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

Sande, Rob van der; Rooijen, Louis van; Buskens, E; Allart, Étienne; Hawton, Keith; Graaf, Y. van der; Engeland, Hermán van

doi:10.1192/bjp.171.1.35

Cited by 116 publications

(102 citation statements)

References 17 publications

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“…However, there were a large number of patients with multiple admissions (20%). This is consistent with the findings from other studies with readmission rates varying between 9 and 23% depending on the length of the study and location (Bialas et al, 1996;McEvedy, 1997;Van der Sande, 1997;Hawton et al, 1999). The frequency of readmission soon after the initial admission suggests that the conditions leading or predisposing to the episodes of self-harm are not resolved and that more research is required in this area.…”

Section: Discussionsupporting

confidence: 89%

A survey of admissions following self-poisoning

Leslie¹,

Greig²,

Mackie³

et al. 2005

Psychiatr. bull.

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Aims and MethodPatients who self-poison are at increased risk of future self-poisoning and early death. Admission patterns and effective treatment strategies are unclear although psychosocial assessment may reduce readmissions. This study aimed to determine admission patterns and the proportion of patients receiving a psychiatric assessment in 4220 consecutive admissions.ResultsThe average age was 34 years (s.d.=13, range 13–94); most were female (56 v. 44%, P<50.001). Twelve per cent of patients were aged 13–18 years, again the majority were female (70 v. 30%, P<50.001). Twenty per cent of patients had multiple admissions, accounting for 42% of the total admissions. There were slightly more admissions per day at the weekend (Friday, Saturday and Sunday; P<0.002). As many as 245 patients were either not referred or ‘self-discharged’ before they were assessed by the liaison psychiatry service.Clinical ImplicationsThese findings may help target medical resources, suggesting that consistent numbers of staff are required during all days of the week.

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Section: Discussionsupporting

confidence: 89%

A survey of admissions following self-poisoning

Leslie¹,

Greig²,

Mackie³

et al. 2005

Psychiatr. bull.

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show abstract

“…14,19 The only other systematic prevention studies targeting suicidal behaviors have been with college students with chronic suicidal ideation. 24 Reported treatment studies focus on adults with repeated suicide attempts 25,26 borderline personality disorder, 27,28 or both, and occasionally on youths hospitalized for suicide attempts. [29][30][31] Most interventions, whether brief or intensive, tend to be associated with positive psychosocial outcomes, such as decreased depression, 14,19,25,30,31 hopelessness, 24,25 anxiety, 19 and anger 19,28 and increased problem-solving skills.…”

mentioning

confidence: 99%

Evaluation of indicated suicide risk prevention approaches for potential high school dropouts

et al. 2001

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OBJECTIVES: This study evaluated the efficacy of 2 indicated preventive interventions, postintervention and at 9-month follow-up. METHODS: Drawn from a pool of potential high school dropouts, 460 youths were identified as being at risk for suicide and participated in 1 of 3 conditions randomly assigned by school: (1) Counselors CARE (C-CARE) (n = 150), a brief one-to-one assessment and crisis intervention; (2) Coping and Support Training (CAST) (n = 155), a small-group skills-building and social support intervention delivered with C-CARE; and (3) usual-care control (n = 155). Survey instruments were administered pre-intervention, following C-CARE (4 weeks), following CAST (10 weeks), and at a 9-month follow-up. RESULTS: Growth curve analyses showed significant rates of decline in attitude toward suicide and suicidal ideation associated with the experimental interventions. C-CARE and CAST, compared with usual care, also were effective in reducing depression and hopelessness. Among females, reductions in anxiety and anger were greater in response to the experimental programs. CAST was most effective in enhancing and sustaining personal control and problem-solving coping for males and females. CONCLUSIONS: School-based, indicated prevention approaches are feasible and effective for reducing suicidal behaviors and related emotional distress and for enhancing protective factors.

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“…14,18 The observation that certain treatment plans serve to positively reinforce self-harming behaviour is well recognized, particularly in patients with borderline personality disorder. 29 Evidence is also emerging that pharmacological treatments can increase risk in certain groups at key temporal stages in treatment.…”

Section: Methodological Problems In Suicidologymentioning

confidence: 99%

“…behaviour that have produced negative findings, 11,[13][14][15][16][17][18] although clearly another explanation is that the interventions were simply ineffective. A small number of trials have shown positive findings, but such trials are often dismissed as being of limited generalizability.…”

Section: Methodological Problems In Suicidologymentioning

confidence: 99%

Policy on the prevention of suicidal behaviour; one treatment for all may be an unrealistic expectation

Pitman

2007

Journal of the Royal Society of Medicine

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

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

Cited by 116 publications

References 17 publications

A survey of admissions following self-poisoning

A survey of admissions following self-poisoning

Evaluation of indicated suicide risk prevention approaches for potential high school dropouts

Policy on the prevention of suicidal behaviour; one treatment for all may be an unrealistic expectation

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