TY - JOUR
T1 - Brief psychological intervention after self-harm
T2 - Randomised controlled trial from Pakistan
AU - Husain, Nusrat
AU - Afsar, Salahuddin
AU - Ara, Jamal
AU - Fayyaz, Hina
AU - Ur Rahman, Raza
AU - Tomenson, Barbara
AU - Hamirani, Munir
AU - Chaudhry, Nasim
AU - Fatima, Batool
AU - Husain, Meher
AU - Naeem, Farooq
AU - Chaudhry, Imran B.
PY - 2014/6
Y1 - 2014/6
N2 - Background: Self-harm is a major risk factor for completed suicide. Aims: To determine the efficacy of a brief psychological intervention - culturally adapted manual-assisted problem-solving training (C-MAP) - delivered following an episode of self-harm compared with treatment as usual (TAU). Method: The study was a randomised controlled assessor-masked clinical trial (trial registration: ClinicalTrials.gov NCT01308151). All patients admitted after an episode of self-harm during the previous 7 days to the participating medical units of three university hospitals in Karachi, Pakistan, were included in the study. A total of 250 patients were screened and 221 were randomly allocated to C-MAP plus treatment as usual (TAU) or to TAU alone. All patients were assessed at baseline, at 3 months (end of intervention) and at 6 months after baseline. The primary outcome measure was reduction in suicidal ideation at 3 months. The secondary outcome measures included hopelessness, depression, coping resources and healthcare utilisation. Results: A total of 108 patients were randomised to the C-MAP group and 113 to the TAU group. Patients in the C-MAP group showed statistically significant improvement on the Beck Scale for Suicide Ideation and Beck Hopelessness Inventory, which was sustained at 3 months after the completion of C-MAP. There was also a significant reduction in symptoms of depression compared with patients receiving TAU. Conclusions: The positive outcomes of this brief psychological intervention in patients attempting self-harm are promising and suggest that C-MAP may have a role in suicide prevention.
AB - Background: Self-harm is a major risk factor for completed suicide. Aims: To determine the efficacy of a brief psychological intervention - culturally adapted manual-assisted problem-solving training (C-MAP) - delivered following an episode of self-harm compared with treatment as usual (TAU). Method: The study was a randomised controlled assessor-masked clinical trial (trial registration: ClinicalTrials.gov NCT01308151). All patients admitted after an episode of self-harm during the previous 7 days to the participating medical units of three university hospitals in Karachi, Pakistan, were included in the study. A total of 250 patients were screened and 221 were randomly allocated to C-MAP plus treatment as usual (TAU) or to TAU alone. All patients were assessed at baseline, at 3 months (end of intervention) and at 6 months after baseline. The primary outcome measure was reduction in suicidal ideation at 3 months. The secondary outcome measures included hopelessness, depression, coping resources and healthcare utilisation. Results: A total of 108 patients were randomised to the C-MAP group and 113 to the TAU group. Patients in the C-MAP group showed statistically significant improvement on the Beck Scale for Suicide Ideation and Beck Hopelessness Inventory, which was sustained at 3 months after the completion of C-MAP. There was also a significant reduction in symptoms of depression compared with patients receiving TAU. Conclusions: The positive outcomes of this brief psychological intervention in patients attempting self-harm are promising and suggest that C-MAP may have a role in suicide prevention.
UR - http://www.scopus.com/inward/record.url?scp=84901842127&partnerID=8YFLogxK
U2 - 10.1192/bjp.bp.113.138370
DO - 10.1192/bjp.bp.113.138370
M3 - Article
C2 - 24676964
AN - SCOPUS:84901842127
SN - 0007-1250
VL - 204
SP - 462
EP - 470
JO - British Journal of Psychiatry
JF - British Journal of Psychiatry
IS - 6
ER -
