[Revealing three psychological states before an acting out in 32 patients hospitalized for suicide attempt]

The purpose of this study was to reconstruct the psychological state of suicidal subjects at the time of the execution of the gesture according to their thoughts, their emotions, their actions, their fantasy life and consciousness.

Thirty-three adult subjects agreed, just days after their suicide attempt, to answer the Interview Method for Suicidal Acts (IMSA). This object of this semi-structured interview is to invite the suicidal to reconstruct mentally and chronologically their suicide attempt. IMSA can follow the thoughts, behavior, consciousness, emotions and activity of the suicidal scenario by helping the patient to reconstruct the phenomenology of his/her actions until the final suicidal gesture.

The data were processed using the method of Classification TwoStep on SPSS, based on Schwarz Bayesian criterion. The results highlight three main types of psychological state: (1) a "kinesthetic" psychological state (called "type K") is characterized by a rupture between the subjective sensation of motor movement and effective motility (motor automatism), the presence of a dissociative state, an "empty" feeling of thought and the absence of an external triggering factor; (2) a "cognitive" psychological state (called "type C") is characterized by a significant reflection on the decision to die and infiltration of the morbid thought, an intense fantasy life around the suicidal scenario, a clear state of consciousness, and an absence of loss of motor control; (3) an "emotional" psychological state (called "type E") is characterized by confusing and chaotic emotional processes, the emergence of a dissociative state, and a significant impact of external events on the onset of the suicide attempt.

This classification of suicide attempts allows us to identify the different combinations of the suicidal process and opens up new therapeutic strategies.