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.

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.

Ten year follow-up study of 65 suicidal adolescents.

INTRODUCTION: This survey studies the 10 year psychosocial outcome of 65 adolescents admitted to the Nancy Children's Hospital in 1994 after a suicide attempt. METHOD: survey conducted using a self-assessment questionnaire sent to adolescents and their parents. RESULTS: The response rate was 55.4%. About seventy per cent (70.5%) of respondents stated they were happy in their affective lives 10 years after the reference attempt, almost 70% (67.6%) had a job, nearly three quarters (72.5%) considered that they were in good health and 59% felt happy. More than half (55%) had made a subsequent suicide attempt. Two patients committed suicide. The originality of this study lies in its methodology since it allows, through comparison of suicide attempters' responses with medical data, a high level of under-declaration of repeated attempts to be detected (41.2%). Statistical study of the associations between the total number of repeated suicide attempts and demographic characteristics of the initial population nonetheless evidenced that patients with a history of suicide attempts and those with a history of early repeated attempts (within three months and/or the year) were significantly more likely to repeat their attempt within ten years. CONCLUSION: Most of the 34 patients traced seemed to have satisfactory personal and professional lives, in contrast to the high level of repeated suicide attempts. Repeated suicide attempts during adolescence appear to be one of the major risk factors in attempting suicide again within 10 years. This confirms the importance of preventive measures after a first suicide attempt.

[Rules for psychiatric emergency hospitalization]. / Modalités d'hospitalisation psychiatrique urgente.

The author describe how psychiatric emergencies are dealt with in France. Emergency rooms can admit these patients 24 hours a day particularly somato-psychiatric emergencies as well as situations of existential crisis. Many psychiatric hospitals have also designed a 24 hours a day response to emergencies but with a great diversity depending on local situations. Free-will hospitalization is the most common response but some situations can require commitment to a psychiatric hospital. The author describes in details the enforcement of the law in the case of hospitalization without patients's consent.