Harrington R, Kerfoot M, Dyer E, McNiven F, Gill J, Harrington V, Woodham A, Byford S
Department of Child and Adolescent Psychiatry, Royal Manchester Children's Hospital, Pendlebury, England.
J Am Acad Child Adolesc Psychiatry. 1998 May;37(5):512-8.
To establish whether an intervention given by child psychiatric social workers to the families of children and adolescents who had attempted suicide by taking an overdose reduced the patients' suicidal feelings and improved family functioning.
One hundred sixty-two patients, aged 16 or younger, who had deliberately poisoned themselves were randomly allocated to routine care (n = 77) or routine care plus the intervention (n = 85). The intervention consisted of an assessment session and four home visits by the social workers to conduct family problem-solving sessions. The control group received no visits. Both groups were assessed at the time of recruitment and 2 and 6 months later. The primary outcome measures were the Suicidal Ideation Questionnaire, the Hopelessness Scale, and the Family Assessment Device.
There were no significant differences in the primary outcomes between the intervention and control groups at either of the outcome assessments. Parents in the intervention group were more satisfied with treatment (mean difference 1.4 [95% confidence interval 0.6 to 2.1]). A subgroup without major depression had much less suicidal ideation at both outcome assessments (analysis of covariance p < .01) compared with controls.
The home-based family intervention resulted in reduced suicidal ideation only for patients without major depression.
确定儿童精神科社会工作者对曾过量服药自杀的儿童及青少年家庭进行的干预,是否能降低患者的自杀念头并改善家庭功能。
162名16岁及以下故意中毒的患者被随机分配至常规护理组(n = 77)或常规护理加干预组(n = 85)。干预包括一次评估会议以及社会工作者进行四次家访以开展家庭问题解决会议。对照组未接受家访。两组在招募时、2个月后和6个月后均接受评估。主要结局指标为自杀意念问卷、绝望量表和家庭评估工具。
在任何一次结局评估中,干预组和对照组在主要结局方面均无显著差异。干预组的家长对治疗更满意(平均差异1.4 [95%置信区间0.6至2.1])。与对照组相比,一个无重度抑郁的亚组在两次结局评估时的自杀意念均少得多(协方差分析p < .01)。
以家庭为基础的干预仅对无重度抑郁的患者有降低自杀意念的效果。