Predictors of outcome following brief psychodynamic-interpersonal therapy for deliberate self-poisoning

Authors

  • Elspeth Guthrie,

    Corresponding author
      Elspeth Guthrie, Professor (Correspondence); Navneet Kapur, Senior Lecturer; James Moorey, Clinical Psychologist; Elizabeth Mendel, Clinical Psychologist; Fredrika Marino Francis, Research Assistant; Sarah Sanderson, Specialist Nurse; Clive Turpin, Specialist Nurse; Gary Boddy, Specialist Nurse
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  • Navneet Kapur,

  • Kevin Mackway-Jones,

  • Carolyn Chew-Graham,

  • James Moorey,

  • Elizabeth Mendel,

  • Fredrika Marino Francis,

  • Sarah Sanderson,

  • Clive Turpin,

  • Gary Boddy


  • School of Psychiatry and Behavioural Sciences, University of Manchester, Rawnsley Building, Manchester Royal Infirmary, Oxford Road, Manchester, M13 9WL. UK. Email: elspeth.a.guthrie@man.ac.uk

  • Kevin Mackway-Jones, Professor

  • Emergency Department, Manchester Royal Infirmary, Manchester, UK

    Carolyn Chew-Graham, Senior Lecturer

    School of General Practice, University of Manchester, Manchester, UK

Elspeth Guthrie, Professor (Correspondence); Navneet Kapur, Senior Lecturer; James Moorey, Clinical Psychologist; Elizabeth Mendel, Clinical Psychologist; Fredrika Marino Francis, Research Assistant; Sarah Sanderson, Specialist Nurse; Clive Turpin, Specialist Nurse; Gary Boddy, Specialist Nurse

Abstract

Background: We found that brief psychodynamic-interpersonal therapy was more helpful than usual care in deliberate self-poisoning patients, and resulted in reduced suicidal ideation and repetition of self-harm in the 6 months post-treatment. Here, we explore which baseline factors predicted outcome following treatment.

Method: Patients presenting to an emergency department with deliberate self-poisoning were randomly assigned to brief psychodynamic-interpersonal therapy (PIT) or usual care. Severity of suicidal ideation 6 months post-treatment was used as the main outcome measure. Sociodemographic features and baseline psychological measures were used as predictor variables. Univariate and regression analyses were used to identify predictors of outcome for the whole group and for those who received psychotherapy.

Results: Principal predictors for the psychotherapy group were baseline severity of depression and a prior history of self-harm. For the group as a whole predictors were severity of suicidal ideation, anxiety and prior history of self-harm.

Conclusions: Four session PIT for deliberate self-poisoning is effective in reducing suicidal ideation in patients with less severe depression, no prior history of self-harm, and who have not consumed alcohol with the overdose. Extended therapy may be indicated for those with more severe depression.

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