To evaluate the clinical and cost-effectiveness of a culturally adapted therapy (C-MAP) in patients with a history of self-harm
Suicide is a serious global public health issue, ranked amongst the leading causes of death in many countries. Most of these (75%) are in the low and middle income countries (LAMIC) and globally suicide is the second leading cause of death in young people 15-29 years of age. There is no official data on suicide from Pakistan, a conservative South Asian Islamic country with historically low suicide rates. Both suicide and attempted suicide are illegal acts, as well as socially and religiously condemned, however, there is accumulating evidence that suicide rates have been gradually increasing in Pakistan over the last few years. The culturally adapted psychological intervention C-MAP utilizes problem solving components within a brief intervention that can be widely utilized in clinical practice. Our previous pilot trial in Karachi shows the efficacy of CBT based intervention(C-MAP) in people who had recently self harmed.The findings from this work have highlighted the applicability of such an intervention to health services in Pakistan for patients who present after a self-harm episode
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
SINGLE
Enrollment
901
C-MAP is a brief problem focused therapy, comprising of six sessions delivered within three months. C-MAP is a manual assisted intervention based on the principles of CBT .In this intervention there is an evaluation of the self-harm attempt, crisis skills, problem solving and basic cognitive techniques to manage emotions, negative thinking and relapse prevention strategies.
Bolan Medical Complex
Quetta, Balochistan, Pakistan
Khyber Teaching Hospital
Peshawar, KPK, Pakistan
Jinah Hospital
Lahore, Punjab Province, Pakistan
Services Hospital
Lahore, Punjab Province, Pakistan
Suicide Attempt Self Injury Interview SASII
Repetition rate of self-harm measured by adapted Suicide Attempt Self-Injury Interview (SASII)
Time frame: up to 12th months
Beck Scale for Suicidal ideation (BSI).
This is a 19-item instrument for detecting and measuring the current intensity of the patients' specific attitudes, behaviours, and specificity of a patient's thoughts to kill him/herself during the past week.
Time frame: Baseline, 3, 6, 9 and 12th months
Beck Hopelessness Scale
This is a 21 items scale measuring symptoms of depression. Higher scores on the scale indicate greater severity of depression
Time frame: Baseline,3rd,6th,9th and 12th months
Beck Depression Inventory (BDI)
This is a 21 items scale measuring symptoms of depression. Higher scores on the scale indicate greater severity of depression
Time frame: Baseline,3rd,6th,9th and 12th months
EuroQol-5 Dimensions (EQ5-D)
A standardised instrument to measure health status and associated population utility weights. It consists of a self-report questionnaire covering five dimensions of health (mobility, self-care, usual activities, pain/ discomfort and anxiety/ depression).
Time frame: Baseline,3rd,6th,9th and 12th months
Coping Resource Inventory (CRI).
To assess the coping resources to manage stress available to an individual.
Time frame: Baseline,3rd,6th,9th and 12th months
Client Satisfaction Questionnaire (CSQ).
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Rawalpindi General Hospital
Rawalpindi, Punjab Province, Pakistan
Civil Hospital
Karachi, Sindh, Pakistan
Abbasi Hospital
Karachi, Sindh, Pakistan
The participants will rate their satisfaction with treatment by using the CSQ.
Time frame: Baseline,3rd,6th,9th and 12th months