RESUMO
INTRODUCTION: Repetition of suicide attempts occurs frequently. There is a lack of knowledge as to which treatment strategies are most effective. MATERIALS AND METHODS: STUDY 1: A cohort of 200 psychiatric inpatients, consecutively admitted for current suicide attempt, were studied as to the association among quality level of examination, treatment and referral to aftercare and repetition of attempted suicide in one year. STUDY 2: Three cohorts of psychiatric inpatients, consecutively admitted for current suicide attempt, were compared for repetition of suicide in one year. The 2001-2002 cohort of 173 inpatients had received problem-oriented therapy and been provided with a contact card to a psychiatric emergency room. The 1994-1995 control cohort of 200 inpatients had received quality-ensured standard treatment. The 1989 control cohort of 126 inpatients had received standard treatment only. Similarly, two cohorts of psychiatric emergency outpatients, referred after current suicide attempts, were compared: 116 patients in 2001-2002 and 75 patients in 1994-1995. RESULTS: A higher quality level of examination and treatment was significantly related to lack of repetition of attempted suicide in one year. No association was found between higher quality level of referrals to aftercare and no repetition of attempted suicide. The rate of repetition of suicide attempts in one year was reduced from 30% to 24% after establishment of quality assurance and problem-oriented therapy, but the reduction was not significant. CONCLUSION: It is still uncertain which treatment modalities of patients admitted for attempted suicide are most effective.
