Clinical curse, predictive factors and effects of intervention after attempted suicide. A randomised controlled study

Abstract One important task for the mental health services is to prevent suicidal behaviour, especially among persons at high risk, e.g. those who have attempted suicide. In two follow-up samples, one and three months after a suicide attempts, both n=97, we found that 32% and 38% of the patients respectively had no treatment and 30% in each sample had suicidal thoughts. In a randomised controlled study (n=216) we investigated the effects of two telephone interventions in addition to ordinary treatment on attendance to treatment, suicidal behaviour and psychosocial functioning 1-12 months after a suicide attempt. There were no general main effects. Among patients who initially had other treatment than psychiatric attendance to such treatment was higher in the intervention group as compared to controls at 12 months. Further, subjects in the intervention group who had no initial treatment contact reduced certain psychological symptoms more than controls. In all patients an improvement in global functioning, psychological symptoms, suicide ideation and a reduction in number of needs were found, with no differences between the intervention and the control group. Initially needs were very common in health, basic and social needs. At follow-up, a significant reduction was found in health aspects, but not in social and basic needs. An analysis of predictive factors for repetition of suicide attempts during follow-up showed that reattempts within one month and three or more suicide attempts before the index attempt were highly predictive for repetition 1-12 months thereafter. It is concluded that telephone follow-up could be useful in patients without psychiatric contact. A special attention should be put to patients who make several suicide attempts.