title: [Reduction in short-term repetition of attempted suicide associated with new organization of psychiatric management of suicide attempters. Two cohorts].
abstract: 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.
authors.affiliation: Unité de psychiatrie et de psychologie médicale, Hôpital Pontchaillou, Rennes (35). francis.eudier@chu-rennes.fr
authors.forename: Francis
authors.initials: F
authors.lastname: Eudier
authors.forename: Sosane
authors.initials: S
authors.lastname: Gault
authors.forename: Agnès
authors.initials: A
authors.lastname: Batt-Moillo
authors.forename: Dominique
authors.initials: D
authors.lastname: Drapier
authors.forename: Bruno
authors.initials: B
authors.lastname: Millet
mesh_terms: 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