Philippe Courtet, Sébastien Guillaume* *Co-Directeur de l'unité
France has one of the world's highest suicidal rates (7th in the EU), a fact often ignored. With approximately 200,000 suicide attempts per year and 10 500 deaths, suicide is the second leading cause of death for 15-45 year-olds. The context is almost always linked with psychiatric disorder (depression, schizophrenia, eating disorder, ...) or environmental stress (alcoholism, abuse, exclusion, ...), but these conditions are not sufficient. We aim to identify those subjects with a specific vulnerability to suicidal behaviour (SB) likely to take action, when exposed to a negative environment (stress, exclusion, abuse ...) . In this model, suicide is no longer conceived as a consequence of a more general state, but as an independent entity. A better understanding of this vulnerability should allow the physician to assess the suicidal risk of patients regardless of pathology. Our research focuses on identifying biomarkers and mechanisms at the origin of the vulnerability to SB. We have observed an association between genes coding for proteins involved in the serotoninergic system, with SB and notably specific SB subtypes (violence, recidivism). However, the literature reports conflicting results, particularly because of the clinical and genetic heterogeneity of SB. It is therefore essential to confirm these results and to clarify the exact association between genetic markers tested and SB (Genesis study) . Other research involves the exploration of a potential endophenotype of suicide (decision making) and we are the first to have demonstrated its role through functional imaging of anatomical abnormalities (ventromedial prefrontal cortex) in emotional regulation as well as in decision making involved in SB (fMRI study of vunerability to SB) . The team is now involved in the identification of other potential endophenotypes of SB, such as pain hypersensitivity and social exclusion (Vasco project). The study of the relationship between personality dimensions and cognitive and genetic polymorphisms is currently being conducted on a general population cohort (ESPRIT study). This has enabled us to detect possible impaired interhemispheric brain connectivity in suicide attempters (atrophy of the posterior part of the corpus callosum). We also developed collaborative European research networks: - EURECA (EUropean REsearch CArtel-Suicide): pathophysiology of SB. - network supported by the ECNP (European College of Neuropsychopharmacology): pharmacogenomics of suicidal risk during antidepressant treatment in young depressed people. Other major psychiatric disorders studied: Eating disorders : Our research is identifying neuropsychological impairments associated with anorexia nervosa and bulimia and investigating the link between SB and anorexia nervosa. We are also investigating the therapeutic effect of repetitive transcranial magnetic stimulation (rTMS) in bulimia nervosa. Bipolar Disorders : The team is a member of a National Network of Expert Centers in Bipolar disorder established by the foundation Fondamental. The network enables us to follow-up large cohorts of patients with standardized evaluation. Smoking cessation : We are involved in several projects aiming at identifying prognostic factors for smoking cessation using neuropsychological, genetics and clinical assessments, and in a project investigating the therapeutic effect of physical activity on smoking abstinence.
Psychologist Post-doctoral Research Fellow
Pharmacy Intern and PhD Student
Statistician and Epidemiologist Senior Research Assistant Inserm