The Epidemiology of Suicide Attempts and Suicidal Thoughts in Flanders

Обзор

The objective of this study is to collect data in Flanders on the incidence of suicide attempts and suicidal ideation across various healthcare settings. The study also aims to assess the proportion of individuals who receive adequate aftercare following a suicide attempt and to systematically document the methods and means used in suicidal behavior.

Подробное описание

This study involves the registration of the frequency and characteristics of suicidal thoughts and suicide attempts among individuals presenting to healthcare services (including general hospitals, psychiatric hospitals, mobile crisis teams, and general practitioners). Participants will be evaluated using a semi-structured interview: the Guideline for Suicide Care and Evaluation (LOES).

The primary objective is to collect detailed data on individuals with suicidal behavior-including suicidal ideation and suicide attempts-using the LOES instrument. This approach allows for the collection of comprehensive information about suicidal individuals in Flanders and the suicidal processes affecting them.

The LOES comprises two components:

1. Basic Assessment The initial assessment occurs shortly after the individual presents at a healthcare institution. During this interview, an emergency nurse, physician, psychologist, or psychiatrist evaluates the individual's cognitive functioning, judgment, emotional state, observable behavior, potential mental health disorders, history of self-harm or suicidal behavior, social support, level of hopelessness, and willingness to engage in follow-up care. Sociodemographic data and details about the current and any previous suicide attempts are also recorded.

The goals of this assessment are: * To ensure the individual feels heard and taken seriously. * To determine the appropriate timing for a more comprehensive risk assessment based on the initial findings. 2. Further Exploration of Suicidality This second phase is conducted by a nurse, psychologist, or psychiatrist. It includes a more in-depth evaluation of the individual's risk factors and treatment needs. Standardized questions cover topics such as suicidal intent, suicidal ideation and concrete planning, motivations for self-harm or suicidal thoughts, ambivalence, experienced life problems, psychiatric history, potential substance use, coping strategies, and care needs of both the individual and their immediate environment.

Based on the data collected through the LOES, a structured and well-supported risk formulation can be established.

Вмешательства

• Другое Semi-structured interview (Guideline for Suicide care and Evaluation =LOES)
  A semi-structured interview is utilized in general hospitals and other healthcare institutions by clinicians and nurses as part of the psychosocial assessment, with the aim of collecting standardized data on episodes of self-harm and individuals experiencing suicidal ideation. The interview consists of two parts: Part 1 is administered shortly after admission to the healthcare facility due to an episode of self-harm or reported suicidal thoughts. It is conducted by a trained nurse or psycholog

Первичные конечные точки

• Baseline Demographic and Socioeconomic Characteristics [Срок оценки: Day 1]
• Baseline Demographic, Socioeconomic and Clinical Admission Characteristics [Срок оценки: Day 1]
• Method of Suicide Attempt Classified by ICD-10 Category [Срок оценки: Day 1]
• Assessment of Current Emotional State (Open-Ended Response) [Срок оценки: Day 1]
• Suicidal Ideation Attributes (Modified SIDAS) [Срок оценки: Day 1]
• Assessment of Suicidal Planning and Intent (Mixed-Methods Interview) [Срок оценки: Day 1]
• History of Suicidal Behavior and Post-Attempt Treatment (Structured Interview) [Срок оценки: Day 1]
• History and Recency of Self-Harming Behavior (Structured Interview) [Срок оценки: Day 1]
• Perceived Social Support and Help-Seeking Behavior (Semi-Structured Interview) [Срок оценки: Day 1]
• Participant's Experience of Hopelessness (Open-Ended Response) [Срок оценки: Day 1]

Критерии участия

Критерии включения

• Everyone who is admitted alive to the emergency department after a suicide attempt is included. All methods used during the suicide attempt are included. Regarding the method of suicide attempts, a distinction is made between self-injury (hanging, strangulation, drowning, stab and cut wounds, jumping from a height, etc.) and self-poisoning (ingestion of (psycho)pharmaceuticals, drugs, alcohol, chemicals, or other harmful substances).
• Everyone who is admitted with suicidal thoughts

Критерии исключения

• Accidental overdose, e.g., someone taking medication for a medical condition without any intent to harm themselves
• Alcohol intoxication without any intent to harm oneself
• Accidental overdose involving party drugs
• Individuals who were deceased upon arrival at the hospital due to suicide

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Нет

Дизайн исследования

Модель наблюдения

Только случаи

Центры проведения

Бельгия · 33 центра

• Azorg — Aalst
• Ziekenhuis aan de Stroom (UKJA) — Antwerp
• Universitair ziekenhuis Antwerpen — Antwerp
• Psychiatrisch ziekenhuis Bilzen-Hoeselt — Bilzen
• Imeldaziekenhuis — Bonheiden
• AZ Klina — Brasschaat
• AZ sint Jan — Bruges
• AZ sint Lucas — Bruges
• … и ещё 25 центров

Публикации

• Vancayseele N, Portzky G, van Heeringen K. Increase in Self-Injury as a Method of Self-Harm in Ghent, Belgium: 1987-2013. PLoS One. 2016 Jun 1;11(6):e0156711. doi: 10.1371/journal.pone.0156711. eCollection 2016. PMID 27249421
• de Beurs D, Vancayseele N, van Borkulo C, Portzky G, van Heeringen K. The association between motives, perceived problems and current thoughts of self-harm following an episode of self-harm. A network analysis. J Affect Disord. 2018 Nov;240:262-270. doi: 10.1016/j.jad.2018.07.047. Epub 2018 Jul 27. PMID 30086470
• Vancayseele N, Rotsaert I, Portzky G, van Heeringen K. Medication used in intentional drug overdose in Flanders 2008-2013. PLoS One. 2019 May 2;14(5):e0216317. doi: 10.1371/journal.pone.0216317. eCollection 2019. PMID 31048918

Идентификаторы

NCT: NCT07021404 · BC-03869

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

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