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Effectiveness of assertive case management for patients with suicidal intent.

Masami Inui-Yukawa1, Hitoshi Miyaoka1, Kenji Yamamoto2

  • 1Department of Psychiatry, Kitasato University, School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0374, Japan.

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Summary

Assertive case management effectively reduces recurrent suicide attempts in self-poisoning patients. This intervention, when promptly introduced post-attempt, significantly lowers overall self-harm episodes and suicide attempts.

Keywords:
Assertive case management interventionEmergency medicineSelf-harmSelf-poisoningSuicide attempt

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Area of Science:

  • Psychiatry
  • Public Health
  • Clinical Psychology

Background:

  • Suicidal behavior represents a significant public health concern.
  • Self-poisoning is a common method of suicide attempt, necessitating effective interventions.
  • Existing treatments require enhancement to prevent recurrent suicidal behavior.

Purpose of the Study:

  • To evaluate the efficacy of assertive case management in preventing suicidal behavior among self-poisoning patients.
  • To assess the impact of assertive case management on recurrent suicide attempts and self-harm episodes.
  • To determine the effectiveness of this intervention in a hospital setting following a suicide attempt.

Main Methods:

  • Secondary analysis of data from the ACTION-J study.
  • Randomized controlled trial comparing assertive case management to enhanced usual care.
  • Inclusion criteria: self-poisoning patients with suicide intent and primary psychiatric diagnosis (DSM-IV-TR axis 1).
  • Primary outcome: incidence of first recurrent suicide attempt within 6 months.

Main Results:

  • The intervention group showed a significantly lower incidence of recurrent suicide attempts within 6 months.
  • Significant reductions in suicide attempts at 1 and 3 months were observed in the intervention group.
  • The number of overall self-harm episodes, non-suicidal self-harm episodes, and suicide attempts was significantly lower in the intervention group.

Conclusions:

  • Assertive case management is an effective intervention for preventing suicidal behavior in self-poisoning patients.
  • Prompt introduction of assertive case management in hospital settings following a suicide attempt yields positive outcomes.
  • This intervention demonstrates significant potential in reducing the recurrence of self-harm and suicide attempts.