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Little evidence exists regarding the effectiveness or cost-effectiveness of alternative treatment services in the field of child and adolescent psychiatry.
To assess the cost-effectiveness of a home-based social work intervention for young people who have deliberately poisoned themselves.
Children aged ⩽16 years, referred to child mental health teams with a diagnosis of deliberate self-poisoning were randomly allocated to either routine care (n=77) or routine care plus the social work intervention (n=85). Clinical and resource-use data were assessed over six months from the date of trial entry.
No significant differences were found between the two groups in terms of the main outcome measures or costs. In a sub-group of children without major depression, suicidal ideation was significantly lower in the intervention group at the six-month follow-up (P=0.01), with no significant differences in cost.
A family-based social work intervention for children and adolescents who have deliberately poisoned themselves is as cost-effective as routine care alone.
The features of adolescents who had taken an overdose were assessed to determine the focus for a treatment trial.
Overdose cases were compared with psychiatric and community controls who had not taken an overdose in respect of mental disorders and family background.
Overdose cases had high rates of major depression, but most of them recovered from depression within six weeks of the overdose. There was a specific association between taking an overdose and family dysfunction.
Family dysfunction could be a useful focus in a clinical trial of the aftercare of adolescents who have taken an overdose.
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