[Reduction in short-term repetition of attempted suicide associated with new organization of psychiatric management of suicide attempters. Two cohorts].
OBJECTIVE
To investigate the impact of the reorganization of psychiatric care in the Accident and Emergency (A&E) unit on repeated suicide attempts.


METHODS
The study includes suicide attempters admitted to the Rennes University Hospital (Brittany, France) A&E unit in 1994 (n=1003) and 2000 (n=1018). We compared the clinical data (age, gender, marital status, suicide history, methods, and outcome at discharge from A&E) and psychiatric management of the two cohorts. The rate of repeated suicide attempts was measured according to the same criterion in 1994 and 2000 (re-admission to the A&E unit).


RESULTS
Both populations of suicide attempters were very similar from both a clinical and demographic point of view. The repetition rate at 1 month was significantly higher (OR=4.16, p=0.0001) in 1994 than in 2000. The difference between the cohorts continued at three and six months, but became statistically insignificant at one year.


CONCLUSIONS
By 2000, organization of psychiatric care in the A&E unit had been substantially strengthened. The presence of a complete psychiatric team (nurses, junior psychiatrist, and senior psychiatrist) in the A&E unit, 24 hours a day, seven days a week, was associated with a lower rate of repeated suicide attempts.
Eudier
Francis
F
Unité de psychiatrie et de psychologie médicale, Hôpital Pontchaillou, Rennes (35). francis.eudier@chu-rennes.fr
Gault
Sosane
S
Batt-Moillo
Agnès
A
Drapier
Dominique
D
Millet
Bruno
B
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D015331:Cohort Studies; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D005260:Female; D005602:France; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000458:organization & administration*; D008875:Middle Aged; D055502:Secondary Prevention; D013406:Suicide, Attempted / Q000517:prevention & control* / Q000706:statistics & numerical data