A Three-month Intervention And Follow-up Study After A Suicide Attempt In The Emergency Departments Of General Hospitals In Shenyang

BackgroundSuicide is a significant public health problem in China. We estimated a mean annual suicide rate of 23 per 100 000 and a total of 287 000 suicide deaths per year in China. Suicide is the fifth leading cause of death in China. To prevent repeated suicide attempts is one of the most significant measures to reduce completed suicide behaviors. The Chinese Department of Health reported a mean annual suicide attempts rate of 229 per 100 000 and a total of 287 000 suicide attempts per year in China. Some randomized controlled trials from Europe and the USA have reported the interventions that effectively prevented repetition of suicide attempts. But, few reports about interventions designed to prevent suicide attempts have been evaluated in China.ObjectiveTo determine whether the interventions to patients after a suicide attempt in the emergency departments of general hospitals would be more effective than control group.Methods239 patients who had attempted suicide and were evaluated by DSM-IV-TR Axis I Disorders (SCID-I/P) at the emergency departments of 4 general hospitals from June 2007 to January 2008 were randomized to the cognitive therapy group or the family and social support group or the control group. After 3-month interventions, participants were followed up. The measurements were used :HAMD,FACES-CV,Quality of life Scale,SSRS,SIS. A double blind method was used in the assessment and intervention. Results1. Subsequent suicide attemptDuring three-month periods , 172 patients were followed up. Only one patient in the control group made 1 subsequent suicide attempt. Nobody in the cognitive therapy and the family and social support groups made suicide attempt.2.Compliance of interventions featuresIn the cognitive therapy group five patients (6%) received cognitive therapy and two patients completely comply. In the family and social support group sixty patients (75%) received intervention and forty-nine patients completely comply. The compliance of interventions between the cognitive therapy group and the family and social support group was significantly different.3.Outcome measuresThe difference of depression measured by HAMD score and the difference the quality of life score were significantly marked from baseline to 3-month assessment in any groups(P<.0001). The score change of HAMD score and the quality of life score and FACES-CV and SSRS between the two assessment points was not significantly different in any groups (Krsskare-Wallis Test:â‘ HAMD: P=.2947;â‘¡the quality of life score: P=.6280;â‘¢SSRS P=.6867;â‘£Cohesion of FACES-CV: P= 6181; Adaptability of FACES-CV: P=.7340).4.Suicide ideationThere were no significant differences among three groups based on rates of suicide ideation between the two assessment points (in the cognitive psychotherapy group:P=.0003;in the family and social support group:P=.0003;in the control group:P<.0001).The change of suicide ideation between women and men were different during two assessment point (Women:P<.0001;Men:P=.0754).ConclusionThe compliance of interventions between the cognitive therapy group and the family and social support group was significantly different.The results of patients in intervention groups were not statistically different with that of patients in the control group.