Geen meetbaar effect van algemene sociaal-psychiatrische nazorg voor suicidepogers; een gerandomiseerd experiment

Objective. To determine whether in suicide attempters intensive psychosocial intervention is beneficial as compared with treatment as usual. Design. Randomized controlled investigation. Setting. Utrecht University Hospital, Utrecht, the Netherlands. Method. 274 suicide attempters presenting for medical treatment and not in need of urgent psychiatric treatment were randomly assigned to either intensive psychosocial treatment or 'care as usual'. After the randomization the patients were asked for their informed consent to the experimental treatment: brief hospitalization in a special crisis intervention unit and problem-solving aftercare with 24-hour open access to the crisis intervention unit. In the control group the care was as usual. The repeated suicide attempts in the year following randomization were counted and after 3, 6 and 12 months general wellbeing was measured using the 'Symptom checklist' (SCL-90) and the 'Hopelessness scale'. Results. No differences in outcome were found. The probability of a repeated suicide attempt during the follow-up of 12 months for patients in the experimental group was almost identical to that of patients in the control group. There were no significant differences in ratings on the SCL-90 and the 'Hopelessness scale' either, indicating no differences in wellbeing between the two groups. The average number of days spent in a psychiatric hospital in the two groups did not differ significantly either. Patients in the experimental group attended more outpatient treatment sessions. Conclusion. The suicide attempters did not benefit from the experimental treatment.