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Randomised controlled trial of therapeutic assessment versus usual assessment in adolescents with self-harm: 2-year follow-up
  1. Dennis Ougrin1,
  2. Isabel Boege2,
  3. Daniel Stahl3,
  4. Reetoodwaj Banarsee4,
  5. Eric Taylor1
  1. 1Department of Child and Adolescent Psychiatry, King's College London, Institute of Psychiatry, London, UK
  2. 2ZfP Suedwuerttemberg, KJPP, Ravensburg, Germany
  3. 3Department of Biostatistics, King's College London, Institute of Psychiatry, London, UK
  4. 4Department of Primary Care and Public Health, Faculty of Medicine, Imperial College London, London, UK
  1. Correspondence to Dr Dennis Ougrin, Child and Adolescent Psychiatrist, King's College London, Institute of Psychiatry,  DeCrespigny Park, Box 85, London SE5 8AF, UK; dennis.ougrin{at}kcl.ac.uk

Abstract

Background An earlier randomised controlled trial demonstrated improved treatment engagement in adolescents who received Therapeutic Assessment (TA) versus Assessment As Usual (AAU), following an emergency presentation with self-harm.

Objectives To determine 2-year outcomes for the same adolescents focusing on frequency of Accident and Emergency (A&E) self-harm presentations and treatment engagement.

Method Patients in the TA groups (n=35) and the AAU group (n=34) were followed up 2 years after the initial assessment. Their primary and secondary care electronic records were analysed.

Results There was no significant difference in the frequency of self-harm resulting in A&E presentations between the two groups (OR 0.69, 95% CI 0.23 to 2.13, p=0.53). Treatment engagement remained higher in the TA group than the AAU group.

Conclusions TA is not associated with a lower frequency of A&E self-harm presentations. The effect of TA on engagement is maintained 2 years after the initial assessment. Interventions to reduce self-harm in adolescents are needed.

Trial registration ISRCTN 81605131, http://www.controlled-trials.com/ISRCTN81605131/

  • Accident & Emergency
  • Child Psychiatry

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