Factores predictores de riesgo de repetición de intento de suicidio en una muestra de pacientes ambulatorios / Relevant risk factors of repeated suicidal attempts in a sample of outpatients

INTRODUCCIÓN: El suicidio representa un problema destacado en la actualidad; una línea de prevención e intervención es la detección de los factores de riesgo. En este estudio se pretende identificar los predictores de suicidio en pacientes con repetición de intento de suicidio (RIS) en seguimiento en un programa de intervención intensiva. MATERIAL Y MÉTODOS: La muestra la forman los pacientes incluidos en el programa de intervención intensiva por intento de suicidio. Se registran las variables sociodemográficas y clínicas, los abandonos, la RIS, las faltas a consulta y los resultados obtenidos en las escalas de depresión y desesperanza de Beck a lo largo de los 12 meses de seguimiento en el programa (inicial, 6 meses y 12 meses). Análisis estadístico: La asociación entre RIS y variables cualitativas de estudio se realizó empleando Chi-Cuadrado y para las cuantitativas T-Student. Los análisis se hicieron utilizando el software SPSS 19.0. El estudio ha sido aprobado por el Comité Autonómico de Ética de la Investigación de Galicia. RESULTADOS: De la muestra de 319 pacientes, 29 (9%) realizan una RIS, 22 (76%) durante los primeros 6 meses del programa. De los pacientes con RIS, 7 (24%) tienen historia de intento previo durante un periodo inferior a 180 días al intento índice (p = 0,033). La intoxicación medicamentosa fue el método más empleado pues fue utilizada en el intento índice por 240 pacientes (76%). Veintisiete (93%) mantienen el método en la RIS (p < 0,001). CONCLUSIONES: La sobreingesta de fármacos como método de intento y reintento, y el tiempo transcurrido desde el intento previo son los factores de riesgo destacados asociados a la RIS, de ahí la importancia de identificar a los pacientes con historia de intento de suicidio para llevar a cabo una intervención más intensiva y un ajuste adecuado del tratamiento sobre todo en los primeros 180 días

INTRODUCTION: Suicide is, at present, an important global public health problem; detection of risk factors can be used as a method for prevention and intervention. This study aims to identify predictors of suicide in patients with suicidal attempt retry (SAR), who are followed-up an in the Intensive Intervention Program (PII). MATERIAL AND METHODS: The sample includes patients followed up at the Intensive Intervention Program because of a previous suicidal attempt. The following variables were collected during the 12 months follow-up (baseline, 6 months and 12 months): Repeated attempts, socio-demographic and clinical variables, lack of adherence and the Beck Depression Inventory and Hopelessness Scale. Statistic analysis: The association between SAR and qualitative study variables was performed using Chi-Square and for the quantitative, T-Student was used. The analysis was carried out with the software SPSS 19.0. The study has been approved by the Research Ethics Committee of Galicia. RESULTS: Of the 319 patients, 29 (9%) of them committed a new suicidal attempt, 22 (76%) of these new attempts happened during the first 6 month of the Program. Of those who repeat the attempt, 7 (24%) have a history of a previous attempt that precede the basal attempt (P=.033) in less than 180 days. Medication overdose is the most used method, as it was used by 240 of the patients (76%). 27 (93%) kept drug overdose as their retry method, also reaching significance(P<.001). CONCLUSIONS: Overdose as a method of attempt and re-attempt, and the time elapsed from the previous attempt, are the highlighted risk factors associated with repeated suicidal attempts. For this reason, it is crucial to identify patients with a new suicide attempt so that a more intense intervention and drug treatment control is delivered during the first 180 days

Relevant risk factors of repeated suicidal attempts in a sample of outpatients. / Factores predictores de riesgo de repetición de intento de suicidio en una muestra de pacientes ambulatorios.

INTRODUCTION: Suicide is, at present, an important global public health problem; detection of risk factors can be used as a method for prevention and intervention. This study aims to identify predictors of suicide in patients with suicidal attempt retry (SAR), who are followed-up an in the Intensive Intervention Program (PII). MATERIAL AND METHODS: The sample includes patients followed up at the Intensive Intervention Program because of a previous suicidal attempt. The following variables were collected during the 12 months follow-up (baseline, 6 months and 12 months): Repeated attempts, socio-demographic and clinical variables, lack of adherence and the Beck Depression Inventory and Hopelessness Scale. STATISTIC ANALYSIS: The association between SAR and qualitative study variables was performed using Chi-Square and for the quantitative, T-Student was used. The analysis was carried out with the software SPSS 19.0. The study has been approved by the Research Ethics Committee of Galicia. RESULTS: Of the 319 patients, 29 (9%) of them committed a new suicidal attempt, 22 (76%) of these new attempts happened during the first 6 month of the Program. Of those who repeat the attempt, 7 (24%) have a history of a previous attempt that precede the basal attempt (P=.033) in less than 180 days. Medication overdose is the most used method, as it was used by 240 of the patients (76%). 27 (93%) kept drug overdose as their retry method, also reaching significance(P<.001). CONCLUSIONS: Overdose as a method of attempt and re-attempt, and the time elapsed from the previous attempt, are the highlighted risk factors associated with repeated suicidal attempts. For this reason, it is crucial to identify patients with a new suicide attempt so that a more intense intervention and drug treatment control is delivered during the first 180 days.

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)