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Randomized Controlled Trial
. 2015 Dec 2;10(12):e0143934.
doi: 10.1371/journal.pone.0143934. eCollection 2015.

Effect of Systematic Follow-Up by General Practitioners after Deliberate Self-Poisoning: A Randomised Controlled Trial

Tine K Grimholt  1   2 , Dag Jacobsen  1 , Ole Rikard Haavet  3 , Leiv Sandvik  4 , Trond Jorgensen  5 , Astrid Berge Norheim  2   6 , Oivind Ekeberg  1   7
Affiliations
Randomized Controlled Trial

Effect of Systematic Follow-Up by General Practitioners after Deliberate Self-Poisoning: A Randomised Controlled Trial

Tine K Grimholt et al. PLoS One. .

Abstract

Objective: To assess whether systematic follow-up by general practitioners (GPs) of cases of deliberate self-poisoning (DSP) by their patients decreases psychiatric symptoms and suicidal behaviour compared with current practice.

Design: Randomised clinical trial with two parallel groups.

Setting: General practices in Oslo and the eastern part of Akershus County.

Participants: Patients aged 18-75 years admitted to hospital for DSP. We excluded patients diagnosed with psychoses, without a known GP, those not able to complete a questionnaire, and patients admitted to psychiatric in-patient care or other institutions where their GP could not follow them immediately after discharge.

Intervention: The GPs received a written guideline, contacted the patients and scheduled a consultation within one week after discharge, and then provided regular consultations for six months. We randomised the patients to either intervention (n = 78) or treatment as usual (n = 98).

Main outcome measures: Primary outcome measure was the Beck Scale for Suicide Ideation (SSI). Secondary outcomes were Beck Depression Inventory (BDI) and Beck Hopelessness Scale (BHS), self-reported further self-harm and treatment for DSP in a general hospital or an emergency medical agency (EMA). We assessed patients on entry to the trial and at three and six months. We collected data from interviews, self-report questionnaires, and hospital and EMA medical records.

Results: There were no significant differences between the groups in SSI, BDI, or BHS mean scores or change from baseline to three or six months. During follow-up, self-reported DSP was 39.5% in the intervention group vs. 15.8% in controls (P = 0.009). Readmissions to general hospitals were similar (13% in both groups (P = 0.963), while DSP episodes treated at EMAs were 17% in the intervention group and 7% in the control group (P = 0.103).

Conclusion: Structured follow-up by GPs after an episode of DSP had no significant effect on suicide ideation, depression or hopelessness. There was no significant difference in repeated episodes of DSP in hospitals or EMAs. However, the total number of incidents of deliberate self-harm reported by the patients was significantly higher in the intervention group.

Trial registration: Trial registration ClinicalTrials.gov Identifier: NCT01342809.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Participant flow chart.
See this image and copyright information in PMC

References

    1. Gunnell D, Bennewith O, Peters TJ, House A, Hawton K (2005) The epidemiology and management of self-harm amongst adults in England. J Public Health (Oxf) 27: 67–73. fdh192 [pii];10.1093/pubmed/fdh192 - DOI - PubMed
    1. Zahl DL, Hawton K (2004) Repetition of deliberate self-harm and subsequent suicide risk: long-term follow-up study of 11,583 patients. Br J Psychiatry 185: 70–75. - PubMed
    1. De LD, Scocco P, Marietta P, Schmidtke A, Bille-Brahe U, Kerkhof AJ et al. (1999) Physical illness and parasuicide: evidence from the European Parasuicide Study Interview Schedule (EPSIS/WHO-EURO). Int J Psychiatry Med 29: 149–163. - PubMed
    1. Mitchell AJ, Dennis M (2006) Self harm and attempted suicide in adults: 10 practical questions and answers for emergency department staff. Emerg Med J 23: 251–255. 23/4/251 [pii];10.1136/emj.2005.027250 - DOI - PMC - PubMed
    1. Nordentoft M, Breum L, Munck LK, Nordestgaard AG, Hunding A, Laursen Bjaeldager PA (1993) High mortality by natural and unnatural causes: a 10 year follow up study of patients admitted to a poisoning treatment centre after suicide attempts. BMJ 306: 1637–1641. - PMC - PubMed

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