Intensive in-patient and community intervention versus routine care after attempted suicide. A randomised controlled intervention study.
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.


METHODS
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.
van der Sande
R
R
Utrecht University Hospital, The Netherlands.
van Rooijen
L
L
Buskens
E
E
Allart
E
E
Hawton
K
K
van der Graaf
Y
Y
van Engeland
H
H
D000328:Adult; D003156:Community Mental Health Services / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D008297:Male; D010342:Patient Acceptance of Health Care; D011613:Psychotherapy / Q000379:methods*; D012008:Recurrence; D012307:Risk Factors; D012944:Social Support; D013406:Suicide, Attempted / Q000517:prevention & control*; D016896:Treatment Outcome