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将明信片、危机卡片和电话联系相结合,制定决策算法以降低自杀再尝试率:个性化简短接触干预的随机临床试验。

Combining Postcards, Crisis Cards, and Telephone Contact Into a Decision-Making Algorithm to Reduce Suicide Reattempt: A Randomized Clinical Trial of a Personalized Brief Contact Intervention.

机构信息

Department of Psychiatry, University Hospital of Lille, Universités de Lille, Lille, France.

SCA Laboratory CNRS-UMR 9193, Lille, France.

出版信息

J Clin Psychiatry. 2018 Sep 25;79(6):17m11631. doi: 10.4088/JCP.17m11631.

Abstract

BACKGROUND

There is growing evidence in the literature that brief contact interventions (BCIs) might be reliable suicide prevention strategies.

OBJECTIVE

To assess the effectiveness of a decision-making algorithm for suicide prevention (ALGOS) combining existing BCIs in reducing suicide reattempts in patients discharged after a suicide attempt.

METHODS

A randomized, multicenter, controlled, parallel trial was conducted in 23 hospitals. The study was conducted from January 26, 2010, to February 28, 2013. People who had made a suicide attempt were randomly assigned to either the intervention group (ALGOS) or the control group. The primary outcome was the rate of participants who reattempted suicide (fatal or not) within the 6-month study period.

RESULTS

1,040 patients were recruited. After 6 months, 58 participants in the intervention group (12.8%) reattempted suicide compared with 77 (17.2%) in the control group. The difference between groups (4.4%; 95% CI, -0.7% to 9.0%) was not significant (complete-case analysis, P = .059).

CONCLUSIONS

These results may help researchers better integrate BCIs into routine health care and provide new insights concerning personalized suicide prevention strategies.

TRIAL REGISTRATION

ClinicalTrials.gov identifier: NCT01123174.

摘要

背景

文献中有越来越多的证据表明,简短接触干预(BCIs)可能是可靠的自杀预防策略。

目的

评估一种结合现有 BCIs 的自杀预防决策算法(ALGOS)在减少自杀未遂患者出院后自杀再尝试的效果。

方法

在 23 家医院进行了一项随机、多中心、对照、平行试验。研究于 2010 年 1 月 26 日至 2013 年 2 月 28 日进行。有自杀企图的人被随机分配到干预组(ALGOS)或对照组。主要结局是在 6 个月的研究期间参与者自杀再尝试(致死或非致死)的发生率。

结果

共招募了 1040 名患者。6 个月后,干预组有 58 名(12.8%)参与者再次尝试自杀,而对照组有 77 名(17.2%)。两组之间的差异(4.4%;95%CI,-0.7%至 9.0%)不显著(完整病例分析,P=.059)。

结论

这些结果可能有助于研究人员更好地将 BCIs 整合到常规医疗保健中,并为个性化的自杀预防策略提供新的见解。

试验注册

ClinicalTrials.gov 标识符:NCT01123174。

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