University of Rochester Medical Center, Rochester, NY, USA.
Department of Psychology, University of Rochester, Rochester, NY, USA.
Gen Hosp Psychiatry. 2021 Sep-Oct;72:66-72. doi: 10.1016/j.genhosppsych.2021.07.002. Epub 2021 Jul 19.
The Attempted Suicide Short Intervention Program (ASSIP) was adapted for hospital delivery and to address substance use problems as well as evaluated for feasibility, acceptability, and therapist fidelity in a series of preparatory steps (n = 28) and in a pilot randomized controlled trial, RCT (n = 34).
In the RCT, patients with suicide attempts and substance use problem(s) with sufficient lengths of stay to deliver three ASSIP therapy sessions in hospital were randomized to adapted ASSIP or treatment as usual control. A blinded assessor identified suicide reattempts over 6-month follow-up with the Columbia-Suicide Severity Rating Scale (C-SSRS) and a comprehensive multi-source method. Treatment process measures and the Scale for Suicidal Ideation (SSI) were also administered.
Median hospital stay was 13 days. ASSIP subjects reported high satisfaction with the treatment and high therapeutic alliance. Study therapists showed high fidelity to the modified ASSIP intervention. Repetition of suicide attempt was common in both study groups including a combined 9 (26%) subjects with reattempt based on C-SSRS and 13 (38%) subjects with reattempt based on multiple sources.
Adult suicide attempt patients with substance use problems who require lengthy hospitalizations are at exceptionally high risk and may require additional strategies to lower risk.
自杀未遂短程干预方案（ASSIP）被改编用于医院分娩，并针对物质使用问题进行了评估，同时在一系列预备步骤（n=28）和一项试点随机对照试验（RCT，n=34）中评估了其可行性、可接受性和治疗师的保真度。
在 RCT 中，具有自杀未遂和物质使用问题且住院时间足以提供三次 ASSIP 治疗的患者被随机分配至改编后的 ASSIP 或常规治疗对照组。一位盲法评估者使用哥伦比亚自杀严重程度评定量表（C-SSRS）和综合多源方法在 6 个月的随访中识别自杀再尝试。还进行了治疗过程测量和自杀意念量表（SSI）的评估。
中位住院时间为 13 天。ASSIP 受试者对治疗非常满意，并对治疗联盟评价很高。研究治疗师对改良后的 ASSIP 干预具有高度保真度。在研究组中，自杀再尝试都很常见，包括基于 C-SSRS 的 9 名（26%）受试者和基于多种来源的 13 名（38%）受试者再尝试。
需要长时间住院的有物质使用问题的成年自杀未遂患者风险极高，可能需要额外的策略来降低风险。
