Evaluation of an intensive intervention program in suicidal behaviour.

INTRODUCTION: Suicide is a public health problem. Consumed suicides reach 1 million cases per year worldwide and it is estimated that the number of suicide attempts is 10 to 20 times higher. The aim of this study was to evaluate the effectiveness in reducing repeat suicide attempts in a program for the prevention of suicidal behavior: Intensive Intervention Program (IIP). METHODS: We performed a study that compared a cohort of patients exposed to IIP intervention with another cohort of patients exposed to conventional therapy. The sample was made up of 191 patients, 89 in the treatment group and 102 patients in conventional treatment group, with a 12-month follow-up. RESULTS: Relapse occurred in 20.6% of patients receiving conventional treatment relapse compared with 10% in the treatment group (p=0.047). Patients treated in the program had a 2.88 times lower risk of relapse (p=0.015), this being independent of the number of previous attempts, age, gender, need for admission after the index attempt and aggregated diagnosis. CONCLUSIONS: The results show that subjects who are treated in the IIP relapse less, need fewer admissions and the time elapsed between the treatment and the first repeat suicide attempt is greater.

Evaluación de un Programa de Intervención Intensiva en Conducta Suicida / Evaluation of an Intensive Intervention Program in Suicidal Behaviour

Introducción: El suicidio es un problema de salud pública. El suicidio consumado asciende a 1 millón de casos al año en el mundo y se estima que el número de intentos de suicidio es 10 o 20 veces superior. El objetivo del presente trabajo es la evaluación de la efectividad en la reducción de reintentos de suicidio en un Programa de prevención de conducta suicida: el Programa de Intervención Intensiva (PII). Metodología: Se realiza un estudio en el que se compara una cohorte de pacientes expuestos a la intervención en PII con otra cohorte de pacientes expuestos a terapia convencional. La muestra está formada por un total de 191 pacientes, 89 del grupo de tratamiento en PII y 102 pacientes del grupo de tratamiento convencional. Con un seguimiento de 12 meses. Resultados: un 20,6% de los pacientes que recibe tratamiento convencional recaen frente al 10% del grupo de tratamiento en PII (p=0,047). Los pacientes atendidos en el programa presentaron un riesgo menor 2,88 veces de recaída (p=0,015), esto es independiente del número de intentos previos, edad, sexo, necesidad de ingreso tras el intento índice y diagnóstico agregado. Conclusiones: Los resultados muestran que los sujetos que reciben tratamiento en el PII tiene menos reintentos, necesitan ingresar menos, y el tiempo trascurrido desde el inicio del tratamiento y el primer reintento es mayor (AU)

Introduction: Suicide is a public health problem. Consumed suicides reach 1 million cases per year worldwide and it is estimated that the number of suicide attempts is 10 to 20 times higher. The aim of this study was to evaluate the effectiveness in reducing repeat suicide attempts in a program for the prevention of suicidal behavior: Intensive Intervention Program (IIP). Methods: We performed a study that compared a cohort of patients exposed to IIP intervention with another cohort of patients exposed to conventional therapy. The sample was made up of 191 patients, 89 in the treatment group and 102 patients in conventional treatment group, with a 12-month follow-up. Results: Relapse occurred in 20.6% of patients receiving conventional treatment relapse compared with 10% in the treatment group (p=0.047). Patients treated in the program had a 2.88 times lower risk of relapse (p=0.015), this being independent of the number of previous attempts, age, gender, need for admission after the index attempt and aggregated diagnosis. Conclusions: The results show that subjects who are treated in the IIP relapse less, need fewer admissions and the time elapsed between the treatment and the first repeat suicide attempt is greater (AU)

Extensive linkage disequilibrium mapping at HTR2A and DRD3 for schizophrenia susceptibility genes in the Galician population.

The serotonin and dopamine neurotransmitter systems are candidate pathways in the development of schizophrenia because of the assumed causal relationship with the observed symptoms as well as effective targeting of the corresponding receptors by antipsychotic drugs. However, genetic association studies have systematically focused on a limited set of genes and single nucleotide polymorphisms (SNPs), including T102C at HTR2A and Ser9Gly at DRD3. Meta-analyses of the associations between these two markers and schizophrenia revealed a true increase in risk, the magnitude of the effect being very low. In the present study we analyzed 260 schizophrenic patients and 354 control subjects from a homogeneous population, the Galician population, using an extensive linkage disequilibrium (LD) mapping approach, genotyping a total of 47 SNPs to test for the existence of additional variants that confer higher risk. We detected nominal significant association with schizophrenia for several haplotype tag SNPs (htSNPs) at HTR2A, although the significance was lost after multiple test corrections. In addition, haplotype analyses involving a sliding window approach, with window size 2 to 4 SNPs, revealed significant differences in frequencies of the DRD3 haplotypes at the 3' half of the gene region. This difference, which remains clearly significant after multiple test corrections (p=0.002, 0.0001, and 0.0025, for window sizes 2, 3, and 4, respectively), was mainly due to over-representation of several rare haplotypes in patients, at the expense of a single common haplotype; this represents interesting evidence of rare haplotypes for susceptibility detected using common htSNPs due to their strong effect.