An intervention and follow-up study following a suicide attempt in the emergency departments of four general hospitals in Shenyang, China

Abstract

Background: Studies on the effects of interventions in patients who have attempted suicide in China have not reported so far.

Aims: To describe the basic situation surrounding the interventions and follow-up of patients who have attempted suicide and to determine whether the interventions would be effective in reducing repeat suicide attempts.

Method: 239 patients who had attempted suicide were evaluated in the emergency departments of four general hospitals. They were randomized into three groups: cognitive therapy group, telephone intervention group, and control group. Postintervention the participants were evaluated at 3, 6, and 12 months separately by the following measurements: a detailed structured questionnaire, Beck Suicide Ideation Scale (SIS), Hamilton Rating Scale for Depression (HAMD), and a quality-of-life scale.

Results: After 12 months, the cumulative dropout rate was 69.5% (n = 57) for the cognitive therapy group, 55.0% (n = 44) for the telephone intervention group, and 64.9% (n = 50) for the control group. One patient (1.2%) in the cognitive therapy group, one patient (1.3%) in the telephone intervention group, and five patients (6.5%) in the control group made at least one subsequent suicide attempt. The rates of repeated attempted suicide among the three groups were not significantly different (χ² = 5.077, p = .08). Five patients (6.1%) received cognitive therapy, and 60 patients (75.0%) received telephone intervention. There were no differences regarding the score of HAMD, a quality-of-life scale, and the rates of subsequent suicide attempt and suicide ideation among the three groups at follow-up.

Conclusions: The dropout rates were higher than those reported in developed countries. Most participants in the cognitive therapy group refused to receive cognitive therapy so that the effect of cognitive therapy for these patients cannot be evaluated. The participants in the telephone intervention group had good compliance, but the effect of telephone intervention could not be confirmed, so that more studies are needed in the future. Consequently, interventions cannot be evaluated accurately in their preventing suicide attempts for patients who have attempted suicide in China at present.