Testing Brief Intervention and Phone Contact among Subjects with Suicidal Behavior: A Randomized Controlled Trial in French Polynesia in the Frames of the World Health Organization/Suicide Trends in At-Risk Territories Study
Identifieur interne : 000295 ( Pmc/Curation ); précédent : 000294; suivant : 000296Testing Brief Intervention and Phone Contact among Subjects with Suicidal Behavior: A Randomized Controlled Trial in French Polynesia in the Frames of the World Health Organization/Suicide Trends in At-Risk Territories Study
Auteurs : Stéphane Amadéo ; Moerani Rereao [Polynésie française] ; Aurelia Malogne [Polynésie française] ; Patrick Favro ; Ngoc Lam Nguyen [Polynésie française] ; Louis Jehel [France] ; Allison Milner [Australie] ; Kairi Kolves [Australie] ; Diego De Leo [Australie]Source :
- Mental Illness [ 2036-7457 ] ; 2015.
Abstract
The World Health Organization
Url:
DOI: 10.4081/mi.2015.5818
PubMed: 26605034
PubMed Central: 4620282
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Testing Brief Intervention and Phone Contact among Subjects with Suicidal Behavior: A Randomized Controlled Trial in French Polynesia in the Frames of the World Health Organization/Suicide Trends in At-Risk Territories Study</title>
<author><name sortKey="Amadeo, Stephane" sort="Amadeo, Stephane" uniqKey="Amadeo S" first="Stéphane" last="Amadéo">Stéphane Amadéo</name>
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<country xml:lang="fr" wicri:curation="lc">Polynésie française</country>
<wicri:regionArea>Tahiti</wicri:regionArea>
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<author><name sortKey="Malogne, Aurelia" sort="Malogne, Aurelia" uniqKey="Malogne A" first="Aurelia" last="Malogne">Aurelia Malogne</name>
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<wicri:regionArea>Tahiti</wicri:regionArea>
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<author><name sortKey="Favro, Patrick" sort="Favro, Patrick" uniqKey="Favro P" first="Patrick" last="Favro">Patrick Favro</name>
<affiliation><nlm:aff id="aff005"><institution>Université de Polynésie Française</institution>
,<addr-line>Polynésie Française</addr-line>
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<author><name sortKey="Nguyen, Ngoc Lam" sort="Nguyen, Ngoc Lam" uniqKey="Nguyen N" first="Ngoc Lam" last="Nguyen">Ngoc Lam Nguyen</name>
<affiliation wicri:level="1"><nlm:aff id="aff006"><institution>Direction de la Santé Publique de Polynésie française</institution>
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<country xml:lang="fr" wicri:curation="lc">Polynésie française</country>
<wicri:regionArea>Tahiti</wicri:regionArea>
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<author><name sortKey="Jehel, Louis" sort="Jehel, Louis" uniqKey="Jehel L" first="Louis" last="Jehel">Louis Jehel</name>
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<country xml:lang="fr">France</country>
<wicri:regionArea>Paris</wicri:regionArea>
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<affiliation wicri:level="1"><nlm:aff id="aff007"><institution>Centre Hospitalier Universitaire</institution>
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<wicri:regionArea>Martinique</wicri:regionArea>
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<author><name sortKey="Milner, Allison" sort="Milner, Allison" uniqKey="Milner A" first="Allison" last="Milner">Allison Milner</name>
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<country xml:lang="fr">Australie</country>
<wicri:regionArea>Brisbane</wicri:regionArea>
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<author><name sortKey="Kolves, Kairi" sort="Kolves, Kairi" uniqKey="Kolves K" first="Kairi" last="Kolves">Kairi Kolves</name>
<affiliation wicri:level="1"><nlm:aff id="aff008">Australian Institute for Suicide Research and Prevention,<institution>Griffith University</institution>
,<addr-line>Brisbane, Australia</addr-line>
</nlm:aff>
<country xml:lang="fr">Australie</country>
<wicri:regionArea>Brisbane</wicri:regionArea>
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<author><name sortKey="De Leo, Diego" sort="De Leo, Diego" uniqKey="De Leo D" first="Diego" last="De Leo">Diego De Leo</name>
<affiliation wicri:level="1"><nlm:aff id="aff008">Australian Institute for Suicide Research and Prevention,<institution>Griffith University</institution>
,<addr-line>Brisbane, Australia</addr-line>
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<country xml:lang="fr">Australie</country>
<wicri:regionArea>Brisbane</wicri:regionArea>
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<series><title level="j">Mental Illness</title>
<idno type="ISSN">2036-7457</idno>
<idno type="eISSN">2036-7465</idno>
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<front><div type="abstract" xml:lang="en"><p>The World Health Organization <italic>Suicide trends in at-risk territories</italic>
study is a multi-site regional research program operating first in French Polynesia and countries of the Western Pacific, then extended to the world. The aims of the study were to establish a monitoring system for suicidal behaviors and to conduct a randomised control trial intervention for non-fatal suicidal behaviors. The latter part is the purpose of the present article. Over the period 2008-2010, 515 patients were admitted at the Emergency Department of the Centre Hospitalier de Polynésie Française for suicidal behavior. Those then hospitalized in the Psychiatry Emergency Unit were asked to be involved in the study and randomly allocated to either Treatment As Usual (TAU) or TAU plus Brief Intervention and Contact (BIC), which provides a psycho-education session and a follow-up of 9 phone contacts over an 18-months period. One hundred persons were assigned to TAU, while 100 participants were allocated to the BIC group. At the end of the follow-up there were no significant differences between the two groups in terms of number of presentations to the hospital for repeated suicidal behaviors. Although the study could not demonstrate the superiority of a treatment over the other, nevertheless – given its importance – the investigation captured public attention and was able to contribute to the awareness of the need of suicide prevention in French Polynesia. The BIC model of intervention seemed to particularly suit the geographical and health care context of the country.</p>
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<front><journal-meta><journal-id journal-id-type="nlm-ta">Ment Illn</journal-id>
<journal-id journal-id-type="iso-abbrev">Ment Illn</journal-id>
<journal-id journal-id-type="publisher-id">MI</journal-id>
<journal-title-group><journal-title>Mental Illness</journal-title>
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<issn pub-type="ppub">2036-7457</issn>
<issn pub-type="epub">2036-7465</issn>
<publisher><publisher-name>PAGEPress Publications, Pavia, Italy</publisher-name>
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<article-meta><article-id pub-id-type="pmid">26605034</article-id>
<article-id pub-id-type="pmc">4620282</article-id>
<article-id pub-id-type="doi">10.4081/mi.2015.5818</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Article</subject>
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<title-group><article-title>Testing Brief Intervention and Phone Contact among Subjects with Suicidal Behavior: A Randomized Controlled Trial in French Polynesia in the Frames of the World Health Organization/Suicide Trends in At-Risk Territories Study</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Amadéo</surname>
<given-names>Stéphane</given-names>
</name>
<xref ref-type="aff" rid="aff001 aff002 aff003 aff004"><sup>1-4</sup>
</xref>
<xref ref-type="corresp" rid="cor1"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Rereao</surname>
<given-names>Moerani</given-names>
</name>
<xref ref-type="aff" rid="aff001"><sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Malogne</surname>
<given-names>Aurelia</given-names>
</name>
<xref ref-type="aff" rid="aff002"><sup>2</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Favro</surname>
<given-names>Patrick</given-names>
</name>
<xref ref-type="aff" rid="aff005"><sup>5</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Nguyen</surname>
<given-names>Ngoc Lam</given-names>
</name>
<xref ref-type="aff" rid="aff006"><sup>6</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Jehel</surname>
<given-names>Louis</given-names>
</name>
<xref ref-type="aff" rid="aff003"><sup>3</sup>
</xref>
<xref ref-type="aff" rid="aff007"><sup>7</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Milner</surname>
<given-names>Allison</given-names>
</name>
<xref ref-type="aff" rid="aff008"><sup>8</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Kolves</surname>
<given-names>Kairi</given-names>
</name>
<xref ref-type="aff" rid="aff008"><sup>8</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>De Leo</surname>
<given-names>Diego</given-names>
</name>
<xref ref-type="aff" rid="aff008"><sup>8</sup>
</xref>
</contrib>
</contrib-group>
<aff id="aff001"><label>1</label>
<institution>Centre Hospitalier de Polynésie Française</institution>
,<addr-line>Tahiti, Polynésie Française</addr-line>
</aff>
<aff id="aff002"><label>2</label>
<institution>Centre de Prévention du Suicide de Polynésie Française</institution>
,<addr-line>Tahiti, Polynésie Française</addr-line>
</aff>
<aff id="aff003"><label>3</label>
<institution>Unité Inserm U699</institution>
,<addr-line>Paris, France</addr-line>
</aff>
<aff id="aff004"><label>4</label>
Centre des Nouvelles Etudes sur le Pacifique,<institution>Université de Nouvelle Calédonie</institution>
</aff>
<aff id="aff005"><label>5</label>
<institution>Université de Polynésie Française</institution>
,<addr-line>Polynésie Française</addr-line>
</aff>
<aff id="aff006"><label>6</label>
<institution>Direction de la Santé Publique de Polynésie française</institution>
,<addr-line>Tahiti, Polynésie Française</addr-line>
</aff>
<aff id="aff007"><label>7</label>
<institution>Centre Hospitalier Universitaire</institution>
,<addr-line>Martinique, France</addr-line>
</aff>
<aff id="aff008"><label>8</label>
Australian Institute for Suicide Research and Prevention,<institution>Griffith University</institution>
,<addr-line>Brisbane, Australia</addr-line>
</aff>
<author-notes><corresp id="cor1">Centre Hospitalier de Polynésie Française (CHPF), Département de Psychiatrie. BP 1640, 98713 Papeete, Tahiti, French Polynesia. <phone>+689.4048.4735</phone>
- <fax>+689.4048.4725</fax>
. <email>amadeo@mail.pf</email>
</corresp>
<fn fn-type="con"><p>Contributions: SA, data collecting and analyzing, references search, manuscript writing; MR, PF, AM, data collecting and intervention; LN data analyzing; LJ, reviewing and AM, KK, DDL, coordination of study, reviewing.</p>
</fn>
<fn fn-type="conflict"><p>Conflict of interest: the authors declare no potential conflict of interest.</p>
</fn>
<fn><p>Conference presentations: Short abstracts of this paper have been presented at the International Association for Suicide Prevention Regional Asia-Pacific conferences (Chennai, 4 december 2012 and Tahiti, 11 june 2014) and at the World Congress on Suicide (Montreal, 15 June 2013) and International Association for Suicide Prevention world conference (Oslo, 24 september 2013).</p>
</fn>
</author-notes>
<pub-date pub-type="epub"><day>09</day>
<month>10</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="collection"><day>30</day>
<month>9</month>
<year>2015</year>
</pub-date>
<volume>7</volume>
<issue>2</issue>
<elocation-id>5818</elocation-id>
<history><date date-type="received"><day>18</day>
<month>1</month>
<year>2015</year>
</date>
<date date-type="rev-recd"><day>10</day>
<month>4</month>
<year>2015</year>
</date>
<date date-type="accepted"><day>15</day>
<month>4</month>
<year>2015</year>
</date>
</history>
<permissions><copyright-statement>©Copyright S. Amadéo et al.</copyright-statement>
<copyright-year>2015</copyright-year>
<copyright-holder>Licensee PAGEPress, Italy</copyright-holder>
<license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by-nc/3.0/"><license-p>This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (<uri xlink:href="http://creativecommons.org/licenses/by-nc/3.0/">http://creativecommons.org/licenses/by-nc/3.0/</uri>
) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p>
</license>
</permissions>
<abstract><p>The World Health Organization <italic>Suicide trends in at-risk territories</italic>
study is a multi-site regional research program operating first in French Polynesia and countries of the Western Pacific, then extended to the world. The aims of the study were to establish a monitoring system for suicidal behaviors and to conduct a randomised control trial intervention for non-fatal suicidal behaviors. The latter part is the purpose of the present article. Over the period 2008-2010, 515 patients were admitted at the Emergency Department of the Centre Hospitalier de Polynésie Française for suicidal behavior. Those then hospitalized in the Psychiatry Emergency Unit were asked to be involved in the study and randomly allocated to either Treatment As Usual (TAU) or TAU plus Brief Intervention and Contact (BIC), which provides a psycho-education session and a follow-up of 9 phone contacts over an 18-months period. One hundred persons were assigned to TAU, while 100 participants were allocated to the BIC group. At the end of the follow-up there were no significant differences between the two groups in terms of number of presentations to the hospital for repeated suicidal behaviors. Although the study could not demonstrate the superiority of a treatment over the other, nevertheless – given its importance – the investigation captured public attention and was able to contribute to the awareness of the need of suicide prevention in French Polynesia. The BIC model of intervention seemed to particularly suit the geographical and health care context of the country.</p>
</abstract>
<kwd-group><title>Key words</title>
<kwd>Tahiti</kwd>
<kwd>suicide</kwd>
<kwd>prevention</kwd>
<kwd>randomized trial</kwd>
</kwd-group>
<funding-group><funding-statement>Funding: tthe study was funded by the <italic>French Polynesia Ministry of Health</italic>
and the <italic>Centre Hospitalier de Polynésie Française.</italic>
</funding-statement>
</funding-group>
<counts><fig-count count="1"></fig-count>
<table-count count="4"></table-count>
<equation-count count="0"></equation-count>
<ref-count count="33"></ref-count>
<page-count count="6"></page-count>
</counts>
</article-meta>
</front>
<floats-group><fig id="fig001" orientation="portrait" position="float"><label>Figure 1.</label>
<caption><p>Flowchart of suicide trends in at-risk territories study in French Polynesia.</p>
</caption>
<graphic xlink:href="mi-2015-2-5818-g001"></graphic>
</fig>
<table-wrap id="table001" orientation="portrait" position="float"><label>Table 1.</label>
<caption><p>Studies on continuity of care of suicide attempters or individuals at-risk of suicidal behavior.</p>
</caption>
<table frame="box" rules="all"><thead><tr><th align="left" valign="top" rowspan="1" colspan="1">Country</th>
<th align="left" valign="top" rowspan="1" colspan="1">Intervention in population having committed a suicide attempt</th>
<th align="left" valign="top" rowspan="1" colspan="1">Results</th>
</tr>
</thead>
<tbody><tr><td align="left" valign="top" rowspan="1" colspan="1">Australia<sup><xref rid="ref12" ref-type="bibr">12</xref>
</sup>
</td>
<td align="left" valign="top" rowspan="1" colspan="1">12 contacts (postal cards every month) after hospital discharge. Young aged 15-24</td>
<td align="left" valign="top" rowspan="1" colspan="1">RCT, n=778. SA ns; SA in intervention group 57/378, 15.1% (95%CI 11.5% to 18.7%) vs in control group 68/394, 17.3% (13.5% to 21.0%). However, in unadjusted analysis the number of repetitions was significantly reduced [IRR=0.55 (0.35 to 0.87)]</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1">Taiwan<sup><xref rid="ref16" ref-type="bibr">16</xref>
</sup>
</td>
<td align="left" valign="top" rowspan="1" colspan="1">6-12 contacts (phone calls during 3-6 month, 2/month). Frequency of contacts change following assessment of risk (BSRS, Pierce RS, SAD PERSONS S): high (psychiatrist), moderate (1-2 contacts/week), low (2 contacts/month), no risk (stop contacts)</td>
<td align="left" valign="top" rowspan="1" colspan="1">No RCT, n= 44,364 received aftercare (854 died by suicide) S<xref ref-type="fn" rid="tfn001">*</xref>
. Interventions decreased subsequent suicides for attempters (with initial willingness for aftercare OR=0.36, 95%CI 0.26-0.51; without initial willingness for aftercare: OR=0.78, 95%CI 0.62-0.97). In addition, aftercare was shown to prolong duration to eventual death.</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1">Spain<sup><xref rid="ref14" ref-type="bibr">14</xref>
</sup>
</td>
<td align="left" valign="top" rowspan="1" colspan="1">7 contacts (phone call at 1 week, 1, 3, 6, 9, 12 months) to assess risk and increase adherence to treatment</td>
<td align="left" valign="top" rowspan="1" colspan="1">RCT, n=991. SA<xref ref-type="fn" rid="tfn001">*</xref>
, Delayed SA<xref ref-type="fn" rid="tfn001">*</xref>
. Mean time in days to first reattempt=346.47 for intervention vs 316.46 in the control group.</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1">Iran<sup><xref rid="ref15" ref-type="bibr">15</xref>
</sup>
</td>
<td align="left" valign="top" rowspan="1" colspan="1">8-9 contacts (postal cards, 1, 2, 3, 4, 6, 8, 10, 12 months + birthday) to assess risk and increase adherence to treatment</td>
<td align="left" valign="top" rowspan="1" colspan="1">RCT, n=2300. SA<xref ref-type="fn" rid="tfn001">*</xref>
, SI<xref ref-type="fn" rid="tfn001">*</xref>
. Reeducation of SI (relative risk reduction (RRR)=0.31, 95%CI 0.22-0.38), SA (RRR=0.42, 95%CI 0.11-0.63) in the intervention group compared to control group.</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1">New Zealand<sup><xref rid="ref11" ref-type="bibr">11</xref>
</sup>
</td>
<td align="left" valign="top" rowspan="1" colspan="1">6 contacts (postal cards over 12 months) after hospital discharge</td>
<td align="left" valign="top" rowspan="1" colspan="1">RCT, n=327. SA ns. No significant differences between the control and intervention groups in the proportion of participants re-presenting with self-harm or in the total number of re-presentations for self-harm.</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1">Brazil, India, Sri Lanka, Iran, China<sup><xref rid="ref8" ref-type="bibr">8</xref>
,<xref rid="ref19" ref-type="bibr">19</xref>
</sup>
</td>
<td align="left" valign="top" rowspan="1" colspan="1">1 hour education session (epidemiology, risk and protecting factors, help solutions, human and phone resources) + 9 contacts (phone call or visit at 1, 2, 4, 7, 11 weeks/4, 6, 12, 18 months)</td>
<td align="left" valign="top" rowspan="1" colspan="1">RCT, n=1867. S<xref ref-type="fn" rid="tfn001">*</xref>
SA ns. Significant reeducation of suicides in the intervention group (BIC, 0.2% vs TAU, 2.2%, chi2=13.83, P<0.001). No change in SA - similar in the BIC and TAU groups (7.6% vs. 7.5%, chi2=0.013; P=0.909), but differences in rates across the five sites.</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1">France<sup><xref rid="ref17" ref-type="bibr">17</xref>
</sup>
</td>
<td align="left" valign="top" rowspan="1" colspan="1">3 contacts (phone call at 1, 3, 13 months) after hospital discharge</td>
<td align="left" valign="top" rowspan="1" colspan="1">RCT, n= 605. 1 mo. SA<xref ref-type="fn" rid="tfn001">*</xref>
3 mo. SA ns. The number of participants contacted at one month who reattempted suicide was significantly lower than that of controls [12% (13/107) vs 22% (62/280); chi2=4.7, df=1, P=0.03]. No differences in the follow-up at 3 months.</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1">Australia<sup><xref rid="ref13" ref-type="bibr">13</xref>
</sup>
</td>
<td align="left" valign="top" rowspan="1" colspan="1">8 contacts (postal cards at 1, 2, 3, 4, 6, 8, 10, 12 months) after hospital discharge</td>
<td align="left" valign="top" rowspan="1" colspan="1">RCT, n=772. SA<xref ref-type="fn" rid="tfn001">*</xref>
. Significant reduction in the rate of SA repetition, with incidence risk ratio of 0.49 (95%CI 0.33-0.73)</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1">Sweden<sup><xref rid="ref18" ref-type="bibr">18</xref>
</sup>
</td>
<td align="left" valign="top" rowspan="1" colspan="1">2 contacts (phone calls at 1, 5 months after 1st SA) + support to initiate or go on the treatment</td>
<td align="left" valign="top" rowspan="1" colspan="1">RCT, n=216. SA ns. Randomized groups did not differ in repetition of SA during follow-up or in improvement in GSI (SCL-90), GAF and SSI, but individuals with no initial treatment the intervention group improved more in certain psychological symptom dimensions (SCL-90).</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1">Italy<sup><xref rid="ref6" ref-type="bibr">6</xref>
,<xref rid="ref7" ref-type="bibr">7</xref>
</sup>
</td>
<td align="left" valign="top" rowspan="1" colspan="1">2 contacts / week for assessment of the needs and to provide emotional support in the elderly + Alarm system to call for help (t<italic>ele-help/tele-check</italic>
service)</td>
<td align="left" valign="top" rowspan="1" colspan="1">No RCT. S<xref ref-type="fn" rid="tfn001">*</xref>
. Short-term: Only one death by suicide in the elderly subjects connected to Tele-Help/Tele-Check vs expected number of 7.44 for the general population. Long-term: Significantly fewer suicide deaths (n=6) occurred among elderly service users [standardized mortality ratio (SMR) 28.8%] than expected (n=20.86; chi2=10.58, d.f.=1, P<0.001)</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1">USA9,10</td>
<td align="left" valign="top" rowspan="1" colspan="1">4 contacts (letters during 5 years) after hospital discharge and refusal to be treated. Follow-up up to 15 years after SA</td>
<td align="left" valign="top" rowspan="1" colspan="1">RCT, n=843. S<xref ref-type="fn" rid="tfn001">*</xref>
. Short term (3 years) and long term (5 and 15 years): Intervention group shows the lowest rate of suicide (P=0.04) in the first five years. Then, the difference with the control group diminishes and disappears after 14 years.</td>
</tr>
</tbody>
</table>
<table-wrap-foot><fn id="tfn001"><p>*Significant reduction; ns, non-significant; SA, suicide attempt; SI, suicidal ideation; S, Suicide; RCT: Randomised Control Trial.</p>
</fn>
</table-wrap-foot>
</table-wrap>
<table-wrap id="table002" orientation="portrait" position="float"><label>Table 2.</label>
<caption><p>Socio-demographic characteristics of subjects enrolled (n=190).</p>
</caption>
<table frame="box" rules="all"><thead><tr><th align="left" valign="top" rowspan="2" colspan="1">Characteristics</th>
<th align="center" valign="top" colspan="2" rowspan="1">TAU (n=100)</th>
<th align="center" valign="top" colspan="2" rowspan="1">BIC (n=90)</th>
<th align="center" valign="top" colspan="2" rowspan="1">P-value</th>
</tr>
<tr><th align="center" valign="top" rowspan="1" colspan="1">n</th>
<th align="center" valign="top" rowspan="1" colspan="1">%</th>
<th align="center" valign="top" rowspan="1" colspan="1">n</th>
<th align="center" valign="top" rowspan="1" colspan="1">%</th>
<th align="left" valign="top" rowspan="1" colspan="1"></th>
</tr>
</thead>
<tbody><tr><td align="left" valign="top" rowspan="1" colspan="1">Age (years)</td>
<td align="center" valign="top" rowspan="1" colspan="1">-</td>
<td align="center" valign="top" rowspan="1" colspan="1">31.48</td>
<td align="center" valign="top" rowspan="1" colspan="1">-</td>
<td align="center" valign="top" rowspan="1" colspan="1">33.00</td>
<td align="center" valign="top" rowspan="1" colspan="1"></td>
</tr>
<tr><td align="left" valign="top" colspan="6" rowspan="1">Sex</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1"> Male</td>
<td align="center" valign="top" rowspan="1" colspan="1">36</td>
<td align="center" valign="top" rowspan="1" colspan="1">36</td>
<td align="center" valign="top" rowspan="1" colspan="1">31</td>
<td align="center" valign="top" rowspan="1" colspan="1">34.4</td>
<td align="center" valign="top" rowspan="1" colspan="1">0.8</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1"> Female</td>
<td align="center" valign="top" rowspan="1" colspan="1">64</td>
<td align="center" valign="top" rowspan="1" colspan="1">64</td>
<td align="center" valign="top" rowspan="1" colspan="1">58</td>
<td align="center" valign="top" rowspan="1" colspan="1">64.4</td>
<td align="center" valign="top" rowspan="1" colspan="1">0.9</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1"> Transsexual</td>
<td align="center" valign="top" rowspan="1" colspan="1">0</td>
<td align="center" valign="top" rowspan="1" colspan="1">0</td>
<td align="center" valign="top" rowspan="1" colspan="1">1</td>
<td align="center" valign="top" rowspan="1" colspan="1">1.1</td>
<td align="center" valign="top" rowspan="1" colspan="1">0.5</td>
</tr>
<tr><td align="left" valign="top" colspan="6" rowspan="1">Marital status</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1"> Single</td>
<td align="center" valign="top" rowspan="1" colspan="1">32</td>
<td align="center" valign="top" rowspan="1" colspan="1">32</td>
<td align="center" valign="top" rowspan="1" colspan="1">25</td>
<td align="center" valign="top" rowspan="1" colspan="1">27.8</td>
<td align="center" valign="top" rowspan="1" colspan="1">0.5</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1"> Married</td>
<td align="center" valign="top" rowspan="1" colspan="1">53</td>
<td align="center" valign="top" rowspan="1" colspan="1">53</td>
<td align="center" valign="top" rowspan="1" colspan="1">58</td>
<td align="center" valign="top" rowspan="1" colspan="1">64.4</td>
<td align="center" valign="top" rowspan="1" colspan="1">0.1</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1"> Widowed</td>
<td align="center" valign="top" rowspan="1" colspan="1">1</td>
<td align="center" valign="top" rowspan="1" colspan="1">1</td>
<td align="center" valign="top" rowspan="1" colspan="1">1</td>
<td align="center" valign="top" rowspan="1" colspan="1">1.1</td>
<td align="center" valign="top" rowspan="1" colspan="1">1.0</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1"> Divorced</td>
<td align="center" valign="top" rowspan="1" colspan="1">12</td>
<td align="center" valign="top" rowspan="1" colspan="1">12</td>
<td align="center" valign="top" rowspan="1" colspan="1">5</td>
<td align="center" valign="top" rowspan="1" colspan="1">5.6</td>
<td align="center" valign="top" rowspan="1" colspan="1">0.1</td>
</tr>
<tr><td align="left" valign="top" colspan="6" rowspan="1">Education</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1"> None</td>
<td align="center" valign="top" rowspan="1" colspan="1">3</td>
<td align="center" valign="top" rowspan="1" colspan="1">3</td>
<td align="center" valign="top" rowspan="1" colspan="1">1</td>
<td align="center" valign="top" rowspan="1" colspan="1">1.1</td>
<td align="center" valign="top" rowspan="1" colspan="1">0.4</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1"> Primary</td>
<td align="center" valign="top" rowspan="1" colspan="1">6</td>
<td align="center" valign="top" rowspan="1" colspan="1">6</td>
<td align="center" valign="top" rowspan="1" colspan="1">9</td>
<td align="center" valign="top" rowspan="1" colspan="1">10</td>
<td align="center" valign="top" rowspan="1" colspan="1">0.3</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1"> Secondary</td>
<td align="center" valign="top" rowspan="1" colspan="1">57</td>
<td align="center" valign="top" rowspan="1" colspan="1">57</td>
<td align="center" valign="top" rowspan="1" colspan="1">38</td>
<td align="center" valign="top" rowspan="1" colspan="1">42.2</td>
<td align="center" valign="top" rowspan="1" colspan="1">0.04</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1"> Higher (non-university)</td>
<td align="center" valign="top" rowspan="1" colspan="1">10</td>
<td align="center" valign="top" rowspan="1" colspan="1">10</td>
<td align="center" valign="top" rowspan="1" colspan="1">9</td>
<td align="center" valign="top" rowspan="1" colspan="1">10</td>
<td align="center" valign="top" rowspan="1" colspan="1">1.0</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1"> University</td>
<td align="center" valign="top" rowspan="1" colspan="1">14</td>
<td align="center" valign="top" rowspan="1" colspan="1">14</td>
<td align="center" valign="top" rowspan="1" colspan="1">25</td>
<td align="center" valign="top" rowspan="1" colspan="1">27.8</td>
<td align="center" valign="top" rowspan="1" colspan="1">0.01</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1"> Other</td>
<td align="center" valign="top" rowspan="1" colspan="1">10</td>
<td align="center" valign="top" rowspan="1" colspan="1">10</td>
<td align="center" valign="top" rowspan="1" colspan="1">8</td>
<td align="center" valign="top" rowspan="1" colspan="1">8.9</td>
<td align="center" valign="top" rowspan="1" colspan="1">0.8</td>
</tr>
<tr><td align="left" valign="top" colspan="6" rowspan="1">Employment</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1"> Full/part-time</td>
<td align="center" valign="top" rowspan="1" colspan="1">50</td>
<td align="center" valign="top" rowspan="1" colspan="1">50</td>
<td align="center" valign="top" rowspan="1" colspan="1">44</td>
<td align="center" valign="top" rowspan="1" colspan="1">49.4</td>
<td align="center" valign="top" rowspan="1" colspan="1">0.9</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1"> Temporary</td>
<td align="center" valign="top" rowspan="1" colspan="1">6</td>
<td align="center" valign="top" rowspan="1" colspan="1">6</td>
<td align="center" valign="top" rowspan="1" colspan="1">9</td>
<td align="center" valign="top" rowspan="1" colspan="1">10.1</td>
<td align="center" valign="top" rowspan="1" colspan="1">0.3</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1"> Unemployed</td>
<td align="center" valign="top" rowspan="1" colspan="1">14</td>
<td align="center" valign="top" rowspan="1" colspan="1">14</td>
<td align="center" valign="top" rowspan="1" colspan="1">18</td>
<td align="center" valign="top" rowspan="1" colspan="1">20.2</td>
<td align="center" valign="top" rowspan="1" colspan="1">0.3</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1"> Disabled</td>
<td align="center" valign="top" rowspan="1" colspan="1">1</td>
<td align="center" valign="top" rowspan="1" colspan="1">1</td>
<td align="center" valign="top" rowspan="1" colspan="1">0</td>
<td align="center" valign="top" rowspan="1" colspan="1">0</td>
<td align="center" valign="top" rowspan="1" colspan="1">1.0</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1"> Retired</td>
<td align="center" valign="top" rowspan="1" colspan="1">3</td>
<td align="center" valign="top" rowspan="1" colspan="1">3</td>
<td align="center" valign="top" rowspan="1" colspan="1">1</td>
<td align="center" valign="top" rowspan="1" colspan="1">1.1</td>
<td align="center" valign="top" rowspan="1" colspan="1">0.4</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1"> Student</td>
<td align="center" valign="top" rowspan="1" colspan="1">10</td>
<td align="center" valign="top" rowspan="1" colspan="1">10</td>
<td align="center" valign="top" rowspan="1" colspan="1">9</td>
<td align="center" valign="top" rowspan="1" colspan="1">10</td>
<td align="center" valign="top" rowspan="1" colspan="1">1.0</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1"> Armed services</td>
<td align="center" valign="top" rowspan="1" colspan="1">2</td>
<td align="center" valign="top" rowspan="1" colspan="1">2</td>
<td align="center" valign="top" rowspan="1" colspan="1">0</td>
<td align="center" valign="top" rowspan="1" colspan="1">0</td>
<td align="center" valign="top" rowspan="1" colspan="1">0.2</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1"> Housekeeper</td>
<td align="center" valign="top" rowspan="1" colspan="1">6</td>
<td align="center" valign="top" rowspan="1" colspan="1">6</td>
<td align="center" valign="top" rowspan="1" colspan="1">4</td>
<td align="center" valign="top" rowspan="1" colspan="1">4.5</td>
<td align="center" valign="top" rowspan="1" colspan="1">0.6</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1"> Other</td>
<td align="center" valign="top" rowspan="1" colspan="1">5</td>
<td align="center" valign="top" rowspan="1" colspan="1">5</td>
<td align="center" valign="top" rowspan="1" colspan="1">5</td>
<td align="center" valign="top" rowspan="1" colspan="1">5</td>
<td align="center" valign="top" rowspan="1" colspan="1">0.9</td>
</tr>
<tr><td align="left" valign="top" colspan="6" rowspan="1">Consequences</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1"> None</td>
<td align="center" valign="top" rowspan="1" colspan="1">32</td>
<td align="center" valign="top" rowspan="1" colspan="1">32.3</td>
<td align="center" valign="top" rowspan="1" colspan="1">23</td>
<td align="center" valign="top" rowspan="1" colspan="1">25.6</td>
<td align="center" valign="top" rowspan="1" colspan="1">0.3</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1"> No danger to life</td>
<td align="center" valign="top" rowspan="1" colspan="1">41</td>
<td align="center" valign="top" rowspan="1" colspan="1">41.4</td>
<td align="center" valign="top" rowspan="1" colspan="1">46</td>
<td align="center" valign="top" rowspan="1" colspan="1">51.1</td>
<td align="center" valign="top" rowspan="1" colspan="1">0.2</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1"> Danger to life</td>
<td align="center" valign="top" rowspan="1" colspan="1">17</td>
<td align="center" valign="top" rowspan="1" colspan="1">17.2</td>
<td align="center" valign="top" rowspan="1" colspan="1">19</td>
<td align="center" valign="top" rowspan="1" colspan="1">21.1</td>
<td align="center" valign="top" rowspan="1" colspan="1">0.5</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1"> No information</td>
<td align="center" valign="top" rowspan="1" colspan="1">9</td>
<td align="center" valign="top" rowspan="1" colspan="1">9.1</td>
<td align="center" valign="top" rowspan="1" colspan="1">2</td>
<td align="center" valign="top" rowspan="1" colspan="1">2.2</td>
<td align="center" valign="top" rowspan="1" colspan="1">0.04</td>
</tr>
<tr><td align="left" valign="top" colspan="6" rowspan="1">Psychiatric disorder</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1"> Alcohol use disorder</td>
<td align="center" valign="top" rowspan="1" colspan="1">2</td>
<td align="center" valign="top" rowspan="1" colspan="1">2</td>
<td align="center" valign="top" rowspan="1" colspan="1">3</td>
<td align="center" valign="top" rowspan="1" colspan="1">3.3</td>
<td align="center" valign="top" rowspan="1" colspan="1">0.7</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1"> Cannabis use disorder</td>
<td align="center" valign="top" rowspan="1" colspan="1">1</td>
<td align="center" valign="top" rowspan="1" colspan="1">1</td>
<td align="center" valign="top" rowspan="1" colspan="1">1</td>
<td align="center" valign="top" rowspan="1" colspan="1">1.1</td>
<td align="center" valign="top" rowspan="1" colspan="1">1.0</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1"> Psychotic disorder</td>
<td align="center" valign="top" rowspan="1" colspan="1">7</td>
<td align="center" valign="top" rowspan="1" colspan="1">7</td>
<td align="center" valign="top" rowspan="1" colspan="1">3</td>
<td align="center" valign="top" rowspan="1" colspan="1">3.3</td>
<td align="center" valign="top" rowspan="1" colspan="1">0.3</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1"> Mood disorder</td>
<td align="center" valign="top" rowspan="1" colspan="1">50</td>
<td align="center" valign="top" rowspan="1" colspan="1">50</td>
<td align="center" valign="top" rowspan="1" colspan="1">47</td>
<td align="center" valign="top" rowspan="1" colspan="1">51.7</td>
<td align="center" valign="top" rowspan="1" colspan="1">0.8</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1"> Anxiety/adjustment disorder</td>
<td align="center" valign="top" rowspan="1" colspan="1">17</td>
<td align="center" valign="top" rowspan="1" colspan="1">17</td>
<td align="center" valign="top" rowspan="1" colspan="1">16</td>
<td align="center" valign="top" rowspan="1" colspan="1">17.6</td>
<td align="center" valign="top" rowspan="1" colspan="1">0.9</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1"> Personality disorder</td>
<td align="center" valign="top" rowspan="1" colspan="1">2</td>
<td align="center" valign="top" rowspan="1" colspan="1">2</td>
<td align="center" valign="top" rowspan="1" colspan="1">2</td>
<td align="center" valign="top" rowspan="1" colspan="1">2.2</td>
<td align="center" valign="top" rowspan="1" colspan="1">1.0</td>
</tr>
</tbody>
</table>
<table-wrap-foot><fn><p>TAU, Treatment As Usual; BIC, Brief Intervention and Contact.</p>
</fn>
</table-wrap-foot>
</table-wrap>
<table-wrap id="table003" orientation="portrait" position="float"><label>Table 3.</label>
<caption><p>Results of Brief Intervention and Contact after 18 months follow-up in French Polynesia (n=190).</p>
</caption>
<table frame="box" rules="all"><thead><tr><th align="left" valign="top" rowspan="2" colspan="1">Characteristics</th>
<th align="center" valign="top" colspan="2" rowspan="1">TAU (n=100)</th>
<th align="center" valign="top" colspan="2" rowspan="1">BIC (n=90)</th>
<th align="center" valign="top" rowspan="2" colspan="1">Test</th>
<th align="center" valign="top" rowspan="2" colspan="1">P-value</th>
</tr>
<tr><th align="center" valign="top" rowspan="1" colspan="1">n</th>
<th align="center" valign="top" rowspan="1" colspan="1">%</th>
<th align="center" valign="top" rowspan="1" colspan="1">n</th>
<th align="center" valign="top" rowspan="1" colspan="1">%</th>
</tr>
</thead>
<tbody><tr><td align="left" valign="top" rowspan="1" colspan="1">New episodes of non-fatal Suicidal behavior</td>
<td align="center" valign="top" rowspan="1" colspan="1">21</td>
<td align="center" valign="top" rowspan="1" colspan="1">21.0</td>
<td align="center" valign="top" rowspan="1" colspan="1">24</td>
<td align="center" valign="top" rowspan="1" colspan="1">26.7</td>
<td align="center" valign="top" rowspan="1" colspan="1">Chi² = 0.84</td>
<td align="center" valign="top" rowspan="1" colspan="1">0.360</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1">Suicide</td>
<td align="center" valign="top" rowspan="1" colspan="1">2</td>
<td align="center" valign="top" rowspan="1" colspan="1">2.0</td>
<td align="center" valign="top" rowspan="1" colspan="1">0</td>
<td align="center" valign="top" rowspan="1" colspan="1">0</td>
<td align="center" valign="top" rowspan="1" colspan="1">Fisher’s exact</td>
<td align="center" valign="top" rowspan="1" colspan="1">0.500</td>
</tr>
</tbody>
</table>
</table-wrap>
<table-wrap id="table004" orientation="portrait" position="float"><label>Table 4.</label>
<caption><p>Suicide repeated NFSB in different subgroups of Brief Intervention and Contact after 18 months follow-up in French Polynesia.</p>
</caption>
<table frame="box" rules="all"><thead><tr><th align="left" valign="top" rowspan="2" colspan="1"></th>
<th align="center" valign="top" colspan="2" rowspan="1">TAU</th>
<th align="center" valign="top" colspan="2" rowspan="1">BIC</th>
<th align="center" valign="top" rowspan="2" colspan="1">Test</th>
<th align="center" valign="top" rowspan="2" colspan="1">P-value</th>
</tr>
<tr><th align="center" valign="top" rowspan="1" colspan="1">n/N<xref ref-type="fn" rid="tfn002">*</xref>
</th>
<th align="center" valign="top" rowspan="1" colspan="1">%</th>
<th align="center" valign="top" rowspan="1" colspan="1">n/N<xref ref-type="fn" rid="tfn002">*</xref>
</th>
<th align="center" valign="top" rowspan="1" colspan="1">%</th>
</tr>
</thead>
<tbody><tr><td align="left" valign="top" rowspan="1" colspan="1">Personality disorders (primary and secondary dg)</td>
<td align="center" valign="top" rowspan="1" colspan="1">3/12</td>
<td align="center" valign="top" rowspan="1" colspan="1">25.0</td>
<td align="center" valign="top" rowspan="1" colspan="1">5/11</td>
<td align="center" valign="top" rowspan="1" colspan="1">45.5</td>
<td align="center" valign="top" rowspan="1" colspan="1">Fisher exact</td>
<td align="center" valign="top" rowspan="1" colspan="1">0.400</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1">History of sexual abuse</td>
<td align="center" valign="top" rowspan="1" colspan="1">9/21</td>
<td align="center" valign="top" rowspan="1" colspan="1">42.8</td>
<td align="center" valign="top" rowspan="1" colspan="1">5/15</td>
<td align="center" valign="top" rowspan="1" colspan="1">33.3</td>
<td align="center" valign="top" rowspan="1" colspan="1">Chi<sup>2</sup>
=0.33</td>
<td align="center" valign="top" rowspan="1" colspan="1">0.563</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1">Past history of suicide attempt</td>
<td align="center" valign="top" rowspan="1" colspan="1">>37/14</td>
<td align="center" valign="top" rowspan="1" colspan="1">50.0</td>
<td align="center" valign="top" rowspan="1" colspan="1">9/17</td>
<td align="center" valign="top" rowspan="1" colspan="1">52.9</td>
<td align="center" valign="top" rowspan="1" colspan="1">Chi<sup>2</sup>
=0.03</td>
<td align="center" valign="top" rowspan="1" colspan="1">0.870</td>
</tr>
</tbody>
</table>
<table-wrap-foot><fn><p>TAU, Treatment As Usual; BIC, Brief Intervention and Contact.</p>
</fn>
<fn id="tfn002"><p>*N, persons with the condition; n, persons with the condition repeatsing NFSB during follow-up.</p>
</fn>
</table-wrap-foot>
</table-wrap>
</floats-group>
</pmc>
</record>
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