Effect of assertive case management intervention on suicide attempters with comorbid Axis I and II psychiatric diagnoses: secondary analysis of a randomised controlled trial.

• Material Type: 博士論文
• Title: Effect of assertive case management intervention on suicide attempters with comorbid Axis I and II psychiatric diagnoses: secondary analysis of a randomised controlled trial.
• Author/Editor: Norimoto, Kazunobu; Ikeshita, Katsumi; Kishimoto, Toshifumi; Okuchi, Kazuo; Yonemoto, Naohiro; Sugimoto, Tatsuya; Chida, Fuminori; Shimoda, Shigero; Hirayasu, Yoshio; Kawanishi, Chiaki
• Author Heading: Norimoto, Kazunobu; Ikeshita, Katsumi; Kishimoto, Toshifumi; Okuchi, Kazuo; Yonemoto, Naohiro; Sugimoto, Tatsuya; Chida, Fuminori; Shimoda, Shigero; Hirayasu, Yoshio; Kawanishi, Chiaki
• Publication, Distribution, etc.: BioMed Central
• Publication Date: 2020-06-16
• Publication Date (W3CDTF): 2020-06-16
• Alternative Title: I軸とII軸を並存する自殺企図患者に対するアサーティブケースマネージメントによる介入の効果：無作為化比較試験の二次解析
• Periodical title: BMC psychiatry
• No. or year of volume/issue: 20 1
• Volume: 20
• Issue: 1
• Pages: Article No.311-
• ISSN (Periodical Title): ISSN : 1471-244X
• Degree grantor/type: 奈良県立医科大学
• Date Granted: 2021-03-15
• Dissertation Number: 乙第1503号
• Degree Type: 博士（医学）
• Text Language Code: eng
• Subject Heading: Suicide; Suicide attempt; Assertive case management intervention; Comorbidity; Axis I; Axis II
• Target Audience: 一般
• Note (General): type:Thesis; Background: Most suicide attempters suffer from psychiatric disorders, which are often comorbid with personality disorders. The effects of intervention on patients who have attempted suicide with comorbid Axis I and II diagnoses have not been fully elucidated. We evaluated whether assertive case management can reduce the repetition of suicidal behaviours in patients who had attempted suicide with comorbid Axis I and II diagnoses. Methods: This study was a secondary analysis of a randomised controlled trial investigating whether assertive case management could reduce the repetition of suicide attempts, compared with enhanced usual care. Subjects were divided into those who had comorbid Axis I and II diagnoses (Axis I + II group), and those who had an Axis I diagnosis without Axis II comorbidity (Axis I group). Outcome measures were compared between patients receiving a case management intervention and patients receiving enhanced usual care, as allocated. The primary outcome measure was the incidence proportion of the first episode of recurrent suicidal behaviour at 6 months after randomisation. We calculated risk ratios (RR) with 95% confidence intervals (CI) at 6 months and 12 months after randomisation of patients in the Axis I and Axis I + II groups. Results: Of 914 enrolled patients, 120 (13.1%) were in the Axis I + II group, and 794 (86.9%) were in the Axis I group. Assertive case management was significantly effective for the Axis I group on the primary outcome at 6 months (risk ratio [RR] 0.51, 95% confidence intervals [CI] 0.31 to 0.84). The RR of the Axis I + II group was 0.44 (95% CI 0.14 to 1.40). Conclusions: Assertive case management not only had an effect on patients who had attempted suicide with only Axis I disorders but may also have a similar effect on patients with comorbid Axis I and II disorders.; 博士（医学）・乙第1503号・令和3年3月15日; © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.; identifier:BMC psychiatry Vol.20 No.1 Article No.311 (2020 Jun); identifier:1471244X; identifier:http://ginmu.naramed-u.ac.jp/dspace/handle/10564/3929; identifier:BMC psychiatry, 20(1): Article No.311
• Access Restrictions: インターネット公開
• Related Material (DOI): 10.1186/s12888-020-02723-9
• Data Provider (Database): 国立情報学研究所 : 学術機関リポジトリデータベース（IRDB）（機関リポジトリ）; https://irdb.nii.ac.jp
• Original Data Provider (Database): 奈良県立医科大学 : 奈良県立医科大学機関リポジトリ GINMU

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