ABSTRACT
Background: Suicide attempters are those people who survive an attempt to commit suicide. There are no intervention models that address issues in suicide attempters in the population. Aim of the study: This study was done to develop a theoretical model for intervention for suicide attempters with psychiatric disorders. Materials and methods: The research work was conducted in the Department of Psychiatry, Shri Sathya Sai Medical College and Research Institute in the year 2018. The study was done in two phases; the first phase consisted of a literature study to develop a four-factor model that included; Intent, Lethality, Life Stressors and Psychiatric disorders. The second phase consisted of validation of the model through a case-control study; Standardised tools were used namely: Mini International Neuropsychiatric Interview Plus (Mini Plus) Scale for Suicidal Ideation, Risk Rescue Rating Scale, Presumptive Stressful Life Events Scale and a Structured Questionnaire for Socio-demographic Characteristics. Results: There was a high statistical difference between the cases and control in suicidal intent. The results showed the high lethality of the suicide attempts made by patients with Axis -1 disorder and have significant life event stressors both as total mean score and number of events (p<0.005). Using the Chi-square test, the cases had more life stresses compared to controls. There was significant variation between groups using ANOVA. Conclusion: Any model of intervention for suicide attempters with Axis 1 disorders must definitely address life stresses. The direction of the relation between Axis 1 disorders and life stresses must be M. Thenral, Arunkumar Annamalai. A study on development of theoretical intervention model for suicide attempters with psychiatric disorders. IAIM, 2019; 6(9): 13-20. Page 14 identified and addressed systematically. An intervention strategy based on the data obtained in the study can be designed, implemented and evaluated for its effectiveness.
ABSTRACT
<p><b>Background</b>Patients with major depressive disorder (MDD) usually have high risk of suicidality. Few studies have investigated the effects of stressful life events (SLEs) on the risk of suicide in Chinese patients who have developed MDD. This study aimed to investigate the impact of SLEs on suicidal risk in Chinese patients with MDD.</p><p><b>Methods</b>In total, 1029 patients with MDD were included from nine psychiatric hospitals to evaluate the impact of SLEs on suicidal risk. Patients fulfilling the Mini-International Neuropsychiatric Interview (MINI) criteria for MDD were included in the study. Patients were excluded if they had lifetime or current diagnoses of psychotic disorder, bipolar disorder, and alcohol or substance dependence. Depressive symptoms were assessed by the 17-item Hamilton Depression Scale (HAMD-17). The suicidal risk of MDD patients was determined by the suicide risk module of MINI. SLEs were assessed by the Life Events Scale.</p><p><b>Results</b>No gender difference was found for suicidal risk in MDD patients. Patients with suicidal risk had younger ages, lower education levels, more drinking behavior, and lower marriage rate, and fewer people had child and more severe depressive symptoms than nonsuicidal risk group. High-level perceived stressfulness (HPS) and number of SLEs that patients were exposed to were significantly greater in patients with suicidal risk than patients without. In multivariate logistic analysis, HPS of SLEs (odds ratio [OR] = 1.54, 95% confidence interval [CI]: 1.16-2.05, P = 0.003) and depressive symptoms (OR = 1.08, 95% CI: 1.05-1.11, P < 0.001) were associated with suicidal risk even after adjustment of gender, age, marriage, drinking behavior, and childless.</p><p><b>Conclusions</b>HPS of SLEs is associated with suicide risk in Chinese patients with MDD. Further suicide prevention programs targeting this risk factor are needed.</p><p><b>Trial Registration</b>ClinicalTrials.gov: NCT02023567; https://clinicaltrials.gov/ct2/show/NCT02023567?term=NCT02023567&rank=1.</p>