Repetition of Suicide Attempts Data from Emergency Care Settings in Five Culturally Different Low- and Middle-Income Countries Participating in the WHO SUPRE-MISS Study

• Main Author: Bertolote, José Manoel [UNESP]
• Publication Date: 2010
• Other Authors: Fleischmann, Alexandra, De Leo, Diego, Phillips, Michael R., Botega, Neury J., Vijayakumar, Lakshmi, De Silva, Damani, Schlebusch, Lourens, Van Tuong Nguyen, Sisask, Merike, Bolhari, Jafar, Wasserman, Danuta
• Format: Conference object
• Language: eng
• Source: Repositório Institucional da UNESP
• Download full: http://dx.doi.org/10.1027/0227-5910/a000052; http://hdl.handle.net/11449/41473
• topic: suicide; repeated suicide attempts; brief intervention; randomized controlled trial; low- and middle-income countries

Background: Attempted suicide is a strong risk factor for subsequent suicidal behaviors. Innovative strategies to deal with people who have attempted suicide are needed, particularly in resource-poor settings. Aims: To evaluate a brief educational intervention and periodic follow-up contacts (BIC) for suicide attempters in five culturally different sites (Campinas, Brazil; Chennai, India; Colombo, Sri Lanka; Karaj, Islamic Republic of Iran; and Yuncheng, People's Republic of China) as part of the WHO Multisite Intervention Study on Suicidal Behaviors (SUPRE-MISS). Methods: Among the 1,867 suicide attempters enrolled in the emergency departments of the participating sites, 922 (49.4%) were randomly assigned to a brief intervention and contact (BIC) group and 945 (50.6%) to a treatment as usual (TAU) group. Repeated suicide attempts over the 18 months following the index attempt - the secondary outcome measure presented in this paper - were identified by follow-up calls or visits. Subsequent completed suicide - the primary outcome measure has been reported in a previous paper. Results: Overall, the proportion of subjects with repeated suicide attempts was similar in the BIC and TAU groups (7.6% vs. 7.5%, chi(2) = 0.013; p = .909), but there were differences in rates across the five sites. Conclusions: This study from five low-and middle-income countries does not confirm the effectiveness of brief educational intervention and follow-up contacts for suicide attempters in reducing subsequent repetition of suicide attempts up to 18 months after discharge from emergency departments.