Postcards in Persia: A Twelve to Twenty-four Month Follow-up of a Randomized Controlled Trial for Hospital-Treated Deliberate Self-Poisoning

Abstract

This study reports the outcomes, during follow-up, of a low-cost postcard intervention in a Randomized Control Trial of hospital-treated self-poisoning (n = 2300). The intervention was 9 postcards over 12 months (plus usual treatment) versus usual treatment. Three binary endpoints at 12–24 months (n = 2001) were: any suicidal ideation, suicide attempt, or self-cutting. There was a significant reduction in any suicidal ideation (RRR 0.20 CI 95% 0.13–0.27), (NNT 8, 6–13), and any suicide attempt (RRR 0.31, 0.06–0.50), (NNT 35, 19–195), in this non-western population. However, there was no effect on self-cutting (RRR -0.01, -1.05–0.51). Sustained, brief contact by mail may reduce some forms of suicidal behavior in self-poisoning patients during the post intervention phase.

Keywords:

• deliberate self-harm
• follow-up studies
• poisoning
• postcards
• reminder systems
• suicide

Additional information

Notes on contributors

Hossein Hassanian-Moghaddam

Hossein Hassanian-Moghaddam, Toxicological Research Center, Loghman-Hakim Hospital, Department of Clinical Toxicology, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Saeedeh Sarjami

Saeedeh Sarjami, Child and Adolescent Psychiatrist, Private Clinic, Tehran, Iran

Ali-Asghar Kolahi

Ali-Asghar Kolahi, Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Terry Lewin

Terry Lewin, Centre for Translational Neuroscience and Mental Health, University of Newcastle, Australia.

Gregory Carter

Gregory L. Carter, Centre for Translational Neuroscience and Mental Health, University of Newcastle, Australia.