Monn Anna, Villar de Araujo Tania, Rüesch Annia, Kronenberg Golo, Hörmann Christoph, Adank Atalìa, Roman Zachary, Schoretsanitis Georgios, Rufer Michael, Seifritz Erich, Kleim Birgit, Olbrich Sebastian
Department of Adult Psychiatry and Psychotherapy, University Hospital of Psychiatry and University of Zurich, Zurich, Switzerland.
Department of Adult Psychiatry and Psychotherapy, University Hospital of Psychiatry and University of Zurich, Zurich, Switzerland.
J Affect Disord. 2025 Aug 1;382:59-67. doi: 10.1016/j.jad.2025.04.023. Epub 2025 Apr 4.
Following the call for rigorous replication practices in crisis intervention and suicide prevention research, this study re-evaluated the efficacy of a brief intervention (ASSIP - Attempted Suicide Short Intervention Program) for patients with a recent suicide attempt in reducing repeated suicidal behavior. In this open-label, randomized, controlled parallel-group trial, 92 patients were assigned to treatment as usual (TAU) or TAU plus ASSIP. The primary outcome was suicidal behavior (suicide attempts and suicide deaths) during a 12-month observation period. Secondary outcomes included the number of suicide attempts and psychiatric inpatient admissions. Twelve patients in the intervention group and six patients in the control group engaged in suicidal behavior, including one suicide death in each group. The intention-to-treat (ITT) analysis found no significant effect of ASSIP in reducing suicidal behavior or admission to psychiatric hospitals. Surprisingly, the per-protocol (PP) analysis revealed a significantly higher incidence rate of suicide re-attempts in the intervention group. Contrary to the original findings, this non-replication study suggests that ASSIP combined with TAU does not significantly reduce suicidal behavior compared to TAU alone. Further research is needed to refine indications for ASSIP therapy and enhance its effectiveness.
在危机干预和自杀预防研究中呼吁采用严格的重复实践之后,本研究重新评估了一种简短干预措施(ASSIP - 自杀未遂短期干预项目)对近期有自杀未遂行为的患者减少重复自杀行为的疗效。在这项开放标签、随机、对照平行组试验中,92名患者被分配到常规治疗(TAU)组或TAU加ASSIP组。主要结局是12个月观察期内的自杀行为(自杀未遂和自杀死亡)。次要结局包括自杀未遂次数和精神科住院次数。干预组有12名患者,对照组有6名患者出现自杀行为,每组各有1例自杀死亡。意向性分析(ITT)发现ASSIP在减少自杀行为或精神科住院方面没有显著效果。令人惊讶的是,符合方案分析(PP)显示干预组自杀未遂的发生率显著更高。与最初的研究结果相反,这项非重复研究表明,与单独使用TAU相比,ASSIP联合TAU并不能显著降低自杀行为。需要进一步研究以完善ASSIP治疗的适应症并提高其有效性。