Disclosure of Suicidal Ideation to General Practitioners Prior to a Suicidal Act: A National Observational Study Using the French Sentinelles Network

Objective Consultation in primary care prior to suicidal acts (suicides [S] and suicide attempts [SA]) offers an opportunity for patients to disclose suicidal ideation (SI). This study aims to assess the frequency of spontaneous disclosure of SI to general practitioners (GPs) or after GPs’ exploration, during the six months preceding a suicidal act, and identify factors associated with spontaneous disclosure. Method GPs from the French Sentinelles Surveillance system completed weekly questionnaires between 2013 and 2024 for all suicidal acts (SA and S) among their patients. Bivariate and multivariate regression analyses were performed. Results: A total of 1,281 suicidal acts were included: 1,033 SA and 223 S. SI had been spontaneously disclosed by 22.6% of the patients. Several factors were associated to this disclosure: history of SA (aOR 2.03, 95% 1.43–2.90); diagnosis of depression (aOR 1.93, 95% 1.32–2.83), consulting for psychological reasons (aOR 1.92, 95% 1.28–2.90), completed suicide (aOR 1.85, 95% 1.15–2.95), period after 2020 (aOR 1.63, 95% 1.13–2.39), consulting during the last month (aOR 1.53, 95% 1.08–2.18). Patients aged 25–65 were less likely to spontaneously disclose SI compared to those under 25 or above 65 (aOR 0.44, 95% CI 0.29–0.68). Conclusion The frequency of spontaneous disclosure of SI by the patient to GPs prior to a suicidal act is low. Efforts to destigmatize SI and implement care systems that facilitate the disclosure of suicidal thoughts should be strengthened.