Follow-up study of suicide attempters who were given crisis intervention during hospital stay: Pilot study

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FOR 10 CONSECUTIVE years the suicide rate in Japan has stayed at around 25 per 100 000, which is the highest among the developed countries.1 Only a few follow-up studies, however, regarding suicide attempters are reported,2,3 and both nationwide and community-based data are lacking in Japan.

The aim of the present study was to determine the prognosis of suicide attempters who were given crisis intervention during hospital stays, follows: (i) immediate psychiatric and psychosocial evaluation; (ii) psycho-education regarding the suicide behavior and psychiatric disease; and (iii) introduction of psychiatric treatment and social resource.

We targeted 144 patients who were admitted to the emergency department between 1 April 2005 and 31 March 2006 due to suicide attempts. Telephone interview was attempted twice, and the following questions were asked: (i) confirmation of survival; or (ii) cause of death. At the first interview (299 ± 100 days after discharge from the emergency department), 115 of 144 patients or their family responded to the interview. The suicide attempt rate was 4.3%, and the suicide rate was 2.6%. At the second interview (638 ± 97 days after discharge), 83 patients or their family responded to the interview. The suicide attempt rate was 10.8%, and the suicide rate was 4.8%, and 61 of 144 patients (42.4%) were not traced. The reasons for lack of contact were as follows: 43 patients moved or changed their personal telephone numbers, and 18 patients refused to participate in this interview.

Suicide rate at the first interview was relatively low compared to other previous studies carried out in Finland and Sweden,4,5 but whether this is due to the effect of crisis intervention is not clear because we could not trace 42.4% of the patients initially targeted. Therefore the main limitation in the present study is due to lack of information on the prognosis of the status of untraced patients.

The National Suicide Prevention Measure Outline was set in 2007. The need for investigation and research on suicide attempters is clearly noted in the outline. The emergency department is where medically serious suicide attempters are carried in, and suicide attempters account for 9% of all patients on annual average (2008).6 The present study suggests that case management in the emergency department might be effective for preventing suicide. Further study, however, with more sophisticated methodology is required to establish a procedure to prevent suicide reattempt.

Received 30 January 2008; revised 17 September 2008; accepted 30 September 2008.

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