Carlos Filinto da Silva Cais

Factors associated with repeated suicide attempts. Preliminary results of the WHO Multisite Intervention Study on Suicidal Behavior (SUPRE-MISS) from Campinas, Brazil.

BACKGROUND This study compares sociodemographic and clinical characteristics of 102 first-time hospital-treated suicide attempters (first-evers) with a group of 101 repeat suicide attempters (repeaters) consecutively admitted to a general hospital in Brazil, during the intake phase of the WHO Multisite Intervention Study on Suicidal Behaviors (SUPRE-MISS). AIMS To compare sociodemographic and clinical characteristics of first-time hospital-treated suicide attempters (first-evers) with a group of repeat suicide attempters (repeaters). METHODS A standardized interview and psychometric scales were administered to all patients. RESULTS Repetition was associated with being of female sex (OR = 2.7; 95% confidence interval (CI) = 1.2-6.2), a housewife (OR = 3.8; 95% CI = 1.2-11.8), and having a score above median on the Beck Depression Inventory (OR = 5.2; 95% CI = 1.7-15.6). CONCLUSIONS The findings suggest that repeaters, namely, depressed housewives who have attempted suicide previously, need specific treatment strategies in order to avoid future suicide attempts.

Suicide prevention training for professionals in the public health network in a large Brazilian city.

The objective of this study was to improve health professionals’ knowledge and attitudes toward suicide prevention. A suicide prevention training of 18 hours duration was conducted with 270 health professionals, mainly primary care workers, who were routinely involved with patients at high risk for suicide. Questionnaires were used to assess changes in attitudes and knowledge. The score in the knowledge questionnaire, with 21 points as maximum value, increased from 8.9 to 13 points (p < .001, significance level of 95%). Of the 25 questionnaire items representing attitudes, 18 showed significant change after the training. This training model has enhanced knowledge and attitudes toward suicide prevention in healthcare workers.

P02-205 Maintained attitudinal changes in nursing personnel after a brief training on suicide prevention

Aim To verify whether nursing personnel working at a general hospital change their attitudes after a brief training course on suicide prevention and if these newly acquired attitudes persist over a 6-month time. Method 317 nursing personnel attended a 6-hour training program. They answered anonymously pre- and post-training the Suicide Behavior Attitude Questionnaire (SBAQ) which comprises 21 visual analogue scale items divided in three factorial sub-scales. The scores on each SBAQ sub-scale (dependent variable) were compared along the time using ANOVA for repeated measures with rank transformation. The time of the measurement and characteristics of the nursing staff were considered as independent variables. Results There have been positive changes in the attitudes and these gains were significantly maintained at the 6-month follow-up evaluation. Improvement was in the Feelings and Professional Capacity factorial subscales (p = 0.0001 and 0.01, respectively). There was no change on the Right to Suicide subscale. Conclusion It was possible to demonstrate positive changes in the attitudes of nursing personnel as assessed six months after a brief training course on suicide prevention. As attitudes influence the effectiveness of the health care personnel interventions our findings may have important implications for the development of suicide prevention programs.

Diagnosis and implications in the therapeutic management of patient with afebrile neurolepctic malignant syndrome

This report aims at raising clinical awareness for the diagnosis of atypical presentations of neuroleptic malignant syndrome (NMS). We describe the case of a female patient with NMS symptoms, except fever, after starting the use of chlorpromazine. The afebrile condition delayed the consideration of NMS by the emergency clinicians who provided her initial assessment. Before this consideration, an anticholinergic agent, not recommended at this condition, was inadvertently prescribed. This might have contributed to the worsening of symptoms. NMS is a life-threatening idiosyncratic reaction most often seen as complication of antipsychotic treatment. Its clinical spectrum is broad and its diagnosis should be considered even if the patients do not fulfill all the possible described symptoms.