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General Hospital Admission in the Management of Parasuicide

A Randomised Controlled Trial

Published online by Cambridge University Press:  02 January 2018

John Waterhouse*
Affiliation:
Institute of Research in Social Sciences, University of York, Crichton Royal Hospital, Dumfries DG1 4TG
Stephen Platt
Affiliation:
MRC Unit for Epidemiological Studies in Psychiatry, Royal Edinburgh Hospital, Morningside Park, Edinburgh EH10 5HF
*
Correspondence

Abstract

Suitably trained junior doctors selected parasuicides with no immediate medical or psychiatric treatment needs on initial assessment in a casualty department. This group was then randomly allocated to hospital admission (38 cases) or discharge home (39 cases). One week later there were no significant differences between groups on diverse outcome measures, including repetition rate, psychological symptoms, and social functioning. A second follow-up using the same measures at 16 weeks also failed to demonstrate any differences between groups, both of which showed considerable overall improvement. A parasuicide management policy consisting of assessment in a casualty department and selective discharge was appropriate for 15% of a hospital-referred population. This lends support to recent government recommendations, but caution should be exercised before such a result is generalised.

Type
Research Article
Copyright
Copyright © Royal College of Psychiatrists, 1990

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