Please select the eligibility criteria that correspond to the clinical trial below.
Title: AID-trial:A Randomized Clinical Trial Comparing the Effect on Repeated Self-harm of Assertive Intervention and Standard Treatment After Deliberate Self-harm
Brief Summary: Background

Previous suicide attempts is a high-risk factor with a repetition rate between 12-30 percent. Compliance with after treatment is often poor. A systematic review by Hawton, 1999 states a lack of evidence on psychosocial interventions due to selections bias or statistical power.

Objective

The aim is to investigate if assertive outreach, incorporating hands-on guidance and motivational support of compliance with follow-up treatment after suicide attempts is able to reduce the frequency of non-fatal and fatal suicide acts in a one-year follow-up period.

Method and Design

A randomized, controlled intervention trial in a prospective design. The patients included will be randomized to either standard treatment (n = 120) or intervention treatment (N = 120), representing 6 - 8 assertive outreach contacts with a research nurse after suicide attempts or deliberate self-harm. The outreach contacts are thought of as supporting and guiding home visits towards compliance with after care or follow-up treatment Inclusion criteria Males and females, aged 12 years or older with a recent suicide attempt or act of deliberate self-harm, living independently and not diagnosed with severe mental illness (psychosis, severe dementia)

Outcome

The primary outcome measure is repeated fatal suicidal act (fatal or non fatal)assessed by the Danish Cause of Death Register and the rate of repeated suicide attempts/deliberate self-harm registered in the medical records by the collaborating wards and units in their routine procedure of treating people applying for help in relation to suicidal behavior.


Options:
A: Inclusion Criteria:

* Attempted suicide
* At least 12 years old

Exclusion Criteria:

* Psychotic disorder
* Severe dementia
* Institutionalised or hospitalised for more than 2 weeks at psychiatric department
B: Inclusion Criteria:

* Meets New Jersey definition of severe mental illness (SMI), which includes a DSM-IV diagnosis of an SMI; within the 3 to 6 months prior to study entry, functional limitations in major life activities that would be appropriate for the client's developmental stage; and within 2 years prior to study entry, two or more treatment episodes of greater intensity than outpatient services (such as inpatient, emergency, or partial hospitalization care, or a single episode lasting 3 months or more) OR a normal living situation disrupted to the point that supportive services were required to maintain the patient in their home or residence, or law enforcement officials were required to intervene
* DSM-IV Axis I diagnosis of schizophrenia, schizoaffective disorder, bipolar disorder, or major depression (as determined by Structured Clinical Interview)
* Diagnosis of current severe PTSD at baseline assessment (as determined by a score greater than 65 on a Clinician Administered PTSD Scale)
* Speaks English

Exclusion Criteria:

* Current diagnosis of alcohol or drug dependence
* Hospitalization or suicide attempt in the past 2 months
C: Inclusion Criteria:

* Age 18-65 years old
* At least 5 pounds weight suppression
* Engaged in non-suicidal self-injury at least once in past month

Exclusion Criteria:

* Indicated being "sure" of suicide attempt on eligibility screener
* Live outside of the United States
* Currently pregnant
D: Inclusion Criteria:

* Age 16 - 25 years old
* Have adequate English language ability to permit the assessment and experimental measures to be completed and use of the smartphone app
* Presented with at least 2 episodes of self-harm (defined in 2.2) over the last three months
* Willing to receive support to reduce / improve management of self-harm urges and behaviour in person, over the phone and via Android smartphone app (own or made available by researchers\*)
* Willing to have letters sent/phone calls made to their General Practitioner (GP) and other relevant clinicians
* Can commit to attending 2 consecutive weekly sessions, and 5 fortnightly phone follow-up sessions, and assessments over follow up period as required by the study
* Resident within geographical areas covered by the Cambridgeshire and Peterborough NHS Foundation trust (CPFT)
* Able to give consent

Exclusion Criteria:

* Experiencing current severe psychopathology that is of impediment to completing the study requirements, e.g. active psychotic symptoms (clinicians assessment)
* Currently treated under the care of the CPFT Personality Disorders Pathway
* Currently under the care of the CPFT Crisis Resolution and Home Treatment Team or under inpatient care
* Learning difficulties, organic brain disease, severe neurological impairment
* Current severe substance or alcohol abuse (clinicians assessment)
* Presence of active suicidal risk on the Mini International Neuropsychiatric Interview (MINI) confirmed by convergent clinical opinion (see risk assessment protocol, Appendix 1)
* Unwilling to engage actively in the Functional Imagery Training (FIT) intervention or to use an imagery-focused approach for treatment
* Unwilling to use a smartphone app
* Taking part in concurrent treatment studies investigating pharmacological or psychological treatment for self-harm

Answer: A