En France, certains auteurs identifient le milieu de travail comme cause exclusive, sinon essentielle, de suicides sur le lieu de travail. Néanmoins, ces interprétations ne sont pas retrouvées dans des études empiriques et épidémiologiques.

Nous avons étudié dans quelle mesure les difficultés professionnelles peuvent contribuer à un fardeau d’adversité qui contribue à augmenter la vulnérabilité suicidaire.

Quatre-vingt-quatre participants, la moitié décédée d’un suicide, en emploi au moment du décès et l’autre moitié en vie et en emploi, ont été recrutés afin de comparer les parcours de vie professionnelle, les tentatives de suicide antérieures et le profil psychiatrique. Les données ont été récoltées selon une méthode d’autopsie psychologique et de calendrier de vie explorant toutes les sphères de vie.

Significativement plus de diagnostics d’un trouble des axes I et II, de comorbidités des axes et de tentatives de suicide sont observés parmi les participants décédés par suicide. De plus, les participants vivants ont rencontré significativement plus d’adversité dans le domaine professionnel au cours de la vie et des cinq dernières années.

Des difficultés professionnelles ne constituent pas un facteur de risque aussi robuste que des troubles psychiatriques. Une application possible est d’orienter l’action contre le suicide par le développement de programmes de prévention de la santé mentale, adaptés à des environnements professionnels.

Over 900,000 people die by suicide every year around the world. Suicide has been described as being a multidimensional act, resulting from a number of risk factors accumulating throughout the life course. Recently, in France, some authors have suggested that work environment is a major or a unique risk factor in the etiology of suicide death. This theoretical position is in contradiction with empirical and epidemiologic evidence.

On the base of data from life trajectories, we studied to which extent work difficulties may contribute to a burden of adversity, which contribute to suicidal vulnerability.

Two groups of participants (n=84) were compared. Half (n=42) were suicide victims who were compared to (n=42) living controls. The individuals from the suicide group were employed at the moment of death and the living controls were employed at the moment of the study. Characteristics of participants were compared in regards to life trajectories (love relationships, social interactions, professional difficulties), past suicide attempts and psychiatric diagnosis. Data were collected according to a psychological autopsy and life calendar methods.

Significantly more mental health disorders on axis I (DSM-IV), especially mood and substances disorders as well as disorders on axis II (especially Cluster C) were observed among deceased participants. Moreover, comorbid mental health disorders and past suicide attempts over the life course were significantly more prevalent among participants deceased by suicide. No significant differences are observed between groups concerning adversities in love relationships and social interactions. However, participants from the control group had significantly more adversities in professional domain over the life course and during the last 5 years.

Work difficulties are not a robust or direct risk factor of suicide, but psychiatric disorders are. These results are in contradiction with opinions of a debate in France concerning a direct link between work and suicides and should foster new debate. Application should promote the development of suicide prevention programs in work environments by focusing on protection and promotion the psychological health of workers.