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Intensive in-patient and community intervention versus routine care after attempted suicide

A randomised controlled intervention study

Published online by Cambridge University Press:  03 January 2018

Rob Van Der Sande ,
Liesbeth Van Rooijen ,
Erik Buskens ,
Esther Allart ,
Keith Hawton ,
Yolanda Van Der Graaf  and
Herman Van Engeland
Rob Van Der Sande*
Affiliation:
Utrecht University Hospital, The Netherlands
Liesbeth Van Rooijen
Affiliation:
Utrecht University Hospital, The Netherlands
Erik Buskens
Affiliation:
Utrecht University Hospital, The Netherlands
Esther Allart
Affiliation:
Utrecht University Hospital, The Netherlands
Keith Hawton
Affiliation:
Oxford University Department of Psychiatry, Warneford Hospital, Oxford
Yolanda Van Der Graaf
Affiliation:
Utrecht University Hospital, The Netherlands
Herman Van Engeland
Affiliation:
Utrecht University Hospital, The Netherlands
*
R. van der Sande, Department of Psychiatry, University Hospital Utrecht, PO Box 85500, 3508 GA, Utrecht, The Netherlands
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Abstract

Background

A randomised clinical trial was carried out in suicide attempters to assess clinical efficacy of an intensive psychosocial intervention compared with treatment as usual.

Method

Two hundred and seventy-four suicide attempters presenting for medical treatment were randomly assigned to either intensive psychosocial treatment or ‘care as usual’. Intensive psychosocial treatment consisted of brief admission to a special crisis-intervention unit and problem-solving aftercare. ‘Care as usual’ included any form of treatment the assessing clinicians thought appropriate. Psychological well-being was evaluated by the SCL–90 and the Hopelessness Scale at 3, 6 and 12 months following entry in the study.

Results

No differences in outcome were found. The probability of repeat suicide attempts in the 12-month follow-up was 0.17 for patients in the experimental group and 0.15 for the control group. There were no differences in ratings on the SCL–90 and the Hopelessness Scale. Patients in the experimental group attended significantly more out-patient treatment sessions.

Conclusions

General implementation of an intensive in-patient and community intervention programme for suicide attempters does not seem justified.

Type
Papers
Information
The British Journal of Psychiatry , Volume 171 , Issue 1 , July 1997 , pp. 35 - 41
Copyright
Copyright © 1997 The Royal College of Psychiatrists 

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References

Allard, R., Marshall, M. & Plante, M. C. (1992) Intensive follow-up does not decrease the risk of repeat suicide attempts. Suicide and Life-Threatening Behavior, 22, 303–314.CrossRefGoogle Scholar
American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM–III–R). Washington, DC: APA.Google Scholar
Arensman, E., Kerkhof, A. J. F. M., Hengeveld, M. W., et al (1994) The epidemiology of attempted suicide in the area of Leiden. The Netherlands. 1989–1992. In Attempted Suicide in Europe. Findings from the Multicentre Study on Parasuicide by the WHO Regional Office for Europe (eds Kerkhof, A. J. F. M., Schmidtke, A., Bille Brahe, U., et al), pp. 53–77. Leiden: DSWO Press.Google Scholar
Arrindell, W. A. & Ettema, J. H. M. (1986) SCL–90 Handleiding bij een multidimensionele Psychopathologie-mdicator. The Netherlands: Lisse. Swetz & Zeitlinger.Google Scholar
Beck, A. T., Schuyler, D. & Herman, J. (1974a) Development of suicidal intent scales. In The Prediction of Suicide (eds Beck, A. T., Resnik, H. L. P. & Lettieri, D. J.). pp. 45–56. Bowie. MD: Charles Press.Google Scholar
Beck, A. T., Weissman, A., Lester, D., et al (1974b) The measurement of pessimism: the Hopelessness Scale. Journal of Consulting and Clinical Psychology, 41, 861–865.CrossRefGoogle Scholar
Bryman, A. & Cramer, D. (1990) Quantitative Data Analysis for Social Scientists. London: Routledge.Google Scholar
Buglass, D. & Horton, J. (1974) A scale for predicting subsequent suicidal behaviour. British Journal of Psychiatry, 124, 573–578.CrossRefGoogle ScholarPubMed
Cotgrove, A., Zirinsky, L., Black, D., et al (1995) Secondary prevention of attempted suicide in adolescence. Journal of Adolescence, 18, 569–577.CrossRefGoogle Scholar
Cox, D. R. (1972) Regression models and life tables. Journal of the Royal Statistical Society (B). 34, 187–202.Google Scholar
Derogatis, L. R., Lipman, R. S. & Covi, L. (1973) SCL–90: An outpatient psychiatric rating scale – preliminary report. Psychopharmacology Bulletin, 9, 13–28.Google ScholarPubMed
Hartong, E. G. Th, M. & Goekoop, J. G. (1985) The Montgomery–Asberg beoordelingsschaal voor depressie. Tijdschrift voor Psychiatrie, 27, 657–668.Google Scholar
Hawton, K. (1997) Attempted suicide. In Science and Practice of Cognitive Behaviour Therapy (eds Clark, D. M. & Fair-burn, C. G.), pp. 251–287. Oxford: Oxford University Press.Google Scholar
Hawton, K., Bancroft, J., Catalan, J., et al (1981) Domiciliary and out-patient treatment of self-poisoning patients by medical and non-medical staff. Psychological Medicine, 11, 169–177.CrossRefGoogle ScholarPubMed
Hawton, K. & Catalan, J. (1987) Attempted Suicide. A Practical Guide to its Nature and Management. Oxford: Oxford University Press.Google Scholar
Hawton, K., McKeown, S., Day, A., et al (1987) Evaluation of outpatient counseling compared with general practitioner care following overdoses. Psychological Medicine, 17, 751–761.CrossRefGoogle ScholarPubMed
Hawton, K. & Fagg, J. (1988) Suicide and other causes of death following attempted suicide. British Medical Journal. 152, 359–366.Google ScholarPubMed
Kerkhof, A. J. F. M. (1985) Suicide en Geestelijke Gezond-heidszorg [Suicide and Mental Health Care]. The Netherlands: Lisse. Swets & Zeitlinger.Google Scholar
Kerkhof, A. J. F. M., Schmidtke, A., Bille-Brahe, U., et al (1994) Attempted Suicide in Europe. Findings from the Multicentre Study on Parasuicide by the WHO Regional Office for Europe. Leiden: DSWO Press.Google Scholar
Kienhorst, C. W. W., de Wilde, E. J., van den Bout, J., et al (1993) Psychometrische eigenschappen van een aantal zelfrapportage-vragenlijsten over “(on)welbevinden”: een onderzoek bij 9393 leerlingen van het Voortgezet Onderwijs [Psychometric characteristics of self-report questionnaires concerning “wellbeing”: a study among 9393 students of secondary education]. Nederlands Tijdschrift voor Psychologie, 140, 118–123.Google Scholar
Kreitman, N. & Casey, R. (1988) Repetition of parasuicide: an epidemiological and clinical study. British Journal of Psychiatry, 153, 792–800.CrossRefGoogle ScholarPubMed
Liberman, R. R. & Eckman, T. (1981) Behavior therapy vs insight-oriented therapy for repeated suicide attempters. Archives of General Psychiatry, 38, 1126–1130.CrossRefGoogle ScholarPubMed
Linehan, M. M., Armstrong, H. E., Suarez, A., et al (1991) Cognitive-behavioral treatment of chronically parasuicidal borderline patients. Archives of General Psychiatry, 48, 1061–1064.CrossRefGoogle ScholarPubMed
Linehan, M. M., Heard, H. L. & Armstrong, K. E. (1993) Naturalistic follow-up of a behavioral treatment for chronically parasuicidal borderline patients. Archives of General Psychiatry. 50, 971–974.CrossRefGoogle ScholarPubMed
McLeavey, B. C., Daly, R. J., Ludgate, J. W., et al (1994) Interpersonal problem-solving skills training in the treatment of self-poisoning patients. Suicide and Life-Threatening Behavior, 24, 382–393.CrossRefGoogle ScholarPubMed
Möller, H. J. (1989) Efficacy of different strategies of aftercare for patients who have attempted suicide. Journal of the Royal Society of Medicine. 82, 643–647.CrossRefGoogle ScholarPubMed
Montgomery, S. A. & Åsberg, M. (1979) A new depression scale designed to be sensitive to change. British Journal of Psychiatry, 134, 382–389.CrossRefGoogle ScholarPubMed
Morgan, H. G., Jones, E. M. & Owen, J. H. (1993) Secondary prevention of non-fatal self-harm. The green card study. British Journal of Psychiatry, 163, 615–616.CrossRefGoogle ScholarPubMed
Nordstrom, P., Samuelsson, M. & Åsberg, M. (1995) Survival analysis of suicide risk after attempted suicide. Acta Psychiatrica Scandinavica. 91, 336–340.CrossRefGoogle ScholarPubMed
Sakinofsky, I. & Roberts, R. S. (1990) Why parasuicides repeat despite problem resolution. British Journal of Psychiatry, 156, 399–405.CrossRefGoogle ScholarPubMed
Salkovskis, P. M., Atha, C. & Storer, D. (1990) Cognitive–behavioural problem solving in the treatment of patients who repeatedly attempt suicide. A controlled trial. British Journal of Psychiatry, 157, 871–876.CrossRefGoogle ScholarPubMed
Thompson, Ch. (1989) The Instruments of Psychiatric Research. Chichester: John Wiley.Google Scholar
Van Heeringen, C., Jannes, S., Buylaert, W., et al (1995) The management of non-compliance with referral to out-patient aftercare among attempted suicide patients: a controlled intervention study. Psychological Medicine, 25. 963–970.CrossRefGoogle ScholarPubMed
Waterhouse, J. & Platt, S. (1990) General hospital admission in the management of parasuicide. A randomized controlled trial. British Journal of Psychiatry, 156, 236–242.CrossRefGoogle Scholar
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