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



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


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.


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.


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

Copyright © 1997 The Royal College of Psychiatrists 

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