Abstract
Background: Assessment of suicide attempters in a general hospital may be influenced by the condition of the patient and the unfavorable circumstances of the hospital environment. Aims: To determine whether the results of a reassessment at home shortly after discharge from hospital differ from the initial assessment in the hospital. Methods: In this prospective study, systematic assessment of 52 suicide attempters in a general hospital was compared with reassessment at home, shortly after discharge. Results: Reassessments at home concerning suicide intent, motives for suicide attempt, and dimensions of psychopathology did not differ significantly from the initial hospital assessment. However, patients’ motives for the suicide attempt had changed to being less impulsive and more suicidal, worrying was significantly higher, and self-esteem was significantly lower. A third of the patients had forgotten their aftercare arrangements and most patients who initially felt no need for additional help had changed their mind at reassessment. Conclusions: Results from this group of suicide attempters suggest that a brief reassessment at home shortly after discharge from hospital should be considered.
References
(1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.
(2003). Practice guideline for the assessment and treatment of patients with suicidal behaviors. American Journal of Psychiatry, 160, 1–60.
(1979). The reasons people give for taking overdoses: A further inquiry. British Journal of Medical Psychology, 52, 353–365.
(2006). Development of suicidal intent scales. In , The prediction of suicide (pp. 45–56). Bowie, MD: Charles Press.
(2008). Self-esteem and suicide ideation in psychiatric outpatients. Suicide and Life-Threatening Behavior, 38, 511–516.
(2006). Brief Symptom Inventory (BSI): De betrouwbaarheid en validiteit van een handzaam alternatief voor de SCL-90 [
The reliability and validity of a useful alternative for the SCL-90 ]. Maandblad Geestelijke Volksgezondheid, 61, 120–141.(1975). The Brief Symptom Inventory. Baltimore, MD: Clinical Psychometric Research.
(2001). Toward an integrative model of suicide attempt: A cognitive psychological approach. Suicide and Life-Threatening Behavior, 31, 153–168.
(1992). Autobiographical memory and problem-solving strategies of parasuicide patients. Psychological Medicine, 22, 399–405.
(2005). Value of measuring suicidal intent in the assessment of people attending hospital following self-poisoning or self-injury. British Journal of Psychiatry, 186, 60–66.
(1998). Deliberate self-harm: Systematic review of efficacy of psychosocial and pharmacological treatments in preventing repetition. British Medical Journal, 317, 441–447.
(2003). Suicide following deliberate self-harm: Long-term follow-up of patients who presented to a general hospital. British Journal of Psychiatry, 182, 537–542.
(1988). Evaluation of psychiatric consultations with suicide attempters. Acta Psychiatrica Scandinavica, 77, 283–289.
(2001). Deliberate self-harm patients who leave the accident and emergency department without a psychiatric assessment: A neglected population at risk of suicide. Journal of Psychosomatic Research, 50, 87–93.
(2002). Why people engage in parasuicide: A cross-cultural study of intentions. Suicide and Life-Threatening Behavior, 32, 380–393.
(2000). A cross-cultural study of suicide intent in parasuicide patients. Suicide and Life-Threatening Behavior, 30, 295–303.
(1983). Psychosociale problematiek en hulpzoeken [
Psychosocial problems and care-seeking ]. Lisse, The Netherlands: Swets & Zeitlinger.(2005). Suicide prevention strategies: A systematic review. Journal of the American Medical Association, 294, 2064–2074.
(1990). Development and validation of the Penn State Worry Questionnaire. Behavior Research and Therapy, 28, 487–495.
(2000). Methods used for parasuicide: Results of the WHO/EURO multicenter study on parasuicide. Social Psychiatry and Psychiatric Epidemiology, 35, 156–163.
(2004). Self-harm. The short-term physical and psychological management and secondary prevention of self-harm in primary and secondary care. London, UK: National Institute for Clinical Excellence.
(1992). Parasuicide in Europe: The WHO/EURO multicenter study on parasuicide. I. Introduction and preliminary analysis for 1989. Acta Psychiatrica Scandinavica, 85, 97–104.
(1965). Society and the adolescent self-image. Princeton, NJ: Princeton University Press.
(2004). Assessment following self-harm in adults (Rep. No. Council Report CR122). London: Royal College of Psychiatrists.
(2004). Level of suicidal intent predicts overall mortality and suicide after attempted suicide: A 12-year follow-up study. BMC Psychiatry, 4, 11.
(1999). The Penn State Worry Questionnaire and the Worry Domains Questionnaire: Structure, reliability, and validity. Clinical Psychology and Psychotherapy, 6, 297–307.
(2000). Memory impairment in those who attempted suicide by benzodiazepine overdose. Journal of Clinical Psychiatry, 61, 456–459.
(2008). Constructive and unconstructive repetitive thought. Psychological Bulletin, 134, 163–206.
(2004). Repetition of deliberate self-harm and subsequent suicide risk: Long-term follow-up study of 11,583 patients. British Journal of Psychiatry, 185, 70–75.
