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. 2020 Apr 10;17(7):2599.
doi: 10.3390/ijerph17072599.

Effectiveness of a Flexible and Continuous Case Management Program for Suicide Attempters

Min-Hyuk Kim  1 , Jinhee Lee  1 , Hyunjean Noh  2 , Jin-Pyo Hong  3 , Hyun Kim  4 , Yong Sung Cha  4 , Joung-Sook Ahn  1 , Sei-Jin Chang  5 , Seongho Min  1
Affiliations

Effectiveness of a Flexible and Continuous Case Management Program for Suicide Attempters

Min-Hyuk Kim et al. Int J Environ Res Public Health. .

Abstract

The purpose of this study was to investigate the effect of continuous case management with a flexible approach on the prevention of suicide by suicide reattempt in a real clinical setting. The subjects in this study were 526 suicide attempters who visited emergency rooms in a teaching hospital in South Korea. Subjects were provided a continuous case management program with a flexible approach according to the severity of their suicide risk and needs. During the entire observation period (from 182 days to 855 days, mean = 572 ± 254), 18 patients (3.7%) died by suicide reattempt: Eight patients (2.27%) in the case management group and 10 patients (7.35%) in the no-case management group. The Cox regression analysis showed that the case management group had a 75% lower risk of death from suicide attempts than the no-case management group (HR = 0.34, 95% CI = 0.13-0.87). This result was shown to be more robust after adjusting for confounding factors such as gender, age, psychiatric treatment, suicide attempts, and family history of suicide (adjusted HR = 0.27, 95% CI = 0.09-0.83). This study was conducted in a single teaching hospital and not a randomized controlled one. A flexible and continuous case management program for suicide attempters is effective for preventing death by suicide reattempts.

Keywords: case management; intervention; suicide; suicide attempts.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow chart of the study participants.
Figure 2
Figure 2
Protocol of the case management program.
Figure 3
Figure 3
Survival curves by case management program. CM: Case management.
See this image and copyright information in PMC

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