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Brief psychological intervention after self-harm: randomised controlled trial from Pakistan.
Nusrat Husain1, Salahuddin Afsar1, Jamal Ara1
1Nusrat Husain, MD, Institute of Brain, Behaviour and Mental Health, University of Manchester, UK; Salahuddin Afsar, FRCP, Dow University of Health Sciences, Karachi, Pakistan; Jamal Ara, FCPS, United Medical and Dental College of Karachi, Karachi, Pakistan; Hina Fayyaz, PMDCP, Pakistan Institute of Learning and Living, Karachi, Pakistan; Raza ur Rahman, FCPS, Dow University of Health Sciences, Karachi, Pakistan; Barbara Tomenson, MSc, Institute of Population Health, University of Manchester, UK; Munir Hamirani, FCPS, Karachi Medical and Dental College and Abbasi Shaheed Hospital, Karachi, Pakistan; Nasim Chaudhry, MD, Institute of Brain, Behaviour and Mental Health, University of Manchester, UK; Batool Fatima, PMDCP, School of Public Health, Boston University, Boston, USA; Meher Husain, MD, Lancashire Care NHS Foundation Trust, UK; Farooq Naeem, PhD, Queens University, Kingston, Ontario, Canada; Imran B. Chaudhry, MD, Institute of Brain, Behaviour and Mental Health, University of Manchester, UK.
Culturally adapted manual-assisted problem-solving training (C-MAP) significantly reduced suicidal ideation and depression in individuals who self-harmed. This brief psychological intervention shows promise for suicide prevention efforts.
Area of Science:
- Psychiatry
- Clinical Psychology
- Public Health
Background:
- Self-harm is a critical predictor of completed suicide.
- Effective interventions are needed to mitigate suicide risk following self-harm episodes.
Purpose of the Study:
- To evaluate the effectiveness of culturally adapted manual-assisted problem-solving training (C-MAP) compared to treatment as usual (TAU).
- To assess C-MAP's impact on suicidal ideation, hopelessness, depression, coping resources, and healthcare utilization post-self-harm.
Main Methods:
- A randomized controlled trial involving 221 patients admitted for self-harm in Karachi, Pakistan.
- Participants were allocated to C-MAP plus TAU or TAU alone.
- Assessments were conducted at baseline, 3 months (end of intervention), and 6 months.
Main Results:
- The C-MAP group demonstrated statistically significant reductions in suicidal ideation and hopelessness.
- Improvements in suicidal ideation were sustained at 3 months post-intervention.
- Significant reductions in depressive symptoms were observed in the C-MAP group compared to TAU.
Conclusions:
- Culturally adapted manual-assisted problem-solving training (C-MAP) is a promising brief psychological intervention for individuals who have self-harmed.
- C-MAP may play a valuable role in suicide prevention strategies.