Suicide Clinical Trial
Official title:
Brief Admission by Self-referral for Individuals With Self-harm: Effects on Compulsory Care
Brief Admission by self-referral (BA) is a standardized treatment model, providing patient-controlled and person-centered care. It was developed to reduce self-harm and compulsory care by promoting autonomy. Randomized clinical trials have not yielded significant between group differences with respect to inpatient care, including compulsory care. The major difficulty in evaluating BA is preventing the control group from cross-contamination, as in the implementation process of BA, all physicians, all inpatient and outpatient staff as well as managers need to be informed and undergo basic education regarding the intervention. As BA addresses a prevalent and frustrating issue in psychiatric health care, there is considerable risk that the approach leaks to the control group, reducing the possibility to detect between-group differences. In the current study this will be addressed through a register-based approach, comparing similar clinics, implementing BA at different timepoints over time. Individuals with traits of borderline personality disorder will be included and comparisons will be made with respect to compulsory care, voluntary inpatient care and mortality.
Status | Recruiting |
Enrollment | 7000 |
Est. completion date | September 14, 2025 |
Est. primary completion date | September 14, 2025 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years to 65 Years |
Eligibility | Inclusion Criteria: - Living in the uptake area of Lund, Linköping, Helsingborg or Norrköping - Age 18-65 years at the time of inclusion - Admitted to hospital either diagnosed with ICD-10 diagnosis BPD F60.3, or admitted at least twice with Intentional self-harm X60-83 in combination with one of more of the following diagnoses ADHD (F90.0-F90.X), Bipolar disorder type 2, (F31.8W, F318A-F, F31.0, F31.8-9, F31.8W) or Autism, Atypical autism, Aspergers syndrome (F84.0, F84.1, F84.5) or Mild intellectual disability (F70.0-F70.9). Exclusion Criteria: - not fulfilling inclusion criteria |
Country | Name | City | State |
---|---|---|---|
Sweden | Region Östergötland | Linköping | |
Sweden | Division of Psychiatry, Region Skåne | Lund | Skåne |
Sweden | Statistiska centralbyrån | Solna | |
Sweden | Socialstyrelsen | Stockholm |
Lead Sponsor | Collaborator |
---|---|
Region Skane | Linkoeping University, Lund University |
Sweden,
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Liljedahl SI, Helleman M, Daukantaite D, Westrin A, Westling S. A standardized crisis management model for self-harming and suicidal individuals with three or more diagnostic criteria of borderline personality disorder: The Brief Admission Skane randomized controlled trial protocol (BASRCT). BMC Psychiatry. 2017 Jun 15;17(1):220. doi: 10.1186/s12888-017-1371-6. — View Citation
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Westling S, Daukantaite D, Liljedahl SI, Oh Y, Westrin A, Flyckt L, Helleman M. Effect of Brief Admission to Hospital by Self-referral for Individuals Who Self-harm and Are at Risk of Suicide: A Randomized Clinical Trial. JAMA Netw Open. 2019 Jun 5;2(6):e195463. doi: 10.1001/jamanetworkopen.2019.5463. Erratum In: JAMA Netw Open. 2019 Oct 2;2(10):e1913724. — View Citation
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Other | Gender distribution | Differences in distribution of diagnoses between men and women | 2010-09-15 - 2025-09-14 | |
Other | Number of admissions with Brief admission by self-referral (BA) | Number of BA admissions (admissions/year) | 2010-09-15 - 2025-09-14 | |
Other | Compulsory admission - median length | Compulsory admission - median length (days/admission) | 2010-09-15 - 2025-09-14 | |
Other | Voluntary psychiatric admissions - median length | Voluntary psychiatric admissions - median length (days/admission) | 2010-09-15 - 2025-09-14 | |
Other | Number of voluntary psychiatric admissions | Number of voluntary psychiatric admissions (admissions/year) | 2010-09-15 - 2025-09-14 | |
Primary | Days with compulsory admission | Days with compulsory admission (days/year) | 2010-09-15 - 2025-09-14 | |
Secondary | Days with voluntary psychiatric admission | Days with voluntary psychiatric admission (days/year) | 2010-09-15 - 2025-09-14 | |
Secondary | Duration of free intervals between admissions | Duration of free intervals between admissions (days) | 2010-09-15 - 2025-09-14 | |
Secondary | Mortality | All cause mortality as well as death by suicide specifically (X60-X84 and Y10-Y34 in ICD10) | 2010-09-15 - 2025-09-14 | |
Secondary | Number of compulsory admissions | Number of compulsory admissions (admissions/year) | 2010-09-15 - 2025-09-14 | |
Secondary | Number of voluntary psychiatric admissions (admissions/year) | Number of voluntary psychiatric admissions | 2010-09-15 - 2025-09-14 | |
Secondary | Number of compulsory acts/year | Number of compulsory acts/year | 2010-09-15 - 2025-09-14 |
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