruptive adolescents are also discussed. In conclusion, we recommend strategies for improving suicide prevention in those environments

L'interprétation du Code civil du Québec : l'occasion d'une réforme de la responsabilité extracontractuelle de l'Administration publique

Le droit de la responsabilité extracontractuelle de l'Administration publique présente de sérieuses lacunes. Une réforme apparaît nécessaire à de nombreux auteurs québécois, canadiens, anglais et américains. Ces auteurs peuvent se regrouper en trois catégories : les défenseurs de l'application accrue du droit privé, les partisans de la création d'un régime mixte et, enfin, les auteurs proposant l'institution d'un régime entièrement autonome de droit public. Deux réformes fondées sur le droit administratif français et proposées par les partisans de la création d'un régime mixte se révèlent particulièrement intéressantes, soit le principe de faute de service et le principe de responsabilité reposant sur le principe d'égalité devant les charges publiques et accordant l'indemnisation du préjudice revêtant un caractère spécial et anormal. À l'occasion de la réforme du Code civil, ces deux réformes pourraient-elles être introduites par les tribunaux ? Une interprétation large et libérale de la notion floue de la faute, telle qu'elle est reformulée dans l'article 1457 du Code civil du Québec, permettrait aux tribunaux de considérer que l’Administration publique a commis une faute lorsqu'elle fait subir à une victime un préjudice spécial et anormal. Cependant, il n'apparaît pas que la réforme du Code civil permette d'accélérer la tendance vers l'assouplissement de la règle de l'individualisation de la faute en matière de responsabilité administrative.Law in matters of extracontractual liability of the Public Administration suffers serious deficiencies. Many Quebec, Canadian, English and American authors endorse the need for reform. These authors may be classified into three categories: the defenders of enhanced application of private law, proponents of the creation of a mixed regime and, lastly, authors who advance the institution of an entirely independent regime in public law. Two reforms based on French administrative law and put forth by proponents of the creation of a mixed regime, prove to be particularly interesting, namely the principle of faulty service and the principle of liability based on the principle of equality before public charges and granting indemnification for injury presenting a special or abnormal character. In the wake of the Civil Code reform, could these two reforms be introduced through the courts ? A broad and liberal interpretation of the extensive notion of fault as reformulated in Q.C.C. article 1457 could enable the courts to consider that the Public Administration has committed a fault when it causes a victim to sustain a special and abnormal injury. It does not appear, however, that the Civil Code reform enables an acceleration of the trend towards making the rule of individualizing fault in matters of administrative liability more flexible

Association between recurrent dreams, disturbing dreams and suicidal ideation in adolescents

Disturbing dreams and recurrent dreams have both been linked to a wide range of psychological difficulties in children. There is growing evidence that the experience of frequent disturbing dreams is associated with suicidal ideation in adults but studies in young adolescents have been limited and the results inconsistent. In addition, the possible relationship between suicidal ideation and recurrent dreams has yet to be studied. We thus investigated the relation between disturbing dreams, recurrent dreams and suicidal ideation in a sample of young adolescents. Self-report measures of disturbing dream frequency, recurrent dream frequency, and suicidal ideation were collected at age 12 years and again at age 13 years from 170 children from a prospective population-based birth cohort. While the rate of disturbing dreams and recurrent dreams dropped between ages 12 and 13, the rate of self-reported suicidal ideation increased between the ages of 12 and 13 years. Analyses taking sex and age into account revealed that young adolescents who reported having had suicidal thoughts over the past year had significantly greater frequencies of disturbing dreams and of recurrent dreams than adolescents who had not thought about suicide. These findings highlight the potential clinical value of assessing disturbing and recurrent dreams as part of the screening process for suicidal ideation in young adolescents

Associations of substance use patterns with attempted suicide among persons who inject drugs: Can distinct use patterns play a role?

Background: While the elevated risk of suicide attempt among persons who inject drugs (PWID) is well documented, whether use of different substances is associated with varying degrees of risk remains unclear. We sought to examine the associations between substance use patterns and attempted suicide in a prospective cohort of PWID in Montreal, Canada. Methods: Between 2004 and 2011, participants completed an interviewer-administered questionnaire eliciting information on socio-demographic, substance use patterns, related behaviors, and mental health markers. Generalized estimating equations were used to model the relationship between self-reported use of six common substances (cocaine, amphetamine, opioids, sedative-hypnotics, cannabis and alcohol), associated patterns of use (chronic, occasional and none), and a recent (past six-month) suicide attempt. Results: At baseline, of 1,240 participants (median age: 39.1, 83.7% male), 71 (5.7%) reported a recent suicide attempt. Among 5,621 observations collected during follow-up, 221 attempts were reported by 143 (11.5%) participants. In multivariate analyses adjusting for socio-demographic and psychosocial stressors, among primary drugs of abuse, chronic [Adjusted Odds Ratio (AOR): 1.97] and occasional (AOR: 1.92) cocaine use, and chronic amphetamine use (AOR: 1.96) were independently associated with attempted suicide. Among co-used substances, chronic sedative-hypnotic use was independently associated with an attempt (AOR: 2.29). No statistically significant association was found for the remaining substances. Conclusion: Among PWID at high risk of attempted suicide, stimulant users appear to constitute a particularly vulnerable sub-group. While the mechanisms underlying these associations remain to be elucidated, findings suggest that stimulant-using PWID should constitute a prime focus of suicide prevention efforts

Associations between peer victimization and suicidal ideation and suicide attempt during adolescence : results from a prospective population-based birth cohort

Objective:To test whether adolescents who are victim-ized by peers are at heightened risk for suicidal ideationand suicide attempt, using both cross-sectional andprospective investigations.Method:Participants are from the Quebec LongitudinalStudy of Child Development, a general population sampleof children born in Quebec in 1997 through 1998 andfollowed up until 15 years of age. Information aboutvictimization and serious suicidal ideation and suicideattempt in the past year was obtained at ages 13 and15 years from self-reports (N¼1,168).Results:Victims reported concurrently higher rates ofsuicidal ideation at age 13 years (11.6–14.7%) and suicideattempt at age 15 years (5.4–6.8%) compared to those whohad not been victimized (2.7–4.1% for suicidal ideationand 1.6–1.9% for suicide attempt). Being victimized bypeers at 13 years predicted suicidal ideation (odds ratio[OR]¼2.27; 95% CI¼1.25–4.12) and suicideattempt (OR¼3.05, 95% CI¼1.36–6.82) 2 years later,even after adjusting for baseline suicidality andmental health problems and a series of confounders(socioeconomic status, intelligence, family’s functioningand structure, hostile-reactive parenting, maternal lifetimesuicidal ideation/suicide attempt). Those who werevictimized at both 13 and 15 years had the highest risk ofsuicidal ideation (OR¼5.41, 95% CI¼2.53–11.53) andsuicide attempt (OR¼5.85, 95% CI¼2.12–16.18) at15 years.Conclusion:Victimization is associated with an increasedrisk of suicidal ideation and suicide attempt over andabove concurrent suicidality and prior mental healthproblems. The longer the history of victimization, thegreater the risk

Psychiatric services utilization in completed suicides of a youth centres population

BACKGROUND: From a retrospective study of youth centres (YCs) and coroner's files, we investigated youths' history of medical service utilization who died by suicide. This is the second of two papers on YCs population, the first paper having shown that the rate of psychopathology was higher in the YCs population compared to the general adolescent population. METHODS: From 1995 to 2000, 422 youths, aged 18 years and younger, died as a result of suicide in Quebec. More than one-third received services from YCs at some point. Using the provincial physician payment and hospitalization database, we examined physical and psychiatric service utilization according to time intervals, as well as hospitalization for psychiatric reasons in the individuals' lifetime and in the year preceding suicide. Suicides were matched to living YCs youths for age, sex, and geographic area. YCs controls were then subdivided into two groups based on file information pertaining to the presence or absence of suicidal behavior or ideation. RESULTS: Compared to living YCs youths, suicides had a higher rate of psychiatric service utilization in the week, month, 90 days, and year preceding suicide, as well as higher levels of lifetime hospitalization for psychiatric reasons than controls with or without a history of suicidal behavior or ideation. We found that 28.3% YCs suicides made use of psychiatric services in the year preceding suicide. CONCLUSION: The rate of psychiatric service utilization by YCs youth suicides is substantially inferior to the needs of this population. Our study underscores the need for appropriate recognition of psychiatric and suicidal problems among YCs population by social and psycho-educational professionals. At the same time, it highlights the issues of general practitioners' risk identification, psychiatric referral and treatment. Our findings suggest the need for improved organization and coordination of psychiatric services to ameliorate treatment delivery

Contribution of genes and environment to the longitudinal association between childhood impulsive‐aggression and suicidality in adolescence

Background Population‐based and family studies showed that impulsive‐aggression predicts suicidality; however, the underlying etiological nature of this association is poorly understood. The objective was to determine the contribution of genes and environment to the association between childhood impulsive‐aggression and serious suicidal ideation/attempt in young adulthood. Methods N = 862 twins (435 families) from the Quebec Newborn Twin Study were followed up from birth to 20 years. Repeated measures of teacher‐assessed impulsive‐aggression were modeled using a genetically informed latent growth model including intercept and slope parameters reflecting individual differences in the baseline level (age 6 years) and in the change (increase/decrease) of impulsive‐aggression during childhood (6 to 12 years), respectively. Lifetime suicidality (serious suicidal ideation/attempt) was self‐reported at 20 years. Associations of impulsive‐aggression intercept and slope with suicidality were decomposed into additive genetic (A) and unique environmental (E) components. Results Additive genetic factors accounted for an important part of individual differences in impulsive‐aggression intercept (A = 90%, E = 10%) and slope (A = 65%, E = 35%). Genetic (50%) and unique environmental (50%) factors equally contributed to suicidality. We found that 38% of the genetic factors accounting for suicidality were shared with those underlying impulsive‐aggression slope, whereas 40% of the environmental factors accounting for suicidality were shared with those associated with impulsive‐aggression intercept. The genetic correlation between impulsive‐aggression slope and suicidality was 0.60, p = .027. Conclusions Genetic and unique environmental factors underlying suicidality significantly overlap with those underlying childhood impulsive‐aggression. Future studies should identify putative genetic and environmental factors to inform prevention

A collaborative model to implement flexible, accessible and efficient oncogenetic services for hereditary breast and ovarian cancer : the C-MOnGene study

Medical genetic services are facing an unprecedented demand for counseling and testing for hereditary breast and ovarian cancer (HBOC) in a context of limited resources. To help resolve this issue, a collaborative oncogenetic model was recently developed and implemented at the CHU de Québec-Université Laval; Quebec; Canada. Here, we present the protocol of the C-MOnGene (Collaborative Model in OncoGenetics) study, funded to examine the context in which the model was implemented and document the lessons that can be learned to optimize the delivery of oncogenetic services. Within three years of implementation, the model allowed researchers to double the annual number of patients seen in genetic counseling. The average number of days between genetic counseling and disclosure of test results significantly decreased. Group counseling sessions improved participants' understanding of breast cancer risk and increased knowledge of breast cancer and genetics and a large majority of them reported to be overwhelmingly satisfied with the process. These quality and performance indicators suggest this oncogenetic model offers a flexible, patient-centered and efficient genetic counseling and testing for HBOC. By identifying the critical facilitating factors and barriers, our study will provide an evidence base for organizations interested in transitioning to an oncogenetic model integrated into oncology care; including teams that are not specialized but are trained in genetics

Total syntheses of (+̲)-Methyl cantabrenonate, (+̲)-Methyl epoxycantabronate, and (+̲)-Crinipellin B

The syntheses of two structurally related target compounds, (±)-methyl cantabrenonate(13) and (±)-methyl epoxycantabronate (14) are described in the first part of this thesis, while the preparation of the naturally occurring crinipellin B (15) is discussed in the second part of the thesis. Two methylenecyclopentane annulation sequences previously developed in our laboratories played key roles in the syntheses of (±)-13, (±)-14 and (±)-15. A new cyclopentenone annulation procedure was elaborated to assemble the last 5-membered ring of crinipellin B (15). The syntheses of (±)-13 and (±)-14 first involved the conversion of 3-methy1-2-cyclopenten- 1-one (64) into the enone 62 via known chemistry. The enone 62 was transformed into the keto alkene 60 in one step utilizing a methylenecyclopentane annulation method developed previously by Piers and Karunaratne. Thus, conjugate addition of the reagent 18 to the enone 62 afforded the lithium enolate anion 106. This intermediate was allowed to undergo intramolecular alkylation, upon addition of HMPA to the solution containing 106 and warming to room temperature. The keto alkene 60 was converted into the ketone 59 via a sequence of steps which allowed establishment of the correct configuration of the methyl group at C-9. Three synthetic operations on the ketone 59 afforded the enone 120which was successfully transformed into (±)-13 and (±)-14. The synthesis of (±)-crinipellin B (15) was accomplished in 22 steps from the commercially available 2-methyl-2-cyclopenten- 1-one. The starting material was efficiently converted into the bicyclic enone 194 which was subjected to a methylenecyclopentane annulation sequence regioisomeric to that described above. Thus, treatment of 194 with the reagent 209 in the presence of TMSBr provided the vinyl germane 219. A trimethylgermyl-iodine exchange on 219 afforded the vinyl iodide 220, which was allowed to cyclize under conditions ((Ph3)4Pd, t-BuOK, t-BuOH, THF) developed previously by Piers and Marais. The keto alkene 191 was obtained in good overall yield from 194. Three synthetic operations on 191 yielded the ketone 224. A newly elaborated cyclopentenone annulation procedure allowed the conversion of 224 into the enedione 267. Alkylation of 224 with (Z)-3-bromo- 1 -iodopropene (251) gave an intermediate vinyl iodide, which was allowed to undergo cyclization by treatment with n-BuLi in THF. The resultant allylic alcohol 249 underwent oxidative rearrangement to furnish the enedione 267. Two synthetic steps provided the enedione epoxide 188, which was converted into (±)-crinipellin B (15).Science, Faculty ofChemistry, Department ofGraduat