Display Settings:

Format

Send to:

Choose Destination
See comment in PubMed Commons below
BMJ. 2012 Aug 22;345:e4972. doi: 10.1136/bmj.e4972.

Effect of assertive outreach after suicide attempt in the AID (assertive intervention for deliberate self harm) trial: randomised controlled trial.

Author information

  • 1Research Unit, Mental Health Centre Copenhagen, Faculty of Health Sciences, University of Copenhagen, Bispebjerg Bakke 23, 2400 Copenhagen NV, Denmark. .morthorst@regionh.dk

Abstract

OBJECTIVE:

To assess whether an assertive outreach intervention after suicide attempt could reduce the frequency of subsequent suicidal acts, compared with standard treatment.

DESIGN:

Randomised, parallel group, superiority trial with blinded outcome assessment.

SETTING:

Outpatient intervention at one location at Copenhagen University Hospital, Denmark.

PARTICIPANTS:

Patients older than 12 years admitted to regional hospitals in Copenhagen with a suicide attempt within the past 14 days. We excluded patients diagnosed with schizophrenia spectrum disorders and patients living in institutions.

INTERVENTION:

Case management through assertive outreach that provided crisis intervention and flexible problem solving. This approach incorporated motivational support and actively assisted patients to scheduled appointments to improve adherence with after-treatment as an add on to standard treatment.

MAIN OUTCOME:

Repeated suicide attempt and death by suicide, recorded in medical records and death register at 1-year follow-up.

RESULTS:

243 patients were included. During 12 months of follow-up, 20/123 (16%) patients in the intervention group had been registered in hospital records with subsequent suicide attempt, compared with 13/120 (11%) in the control group (odds ratio 1.60, 95% confidence interval 0.76 to 3.38; P=0.22). By contrast, self reported data on new events showed 11/95 (12%) in the intervention group versus 13/74 (18%) in the control group (0.61, 0.26 to 1.46; P=0.27). By imputing missing data on the selfreported outcomes, we estimated 15/123 (12%) events in the intervention group and 23/120 (19%) in the control group (0.69, 0.34 to 1.43; P=0.32).

CONCLUSION:

Assertive outreach showed no significant effect on subsequent suicide attempt. The difference in rates of events between register data and self reported data could indicate detection bias.

TRIAL REGISTRATION:

ClinicalTrials.gov NCT00700089.

Comment in

PMID:
22915730
[PubMed - indexed for MEDLINE]
PMCID:
PMC3425442
Free PMC Article

Images from this publication.See all images (1)Free text

PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Icon for HighWire Icon for PubMed Central
    Loading ...
    Write to the Help Desk