Effectiveness of assertive case management for patients with suicidal intent

PSYCHIATRY RESEARCH

卷:304

Article

Inui-Yukawa, Masami¹  Miyaoka, Hitoshi¹  Yamamoto, Kenji²  Kamijo, Yoshito³  Takai, Michiko³  Yonemoto, Naohiro^4,5  Kawanishi, Chiaki⁶  Otsuka, Kotaro⁷  Tachikawa, Hirokazu⁸  Hirayasu, Yoshio⁹ 

[1] Kitasato Univ, Dept Psychiat, Sch Med, Minami Ku, 1-15-1 Kitasato, Sagamihara, Kanagawa 2520374, Japan

[2] Tokai Univ, Sch Med, Dept Psychiat, 143 Shimokasuya, Isehara, Kanagawa 2591193, Japan

[3] Saitama Med Univ, Fac Med, Dept Emergency Med, 38 Morohongo,Moroyama Machi, Saitama 3500495, Japan

[4] Natl Ctr Neurol & Psychiat, Natl Inst Mental Hlth, Dept Neuropsychopharmacol, 4-1-1 Ogawahigashimachi, Kodaira, Tokyo 1878551, Japan

[5] Juntendo Univ, Sch Med, Dept Publ Hlth, Bunkyo Ku, 2-1-1 Hongo, Tokyo 1138421, Japan

[6] Sapporo Med Univ, Grad Sch Med, Dept Neuropsychiat, Chuo Ku, S-1,W-17, Sapporo, Hokkaido 0608556, Japan

[7] Iwate Med Univ, Sch Med, Dept Neuropsychiat, 19-1 Uchimaru, Morioka, Iwate 0208505, Japan

[8] Univ Tsukuba, Fac Med, Dept Disaster & Community Psychiat, 1-1-1 Tennodai, Tsukuba, Ibaraki 3058575, Japan

[9] Hirayasu Hosp, 346 Kyouzuka, Urasoe, Okinawa 9012553, Japan

关键词: Assertive case management intervention;    Emergency medicine;    Self-harm;    Self-poisoning;    Suicide attempt;   

DOI  :  10.1016/j.psychres.2021.114125

来源: Elsevier

【 摘 要 】

The aim of this study was to examine the effectiveness of assertive case management intervention in preventing suicidal behaviour in self-poisoning patients. We conducted a secondary analysis of data from the ACTION-J study. Participants were self-poisoning patients with clear suicide intent admitted to emergency departments and with a primary psychiatric diagnosis (as per DSM-IV-TR axis 1). Patients were randomly assigned either to assertive case management or enhanced usual care. The primary outcome measure was the incidence of a first recurrent suicide attempt within 6 months. This study is registered at ClinicalTrials.gov (NCT00736918) and UMIN-CTR (C000000444). There were 297 self-poisoning patients in the intervention group and 295 in the control group. The primary outcome was significantly lower in the intervention group than in the control group. The incidence of a first recurrent suicide attempt within 1 and 3 months was also significantly lower in the intervention group, as was the number of overall self-harm episodes over the entire study period. Furthermore, the number of non-suicidal self-harm episodes and suicide attempts was significantly lower in the intervention group. Assertive case management is effective when promptly introduced in a hospital setting as an intervention following a suicide attempt, particularly for self-poisoning patients.

【 授权许可】

Free