DOI: 10.5061/dryad.85nf3
title: Data from: A novel brief therapy for patients who attempt suicide: a 24-months follow-up randomized controlled study of the Attempted Suicide Short Intervention Program (ASSIP)

description: Background: Attempted suicide is the main risk factor for repeated
 suicidal behavior. However, the evidence for follow-up treatments of these
 patients is limited. The objective of the present study was to evaluate
 the efficacy of ASSIP (Attempted Suicide Short Intervention Program) in
 reducing suicidal behavior. ASSIP is a novel brief therapy based on a
 patient-centered model of suicidal behavior, with an emphasis on early
 therapeutic alliance. Methods and Findings: Patients who had recently
 attempted suicide were randomly allocated to treatment as usual (N=60) or
 treatment as usual plus ASSIP (N=60). ASSIP participants received three
 therapy sessions followed by regular contact through personalized letters
 over 24 months. Participants considered to be at high risk of suicide were
 included, 63% were diagnosed with an affective disorder, and 50% had a
 history of prior suicide attempts. Clinical exclusion criteria were
 habitual self-harm, serious cognitive impairment, and psychotic disorder.
 Study participants completed a set of psychosocial and clinical
 questionnaires every 6 months over a 24-months follow-up period. The study
 represents a real-world clinical setting at an outpatient clinic of an
 university hospital of psychiatry. Primary outcome measure was repeat
 suicide attempts during the 24-months follow-up period. Secondary outcome
 measures were suicidal ideation and healthcare utilization. Furthermore,
 effects of prior suicide attempts, depression at baseline, diagnosis, and
 therapeutic alliance on outcome were investigated. During the 24-months
 follow-up period, 5 repeat attempts were recorded in the ASSIP group and
 41 attempts in the control group. The rates of participants reattempting
 suicide at least once were 8.3% (n=5) and 26.7% (n=16). ASSIP was
 associated with an approximately 80% reduced risk of repeat episodes (Wald
 ?21=13.1; 95% CI 12.4-13.7; p=.0004). ASSIP participants spent 72% fewer
 days in hospital during follow-up (ASSIP: 29 days; control group: 105
 days; W=94.5, p=.038). Higher scores of patient-rated therapeutic alliance
 in this group were associated with a lower rate of repeat suicide
 attempts. Prior suicide attempts, depression, and a diagnosis of
 personality disorder at baseline did not significantly affect outcome.
 Participants with a diagnosis of borderline personality disorder (n=20)
 had more previous suicide attempts and a higher number of reattempts. Key
 study limitations were missing data and dropout rates. Although both were
 generally low they increased during follow-up. At 24 months the group
 difference between the dropout rates was significant: ASSIP: 7% (n=4),
 control: 22% (n=13). A further limitation is that we do not have detailed
 information of the co-active follow-up treatment apart from the 6-monthly
 self-reports on the setting and the duration of treatment as usual.
 Conclusions: ASSIP, a manual-based brief therapy for patients who had
 recently attempted suicide, administered in addition to the usual clinical
 treatment, was efficacious in reducing suicidal behavior in a real-world
 clinical setting. ASSIP fulfills the need for an easy to administer
 low-cost intervention. Large pragmatic trials will be needed to
 conclusively establish the efficacy of ASSIP and replicate our findings in
 other clinical settings. ClinicalTrials.gov Identifier: NCT02505373
description: ASSIP Data
 fileData file from the ASSIP
 24-months follow-up randomized controlled study.assip.RDataAnalysis script for ASSIPWe provide a short analysis script (survival.R) to replicate the main findings of our study using the original data (assip.RData).survival.R