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Ng L, Diamond D, Ang M. Text2whaiora after a suicide attempt: Text message design alongside people with lived experience. PLoS One 2024; 19:e0306801. [PMID: 39240937 PMCID: PMC11379222 DOI: 10.1371/journal.pone.0306801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 06/24/2024] [Indexed: 09/08/2024] Open
Abstract
BACKGROUND People with lived experience have had limited opportunities to meaningfully contribute to the design of caring contacts interventions. The objective of this study was to co-design text messages with peer support specialist staff to determine optimal language and delivery, within a cultural context. METHODS In this qualitative study, participants were professional peer support specialist staff with lived experience employed by specialist mental health services. They were asked to evaluate the initial series of text messages by taking part in a focus group using a semi-structured interview. This was audiotaped, transcribed and analysed using reflexive thematic analysis with specific coding of cultural themes. RESULTS Three main themes were identified: upholding a person's autonomy; establishing connection as a bridge to safety; and, words as healing rongoā (remedy). The last theme contained a cultural subtheme: Māori language providing entry to the Māori world. CONCLUSION People with lived experience breathe empowerment and hope into caring contacts interventions and should be considered vital partners in developing any suicide prevention initiative. Feeling genuinely cared for promotes connection and may enable an internal sense of safety. Tailoring of texts can be enhanced by culturally nuanced language.
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Affiliation(s)
- Lillian Ng
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
- Department of Mental Health and Addictions, Health New Zealand Te Whatu Ora Counties Manukau, Auckland, New Zealand
| | - Danielle Diamond
- Department of Mental Health and Addictions, Health New Zealand Te Whatu Ora Counties Manukau, Auckland, New Zealand
| | - Mike Ang
- Department of Mental Health and Addictions, Health New Zealand Te Whatu Ora Counties Manukau, Auckland, New Zealand
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Thomas GV, Camacho E, Masood FA, Huang Y, Valleru J, Bridge JA, Ackerman J. Development and Implementation of Postdischarge Text Messages to Adolescents With Suicidal Thoughts and Behaviors Through Caring Contacts: Implementation Study. JMIR Pediatr Parent 2024; 7:e51570. [PMID: 39137019 DOI: 10.2196/51570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 05/23/2024] [Accepted: 06/11/2024] [Indexed: 08/15/2024] Open
Abstract
BACKGROUND Youth suicide is a pressing public health concern, and transitions in care after a suicidal crisis represent a period of elevated risk. Disruptions in continuity of care and emotional support occur frequently. "Caring contacts" validating messages post discharge have the potential to enhance connections with patients and have been shown to improve outcomes. More recently, positive outcomes have been noted using caring contact text messages (SMS and MMS), which hold promise for engaging patients in a pediatric setting, but there are few studies describing the large-scale implementation of such an approach. OBJECTIVE This study aims to describe the process of developing and implementing automated caring contacts within a quality improvement framework, using a standardized series of supportive texts and images, for adolescents discharged from high-acuity programs at a large midwestern pediatric hospital. We describe lessons learned, including challenges and factors contributing to success. METHODS We implemented the caring contacts intervention in 3 phases. Phase 1 entailed developing supportive statements and images designed to promote hope, inclusivity, and connection in order to create 2 sets of 8 text messages and corresponding images. Phase 2 included piloting caring contacts manually in the hospital's Psychiatric Crisis Department and Inpatient Psychiatry Unit and assessing the feasibility of implementation in other services, as well as developing workflows and addressing legal considerations. Phase 3 consisted of implementing an automated process to scale within 4 participating hospital services and integrating enrollment into the hospital's electronic medical records. Process outcome measures included staff compliance with approaching and enrolling eligible patients and results from an optional posttext survey completed by participants. RESULTS Compliance data are presented for 4062 adolescent patients eligible for caring contacts. Overall, 88.65% (3601/4062) of eligible patients were approached, of whom 52.43% (1888/3601) were enrolled. In total, 94.92% (1792/1888) of enrolled participants completed the program. Comparisons of the patients eligible, approached, enrolled, and completed are presented. Primary reasons for eligible patients declining include not having access to a mobile phone (686/1705, 40.23%) and caregivers preferring to discuss the intervention at a later time (754/1705, 44.22%). The majority of patients responding to the optional posttext survey reported that the texts made them feel moderately to very hopeful (219/264, 83%), supported (232/264, 87.9%), that peers would be helped by these texts (243/264, 92%), and that they would like to keep receiving texts given the option (227/264, 86%). CONCLUSIONS This study describes the successful implementation of automated postdischarge caring contacts texts to scale with an innovative use of images and demonstrates how a quality improvement methodology resulted in a more effective and efficient process. This paper also highlights the potential for technology to enhance care for at-risk youth and create more accessible, inclusive, and sustainable prevention strategies.
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Affiliation(s)
- Glenn V Thomas
- Behavioral Health Services, Nationwide Children's Hospital, Columbus, OH, United States
- Department of Psychiatry & Behavioral Health, The Ohio State University, Columbus, OH, United States
| | - Elena Camacho
- Behavioral Health Services, Nationwide Children's Hospital, Columbus, OH, United States
| | - Fatimah A Masood
- Behavioral Health Services, Nationwide Children's Hospital, Columbus, OH, United States
| | - Yungui Huang
- The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, United States
| | - Jahnavi Valleru
- Patient Safety Education & Research, Ascension, St. Louis, MO, United States
| | - Jeffrey A Bridge
- Department of Psychiatry & Behavioral Health, The Ohio State University, Columbus, OH, United States
- The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, United States
- Department of Pediatrics, The Ohio State University, Columbus, OH, United States
| | - John Ackerman
- Behavioral Health Services, Nationwide Children's Hospital, Columbus, OH, United States
- Department of Psychiatry & Behavioral Health, The Ohio State University, Columbus, OH, United States
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Soderlund PD, Cheung EH, Cadiz MP, Siddiq H, Yerstein M, Lee S, Wells K, Heilemann MV. Bridging the gap: a qualitative study of providers' perceptions of a partnered crisis follow-up program for suicidal patients post-emergency department discharge. BMC Psychiatry 2023; 23:854. [PMID: 37978360 PMCID: PMC10655296 DOI: 10.1186/s12888-023-05106-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 08/11/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Effective interventions are needed to address suicide risk following discharge from the hospital emergency department or inpatient setting. Studies that examine follow-up contact methods show promise, but little is known about how follow-up programs are implemented in the real world and who is benefitting. The purpose of this formative evaluation and analysis was to gain insight about the usefulness and value of a partnered suicide prevention follow-up program (academic medical center emergency department partnered with a regional suicide prevention center) from the standpoint of psychiatry resident physicians providing direct care and suicide prevention center crisis counselors making follow-up outreach telephone calls to patients. METHODS A qualitative thematic analysis was conducted with focus group data from a convenience sample of psychiatry residents who performed consultations in the emergency department setting and counselors at the suicide prevention center crisis follow-up program. Focus group sessions, using semi-structured question guides, were completed at each participant group's workplace. Grounded theory techniques were used to guide coding and analytic theme development. RESULTS Analyses resulted in four overarching themes: valuing the program's utility and benefit to patients, desiring to understand what happens from emergency department discharge to program follow-up, having uncertainty about which patients would benefit from the program, and brainstorming to improve the referral process. Psychiatry residents appreciated the option of an "active" referral service (one that attempts to actively engage a patient after discharge through outreach), while suicide prevention crisis counselors valued their ability to offer a free and immediate service that had potential for fostering meaningful relationships. Both participant groups desired a better understanding of their partner's program operations, a uniform and smooth referral process, and awareness of who may or may not benefit from program services. CONCLUSION Results revealed the need for improved communication and implementation, such as expanded inter-agency contacts, consistent provider training, more documentation of the requirements and rules, a consistent message about program logistics for patients, and coordination between the program elements.
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Affiliation(s)
- Patricia D Soderlund
- Memory Keepers Medical Discovery Team, University of Minnesota Medical School, 624 East 1St St, Duluth, MN, 20155805, USA.
- Division of General Internal Medicine, David Geffen School of Medicine, University of California Los Angeles, National Clinician Scholars Program, 1100 Glendon Ave., Suite 900, Los Angeles, CA, 90024, USA.
| | - Erick H Cheung
- David Geffen School of Medicine, Department of Psychiatry and Biobehavioral Sciences, University of California, Jane and Terry Semel Institute for Neuroscience and Human Behavior, Resnick Neuropsychiatric Hospital, 757 Westwood Plaza, Los Angeles, CA, 90095, USA
| | - Madonna P Cadiz
- Luskin School of Public Affairs, University of California Los Angeles, 337 Charles E Young Dr E, Los Angeles, CA, 90095, USA
| | - Hafifa Siddiq
- Charles R. Drew University College of Nursing, 1731 E. 120th St., Los Angeles, CA, 90059, USA
- Division of General Internal Medicine and Health Services Research, University of California Los Angeles, 1100 Glendon Ave., Suite 900, Los Angeles, CA, 90024, USA
| | - Maria Yerstein
- Boston University School of Medicine, St. Elizabeth's Medical Center, 736 Cambridge St, Brighton, MA, 02135, USA
| | - Sae Lee
- Didi Hirsch Mental Health Services, 4760 S. Sepulveda Blvd, Culver City, CA. 90230, USA
| | - Kenneth Wells
- David Geffen School of Medicine, Department of Psychiatry and Biobehavioral Sciences, University of California, Jane and Terry Semel Institute for Neuroscience and Human Behavior, Resnick Neuropsychiatric Hospital, 757 Westwood Plaza, Los Angeles, CA, 90095, USA
- Research Center for Health Services and Society, UCLA Jane and Terry Semel Institute for Neuroscience and Human Behavior, 760 Westwood Plaza, Suite 17.369B, Los Angeles, CA, 90024, USA
- David Geffen School of Medicine, National Clinician Scholars Program, Division of General Internal Medicine and Health Services Research, 1100 Glendon Ave., Suite 900, Los Angeles, CA, 90024, USA
- Department of Mental Health, Veterans Affairs Greater Los Angeles HealthCare System, 11301 Wilshire Boulevard, Los Angeles, CA, 90073, USA
| | - MarySue V Heilemann
- School of Nursing, Factor Building, University of California Los Angeles, Box 6919, Los Angeles, CA, 90095, USA
- Division of General Internal Medicine, David Geffen School of Medicine, University of California Los Angeles, National Clinician Scholars Program, 1100 Glendon Ave., Suite 900, Los Angeles, CA, 90024, USA
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Shin HD, Durocher K, Sequeira L, Zaheer J, Torous J, Strudwick G. Information and communication technology-based interventions for suicide prevention implemented in clinical settings: a scoping review. BMC Health Serv Res 2023; 23:281. [PMID: 36959599 PMCID: PMC10037806 DOI: 10.1186/s12913-023-09254-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 03/07/2023] [Indexed: 03/25/2023] Open
Abstract
BACKGROUND A large number of information and communication technology (ICT) based interventions exist for suicide prevention. However, not much is known about which of these ICTs are implemented in clinical settings and their implementation characteristics. In response, this scoping review aimed to systematically explore the breadth of evidence on ICT-based interventions for suicide prevention implemented in clinical settings and then to identify and characterize implementation barriers and facilitators, as well as evaluation outcomes, and measures. METHODS We conducted this review following the Joanna Briggs Institute methodology for scoping reviews. A search strategy was applied to the following six databases between August 17-20, 2021: MEDLINE, Embase, CINAHL, PsycINFO, Web of Science, and Library, Information Science and Technology Abstracts. We also supplemented our search with Google searches and hand-searching reference lists of relevant reviews. To be included in this review, studies must include ICT-based interventions for any spectrum of suicide-related thoughts and behaviours including non-suicidal self-injury. Additionally, these ICTs must be implemented in clinical settings, such as emergency department and in-patient units. We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) checklist to prepare this full report. RESULTS This review included a total of 75 citations, describing 70 studies and 66 ICT-based interventions for suicide prevention implemented in clinical settings. The majority of ICTs were computerized interventions and/or applications (n = 55). These ICTs were commonly used as indicated strategies (n = 49) targeting patients who were actively presenting with suicide risk. The three most common suicide prevention intervention categories identified were post-discharge follow-up (n = 27), screening and/or assessment (n = 22), and safety planning (n = 20). A paucity of reported information was identified related to implementation strategies, barriers and facilitators. The most reported implementation strategies included training, education, and collaborative initiatives. Barriers and facilitators of implementation included the need for resource supports, knowledge, skills, motivation as well as engagement with clinicians with research teams. Studies included outcomes at patient, clinician, and health system levels, and implementation outcomes included acceptability, feasibility, fidelity, and penetration. CONCLUSION This review presents several trends of the ICT-based interventions for suicide prevention implemented in clinical settings and identifies a need for future research to strengthen the evidence base for improving implementation. More effort is required to better understand and support the implementation and sustainability of ICTs in clinical settings. The findings can also serve as a future resource for researchers seeking to evaluate the impact and implementation of ICTs.
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Affiliation(s)
- Hwayeon Danielle Shin
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
| | - Keri Durocher
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Arthur Labatt Family School of Nursing, Western University, London, Ontario, Canada
- School of Health, Community Service & Creative Design, Lambton College, Sarnia, Ontario, Canada
| | - Lydia Sequeira
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Juveria Zaheer
- Health Outcomes and Performance Evaluation (HOPE) Research Unit, Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Gerald Sheff and Shanitha Kachan Emergency Department, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - John Torous
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Gillian Strudwick
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
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Edwards A, Ozer F, Cueva K. Feasibility of a Supportive Text Messaging Intervention in Northwest Alaska. JOURNAL OF TECHNOLOGY IN BEHAVIORAL SCIENCE 2023; 8:113-117. [PMID: 37215393 PMCID: PMC9973232 DOI: 10.1007/s41347-022-00293-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 11/04/2022] [Accepted: 11/21/2022] [Indexed: 05/24/2023]
Abstract
Suicide disproportionately impacts young Alaska Native people in the northwestern region of Alaska. As part of its efforts to address this challenge, Maniilaq Association developed a program to determine the feasibility of sending short text messages of caring and support. Process evaluation measures included the number of enrollees and the number of text messages sent each month. To determine participant satisfaction and seek recommendations for improvements, a short, online survey was disseminated to enrollees via text message in 2021 and 2022. Between January 2020 and September 2021, text messages were sent each month to about 100 participants, each with an accompanying image. Messages included "You are capable of amazing things" and "You are enough". Twenty-five individuals completed the 2021 survey and 11 the 2022 survey; three quarters lived in Northwest Arctic. Respondents said the messages improved their mood and made them feel like they mattered a lot or a great deal. The intervention was well-received by participants, inspiring individuals to reach out to others and reach out for help for themselves. Recommendations for improvements included increasing culturally relevant and meaningful quotes and the frequency and consistency of messages. Due to concerns around confidentiality, it is unclear if the initiative reached those most at-risk for suicide. However, participants sharing the messages among the small population of the region may have facilitated a broader reach than would otherwise be expected. Supplementary Information The online version contains supplementary material available at 10.1007/s41347-022-00293-z.
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Affiliation(s)
- Alexandra Edwards
- Center for Behavioral Health Research and Services, Institute of Social and Economic Research, University of Alaska Anchorage, Anchorage, Alaska, USA
| | - Faith Ozer
- Center for Behavioral Health Research and Services, Institute of Social and Economic Research, University of Alaska Anchorage, Anchorage, Alaska, USA
| | - Katie Cueva
- Center for Behavioral Health Research and Services, Institute of Social and Economic Research, University of Alaska Anchorage, Anchorage, Alaska, USA
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Rusé J, Clenet A, Vaiva G, Debien C, Arbus C, Salles J. The association between reattempted suicide and incoming calls to the brief contact intervention service, VigilanS: a study of the clinical profile of callers. BMC Psychiatry 2023; 23:21. [PMID: 36624409 PMCID: PMC9829445 DOI: 10.1186/s12888-022-04503-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 12/27/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Suicide is a major health problem globally. As attempted suicide is a major risk factor for suicide, specific prevention strategies have been designed for use thereafter. An example is the brief contact intervention (BCI). In this regard, France employs a composite BCI, VigilanS, which utilizes three types of contact: phone calls, postcards and a 'who to contact in a crisis' card. Previous studies have found that this system is effective at preventing suicide. Nevertheless, VigilanS was not effective in the same way for all the patients included. This observation raises the question of specific adaptation during follow-up for populations that were less receptive to the service. In consideration of this issue, we identified one study which found that incoming calls to the service were linked with a higher risk of suicide reattempts. However, this study did not document the profiles of the patients who made these calls. Better understanding of why this population is more at risk is important in terms of identifying factors that could be targeted to improve follow-up. This research therefore aims to bring together such data. METHODS We performed a retrospective analysis of 579 patients referred to VigilanS by Toulouse University Hospital (France). We examined the sociodemographics, clinical characteristics, and follow-ups in place and compared the patients who made incoming calls to the service versus those who did not. Subsequently, we conducted a regression analysis using the significantly associated element of patients calling VigilanS. Then, in order to better understand this association, we analyzed the factors, including such calls, that were linked to the risk of suicide reattempts. RESULTS We found that 22% of the patients in our sample called the VigilanS service. These individuals: were older, at 41.4 years versus 37.9 years for the non-callers; were more likely to have a borderline personality disorder (BPD) diagnosis (28.9% versus 19.3%); and had a history of suicide attempts (71.9% versus 54.6%). Our analysis confirmed that incoming calls to VigilanS (OR = 2.9) were associated with reattempted suicide, as were BPD (OR = 1.8) and a history of suicide attempts (OR = 1.7). CONCLUSION There was a high risk that the patients calling VigilanS would make another suicide attempt. However, this association was present regardless of the clinical profile. We postulate that this link between incoming calls and reattempted suicide may arise because this form of contact is, in fact, a way in which patients signal that a further attempt will be made.
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Affiliation(s)
- Jeanne Rusé
- grid.411175.70000 0001 1457 2980Department of Psychiatry, University Hospital of Toulouse, CHU Toulouse, Toulouse, France
| | - Adeline Clenet
- grid.411175.70000 0001 1457 2980Department of Psychiatry, University Hospital of Toulouse, CHU Toulouse, Toulouse, France
| | - Guillaume Vaiva
- Centre National de Ressources et de Résilience Lille-Paris, Lille, France ,grid.410463.40000 0004 0471 8845Department of Psychiatry, Centre Hospitalier Universitaire de Lille, Inserm, U1172-LilNCog-Lille Neuroscience and Cognition, Lille, France
| | - Christophe Debien
- Centre National de Ressources et de Résilience Lille-Paris, Lille, France ,grid.410463.40000 0004 0471 8845Department of Psychiatry, Centre Hospitalier Universitaire de Lille, Lille, France
| | - Christophe Arbus
- grid.411175.70000 0001 1457 2980University Hospital of Toulouse, CHU Toulouse, Department of Psychiatry, Toulouse NeuroImaging Center, ToNIC, University of Toulouse, Inserm, UPS, Toulouse, France
| | - Juliette Salles
- University Hospital of Toulouse, CHU Toulouse, Department of Psychiatry, Infinity (Toulouse Institute for Infectious and Inflammatory Diseases), INSERM UMR1291, CNRS UMR5051, Université Toulouse III, Toulouse, France.
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Barrigon ML, Porras-Segovia A, Courtet P, Lopez-Castroman J, Berrouiguet S, Pérez-Rodríguez MM, Artes A, Baca-Garcia E. Smartphone-based Ecological Momentary Intervention for secondary prevention of suicidal thoughts and behaviour: protocol for the SmartCrisis V.2.0 randomised clinical trial. BMJ Open 2022; 12:e051807. [PMID: 36127081 PMCID: PMC9490606 DOI: 10.1136/bmjopen-2021-051807] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Suicide is one of the leading public health issues worldwide. Mobile health can help us to combat suicide through monitoring and treatment. The SmartCrisis V.2.0 randomised clinical trial aims to evaluate the effectiveness of a smartphone-based Ecological Momentary Intervention to prevent suicidal thoughts and behaviour. METHODS AND ANALYSIS The SmartCrisis V.2.0 study is a randomised clinical trial with two parallel groups, conducted among patients with a history of suicidal behaviour treated at five sites in France and Spain. The intervention group will be monitored using Ecological Momentary Assessment (EMA) and will receive an Ecological Momentary Intervention called 'SmartSafe' in addition to their treatment as usual (TAU). TAU will consist of mental health follow-up of the patient (scheduled appointments with a psychiatrist) in an outpatient Suicide Prevention programme, with predetermined clinical appointments according to the Brief Intervention Contact recommendations (1, 2, 4, 7 and 11 weeks and 4, 6, 9 and 12 months). The control group would receive TAU and be monitored using EMA. ETHICS AND DISSEMINATION This study has been approved by the Ethics Committee of the University Hospital Fundación Jiménez Díaz. It is expected that, in the near future, our mobile health intervention and monitoring system can be implemented in routine clinical practice. Results will be disseminated through peer-reviewed journals and psychiatric congresses. Reference number EC005-21_FJD. Participants gave informed consent to participate in the study before taking part. TRIAL REGISTRATION NUMBER NCT04775160.
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Affiliation(s)
- Maria Luisa Barrigon
- Grupo de Investigación en Psiquiatría Translacional, Instituto de Investigación Sanitaria de la Fundación Jiménez Díaz, Madrid, Spain
- Department of Psychiatry, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
- Universidad Autonoma de Madrid, Madrid, Spain
| | - Alejandro Porras-Segovia
- Grupo de Investigación en Psiquiatría Translacional, Instituto de Investigación Sanitaria de la Fundación Jiménez Díaz, Madrid, Spain
| | - Philippe Courtet
- Department of Emergency Psychiatry and Acute Care, Centre Hospitalier Universitaire Montpellier, University of Montpellier, Montpellier, France
| | | | | | | | - Antonio Artes
- Departamento de Teoría de Señal, Universidad Carlos III de Madrid, Getafe, Spain
| | - Enrique Baca-Garcia
- Department of Psychiatry, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
- Universidad Autonoma de Madrid, Madrid, Spain
- Department of Adult Psychiatry, Nîmes University Hospital, Nimes, France
- Universidad Catolica del Maule, Talca, Chile
- CIBERSAM (Centro de Investigacion en Salud Mental), Carlos III Institute of Health, Madrid, Spain
- Department of Psychiatry, University Hospital Rey Juan Carlos, Mostoles, Spain
- Department of Psychiatry, General Hospital of Villalba, Madrid, Spain
- Department of Psychiatry, University Hospital Infanta Elena, Valdemoro, Spain
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Ryan TC, Chambers S, Gravey M, Jay SY, Wilcox HC, Cwik M. A Brief Text-Messaging Intervention for Suicidal Youths After Emergency Department Discharge. Psychiatr Serv 2022; 73:954-957. [PMID: 35172597 DOI: 10.1176/appi.ps.202000559] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Research has shown that the months after hospital discharge following treatment for suicidal thoughts or behaviors is a high-risk period for suicide. Moreover, the needs of a subset of youths at increased risk for suicide are not being met by community mental health providers, resulting in frequent emergency department (ED) visits. While undertaking a quality improvement effort, the authors' health care system piloted caring text messages to support youths discharged from the hospital after screening positive for suicide risk in the ED. The text-messaging intervention was feasible and acceptable, and youths reported that the messages helped reduce their suicidal thoughts and behaviors postdischarge. The results of this text-messaging intervention prompted the Maryland Department of Health to offer a similar intervention to all Marylanders.
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Affiliation(s)
- Taylor C Ryan
- Department of Mental Health (Ryan, Wilcox) and Center for American Indian Health (Cwik), Johns Hopkins University Bloomberg School of Public Health, Baltimore; Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore (Chambers); SAS Sys. Vision, Lannion, France (Gravey); Department of Psychology, University of Maryland Baltimore County, Baltimore (Jay). Marcela Horvitz-Lennon, M.D., Kenneth Minkoff, M.D., and Esperanza Diaz, M.D., are editors of this column
| | - Shawn Chambers
- Department of Mental Health (Ryan, Wilcox) and Center for American Indian Health (Cwik), Johns Hopkins University Bloomberg School of Public Health, Baltimore; Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore (Chambers); SAS Sys. Vision, Lannion, France (Gravey); Department of Psychology, University of Maryland Baltimore County, Baltimore (Jay). Marcela Horvitz-Lennon, M.D., Kenneth Minkoff, M.D., and Esperanza Diaz, M.D., are editors of this column
| | - Michel Gravey
- Department of Mental Health (Ryan, Wilcox) and Center for American Indian Health (Cwik), Johns Hopkins University Bloomberg School of Public Health, Baltimore; Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore (Chambers); SAS Sys. Vision, Lannion, France (Gravey); Department of Psychology, University of Maryland Baltimore County, Baltimore (Jay). Marcela Horvitz-Lennon, M.D., Kenneth Minkoff, M.D., and Esperanza Diaz, M.D., are editors of this column
| | - Samantha Y Jay
- Department of Mental Health (Ryan, Wilcox) and Center for American Indian Health (Cwik), Johns Hopkins University Bloomberg School of Public Health, Baltimore; Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore (Chambers); SAS Sys. Vision, Lannion, France (Gravey); Department of Psychology, University of Maryland Baltimore County, Baltimore (Jay). Marcela Horvitz-Lennon, M.D., Kenneth Minkoff, M.D., and Esperanza Diaz, M.D., are editors of this column
| | - Holly C Wilcox
- Department of Mental Health (Ryan, Wilcox) and Center for American Indian Health (Cwik), Johns Hopkins University Bloomberg School of Public Health, Baltimore; Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore (Chambers); SAS Sys. Vision, Lannion, France (Gravey); Department of Psychology, University of Maryland Baltimore County, Baltimore (Jay). Marcela Horvitz-Lennon, M.D., Kenneth Minkoff, M.D., and Esperanza Diaz, M.D., are editors of this column
| | - Mary Cwik
- Department of Mental Health (Ryan, Wilcox) and Center for American Indian Health (Cwik), Johns Hopkins University Bloomberg School of Public Health, Baltimore; Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore (Chambers); SAS Sys. Vision, Lannion, France (Gravey); Department of Psychology, University of Maryland Baltimore County, Baltimore (Jay). Marcela Horvitz-Lennon, M.D., Kenneth Minkoff, M.D., and Esperanza Diaz, M.D., are editors of this column
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Pouquet M, Niare D, Guerrisi C, Blanchon T, Hanslik T, Younes N. [Suicide prevention: How to act?]. Rev Med Interne 2022; 43:375-380. [PMID: 35606205 DOI: 10.1016/j.revmed.2022.03.342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 03/04/2022] [Accepted: 03/26/2022] [Indexed: 11/17/2022]
Abstract
Although being complex, suicide is a phenomenon considered as preventable, and its prevention has been made as a public health priority. Some interventions to prevent suicide have been evaluated, such as the education of the healthcare workers, especially in the suicidal assessment (suicidal risk and suicidal emergency/dangerousness), the diagnosis and management of common mental disorders, the care provided after a suicide attempt, the restriction access to common means of suicide, the use of websites to educate the public, or the appropriate reports of suicide in media. Other interventions, even not rigorously evaluated, are implemented in France as in many parts of the world. It is the case of interventions among identified high-risk groups. To be efficient, prevention programs should simultaneously include different strategies targeting several known risk factors for suicide. Clinicians play a crucial role in the suicide prevention strategies.
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Affiliation(s)
- M Pouquet
- Sorbonne université, Inserm, institut Pierre-Louis d'épidémiologie et de santé publique, (IPLESP), 75012 Paris, France.
| | - D Niare
- Sorbonne université, Inserm, institut Pierre-Louis d'épidémiologie et de santé publique, (IPLESP), 75012 Paris, France
| | - C Guerrisi
- Sorbonne université, Inserm, institut Pierre-Louis d'épidémiologie et de santé publique, (IPLESP), 75012 Paris, France
| | - T Blanchon
- Sorbonne université, Inserm, institut Pierre-Louis d'épidémiologie et de santé publique, (IPLESP), 75012 Paris, France
| | - T Hanslik
- Sorbonne université, Inserm, institut Pierre-Louis d'épidémiologie et de santé publique, (IPLESP), 75012 Paris, France; Service de médecine interne, hôpital Ambroise-Paré, Assistance publique-Hôpitaux de Paris, AP-HP, 92100 Boulogne-Billancourt, France; UFR des sciences de la santé Simone-Veil, université de Versailles-Saint-Quentin-en-Yvelines, 78280 Versailles, France
| | - N Younes
- UFR des sciences de la santé Simone-Veil, université de Versailles-Saint-Quentin-en-Yvelines, 78280 Versailles, France; Université Versailles-Saint-Quentin, université Paris Saclay, CESP, Team DevPsy, 94807 Villejuif, France; Centre hospitalier Versailles, service hospitalo-universitaire de psychiatrie de l'adulte et d'addictologie, 78157 Le Chesnay, France; Université Versailles-Saint-Quentin-en-Yvelines, Versailles, France
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Fossi LD, Debien C, Demarty AL, Vaiva G, Messiah A. Loss to follow-up in a population-wide brief contact intervention to prevent suicide attempts - The VigilanS program, France. PLoS One 2022; 17:e0263379. [PMID: 35231052 PMCID: PMC8887722 DOI: 10.1371/journal.pone.0263379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 01/18/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Brief Contact Interventions (BCIs) after a suicide attempt (SA) are an important element of prevention against SA and suicide. VigilanS generalizes to a whole French region a BCI combining resource cards, telephone calls and sending postcards, according to a predefined algorithm. However, a major obstacle to such real-life intervention is the loss of contact during follow-up. Here, we analyze the occurrence of loss of follow-up (LFU) and compare characteristics of patients LFU with follow-up completers. METHODS The study concerned patients included in VigilanS over the period from 1st January 2015 to 31 December 2018, with an end of follow-up on 1st July 2019. We performed a series of descriptive analysis and logistic regressions. The outcome was the loss to follow-up, relative to the 6th month call marking the end of the follow-up; the predictive variables were the characteristics of the patient at entry and during follow-up. Age and sex were considered as adjustment variables. RESULTS 11879 inclusions occurred during the study period, corresponding to 10666 different patients. The mean age was 40.6 ± 15 years. More than a third were non-first suicide attempters (46.6%) and the most frequent means of suicide was by voluntary drug intoxication (83.2%). 8335 patients were LFU. After simple and multiple regression, a significant relationship with loss to follow-up was identified among non-first suicide attempters, alcohol consumers, patients having no companion on arrival at the emergency room, patients who didn't make or receive any calls. An increased stay in hospital after a SA was a protective factor against loss of follow-up. CONCLUSION A majority of patients were lost to follow-up by the expected surveillance time of 6 months. Characteristics of lost patients will help focusing efforts to improve retention in the VigilanS program and might give insights for BCI implemented elsewhere.
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Affiliation(s)
- Larissa Djembi Fossi
- INSERM, MOODS Research unit “Depression, Anxiety, Psychotraumatism and Suicide”, Centre de recherche en Epidémiologie et santé des populations (CESP), Université Paris-Saclay, Hôpital Paul-Brousse, Villejuif, France
- INSERM, Sorbonne University, Institut Pierre Louis d’Épidémiologie et de Santé Publique, Social Epidemiology Team, Paris, France
| | - Christophe Debien
- Department of Psychiatry, University Hospital of Lille, Lille, France
- Univ. Lille, Inserm, CHU Lille, U1172—LilNCog (JPARC)—Lille Neurosciences & Cognition, Lille, France
- Centre National de Ressources et Résilience Pour Les Psychotraumas (Cn2r Lille Paris), Department of Psychiatry, University Hospital of Lille, Lille, France
| | | | - Guillaume Vaiva
- Department of Psychiatry, University Hospital of Lille, Lille, France
- Univ. Lille, Inserm, CHU Lille, U1172—LilNCog (JPARC)—Lille Neurosciences & Cognition, Lille, France
- Centre National de Ressources et Résilience Pour Les Psychotraumas (Cn2r Lille Paris), Department of Psychiatry, University Hospital of Lille, Lille, France
| | - Antoine Messiah
- INSERM, MOODS Research unit “Depression, Anxiety, Psychotraumatism and Suicide”, Centre de recherche en Epidémiologie et santé des populations (CESP), Université Paris-Saclay, Hôpital Paul-Brousse, Villejuif, France
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11
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Substance use and suicide outcomes among self-injured trauma patients. Drug Alcohol Depend 2021; 226:108906. [PMID: 34315104 DOI: 10.1016/j.drugalcdep.2021.108906] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 05/26/2021] [Accepted: 05/30/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND Research indicates alcohol (AUD) or substance (SUD) use disorders and acute alcohol or drug use serve as risk factors for suicidal behaviors and death both distally and proximally to a suicidal event. However, limited research has investigated these relationships among medically serious suicide attempters at the time of injury without relying on cohorts of substance users only or by examining suicide decedent characteristics. METHODS Data were collected from the National Trauma Data Bank (NTDB) for 2017. The sample comprised patients who engaged in suicidal and self-injurious acts that were medically serious enough to require trauma admission and were tested for alcohol (N = 9,196) or drug (N = 8,121) exposure upon admission. Logistic regression determined relationships between acute alcohol/substance use, presence of AUDs and SUDs and suicide mortality risk, while linear regression evaluated substance conditions and injury severity and length of stay (LOS). RESULTS AUDs (OR = 0.59[0.42-0.83]) and SUDs (OR = 0.66[0.48-0.90]) had reduced odds of death but increased LOS (β = 1.7, p < .001; β = 0.82, p = .024). Blood alcohol concentration (BAC) was positively associated with reduced odds of death (OR = 0.20[0.06-0.61]), injury severity (β = -5.3, p < .001), and LOS (β = -7.5, p < .001). Presence of cocaine (β = -0.80, p = .044) and opioids (β = -1.4, p < .001) were associated lower injury severity, while MDMA (β = 3.6, p = .016) and methamphetamine (β = 1.5, p = .025) were associated with increased injury severity. CONCLUSIONS While higher BAC may be associated with lower odds of mortality during a single high-risk suicide event, substance users may be at increased risk for worse outcomes over time. Targeted interventions should be considered to interrupt and develop healthy alternatives for survivors with substance use conditions.
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Djembi Fossi L, Debien C, Demarty AL, Vaiva G, Messiah A. SUICIDE REATTEMPT IN A POPULATION-WIDE BRIEF CONTACT INTERVENTION TO PREVENT SUICIDE ATTEMPTS - THE VIGILANS PROGRAM, FRANCE. Eur Psychiatry 2021; 64:e57. [PMID: 34266505 PMCID: PMC8516749 DOI: 10.1192/j.eurpsy.2021.2221] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective Among the postcrisis suicide prevention programmes, brief contact interventions (BCIs) have been proven to be efficient. VigilanS generalizes to a whole French region a BCI combining resource cards, telephone calls, and sending postcards, according to a predefined algorithm. However, a major problem in suicide prevention is the suicide reattempt, which can lead to final suicide. Here, we analyze the suicide reattempt in VigilanS. Methods The study concerned patients included in VigilanS over the period from January 1, 2015 to December 31, 2018, with an end of follow-up on July 1, 2019. We performed a series of descriptive analyses, survival curves, and regressions. The outcome was the suicide reattempt, and the predictive variables were the characteristics of the patient at entry and during follow-up in VigilanS. Age and sex were considered as adjustment variables. Results A total of 11,879 inclusions occurred during the study period, corresponding to 10,666 different patients, among which 905 reattempted suicide. More than half were primary suicide attempters (53.4%). A significant relationship with suicide reattempt was identified for the following characteristics: being a non-primary suicide attempter, having attempted suicide by voluntary drug intoxication and phlebotomy, alcohol consumption among primary suicide attempters, and having no companion at the emergency room visit among non-primary suicide attempters. Hanging (as suicide method), having made no call to VigilanS were protective factors. Conclusion This study provides us with a valuable insight into the profiles of patients repeating a suicide attempts, which is important for suicide prevention in general.
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Affiliation(s)
- Larissa Djembi Fossi
- INSERM, MOODS Research unit "Depression, Anxiety, Psychotraumatism and Suicide", Centre de recherche en Epidémiologie et santé des populations (CESP), Université Paris-Saclay, Hôpital Paul-Brousse, Villejuif, France.,INSERM, Sorbonne University, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Social Epidemiology Team, Paris, France
| | - Christophe Debien
- Department of Psychiatry, University Hospital of Lille.,Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog (JPARC) - Lille Neurosciences & Cognition, F-59000Lille, France.,Centre National de Ressources et Résilience pour les psychotraumas (Cn2r Lille Paris), Lille, France Department of Psychiatry, University Hospital of Lille
| | | | - Guillaume Vaiva
- Department of Psychiatry, University Hospital of Lille.,Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog (JPARC) - Lille Neurosciences & Cognition, F-59000Lille, France.,Centre National de Ressources et Résilience pour les psychotraumas (Cn2r Lille Paris), Lille, France Department of Psychiatry, University Hospital of Lille
| | - Antoine Messiah
- INSERM, MOODS Research unit "Depression, Anxiety, Psychotraumatism and Suicide", Centre de recherche en Epidémiologie et santé des populations (CESP), Université Paris-Saclay, Hôpital Paul-Brousse, Villejuif, France
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13
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Cliffe B, Tingley J, Greenhalgh I, Stallard P. mHealth Interventions for Self-Harm: Scoping Review. J Med Internet Res 2021; 23:e25140. [PMID: 33929329 PMCID: PMC8122298 DOI: 10.2196/25140] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 01/19/2021] [Accepted: 03/16/2021] [Indexed: 12/18/2022] Open
Abstract
Background Self-harm is a growing issue with increasing prevalence rates; however, individuals who self-harm do not often receive treatment. Mobile health (mHealth) interventions are a possible solution to some of the barriers that individuals face when seeking support, and they have also been found to be effective in improving mental health. Thus far, reviews of mHealth interventions for self-harm have been limited by study type. Therefore, we determined that a broader scoping review will provide a more exhaustive understanding of mHealth interventions for self-harm. Objective This scoping review aims to identify mHealth interventions for self-harm within the literature, understand the types and features of interventions that have been developed and evaluated, highlight research findings around mHealth interventions for self-harm, and determine what outcomes are typically used to assess the efficacy of interventions. Methods A search was conducted using Embase, PubMed, PsycINFO, PsycEXTRA, Web of Science, and the Cochrane Library. Studies were included if they described an mHealth intervention designed to have a direct (ie, if the intervention was designed for self-harm or for people who self-harm) or indirect (ie, if self-harm was measured as an outcome) treatment effect and if the paper was available in English. There were no exclusion criteria based on the study design. Results A total of 36 papers were included in the review, and most of them were randomized controlled trials published within the last 4 years. The interventions were mostly smartphone apps and calling or texting services, with 62% (21/34) having underlying therapeutic models to inform the intervention content. They were generally shown to be promising and appealing, but only 5 were widely available for use. Outcomes focused on a reduction of self-harm and suicidality, mood, and the users’ experiences of the intervention. Samples were typically nondiverse, and there was limited variety in the study designs and in the measurements of self-harm recovery. Conclusions Promising and appealing mHealth interventions have been developed but are not widely available. Research could benefit from greater diversity as well as a broader and more nuanced understanding of recovery from self-harm.
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Affiliation(s)
- Bethany Cliffe
- Department for Health, University of Bath, Bath, United Kingdom
| | - Jessica Tingley
- Child and Adolescent Mental Health Services, Oxford Health NHS Foundation Trust, Bristol, United Kingdom
| | - Isobel Greenhalgh
- Child and Adolescent Mental Health Services, Oxford Health NHS Foundation Trust, Bristol, United Kingdom
| | - Paul Stallard
- Department for Health, University of Bath, Bath, United Kingdom.,Child and Adolescent Mental Health Services, Oxford Health NHS Foundation Trust, Bristol, United Kingdom
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Witt KG, Hetrick SE, Rajaram G, Hazell P, Taylor Salisbury TL, Townsend E, Hawton K. Psychosocial interventions for self-harm in adults. Cochrane Database Syst Rev 2021; 4:CD013668. [PMID: 33884617 PMCID: PMC8094743 DOI: 10.1002/14651858.cd013668.pub2] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Self-harm (SH; intentional self-poisoning or self-injury regardless of degree of suicidal intent or other types of motivation) is a growing problem in most counties, often repeated, and associated with suicide. There has been a substantial increase in both the number of trials and therapeutic approaches of psychosocial interventions for SH in adults. This review therefore updates a previous Cochrane Review (last published in 2016) on the role of psychosocial interventions in the treatment of SH in adults. OBJECTIVES To assess the effects of psychosocial interventions for self-harm (SH) compared to comparison types of care (e.g. treatment-as-usual, routine psychiatric care, enhanced usual care, active comparator) for adults (aged 18 years or older) who engage in SH. SEARCH METHODS We searched the Cochrane Common Mental Disorders Specialised Register, the Cochrane Library (Central Register of Controlled Trials [CENTRAL] and Cochrane Database of Systematic reviews [CDSR]), together with MEDLINE, Ovid Embase, and PsycINFO (to 4 July 2020). SELECTION CRITERIA We included all randomised controlled trials (RCTs) comparing interventions of specific psychosocial treatments versus treatment-as-usual (TAU), routine psychiatric care, enhanced usual care (EUC), active comparator, or a combination of these, in the treatment of adults with a recent (within six months of trial entry) episode of SH resulting in presentation to hospital or clinical services. The primary outcome was the occurrence of a repeated episode of SH over a maximum follow-up period of two years. Secondary outcomes included treatment adherence, depression, hopelessness, general functioning, social functioning, suicidal ideation, and suicide. DATA COLLECTION AND ANALYSIS We independently selected trials, extracted data, and appraised trial quality. For binary outcomes, we calculated odds ratio (ORs) and their 95% confidence intervals (CIs). For continuous outcomes, we calculated mean differences (MDs) or standardised mean differences (SMDs) and 95% CIs. The overall quality of evidence for the primary outcome (i.e. repetition of SH at post-intervention) was appraised for each intervention using the GRADE approach. MAIN RESULTS We included data from 76 trials with a total of 21,414 participants. Participants in these trials were predominately female (61.9%) with a mean age of 31.8 years (standard deviation [SD] 11.7 years). On the basis of data from four trials, individual cognitive behavioural therapy (CBT)-based psychotherapy may reduce repetition of SH as compared to TAU or another comparator by the end of the intervention (OR 0.35, 95% CI 0.12 to 1.02; N = 238; k = 4; GRADE: low certainty evidence), although there was imprecision in the effect estimate. At longer follow-up time points (e.g., 6- and 12-months) there was some evidence that individual CBT-based psychotherapy may reduce SH repetition. Whilst there may be a slightly lower rate of SH repetition for dialectical behaviour therapy (DBT) (66.0%) as compared to TAU or alternative psychotherapy (68.2%), the evidence remains uncertain as to whether DBT reduces absolute repetition of SH by the post-intervention assessment. On the basis of data from a single trial, mentalisation-based therapy (MBT) reduces repetition of SH and frequency of SH by the post-intervention assessment (OR 0.35, 95% CI 0.17 to 0.73; N = 134; k = 1; GRADE: high-certainty evidence). A group-based emotion-regulation psychotherapy may also reduce repetition of SH by the post-intervention assessment based on evidence from two trials by the same author group (OR 0.34, 95% CI 0.13 to 0.88; N = 83; k = 2; moderate-certainty evidence). There is probably little to no effect for different variants of DBT on absolute repetition of SH, including DBT group-based skills training, DBT individual skills training, or an experimental form of DBT in which participants were given significantly longer cognitive exposure to stressful events. The evidence remains uncertain as to whether provision of information and support, based on the Suicide Trends in At-Risk Territories (START) and the SUicide-PREvention Multisite Intervention Study on Suicidal behaviors (SUPRE-MISS) models, have any effect on repetition of SH by the post-intervention assessment. There was no evidence of a difference for psychodynamic psychotherapy, case management, general practitioner (GP) management, remote contact interventions, and other multimodal interventions, or a variety of brief emergency department-based interventions. AUTHORS' CONCLUSIONS Overall, there were significant methodological limitations across the trials included in this review. Given the moderate or very low quality of the available evidence, there is only uncertain evidence regarding a number of psychosocial interventions for adults who engage in SH. Psychosocial therapy based on CBT approaches may result in fewer individuals repeating SH at longer follow-up time points, although no such effect was found at the post-intervention assessment and the quality of evidence, according to the GRADE criteria, was low. Given findings in single trials, or trials by the same author group, both MBT and group-based emotion regulation therapy should be further developed and evaluated in adults. DBT may also lead to a reduction in frequency of SH. Other interventions were mostly evaluated in single trials of moderate to very low quality such that the evidence relating to the use of these interventions is inconclusive at present.
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Affiliation(s)
- Katrina G Witt
- Orygen, Parkville, Melbourne, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - Sarah E Hetrick
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Gowri Rajaram
- Orygen, Parkville, Melbourne, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - Philip Hazell
- Speciality of Psychiatry, University of Sydney School of Medicine, Sydney, Australia
| | - Tatiana L Taylor Salisbury
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Ellen Townsend
- Self-Harm Research Group, School of Psychology, University of Nottingham, Nottingham, UK
| | - Keith Hawton
- Centre for Suicide Research, Department of Psychiatry, University of Oxford, Oxford, UK
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15
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Ooi G, Schwenk ES, Torjman MC, Berg K. A Randomized Trial of Manual Phone Calls Versus Automated Text Messages for Peripheral Nerve Block Follow-Ups. J Med Syst 2021; 45:7. [PMID: 33404791 DOI: 10.1007/s10916-020-01699-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 12/10/2020] [Indexed: 11/29/2022]
Abstract
Mobile phone applications (apps) have been used for patient follow-up in the postoperative period, specifically to assess for complications and patient satisfaction. Few studies have evaluated their use in regional anesthesia. The objective of this study was to compare follow-up response rates using manual phone calls versus an automated patient outreach (APO) app for peripheral nerve block patients. We hypothesized that the response rate would be higher in the APO group. A mobile app, "JeffAnesthesia," was developed, which sends notifications to patients to answer survey questions in the app. We randomly assigned patients who received peripheral nerve blocks for postoperative pain to either a manual phone call or an APO app group, with follow-up in each category occurring between postoperative days (POD) 14-21 and 90-100. In total, 60 patients were assigned to the phone call group and 60 patients to the APO app group. Between POD 14-21, 9 (15%) patients were reached in the manual phone call arm, and 16 (26.7%) patients were reached in the APO arm (p = 0.117). At POD 90-100, follow-up was successful with 5 (8.2%) in the manual phone call group vs. 3 (5.0%) patients in the APO app group (p = 0.300). Overall response rate was poor, with comparable response rates between groups. The APO method may reduce time spent by anesthesia staff on follow-up calls, but our data do not suggest this method improves response rates significantly. Further studies are needed to better understand the reasons for the poor response rate and strategies for improvement.
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Affiliation(s)
- Gavyn Ooi
- Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA
| | - Eric S Schwenk
- Department of Anesthesiology, Thomas Jefferson University Hospital, Philadelphia, PA, USA
| | - Marc C Torjman
- Department of Anesthesiology, Thomas Jefferson University Hospital, Philadelphia, PA, USA
| | - Kent Berg
- Department of Anesthesiology, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
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16
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Ligier F, Kurzenne M, Kabuth B, Guillemin F. Ten years psychosocial outcomes among adolescents following suicide attempts - early recurrence and psychosocial outcomes. Encephale 2020; 47:299-305. [PMID: 33293033 DOI: 10.1016/j.encep.2020.09.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 08/14/2020] [Accepted: 09/08/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVES A suicide attempt (SA) is a major risk factor of recurrent SA in adolescence and may be associated with psychological or social problems in the future. REPEATERS is a longitudinal study which examines the long-term psychosocial outcome of adolescents following attempted suicide. It focuses on the impact of early recurrence (i.e., within the first year of the index SA) - data which is, in fact, poorly documented. METHODS Ten years after the index SA, a self-reporting questionnaire was sent to all adolescents who had attempted suicide and were followed up by the CHRU (Regional University Hospital Centre) de Nancy, France, between 1994 and 2003 and their parents. The purpose of this questionnaire was to assess psychosocial outcomes. Data concerning SA were collected retrospectively. RESULTS After ten years, 146 of the 309 adolescents who had attempted suicide and were participating in the study had responded: 90% lived with a partner and 41% had children. The mean (SD) current emotional life of suicide attempt survivors scored 7.3 (2.3) on a scale of 0 to 10. Compared to the general population of the same age, responders felt more depressed than their peers (29% vs. less than 8% of males and 20% of females), had more suicidal thoughts (14% vs. 5%), and had more SAs (27% vs. 0.3%). Moreover, the risk of recurrence over the ten year period was associated with suicide recurrence in the first year after the index SA (odds ratio [OR]=2.3; 95% confidence interval [CI]=1.1-4.9) and with a lower level of education at ten years (OR=0.37; 95% CI=0.19-0.45). CONCLUSIONS Although a favorable outcome was reported ten years after the event for the majority of adolescents who had attempted suicide, some with a lower level of education were nevertheless at increased risk of recurrence and depression. Post-intervention strategies are therefore essential in order to evaluate risk factors which may persist if not taken into consideration.
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Affiliation(s)
- F Ligier
- University department of child and adolescent psychiatry (PUPEA), psychotherapeutic center of Nancy, Laxou, France; EA 4360 APEMAC, university of Lorraine, Nancy, France.
| | - M Kurzenne
- University department of child and adolescent psychiatry (PUPEA), psychotherapeutic center of Nancy, Laxou, France
| | - B Kabuth
- University department of child and adolescent psychiatry (PUPEA), psychotherapeutic center of Nancy, Laxou, France
| | - F Guillemin
- EA 4360 APEMAC, university of Lorraine, Nancy, France
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Czyz EK, Arango A, Healy N, King CA, Walton M. Augmenting Safety Planning With Text Messaging Support for Adolescents at Elevated Suicide Risk: Development and Acceptability Study. JMIR Ment Health 2020; 7:e17345. [PMID: 32160150 PMCID: PMC7281145 DOI: 10.2196/17345] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Revised: 03/08/2020] [Accepted: 03/09/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Suicide is the second leading cause of death among adolescents. A critical need exists for developing promising interventions for adolescents after psychiatric hospitalization who are at a high risk of experiencing repeated suicidal behaviors and related crises. The high-risk period following psychiatric hospitalization calls for cost-effective and scalable continuity of care approaches to support adolescents' transition from inpatient care. Text messages have been used to improve a wide range of behavioral and health outcomes and may hold promise as an accessible continuity of care strategy for youth at risk of suicide. OBJECTIVE In this study of 40 adolescents at elevated suicide risk, we report on the iterative development and acceptability of a text-based intervention designed to encourage adaptive coping and safety plan adherence in the high-risk period following psychiatric hospitalization. METHODS Adolescents (aged 13-17 years) who were hospitalized because of last-month suicide attempts or last-week suicidal ideation took part in either study phase 1 (n=25; 19/25, 76% female), wherein message content was developed and revised on the basis of feedback obtained during hospitalization, or study phase 2 (n=15; 11/15, 73% female), wherein text messages informed by phase 1 were further tested and refined based on feedback obtained daily over the course of a month after discharge (n=256 observations) and during an end-of-study phone interview. RESULTS Quantitative and qualitative feedback across the 2 study phases pointed to the acceptability of text-based support. Messages were seen as having the potential to be helpful with the transition after hospitalization, with adolescents indicating that texts may serve as reminders to use coping strategies, contribute to improvement in mood, and provide them with a sense of encouragement and hope. At the same time, some adolescents expressed concerns that messages may be insufficient for all teens or circumstances. In phase 2, the passage of time did not influence adolescents' perception of messages in the month after discharge (P=.74); however, there were notable daily level associations between the perception of messages and adolescents' affect. Specifically, higher within-person (relative to adolescents' own average) anger was negatively related to liking text messages (P=.005), whereas within-person positive affect was associated with the perception of messages as more helpful (P=.04). CONCLUSIONS Text-based support appears to be an acceptable continuity of care strategy to support adolescents' transition after hospitalization. The implications of study findings are discussed. Future work is needed to evaluate the impact of text-based interventions on suicide-related outcomes.
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Affiliation(s)
- Ewa K Czyz
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
| | - Alejandra Arango
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
| | - Nathaniel Healy
- Department of Psychology, University of Houston, Houston, TX, United States
| | - Cheryl A King
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
| | - Maureen Walton
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States.,Injury Prevention Center, University of Michigan, Ann Arbor, MI, United States
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Fossi Djembi L, Vaiva G, Debien C, Duhem S, Demarty AL, Koudou YA, Messiah A. Changes in the number of suicide re-attempts in a French region since the inception of VigilanS, a regionwide program combining brief contact interventions (BCI). BMC Psychiatry 2020; 20:26. [PMID: 31992251 PMCID: PMC6986096 DOI: 10.1186/s12888-020-2443-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 01/13/2020] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Brief Contact Interventions (BCIs) after a suicide attempt (SA) are an important element of prevention against SA and suicide. They are easier to generalize to an entire population than other forms of intervention. VigilanS generalizes to a whole French region a BCI combining resource cards, telephone calls and mailings, according to a predefined algorithm. It was implemented gradually in the Nord-Pas-de-Calais (NPC), France, between 2015 and 2018. Here, we evaluate the effectiveness of VigilanS, in terms of SA reduction, using annual data collected by participating centers. Hypothesis tested: the higher the VigilanS implementation in a center (measured by penetrance), the greater the decrease in the number of SA observed in this center. METHODS The study period was from 2014 to 2018, across all of NPC centers. We performed a series of linear regressions, each center representing a statistical unit. The outcome was the change in the number of SA, relative to the initial number, and the predictive variable was VigilanS' penetrance: number of patients included in VigilanS over the total number of SA. Search for influential points (points beyond threshold values of 3 influence criteria) and weighted least squares estimations were performed. RESULTS Twenty-one centers were running VigilanS in 2018, with an average penetrance of 32%. A significant relationship was identified, showing a sharp decrease in SA as a function of penetrance (slope = - 1.13; p = 3*10- 5). The model suggested that a 25% of penetrance would yield a SA decrease of 41%. CONCLUSION VigilanS has the potential to reduce SA. Subgroup analyzes are needed to further evaluate its effectiveness. Subgroup analyses remain to be done, in order to evaluate the specific variations of SA by group.
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Affiliation(s)
- Larissa Fossi Djembi
- INSERM Research unit U-1178 "Mental Health and Public Health", Centre de recherche en Epidémiologie et santé des populations (CESP), INSERM, Université Paris-Sud, Université Paris-Saclay, Hôpital Paul-Brousse, Villejuif, France.
| | - Guillaume Vaiva
- 0000 0001 0206 8146grid.413133.7INSERM Research unit U-1178 “Mental Health and Public Health”, Centre de recherche en Epidémiologie et santé des populations (CESP), INSERM, Université Paris-Sud, Université Paris-Saclay, Hôpital Paul-Brousse, Villejuif, France ,0000 0001 2242 6780grid.503422.2SCALab Laboratory, CNRS, UMR 9193, Université de Lille, Lille, France ,0000 0004 0471 8845grid.410463.4Department of Adult Psychiatry, Hôpital Fontan, CHRU de Lille, Lille, France
| | - Christophe Debien
- 0000 0001 2242 6780grid.503422.2SCALab Laboratory, CNRS, UMR 9193, Université de Lille, Lille, France ,0000 0004 0471 8845grid.410463.4Department of Adult Psychiatry, Hôpital Fontan, CHRU de Lille, Lille, France
| | - Stéphane Duhem
- 0000 0004 0471 8845grid.410463.4Department of Adult Psychiatry, Hôpital Fontan, CHRU de Lille, Lille, France ,0000 0001 2242 6780grid.503422.2INSERM, Clinical Investigation Center (CIC) 1403, CHRU de Lille, Université de Lille, Lille, France
| | - Anne-Laure Demarty
- 0000 0004 0471 8845grid.410463.4Department of Adult Psychiatry, Hôpital Fontan, CHRU de Lille, Lille, France ,0000 0001 2242 6780grid.503422.2INSERM, Clinical Investigation Center (CIC) 1403, CHRU de Lille, Université de Lille, Lille, France
| | - Yves-Akoli Koudou
- 0000 0001 0206 8146grid.413133.7UMRS 1018 Centre de recherche en Epidémiologie et santé des populations (CESP) “Epidemiology of Cancer, Genes and Environment”, Hôpital Paul-Brousse, Villejuif, France
| | - Antoine Messiah
- 0000 0001 0206 8146grid.413133.7INSERM Research unit U-1178 “Mental Health and Public Health”, Centre de recherche en Epidémiologie et santé des populations (CESP), INSERM, Université Paris-Sud, Université Paris-Saclay, Hôpital Paul-Brousse, Villejuif, France
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19
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Martínez-Alés G, Jiménez-Sola E, Román-Mazuecos E, Sánchez-Castro MP, de Dios C, Rodríguez-Vega B, Bravo-Ortiz MF. An Emergency Department-Initiated Intervention to Lower Relapse Risk after Attempted Suicide. Suicide Life Threat Behav 2019; 49:1587-1599. [PMID: 30762253 DOI: 10.1111/sltb.12542] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2018] [Accepted: 01/08/2019] [Indexed: 12/01/2022]
Abstract
OBJECTIVE According to randomized trials, contact after a suicide attempt lowers relapse risk. However, effectiveness studies based on real clinical data can provide additional external validity. METHOD We conducted an observational study to determine if an emergency department (ED)-initiated intervention for suicide attempt risk reduction, consisting on scheduling a single added appointment within 7 days after discharge following a suicide attempt, can reduce the risk of relapse. The study included 1,775 patients who had been treated at a general hospital ED due to a suicide attempt. The principal outcome measure was ED return after a new attempt. We obtained Kaplan-Meier survival functions and used Cox proportional hazard regression models to estimate unadjusted and adjusted risks of relapse by treatment phase. Covariates included: age, gender, history of suicide attempts, history of psychiatric disorders, concurrent alcohol/drug abuse, number of attempts during follow-up, admission as an inpatient and family support. RESULTS A total of 497 (22.5%) attempts were followed by a relapse. Subjects exposed to the studied intervention had a lower risk of relapse after a suicide attempt, with a 24% adjusted risk reduction estimate. CONCLUSION Our real-world results suggest that an additional early appointment, scheduled before discharging suicide attempters, reduces suicide reattempt risk.
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Affiliation(s)
- Gonzalo Martínez-Alés
- Department of Psychiatry, La Paz University Hospital, Madrid, Spain.,Universidad Autónoma de Madrid School of Medicine, Madrid, Spain
| | | | | | | | - Consuelo de Dios
- Department of Psychiatry, La Paz University Hospital, Madrid, Spain.,Universidad Autónoma de Madrid School of Medicine, Madrid, Spain.,Instituto de Investigación Hospital Universitario La Paz (IDIPAZ), Madrid, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Beatriz Rodríguez-Vega
- Department of Psychiatry, La Paz University Hospital, Madrid, Spain.,Universidad Autónoma de Madrid School of Medicine, Madrid, Spain.,Instituto de Investigación Hospital Universitario La Paz (IDIPAZ), Madrid, Spain
| | - María Fe Bravo-Ortiz
- Department of Psychiatry, La Paz University Hospital, Madrid, Spain.,Universidad Autónoma de Madrid School of Medicine, Madrid, Spain.,Instituto de Investigación Hospital Universitario La Paz (IDIPAZ), Madrid, Spain
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20
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Moreno-Pino F, Porras-Segovia A, López-Esteban P, Artés A, Baca-García E. Validation of Fitbit Charge 2 and Fitbit Alta HR Against Polysomnography for Assessing Sleep in Adults With Obstructive Sleep Apnea. J Clin Sleep Med 2019; 15:1645-1653. [PMID: 31739855 PMCID: PMC6853383 DOI: 10.5664/jcsm.8032] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 07/17/2019] [Accepted: 07/17/2019] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES Consumer wearable devices may be a helpful method of assessing sleep, but validation is required for their use in clinical practice. Our aim was to validate two models of Fitbit sleep trackers that rely on both accelerometer and heart rate sensors against polysomnography in participants with obstructive sleep apnea (OSA). METHODS Participants were adults presenting with symptoms of OSA and attending our outpatient sleep clinic. A polysomnography (PSG) was applied to all participants at the same time they were wearing a Fitbit sleep tracker. Using paired t tests and Bland-Altman plots, we compared the sleep measures provided by the wearable devices with those obtained by PSG. Since Fitbit devices' automatic detection of sleep start time can cause bias, we performed a correction using Huber loss function-based linear regression and a leave-one-out strategy. RESULTS Our sample consisted of 65 patients. Diagnosis of OSA was confirmed on 55 (84.6%). There were statistically significant differences between PSG and Fitbit measures for all sleep outcomes but rapid eye movement sleep. Fitbit devices overestimated total sleep time, and underestimated wake after sleep onset and sleep onset latency. After correction of bias, Fitbit-delivered measures of sleep onset latency did not significantly differ of those provided by PSG. CONCLUSIONS Fitbit wearable devices showed an acceptable sensitivity but poor specificity. Consumer sleep trackers still have insufficient accuracy for clinical settings, especially in clinical populations. Solving technical issues and optimizing clinically-oriented features could make them apt for their use in clinical practice in a nondistant future.
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Affiliation(s)
- Fernando Moreno-Pino
- Universidad Carlos III de Madrid, Leganés, Spain
- Gregorio Marañón Health Research Institute, Madrid, Spain
- *Contributed equally
| | - Alejandro Porras-Segovia
- Universidad Carlos III de Madrid, Leganés, Spain
- Department of Psychiatry, University Hospital Jimenez Diaz Foundation, Madrid, Spain
- International School for Postgraduate Studies, University of Granada, Granada, Spain
| | | | - Antonio Artés
- Universidad Carlos III de Madrid, Leganés, Spain
- Gregorio Marañón Health Research Institute, Madrid, Spain
| | - Enrique Baca-García
- Department of Psychiatry, University Hospital Jimenez Diaz Foundation, Madrid, Spain
- Department of Psychiatry, Madrid Autonomous University, Madrid, Spain
- Department of Psychiatry, University Hospital Rey Juan Carlos, Mostoles, Spain
- Department of Psychiatry, General Hospital of Villalba, Madrid, Spain
- Department of Psychiatry, University Hospital Infanta Elena, Valdemoro, Spain
- Universidad Catolica del Maule, Talca, Chile
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21
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Stevens GJ, Hammond TE, Brownhill S, Anand M, de la Riva A, Hawkins J, Chapman T, Baldacchino R, Micallef JA, Andepalli J, Kotak A, Gunja N, Page A, Gould G, Ryan CJ, Whyte IM, Carter GL, Jones A. SMS SOS: a randomized controlled trial to reduce self-harm and suicide attempts using SMS text messaging. BMC Psychiatry 2019; 19:117. [PMID: 30999952 PMCID: PMC6471753 DOI: 10.1186/s12888-019-2104-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Accepted: 04/05/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Hospital-treated deliberate self-harm (DSH) is common, costly and has high repetition rates. Since brief contact interventions (BCIs) may reduce the risk of DSH repetition, we aim to evaluate whether a SMS (Short Message Service) text message Intervention plus Treatment As Usual (TAU) compared to TAU alone will reduce hospital DSH re-presentation rates in Western Sydney public hospitals in Australia. METHODS/DESIGN Our study is a 24-month randomized controlled trial (RCT). Adult patients who present with DSH to hospital emergency, psychiatric, and mental health triage and assessment departments will be randomly assigned to an Intervention condition plus TAU receiving nine SMS text messages at 1, 2, 3, 4, 5, 6, 8, 10 and 12-months post-discharge. Each message will contain telephone numbers for two mental health crises support tele-services. Primary outcomes will be the difference in the number of DSH re-presentations, and the time to first re-presentation, within 12-months of discharge. DISCUSSION This study protocol describes the design and implementation of an RCT using SMS text messages, which aim to reduce hospital re-presentation rates for DSH. Positive study findings would support the translation of an SMS-aftercare protocol into mental health services at minimal expense. TRIAL REGISTRATION AND ETHICS APPROVAL This trial has been registered with the Australian and New Zealand Clinical Trials Registry (Trial registration: ACTRN12617000607370 . Registered 28 April 2017) and has been approved by two Local Health Districts (LHDs). Western Sydney LHD Human Research Ethics Committee approved the study for Westmead Hospital and Blacktown Hospital (Protocol: HREC/16/WMEAD/336). Nepean Blue Mountains LHD Research Governance Office approved the study for Nepean Hospital (SSA/16/Nepean/170).
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Affiliation(s)
- Garry J. Stevens
- 0000 0000 9939 5719grid.1029.aSchool of Social Sciences and Psychology, Western Sydney University (WSU), Kingswood, NSW Australia
| | - Trent E. Hammond
- 0000 0004 0453 1183grid.413243.3Triage and Assessment Centre, Mental Health Centre, Nepean Hospital, Nepean Blue Mountains LHD, Kingswood, NSW Australia
| | - Suzanne Brownhill
- 0000 0001 0180 6477grid.413252.3Consultation Liaison Psychiatry, Westmead Hospital, Western Sydney Local Health District (WSLHD), Westmead, NSW Australia
| | - Manish Anand
- 0000 0001 0180 6477grid.413252.3Consultation Liaison Psychiatry, Westmead Hospital, Western Sydney Local Health District (WSLHD), Westmead, NSW Australia
| | - Anabel de la Riva
- 0000 0001 0180 6477grid.413252.3Consultation Liaison Psychiatry, Westmead Hospital, Western Sydney Local Health District (WSLHD), Westmead, NSW Australia
| | - Jean Hawkins
- 0000 0004 0572 7882grid.460687.bConsultation Liaison Psychiatry, Blacktown Hospital, WSLHD, Blacktown, NSW Australia
| | - Tristan Chapman
- 0000 0004 0453 1183grid.413243.3Triage and Assessment Centre, Mental Health Centre, Nepean Hospital, Nepean Blue Mountains LHD, Kingswood, NSW Australia
| | - Richard Baldacchino
- 0000 0004 0453 1183grid.413243.3Specialist Mental Health Older People Service, Mental Health Centre, Nepean Hospital, NBMLHD, Kingswood, NSW Australia
| | - Jo-Anne Micallef
- 0000 0004 0453 1183grid.413243.3Child and Youth Consultation Liaison, Nepean Hospital, NBMLHD, Kingswood, NSW Australia
| | | | - Anita Kotak
- 0000 0004 0453 1183grid.413243.3Triage and Assessment Centre, Mental Health Centre, Nepean Hospital, Nepean Blue Mountains LHD, Kingswood, NSW Australia
| | - Naren Gunja
- Department of Clinical Pharmacology and Toxicology, Western Sydney Health, Westmead, NSW Australia ,0000 0004 1936 834Xgrid.1013.3Sydney Medical School, University of Sydney, Sydney, NSW Australia
| | - Andrew Page
- Translational Health Research Institute, School of Medicine, WSU, Campbelltown, NSW Australia
| | - Grahame Gould
- 0000 0004 0486 528Xgrid.1007.6Illawarra Institute for Mental Health, University of Wollongong, Wollongong, NSW Australia
| | - Christopher J. Ryan
- 0000 0004 1936 834Xgrid.1013.3Sydney Medical School, University of Sydney, Sydney, NSW Australia
| | - Ian M. Whyte
- Department of Clinical Toxicology and Pharmacology, Calvary Mater Hospital Newcastle, Waratah, NSW Australia ,0000 0000 8831 109Xgrid.266842.cSchool of Medicine and Public Health, Faculty of Health and Medicine, Newcastle University, Callaghan, NSW Australia
| | - Gregory L. Carter
- 0000 0000 8831 109Xgrid.266842.cSchool of Medicine and Public Health, Faculty of Health and Medicine, Newcastle University, Callaghan, NSW Australia
| | - Alison Jones
- 0000 0004 0486 528Xgrid.1007.6Vice Chancellor’s Unit, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW Australia
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22
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Porras-Segovia A, Pérez-Rodríguez MM, López-Esteban P, Courtet P, Barrigón M ML, López-Castromán J, Cervilla JA, Baca-García E. Contribution of sleep deprivation to suicidal behaviour: A systematic review. Sleep Med Rev 2019; 44:37-47. [DOI: 10.1016/j.smrv.2018.12.005] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 12/03/2018] [Accepted: 12/05/2018] [Indexed: 12/11/2022]
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23
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Combining green cards, telephone calls and postcards into an intervention algorithm to reduce suicide reattempt (AlgoS): P-hoc analyses of an inconclusive randomized controlled trial. PLoS One 2019. [PMID: 30707710 DOI: 10.1371/journal.pone.0210778] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Brief contact interventions (BCIs) might be reliable suicide prevention strategies. BCI efficacy trials, however, gave equivocal results. AlgoS trial is a composite BCI that yielded inconclusive results when analyzed with Intention-To-Treat strategy. In order to elicit intervention strengths and weaknesses, post-hoc analyses of AlgoS data were performed. METHODS AlgoS was a randomized controlled trial conducted in 23 French hospitals. Suicide attempters were randomly assigned to either the intervention group (AlgoS) or the control group (Treatment as usual TAU). In the AlgoS arm, first-time suicide attempters received crisis cards; non first-time suicide attempters received a phone call, and post-cards if the call could not be completed, or if the participant was in crisis and/or non-compliant with the post-discharge treatment. An As Treated strategy, accounting for the actual intervention received, was combined with subgroup analyses. RESULTS 1,040 patients were recruited and randomized into two groups of N = 520, from which 53 withdrew participation; 15 were excluded after inclusion/exclusion criteria reassessment. AlgoS first attempters were less likely to reiterate suicide attempt (SA) than their TAU counterparts at 6 and 13-14 months (RR [95% CI]: 0.46 [0.25-0.85] and 0.50 [0.31-0.81] respectively). AlgoS non-first attempters had similar SA rates as their TAU counterparts at 6 and 13-14 months (RR [95% CI]: 0.84 [0.57-1.25] and 1.00 [0.73-1.37] respectively). SA rates were dissimilar within the AlgoS non-first attempter group. CONCLUSIONS This new set of analysis suggests that crisis cards could be efficacious to prevent new SA attempts among first-time attempters, while phone calls were probably not significantly efficacious among multi-attempters. Importantly, phone calls were informative of new SA risk, thus a key component of future interventions.
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Messiah A, Notredame CE, Demarty AL, Duhem S, Vaiva G. Combining green cards, telephone calls and postcards into an intervention algorithm to reduce suicide reattempt (AlgoS): P-hoc analyses of an inconclusive randomized controlled trial. PLoS One 2019; 14:e0210778. [PMID: 30707710 PMCID: PMC6358079 DOI: 10.1371/journal.pone.0210778] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 01/01/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Brief contact interventions (BCIs) might be reliable suicide prevention strategies. BCI efficacy trials, however, gave equivocal results. AlgoS trial is a composite BCI that yielded inconclusive results when analyzed with Intention-To-Treat strategy. In order to elicit intervention strengths and weaknesses, post-hoc analyses of AlgoS data were performed. METHODS AlgoS was a randomized controlled trial conducted in 23 French hospitals. Suicide attempters were randomly assigned to either the intervention group (AlgoS) or the control group (Treatment as usual TAU). In the AlgoS arm, first-time suicide attempters received crisis cards; non first-time suicide attempters received a phone call, and post-cards if the call could not be completed, or if the participant was in crisis and/or non-compliant with the post-discharge treatment. An As Treated strategy, accounting for the actual intervention received, was combined with subgroup analyses. RESULTS 1,040 patients were recruited and randomized into two groups of N = 520, from which 53 withdrew participation; 15 were excluded after inclusion/exclusion criteria reassessment. AlgoS first attempters were less likely to reiterate suicide attempt (SA) than their TAU counterparts at 6 and 13-14 months (RR [95% CI]: 0.46 [0.25-0.85] and 0.50 [0.31-0.81] respectively). AlgoS non-first attempters had similar SA rates as their TAU counterparts at 6 and 13-14 months (RR [95% CI]: 0.84 [0.57-1.25] and 1.00 [0.73-1.37] respectively). SA rates were dissimilar within the AlgoS non-first attempter group. CONCLUSIONS This new set of analysis suggests that crisis cards could be efficacious to prevent new SA attempts among first-time attempters, while phone calls were probably not significantly efficacious among multi-attempters. Importantly, phone calls were informative of new SA risk, thus a key component of future interventions.
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Affiliation(s)
- Antoine Messiah
- INSERM Research unit U-1178 “Mental Health and Public Health”, Centre de recherche en Épidémiologie et Santé des Populations (CESP), INSERM, Université Paris-Sud, UVSQ, Université Paris-Saclay, Villejuif, France
| | - Charles-Edouard Notredame
- SCALab Laboratory, CNRS, UMR 9193, Universités de Lille, Lille, France
- Department of Child and Adolescent Psychiatry, Hôpital Fontan, CHRU Lille, Lille, France
| | - Anne-Laure Demarty
- Inserm Clinical Investigation Center (CIC) 1403, CHRU and Universités de Lille, Lille, France
- Department of Adult Psychiatry, Hôpital Fontan, CHRU Lille, Lille, France
| | - Stéphane Duhem
- Inserm Clinical Investigation Center (CIC) 1403, CHRU and Universités de Lille, Lille, France
- Department of Adult Psychiatry, Hôpital Fontan, CHRU Lille, Lille, France
| | - Guillaume Vaiva
- INSERM Research unit U-1178 “Mental Health and Public Health”, Centre de recherche en Épidémiologie et Santé des Populations (CESP), INSERM, Université Paris-Sud, UVSQ, Université Paris-Saclay, Villejuif, France
- SCALab Laboratory, CNRS, UMR 9193, Universités de Lille, Lille, France
- Department of Adult Psychiatry, Hôpital Fontan, CHRU Lille, Lille, France
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[An example of post-discharge monitoring after a suicide attempt: VigilanS]. Encephale 2018; 45 Suppl 1:S13-S21. [PMID: 30477899 DOI: 10.1016/j.encep.2018.09.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 09/04/2018] [Accepted: 09/08/2018] [Indexed: 11/21/2022]
Abstract
BACKGROUND Attempted suicide is a major risk factor of further re-attempts and death. Self-harm behaviors are related to multiple causes explaining why it is ineffective to have a single and simple strategy to offer after the clinical assessment in reducing morbidity and mortality. Furthermore, treatment adherence is known to be especially poor in a context where social connection seems compromised and a source of pain. Effective interventions can be divided into two categories: intensive intervention programs (care at home, supported by a series of brief psychotherapy interventions) and case management programs that rely on a "stay in contact" dimension. These programs, initiated by Jerome Motto and its short letters may consist of: (1) sending letters or postcards after discharge of the ER; (2) giving a crisis card that offers a crisis telephone line and a crisis unit for hospitalization if needed, and; (3) placing a phone call at some time distance after the discharge. The aim is to enhance a "connectedness feeling" with the patient. These different strategies have proven to be even more effective in some specific subgroups, highlighting the heterogeneity of this population. Each modality of contact was well accepted and generated a positive involvement of the patients. METHOD It led to the idea of combining these different strategies in an algorithm built on the specificity of identified subgroups. A randomized controlled trial, named ALGOS was carried out in France to test this algorithm in 2011. The algorithm consisted of: (1) delivering a crisis card for first attempters; (2) giving a phone call for re-attempters to re-assess their situation between the 10th and 21st day after their discharge, and to propose a new intervention if needed, and; (3) in case of an unsuccessful call or a refusal of proposed care, sending personalized postcards for 6 months. All of this was supported with shared information to the general practitioner of the patient. This study was further adapted to routine care in 2015 in the northern departments of France, Nord and Pas-de-Calais (4.3 million people), taking the name of VigilanS. The inclusion consists of sending a form for every patient assessed after a suicide attempt in the two departments to the medical staff of VigilanS in order to provide information about the patient and the context of his suicide attempt. The algorithm has been modified in giving the crisis card to all the patients whether it is a first attempt or not. An information letter, explaining the aim of the monitoring is also given to the patient, and to his general practitioner. The calling staff is composed of 4 nurses and 4 psychologists, all trained in suicidal crisis management. They use a phone platform located in the Emergency Medical Assistance Service (SAMU) of the Nord department on a halftime basis and manage the incoming calls from the patients as well as the outgoing calls towards the patients, their relatives and their medical contacts. A set of 4 postcards (1 per month) can be sent if needed in case of an inconclusive or a failed phone call. CONCLUSION Built on a monitoring philosophy, VigilanS has further developed a real crisis case management dimension requiring enough time to insure an effective medical supervision and strong networking abilities. A specific time is also needed to take care of all the technical aspects of the organization. This program expertise, designed by Northern departments to prevent suicide, can be shared with other French or even foreign territories.
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26
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Courtet P, Olié E. [Social pain at the core of suicidal behavior]. Encephale 2018; 45 Suppl 1:S7-S12. [PMID: 30428996 DOI: 10.1016/j.encep.2018.09.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 08/31/2018] [Accepted: 09/08/2018] [Indexed: 01/05/2023]
Abstract
BACKGROUND Intolerable pain is often reported in suicide notes. Moreover, the frequency of life events preceding a suicidal act is high, especially interpersonal difficulties. Such adversity is the source of psychological or social pain. METHODS We propose a narrative review to discuss the role of pain in the suicidal process while having a focus on social ties. RESULTS Using Ecological Momentary Assessment in suicide attempters it has been shown that being alone increased suicidal ideation while being with close others significantly reduced this risk. At a neuroanatomical level, suicidal vulnerability is associated with dysfunctional insula activation during social exclusion, a region involved in social and physical pain processing. Social pain elicited by social exclusion or devaluation shares common neurobiological patterns with physical pain. It is also an exemplar of psychological pain. Despite the complexity of its definition, higher psychological pain levels are associated with suicidal ideation and acts. Finally, intense physical pain or chronic pain are strong risk factors of suicidal ideation and act. Interestingly, suicide notes often report the existence of an intolerable pain. Presence of psychological pain and difficulties in communication predict the lethality and seriousness of suicide attempts. Moreover, presence of psychological pain is associated with more impulsive choices in suicidal patients, suggesting that a suicidal act is a means to escape intolerable suffering despite negative long-term consequences (i.e. death). Analgesics are usually used to get relief from pain but are also frequently involved in suicidal overdoses. It has been shown that opioid analgesics are associated with an increased risk of suicide. Higher consumption of opioid analgesics has been shown in suicidal patients in comparison to patients with history of depression but no suicidal act and healthy controls whereas non-suicidal patients were those reporting higher presence of pain in comparison to healthy controls. It may suggest that opioids are being used by suicidal patients to get relief from psychological/social pain rather than from physical pain. Involvement of opioidergic system in suicidal process opens new therapeutic strategies. Recently, the time-limited, short-term use of very low dosages of sublingual buprenorphine (vs. placebo) was associated with decreased suicidal ideation and mental pain in severely suicidal patients without substance abuse. In a randomized controlled trial comparing a 7-week acceptance and commitment therapy (ACT) versus relaxation group, as adjunct to treatment as usual for adult outpatients suffering from a current suicidal behavior disorder, ACT has shown its effectiveness in reducing suicidal ideation and psychological pain. Evidence indicates that maintaining contact either via letter, postcard or telephone with at-risk adults following discharge from care services after a suicide attempt can reduce reattempt risk. Based on these results, a preventive program of recontact for suicide attempters, VIGILANS, has been developed in France in usual care. CONCLUSION The approach of the suicidal issue by the angle of pain and social disconnection offers new advances to improve clinical assessment, to identify new biological pathways involved in suicidal risk, and to propose innovative therapeutic and preventive actions.
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Affiliation(s)
- P Courtet
- Département d'urgence et post-urgence psychiatrique, université Montpellier, CHU de Montpellier, 371, avenue du Doyen-Gaston-Giraud, 34295 Montpellier cedex 5, France.
| | - E Olié
- Département d'urgence et post-urgence psychiatrique, université Montpellier, CHU de Montpellier, 371, avenue du Doyen-Gaston-Giraud, 34295 Montpellier cedex 5, France
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Muñoz-Sánchez JL, Delgado C, Parra-Vidales E, Franco-Martín M. Facilitating Factors and Barriers to the Use of Emerging Technologies for Suicide Prevention in Europe: Multicountry Exploratory Study. JMIR Ment Health 2018; 5:e7. [PMID: 29367183 PMCID: PMC5803527 DOI: 10.2196/mental.7784] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 10/05/2017] [Accepted: 10/29/2017] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND This study provides an analysis on the use of emerging technologies for the prevention of suicide in 8 different European countries. OBJECTIVE The objective of this study was to analyze the potentiality of using emerging technologies in the area of suicide prevention based on the opinion of different professionals involved in suicide prevention. METHODS Opinions of 3 groups of stakeholders (ie, relevant professionals in suicide field) were gathered using a specifically designed questionnaire to explore dimensions underlying perceptions of facilitating factors and barriers in relation to the use of emerging technologies for suicide prevention. RESULTS Goal 1 involved facilitating factors for the use of emerging technologies in suicide prevention. Northern European countries, except for Belgium, attach greater relevance to those that optimize implementation and benefits. On the other hand, Southern European countries attach greater importance to professionally oriented and user-centered facilitating factors. According to different stakeholders, the analysis of these facilitating factors suggest that professionals in the field of social work attach greater relevance to those that optimize implementation and benefits. However, professionals involved in the area of mental health, policy makers, and political decision makers give greater importance to professionally oriented and user-centered facilitating factors. Goal 2 was related to barriers to the usability of emerging technologies for suicide prevention. Both countries and stakeholders attach greater importance to barriers associated with resource constraints than to those centered on personal limitations. There are no differences between countries or between stakeholders. Nevertheless, there is a certain stakeholders-countries interaction that indicates that the opinions on resource constraints expressed by different stakeholders do not follow a uniform pattern in different countries, but they differ depending on the country. CONCLUSIONS Although all countries and stakeholders agree in identifying resource constraints as the main barrier to the use of emerging technologies, factors facilitating their use in suicide prevention differ among countries and among stakeholders.
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Affiliation(s)
| | - Carmen Delgado
- Faculty of Psychology, Universidad Pontificia de Salamanca, Salamanca, Spain
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Berrouiguet S, Larsen ME, Mesmeur C, Gravey M, Billot R, Walter M, Lemey C, Lenca P. Toward mHealth Brief Contact Interventions in Suicide Prevention: Case Series From the Suicide Intervention Assisted by Messages (SIAM) Randomized Controlled Trial. JMIR Mhealth Uhealth 2018; 6:e8. [PMID: 29321126 PMCID: PMC5784185 DOI: 10.2196/mhealth.7780] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 09/06/2017] [Accepted: 10/03/2017] [Indexed: 02/01/2023] Open
Abstract
Background Research indicates that maintaining contact either via letter or postcard with at-risk adults following discharge from care services after a suicide attempt (SA) can reduce reattempt risk. Pilot studies have demonstrated that interventions using mobile health (mHealth) technologies are feasible in a suicide prevention setting. Objective The aim of this study was to report three cases of patients recruited in the Suicide Intervention Assisted by Messages (SIAM) study to describe how a mobile intervention may influence follow-up. Methods SIAM is a 2-year, multicenter randomized controlled trial conducted by the Brest University Hospital, France. Participants in the intervention group receive SIAM text messages 48 hours after discharge, then at day 8 and day 15, and months 1, 2, 3, 4, 5, and 6. The study includes participants aged 18 years or older, who have attended a participating hospital for an SA, and have been discharged from the emergency department (ED) or a psychiatric unit (PU) for a stay of less than 7 days. Eligible participants are randomized between the SIAM intervention messages and a control group. In this study, we present three cases from the ongoing SIAM study that demonstrate the capability of a mobile-based brief contact intervention for triggering patient-initiated contact with a crisis support team at various time points throughout the mobile-based follow-up period. Results Out of the 244 patients recruited in the SIAM randomized controlled trial, three cases were selected to illustrate the impact of mHealth on suicide risk management. Participants initiated contact with the emergency crisis support service after receiving text messages up to 6 months following discharge from the hospital. Contact was initiated immediately following receipt of a text message or up to 6 days following a message. Conclusions This text message–based brief contact intervention has demonstrated the potential to reconnect suicidal individuals with crisis support services while they are experiencing suicidal ideation as well as in a period after receiving messages. As follow-up phone calls over an extended period of time may not be feasible, this intervention has the potential to offer simple technological support for individuals following discharge from the ED. Trial Registration ClinicalTrials.gov NCT02106949; https://clinicaltrials.gov/ct2/show/NCT02106949 (Archived by WebCite at http://www.webcitation.org/6wMtAFL49)
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Affiliation(s)
- Sofian Berrouiguet
- IMT Atlantique, Lab-STICC, Université Bretagne Loire F-29238 Brest, Brest, France.,EA 7479 SPURBO, Université de Bretagne occidentale, Brest, France
| | - Mark Erik Larsen
- Black Dog Institute, University of New South Wales, Sydney, Australia
| | - Catherine Mesmeur
- Adult Psychiatry, Brest Medical University Hospital at Bohars, Brest, France
| | | | - Romain Billot
- IMT Atlantique, Lab-STICC, Université Bretagne Loire F-29238 Brest, Brest, France.,EA 7479 SPURBO, Université de Bretagne occidentale, Brest, France
| | - Michel Walter
- Adult Psychiatry, Brest Medical University Hospital at Bohars, Brest, France
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- Réseau HUGOPSY, Rennes, France
| | - Christophe Lemey
- Adult Psychiatry, Brest Medical University Hospital at Bohars, Brest, France
| | - Philippe Lenca
- IMT Atlantique, Lab-STICC, Université Bretagne Loire F-29238 Brest, Brest, France
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Larsen ME, Shand F, Morley K, Batterham PJ, Petrie K, Reda B, Berrouiguet S, Haber PS, Carter G, Christensen H. A Mobile Text Message Intervention to Reduce Repeat Suicidal Episodes: Design and Development of Reconnecting After a Suicide Attempt (RAFT). JMIR Ment Health 2017; 4:e56. [PMID: 29237584 PMCID: PMC5745353 DOI: 10.2196/mental.7500] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Revised: 09/24/2017] [Accepted: 10/11/2017] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Suicide is a leading cause of death, particularly among young people. Continuity of care following discharge from hospital is critical, yet this is a time when individuals often lose contact with health care services. Offline brief contact interventions following a suicide attempt can reduce the number of repeat attempts, and text message (short message service, SMS) interventions are currently being evaluated. OBJECTIVE The aim of this study was to extend postattempt caring contacts by designing a brief Web-based intervention targeting proximal risk factors and the needs of this population during the postattempt period. This paper details the development process and describes the realized system. METHODS To inform the design of the intervention, a lived experience design group was established. Participants were asked about their experiences of support following their suicide attempt, their needs during this time, and how these could be addressed in a brief contact eHealth intervention. The intervention design was also informed by consultation with lived experience panels external to the project and a clinical design group. RESULTS Prompt outreach following discharge, initial distraction activities with low cognitive demands, and ongoing support over an extended period were identified as structural requirements of the intervention. Key content areas identified included coping with distressing feelings, safety planning, emotional regulation and acceptance, coping with suicidal thoughts, connecting with others and interpersonal relationships, and managing alcohol consumption. CONCLUSIONS The RAFT (Reconnecting AFTer a suicide attempt) text message brief contact intervention combines SMS contacts with additional Web-based brief therapeutic content targeting key risk factors. It has the potential to reduce the number of repeat suicidal episodes and to provide accessible, acceptable, and cost-effective support for individuals who may not otherwise seek face-to-face treatment. A pilot study to test the feasibility and acceptability of the RAFT intervention is underway.
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Affiliation(s)
- Mark Erik Larsen
- Black Dog Institute, University of New South Wales, Sydney, Australia
| | - Fiona Shand
- Black Dog Institute, University of New South Wales, Sydney, Australia
| | - Kirsten Morley
- National Health and Medical Research Council Centre of Research Excellence in Mental Health and Substance Use, Discipline of Addiction Medicine, University of Sydney, Sydney, Australia
| | - Philip J Batterham
- Centre for Mental Health Research, Australian National University, Canberra, Australia
| | - Katherine Petrie
- Black Dog Institute, University of New South Wales, Sydney, Australia
| | - Bill Reda
- Black Dog Institute, University of New South Wales, Sydney, Australia
| | - Sofian Berrouiguet
- Brest Medical University Hospital at Bohars, Adult Psychiatry, IMT Atlantique, Lab-STICC, UBL, F-29238 Brest, France, EA 7479 SPURBO, Université de Bretagne Occidentale, Brest, France
| | - Paul S Haber
- National Health and Medical Research Council Centre of Research Excellence in Mental Health and Substance Use, Discipline of Addiction Medicine, University of Sydney, Sydney, Australia.,Drug Health Services, Royal Prince Alfred Hospital, Sydney, Australia
| | - Gregory Carter
- Centre for Brain and Mental Health Research, University of Newcastle, Newcastle, Australia
| | - Helen Christensen
- Black Dog Institute, University of New South Wales, Sydney, Australia
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Berrouiguet S, Courtet P, Larsen ME, Walter M, Vaiva G. Suicide prevention: Towards integrative, innovative and individualized brief contact interventions. Eur Psychiatry 2017; 47:25-26. [PMID: 29096129 DOI: 10.1016/j.eurpsy.2017.09.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Revised: 09/06/2017] [Accepted: 09/10/2017] [Indexed: 10/18/2022] Open
Affiliation(s)
- S Berrouiguet
- Department of Psychiatry, University Hospital of Brest, Lab-STICC - CNRS UMR 6285, EA 7479 SPURBO, UBO, 29200 Brest, France.
| | - P Courtet
- Department of Emergency Psychiatry and Post-Acute Care, Inserm U1061, University of Montpellier, 34090 Montpellier, France
| | - M E Larsen
- Black Dog Institute, University of New South Wales, Sydney, Randwick NSW 2031, Australia
| | - M Walter
- Department of Psychiatry, University Hospital of Brest, Lab-STICC - CNRS UMR 6285, EA 7479 SPURBO, UBO, 29200 Brest, France
| | - G Vaiva
- Department of Psychiatry, University Hospital of Lille, Universités de Lille, 59037 Lille, France; SCA Lab CNRS, UMR 9193, Lille, France
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31
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Falcone G, Nardella A, Lamis DA, Erbuto D, Girardi P, Pompili M. Taking care of suicidal patients with new technologies and reaching-out means in the post-discharge period. World J Psychiatry 2017; 7:163-176. [PMID: 29043154 PMCID: PMC5632601 DOI: 10.5498/wjp.v7.i3.163] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Revised: 05/07/2017] [Accepted: 07/17/2017] [Indexed: 02/05/2023] Open
Abstract
Suicide is a global public health problem with over one million people dying by suicide each year worldwide. Research efforts have focused on developing and testing novel suicide prevention strategies employing recent technological advances. In order to provide a review regarding the role of new technologies (e.g., postcards/letters, text messages, crisis cards, telephone contacts, online interventions) in suicide prevention, we searched PubMed, ScienceDirect, ResearchGate, and Crisis to identify all papers in English from 1977 to 2016. Our results indicated that brief contact interventions show promise in reducing the number of episodes of repeated self-harm and/or suicide attempts following discharge from the Emergency Department or psychiatric units. Innovative methods of contact (e.g., text messages) are easily implemented by clinicians and received by patients in the period of post discharge and have been shown to be beneficial. However, more research employing randomized clinical trials investigating the potential benefits of these novel suicide prevention methods is warranted. Future researchers should continue improving and testing new technologies in the prevention of suicide.
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Affiliation(s)
- Giulia Falcone
- Psychiatry Residency Training Program, Faculty of Medicine and Psychology, Sapienza University of Rome, 00189 Rome, Italy
| | - Adele Nardella
- Psychiatry Residency Training Program, Faculty of Medicine and Psychology, Sapienza University of Rome, 00189 Rome, Italy
| | - Dorian A Lamis
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA 30303, United States
| | - Denise Erbuto
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant’Andrea Hospital, Sapienza University of Rome, 00189 Rome, Italy
| | - Paolo Girardi
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant’Andrea Hospital, Sapienza University of Rome, 00189 Rome, Italy
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant’Andrea Hospital, Sapienza University of Rome, 00189 Rome, Italy
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Metzger MH, Tvardik N, Gicquel Q, Bouvry C, Poulet E, Potinet-Pagliaroli V. Use of emergency department electronic medical records for automated epidemiological surveillance of suicide attempts: a French pilot study. Int J Methods Psychiatr Res 2017; 26:e1522. [PMID: 27634457 PMCID: PMC6877202 DOI: 10.1002/mpr.1522] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Revised: 06/14/2016] [Accepted: 07/18/2016] [Indexed: 01/25/2023] Open
Abstract
The aim of this study was to determine whether an expert system based on automated processing of electronic health records (EHRs) could provide a more accurate estimate of the annual rate of emergency department (ED) visits for suicide attempts in France, as compared to the current national surveillance system based on manual coding by emergency practitioners. A feasibility study was conducted at Lyon University Hospital, using data for all ED patient visits in 2012. After automatic data extraction and pre-processing, including automatic coding of medical free-text through use of the Unified Medical Language System, seven different machine-learning methods were used to classify the reasons for ED visits into "suicide attempts" versus "other reasons". The performance of these different methods was compared by using the F-measure. In a test sample of 444 patients admitted to the ED in 2012 (98 suicide attempts, 48 cases of suicidal ideation, and 292 controls with no recorded non-fatal suicidal behaviour), the F-measure for automatic detection of suicide attempts ranged from 70.4% to 95.3%. The random forest and naïve Bayes methods performed best. This study demonstrates that machine-learning methods can improve the quality of epidemiological indicators as compared to current national surveillance of suicide attempts.
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Affiliation(s)
- Marie-Hélène Metzger
- Université Paris 13 Sorbonne Paris Cité, Laboratoire Educations et Pratiques de Santé EA 3412, Bobigny, France.,Hospices Civils de Lyon, Hôpital de la Croix-Rousse, Unité d'hygiène et d'épidémiologie, Lyon, France
| | - Nastassia Tvardik
- Université Paris 13 Sorbonne Paris Cité, Laboratoire Educations et Pratiques de Santé EA 3412, Bobigny, France
| | - Quentin Gicquel
- Université de Lyon, Lyon, France.,CNRS UMR 5558, Laboratoire de Biométrie et Biologie Evolutive, Villeurbanne, France
| | - Côme Bouvry
- Université de Lyon, Lyon, France.,CNRS UMR 5558, Laboratoire de Biométrie et Biologie Evolutive, Villeurbanne, France
| | - Emmanuel Poulet
- Université de Lyon, Lyon, France.,Hospices Civils de Lyon, Groupement Hospitalier Edouard Herriot, Psychiatrie des Urgences, Lyon, France.,Université Lyon 1, EA 4615 «SIPAD» (Stimulation in Psychiatric and Addictives Disorders), Lyon, France
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Djelaj V, Patterson D, Romero CM. A Qualitative Exploration of Sexual Assault Patients' Barriers to Accessing and Completing HIV Prophylaxis. JOURNAL OF FORENSIC NURSING 2017; 13:45-51. [PMID: 28525428 DOI: 10.1097/jfn.0000000000000153] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Sexual assault patients may encounter barriers when accessing, accepting, and completing nonoccupational postexposure prophylaxis (nPEP), such as lacking insurance or an understanding of nPEP. However, less is known about how sexual assault forensic examiner (SAFE) programs' protocols, approaches to discussing nPEP, and community resources may influence nPEP completion. Utilizing a qualitative case study framework, we conducted semistructured interviews with 10 SAFEs from an urban SAFE program in which emergency department physicians write prescriptions for nPEP before sending patients to the SAFE program. The participants identified barriers encountered by their patients, ranging from emergency department providers inconsistently offering prescriptions for the correct medication, to difficulty locating a local pharmacy stocking nPEP. The SAFEs also expressed concern that uninsured patients had to complete additional steps to access nPEP, while feeling overwhelmed by the immediacy of their assaults. Several participants raised concern that patients' emotional distress and fear of acquiring HIV may impede their ability to comprehend information and access nPEP. Participants also noted that the 28-day nPEP regimen might be a daily reminder for patients of the sexual assault. The SAFEs identified multiple strategies for discussing HIV and nPEP with these patients. Implications of the SAFE's role in reducing barriers are discussed.
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Affiliation(s)
- Valentina Djelaj
- Author Affiliations: School of Social Work, Wayne State University
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Kopp-Bigault C, Walter M, Thevenot A. The social representations of suicide in France: An inter-regional study in Alsace and Brittany. Int J Soc Psychiatry 2016; 62:737-748. [PMID: 27815513 DOI: 10.1177/0020764016675652] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Suicide is a major worldwide public health issue. Various studies showed that individual attitudes toward suicide change in a region with high suicide rate. Attitudes are one of the components of a global and complex system: social representations (SRs). AIMS In France, the Brittany region has an abnormally high death rate due to suicides. Our research focuses on the SRs of suicide in this region. The hypothesis underlying this project is that suicide SRs are different between an area with a high suicide rate and a region less affected by suicide. METHOD A comparative study between the Brittany and Alsace regions, with the latter showing a statistically much lower suicide rate. The persons polled responded to a three-word free-association task around the question 'For you, suicide is …?' An analysis of word frequency and evocation rank was then carried out. RESULTS In confirmation of our hypothesis, SRs were different between Brittany and the control region. CONCLUSION The study's results open new avenues of research, specific to Brittany, in terms of the collective or individual effects of suicides, in terms of psycho-pathological conditions - essentially on depression, and in terms of training, on the stereotypes associated with suicide.
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Affiliation(s)
- Céline Kopp-Bigault
- Université de Strasbourg, Faculté de Psychologie, Strasbourg, France and Centre Hospitalier des Pays de Morlaix, Morlaix, France
| | - Michel Walter
- UFR de Medecine et Sciences de la Sante, Universite de Bretagne Occidentale, Brest, France and Centre Hospitalier Régional Universitaire de Brest, France
| | - Anne Thevenot
- Université de Strasbourg, Faculté de Psychologie, Strasbourg, France
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Mousavi SG, Amini M, Mahaki B, Bagherian-Sararoudi R. Effect of phone call versus face-to-face follow-up on recurrent suicide attempts prevention in individuals with a history of multiple suicide attempts. Adv Biomed Res 2016; 5:184. [PMID: 28028524 PMCID: PMC5156977 DOI: 10.4103/2277-9175.190990] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Accepted: 10/31/2015] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND To evaluate the efficacy of different ways of communications on prevention of suicidal reattempt, we compared the efficacy of phone call versus face-to-face follow-up in patients with previous attempt. MATERIALS AND METHODS In a randomized controlled clinical trial, 55 suicide reattempters who were admitted to the poisoning emergency were divided into phone call (29 patients) and face-to-face (26 patients) groups randomly. They were followed at 8 occasions: 2nd and 4th weeks, and the 2nd, 3rd, 4th, 5th, 6th, and 8th months. The suicidal reattempt, suicidal thought, hope, and interest of the patients were assessed on each occasion, and the patients were guided to visit by a therapist, if needed. The findings were analyzed by Mann-Whitney, Chi-square, Cochran, Friedman, and independent t-tests using SPSS 20. RESULTS The status of "hope" and "interest" improved in both groups, but it showed more significant difference in the face-to-face group. Suicidal thoughts in both groups decreased over time, and this was more significant in the face-to-face group. However, we did not found any significant difference in the frequency of the suicidal reattempts between two groups. CONCLUSION Face-to-face versus phone call follow-up of suicide attempters can significantly alleviate suicidal thoughts and improve hopes and interests.
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Affiliation(s)
- Seyed Ghafur Mousavi
- Department of Psychiatry, Behavioral Sciences Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohsen Amini
- Department of Psychiatry, Behavioral Sciences Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Behzad Mahaki
- Department of Epidemiology, Behavioral Sciences Research Center, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Reza Bagherian-Sararoudi
- Department of Psychiatry, Behavioral Sciences Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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Ligier F, Kabuth B, Guillemin F. MEDIACONNEX: a multicenter randomised trial based on short message service to reduce suicide attempt recurrence in adolescents. BMC Psychiatry 2016; 16:251. [PMID: 27435094 PMCID: PMC4952238 DOI: 10.1186/s12888-016-0965-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Accepted: 07/12/2016] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Suicide attempt among adolescents is a public health problem around the world. The risk of recurrence is high: about 30 % of adolescents. New ways to prevent suicide attempt recurrence being developed for adult suicide attempters include maintaining contact with them, and results are encouraging. METHODS/DESIGN The MEDIACONNEX study will be a simple blinded, parallel-group, multicenter randomised controlled trial. It will compare usual care alone to a program based on usual care plus short message service (SMS) provided to adolescents who attempt suicide and who receive treatment in pediatric and adolescent psychiatry units at hospitals in eastern France. Adolescents will be recruited over an 18-month period. The intervention will be based on the SMS, involving personalized and evolving text messages, sent on days 7 to 14 and months 1, 2, 4 and 6 after the SA. The primary endpoint will be the recurrence of an SA, with an assessment during 12 months. Secondary endpoints will be the evolution of 1) social networks, 2) depression and 3) health-related quality of life, with an assessment at inclusion and at 6 months. DISCUSSION This paper describes the design of MEDIACONNEX, which will assess the effectiveness of an SMS program for adolescent suicide attempters on SA recurrence. This program will be easy to reproduce and inexpensive. TRIAL REGISTRATION The study was registered at ClinicalTrials.gov (no. NCT02762734 ) on March 2016.
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Affiliation(s)
- Fabienne Ligier
- />Université de Lorraine, Université Paris Descartes, EA 4360 APEMAC, Nancy – CHU de Nancy, Hôpital d’enfants, Service de Psychiatrie pour enfants et adolescents, rue du Morvan, 54500 Vandoeuvre-lès-Nancy, France
| | - Bernard Kabuth
- />CHU de Nancy, Hôpital d’enfants, Service de Psychiatrie pour enfants et adolescents, Nancy, France
| | - Francis Guillemin
- />Université de Lorraine, Université Paris Descartes, EA 4360 APEMAC, Nancy - INSERM CIC-EC 1433 – CHU de Nancy, Service d’épidémiologie et évaluation cliniques, Nancy, France
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Berrouiguet S, Baca-García E, Brandt S, Walter M, Courtet P. Fundamentals for Future Mobile-Health (mHealth): A Systematic Review of Mobile Phone and Web-Based Text Messaging in Mental Health. J Med Internet Res 2016; 18:e135. [PMID: 27287668 PMCID: PMC4920962 DOI: 10.2196/jmir.5066] [Citation(s) in RCA: 202] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Accepted: 01/30/2016] [Indexed: 01/02/2023] Open
Abstract
Background Mobile phone text messages (short message service, SMS) are used pervasively as a form of communication. Almost 100% of the population uses text messaging worldwide and this technology is being suggested as a promising tool in psychiatry. Text messages can be sent either from a classic mobile phone or a web-based application. Reviews are needed to better understand how text messaging can be used in mental health care and other fields of medicine. Objective The objective of the study was to review the literature regarding the use of mobile phone text messaging in mental health care. Methods We conducted a thorough literature review of studies involving text messaging in health care management. Searches included PubMed, PsycINFO, Cochrane, Scopus, Embase and Web of Science databases on May 25, 2015. Studies reporting the use of text messaging as a tool in managing patients with mental health disorders were included. Given the heterogeneity of studies, this review was summarized using a descriptive approach. Results From 677 initial citations, 36 studies were included in the review. Text messaging was used in a wide range of mental health situations, notably substance abuse (31%), schizophrenia (22%), and affective disorders (17%). We identified four ways in which text messages were used: reminders (14%), information (17%), supportive messages (42%), and self-monitoring procedures (42%). Applications were sometimes combined. Conclusions We report growing interest in text messaging since 2006. Text messages have been proposed as a health care tool in a wide spectrum of psychiatric disorders including substance abuse, schizophrenia, affective disorders, and suicide prevention. Most papers described pilot studies, while some randomized clinical trials (RCTs) were also reported. Overall, a positive attitude toward text messages was reported. RCTs reported improved treatment adherence and symptom surveillance. Other positive points included an increase in appointment attendance and in satisfaction with management and health care services. Insight into message content, preventative strategies, and innovative approaches derived from the mental health field may be applicable in other medical specialties.
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Affiliation(s)
- Sofian Berrouiguet
- Brest Medical University Hospital at Bohars, Adult Psychiatry, Brest, France.
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Hawton K, Witt KG, Taylor Salisbury TL, Arensman E, Gunnell D, Hazell P, Townsend E, van Heeringen K. Psychosocial interventions for self-harm in adults. Cochrane Database Syst Rev 2016; 2016:CD012189. [PMID: 27168519 PMCID: PMC8786273 DOI: 10.1002/14651858.cd012189] [Citation(s) in RCA: 98] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
BACKGROUND Self-harm (SH; intentional self-poisoning or self-injury) is common, often repeated, and associated with suicide. This is an update of a broader Cochrane review first published in 1998, previously updated in 1999, and now split into three separate reviews. This review focuses on psychosocial interventions in adults who engage in self-harm. OBJECTIVES To assess the effects of specific psychosocial treatments versus treatment as usual, enhanced usual care or other forms of psychological therapy, in adults following SH. SEARCH METHODS The Cochrane Depression, Anxiety and Neurosis Group (CCDAN) trials coordinator searched the CCDAN Clinical Trials Register (to 29 April 2015). This register includes relevant randomised controlled trials (RCTs) from: the Cochrane Library (all years), MEDLINE (1950 to date), EMBASE (1974 to date), and PsycINFO (1967 to date). SELECTION CRITERIA We included RCTs comparing psychosocial treatments with treatment as usual (TAU), enhanced usual care (EUC) or alternative treatments in adults with a recent (within six months) episode of SH resulting in presentation to clinical services. DATA COLLECTION AND ANALYSIS We used Cochrane's standard methodological procedures. MAIN RESULTS We included 55 trials, with a total of 17,699 participants. Eighteen trials investigated cognitive-behavioural-based psychotherapy (CBT-based psychotherapy; comprising cognitive-behavioural, problem-solving therapy or both). Nine investigated interventions for multiple repetition of SH/probable personality disorder, comprising emotion-regulation group-based psychotherapy, mentalisation, and dialectical behaviour therapy (DBT). Four investigated case management, and 11 examined remote contact interventions (postcards, emergency cards, telephone contact). Most other interventions were evaluated in only single small trials of moderate to very low quality.There was a significant treatment effect for CBT-based psychotherapy compared to TAU at final follow-up in terms of fewer participants repeating SH (odds ratio (OR) 0.70, 95% confidence interval (CI) 0.55 to 0.88; number of studies k = 17; N = 2665; GRADE: low quality evidence), but with no reduction in frequency of SH (mean difference (MD) -0.21, 95% CI -0.68 to 0.26; k = 6; N = 594; GRADE: low quality).For interventions typically delivered to individuals with a history of multiple episodes of SH/probable personality disorder, group-based emotion-regulation psychotherapy and mentalisation were associated with significantly reduced repetition when compared to TAU: group-based emotion-regulation psychotherapy (OR 0.34, 95% CI 0.13 to 0.88; k = 2; N = 83; GRADE: low quality), mentalisation (OR 0.35, 95% CI 0.17 to 0.73; k = 1; N = 134; GRADE: moderate quality). Compared with TAU, dialectical behaviour therapy (DBT) showed a significant reduction in frequency of SH at final follow-up (MD -18.82, 95% CI -36.68 to -0.95; k = 3; N = 292; GRADE: low quality) but not in the proportion of individuals repeating SH (OR 0.57, 95% CI 0.21 to 1.59, k = 3; N = 247; GRADE: low quality). Compared with an alternative form of psychological therapy, DBT-oriented therapy was also associated with a significant treatment effect for repetition of SH at final follow-up (OR 0.05, 95% CI 0.00 to 0.49; k = 1; N = 24; GRADE: low quality). However, neither DBT vs 'treatment by expert' (OR 1.18, 95% CI 0.35 to 3.95; k = 1; N = 97; GRADE: very low quality) nor prolonged exposure DBT vs standard exposure DBT (OR 0.67, 95% CI 0.08 to 5.68; k = 1; N =18; GRADE: low quality) were associated with a significant reduction in repetition of SH.Case management was not associated with a significant reduction in repetition of SH at post intervention compared to either TAU or enhanced usual care (OR 0.78, 95% CI 0.47 to 1.30; k = 4; N = 1608; GRADE: moderate quality). Continuity of care by the same therapist vs a different therapist was also not associated with a significant treatment effect for repetition (OR 0.28, 95% CI 0.07 to 1.10; k = 1; N = 136; GRADE: very low quality). None of the following remote contact interventions were associated with fewer participants repeating SH compared with TAU: adherence enhancement (OR 0.57, 95% CI 0.32 to 1.02; k = 1; N = 391; GRADE: low quality), mixed multimodal interventions (comprising psychological therapy and remote contact-based interventions) (OR 0.98, 95% CI 0.68 to 1.43; k = 1 study; N = 684; GRADE: low quality), including a culturally adapted form of this intervention (OR 0.83, 95% CI 0.44 to 1.55; k = 1; N = 167; GRADE: low quality), postcards (OR 0.87, 95% CI 0.62 to 1.23; k = 4; N = 3277; GRADE: very low quality), emergency cards (OR 0.82, 95% CI 0.31 to 2.14; k = 2; N = 1039; GRADE: low quality), general practitioner's letter (OR 1.15, 95% CI 0.93 to 1.44; k = 1; N = 1932; GRADE: moderate quality), telephone contact (OR 0.74, 95% CI 0.42 to 1.32; k = 3; N = 840; GRADE: very low quality), and mobile telephone-based psychological therapy (OR not estimable due to zero cell counts; GRADE: low quality).None of the following mixed interventions were associated with reduced repetition of SH compared to either alternative forms of psychological therapy: interpersonal problem-solving skills training, behaviour therapy, home-based problem-solving therapy, long-term psychotherapy; or to TAU: provision of information and support, treatment for alcohol misuse, intensive inpatient and community treatment, general hospital admission, or intensive outpatient treatment.We had only limited evidence on whether the intervention had different effects in men and women. Data on adverse effects, other than planned outcomes relating to suicidal behaviour, were not reported. AUTHORS' CONCLUSIONS CBT-based psychological therapy can result in fewer individuals repeating SH; however, the quality of this evidence, assessed using GRADE criteria, ranged between moderate and low. Dialectical behaviour therapy for people with multiple episodes of SH/probable personality disorder may lead to a reduction in frequency of SH, but this finding is based on low quality evidence. Case management and remote contact interventions did not appear to have any benefits in terms of reducing repetition of SH. Other therapeutic approaches were mostly evaluated in single trials of moderate to very low quality such that the evidence relating to these interventions is inconclusive.
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Affiliation(s)
- Keith Hawton
- Centre for Suicide Research, University Department of Psychiatry, Warneford Hospital, Oxford, UK, OX3 7JX
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Vaiva G. Prévention du suicide : du recontact à la santé connectée. Eur Psychiatry 2015. [DOI: 10.1016/j.eurpsy.2015.09.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Un geste suicidaire correspond à une volonté de changement vécue comme impossible et qui se solde par une rupture brutale. L’intérêt d’un recontact réside dans la proposition d’un changement tout en retissant ce lien qui nous unit à l’autre, aux autres. La communication de Vincent Jardon a pour objectif de reprendre l’histoire de cette idée du recontact et de la veille auprès d’un patient suicidant, d’en décrire les différentes modalités (cartes ressources, caring letters, cartes postales, appel téléphonique, SMS…) et ce qu’elles apportent (notion de connectedness, fiabilisation des soins). La démonstration de l’efficacité des soins basés sur le recontact, comme l’observation qu’un geste suicidaire suit régulièrement un événement de vie stressant, notamment dans le domaine social, sont deux arguments suggérant l’existence d’une sensibilité accrue aux stress sociaux chez les suicidants. P. Courtet proposera les arguments neuroscientifiques actuels (imagerie, neurospychologie, inflammation) en faveur de cette hypothèse. Il poursuivra sur l’intérêt des nouvelles technologies de la communication (à l’aide de Smartphones) dans l’évaluation in vivo des patients à risque suicidaire. Non seulement, il est démontré que l’évaluation répétée du risque suicidaire dans l’environnement naturel du sujet n’est pas délétère pour les sujets, mais en outre que ce type d’innovation apporte des informations de grand intérêt pour suivre les séquences environnementales conduisant à la génération des idées de suicide. Si le recontact téléphonique ou postal prévient la récidive suicidaire et que les Smartphones sont des outils pertinents d’accompagnement des patients, S. Berrouiguet a raison de faire l’hypothèse qu’un dispositif de veille par SMS aura un intérêt dans la prévention de la récidive suicidaire. Il présentera le protocole de l’étude SIAM et les résultats préliminaires d’une intervention par SMS (ou message texto), adressés depuis une plateforme Internet, destinée à la réduction de la récidive suicidaire.
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Ghanbari B, Malakouti SK, Nojomi M, Alavi K, Khaleghparast S. Suicide Prevention and Follow-Up Services: A Narrative Review. Glob J Health Sci 2015; 8:145-53. [PMID: 26652085 PMCID: PMC4877223 DOI: 10.5539/gjhs.v8n5p145] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2015] [Revised: 08/21/2015] [Accepted: 09/28/2015] [Indexed: 01/03/2023] Open
Abstract
Previous suicide attempt is the most important predictor of death by suicide. Thus preventive interventions after attempting to suicide is essential to prevent reattempts. This paper attempts to determine whether phone preventive interventions or other vehicles (postal cards, email and case management) are effective in reattempt prevention and health promotion after discharge by providing an overview of studies on suicide reattempts. The research investigated in this review conducted from 1995 to 2014. A total of 26 cases related to the aim of this research were derived from 36 English articles with the aforementioned keywords Research shows that providing comprehensive aids, social support, and follow-up after discharge can significantly prevent suicide reattempts. Several studies showed that follow-up support (phone calls, crisis cards, mails, postal cards.) after discharge can significantly decrease the risk of suicide. More randomized controlled trials (RCT) are required to determine what factors of follow-up are more effective than other methods.
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Affiliation(s)
- Behrooz Ghanbari
- Mental Health Research Center (MHRC), Tehran Institute of Psychiatry, Faculty of behavioral sciences and mental health, Iran University of Medical Sciences (IUMS), Tehran, Iran..
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Luxton DD, June JD, Chalker SA. Mobile Health Technologies for Suicide Prevention: Feature Review and Recommendations for Use in Clinical Care. ACTA ACUST UNITED AC 2015. [DOI: 10.1007/s40501-015-0057-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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