Repetition of Suicide Attempts

Bertolote, José Manoel; Fleischmann, Alexandra; Leo, Diego De; Phillips, Michael R.; Botega, Neury José; Vijayakumar, Lakshmi; Silva, Damani de; Schlebusch, Lourens; Nguyen, Van Tuong; Sisask, Merike; Bolhari, Jafar; Wasserman, Danuta

doi:10.1027/0027-5910/a000052

Cited by 102 publications

(63 citation statements)

References 29 publications

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“…18 were either cross sectional descriptive studies or retrospective studies based on medical case records (Table 1). One study included an intervention (brief intervention and contact following attempted self-harm) and was a randomized controlled trial [16]. In all except two studies, participants were inpatients admitted to hospital for medical treatment of acute self-poisoning.…”

Section: Resultsmentioning

confidence: 99%

Characteristics of non-fatal self-poisoning in Sri Lanka: a systematic review

2013

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BackgroundThe rate of non-fatal self-poisoning in Sri Lanka has increased in recent years, with associated morbidity and economic cost to the country. This review examines the published literature for the characteristics and factors associated with non-fatal self-poisoning in Sri Lanka.MethodsElectronic searches were conducted in Psychinfo, Proquest, Medline and Cochrane databases from inception to October 2011.Results26 publications (representing 23 studies) were eligible to be included in the review. A majority of studies reported non-fatal self-poisoning to be more common among males, with a peak age range of 10–30 years. Pesticide ingestion was the most commonly used method of non-fatal self-poisoning. However three studies conducted within the last ten years, in urban areas of the country, reported non-fatal self-poisoning by medicinal overdose to be more common, and also reported non-fatal self-poisoning to be more common among females. Interpersonal conflict was the most commonly reported short-term stressor associated with self-poisoning. Alcohol misuse was reported among males who self-poisoned, and data regarding other psychiatric morbidity was limited.ConclusionsThe findings indicate that pesticide ingestion is the commonest method of non-fatal self-poisoning in Sri Lanka, and it is more common among young males, similar to other Asian countries. However there appears to be an emerging pattern of increasing medicinal overdoses, paralleled by a gender shift towards increased female non-fatal self-poisoning in urban areas.Many non-fatal self-poisoning attempts appear to occur in the context of acute interpersonal stress, with short premeditation, and associated with alcohol misuse in males. Similar to other Asian countries, strategies to reduce non-fatal self-poisoning in Sri Lanka require integrated intervention programs with several key aspects, including culturally appropriate interventions to develop interpersonal skills in young people, community based programs to reduce alcohol misuse, and screening for and specific management of those at high risk of repetition following an attempt of self-poisoning.

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Section: Resultsmentioning

confidence: 99%

Characteristics of non-fatal self-poisoning in Sri Lanka: a systematic review

2013

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“…Direct comparisons with non-western or developing countries is limited by the lack of studies (Owens et al, 2002), however one intervention trial conducted in five nonwestern countries in hospital treated suicide attempt populations reported 18 month follow-up data, which helps to contextualise the results of the current study (Bertolote et al, 2010). The proportions with any repeated suicide attempt for intervention v control were: Campinas, Brazil (30% v 16%), Chennai, India (3% v 7%), Colombo, Sri Lanka (2% v 4%), Yuncheng, China (2% v 0%) and Karaj, Iran (11% v 9%); with no overall difference in repeated suicide attempt (7.6% v 7.5%).…”

Section: Dsp and Other Suicidal Behaviours In A Non-western Countrymentioning

confidence: 89%

“…larger than other studies using randomisation of the individual or cluster randomisation of general practices (Bertolote et al, 2010;Bennewith et al, 2002). The retention rate of 87% after 24 months was high and there was nearly equal loss to follow-up in either group (13.3% intervention v 12.7% control).…”

Section: Strengths and Limitations Of The Studymentioning

confidence: 97%

“…However, it is feasible to evaluate interventions for suicidal behaviour in nonwestern countries; a recent RCT of a brief intervention and ongoing contact for "suicide 3 attempters" in Brazil, India, Sri Lanka, Islamic Republic of Iran and China, reported significantly fewer suicides (Fleischmann et al, 2008) but no difference in repetition of self harm (Bertolote et al, 2010).…”

Section: Introductionmentioning

confidence: 98%

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Postcards in Persia: A Twelve to Twenty-four Month Follow-up of a Randomized Controlled Trial for Hospital-Treated Deliberate Self-Poisoning

Hassanian‐Moghaddam

Sarjami²,

Kolahi

et al. 2015

Archives of Suicide Research

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This study reports the outcomes, during follow-up, of a low-cost postcard intervention in a Randomized Control Trial of hospital-treated self-poisoning (n = 2300). The intervention was 9 postcards over 12 months (plus usual treatment) versus usual treatment. Three binary endpoints at 12-24 months (n = 2001) were: any suicidal ideation, suicide attempt, or self-cutting. There was a significant reduction in any suicidal ideation (RRR 0.20 CI 95% 0.13-0.27), (NNT 8, 6-13), and any suicide attempt (RRR 0.31, 0.06-0.50), (NNT 35, 19-195), in this non-western population. However, there was no effect on self-cutting (RRR -0.01, -1.05-0.51). Sustained, brief contact by mail may reduce some forms of suicidal behavior in self-poisoning patients during the post intervention phase.

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“…Data on rates of repetition of self-harm in Sri Lanka is limited; two studies in this review prospectively examined the rates of repetition following non-fatal self-poisoning, and reported repetition rates of 4% and 2.7% at 18 month and 12 month follow-up, respectively (16,17).…”

Section: Repetition Risk After Self-harmmentioning

confidence: 99%