Furuno T, et al. – A multicentre, randomised controlled trial was performed with the aim to assess the effectiveness of assertive case management on repeat self–harm in patients admitted for the suicide attempt. The authors discovered that assertive case management following emergency admission for a suicide attempt lessened the incident rate of repeat overall self–harm.

Methods

• This trial was conducted at 17 general hospitals in Japan.
• For this trial, nine hundred fourteen adult patients admitted to emergency departments for a suicide attempt and had a DSM-IV-TR axis I disorder were randomly assigned to 2 groups, to receive either assertive case management (intervention) or enhanced usual care (control).
• Assertive case management was presented by the case manager during emergency department admissions for suicide attempts, and proceeded after discharge.
• Interventions were given until the end of the examination period (for at least 18 months and up to 5 years).

Results

• The results of this study showed that the number of overall self-harm episodes per person-year was significantly lower in the intervention group (adjusted incidence risk ratio (IRR) 0.88, 95%CI 0.80–0.96, p=0.0031).
• Subgroup analysis demonstrated a greater decline of overall self-harm episodes among patients with no previous suicide attempt at baseline (adjusted IRR 0.73, 95% CI 0.53–0.98, p=0.037).