Electronic supplementary material
Aims and Hypothesis
Evaluating, according to the method validated by Beecham in 1992 , the medical and economic impact within the year following the introduction of ALGOS algorithm
Evaluating the reduction of other suicidal behaviours at 6 months (decrease of the total number of suicide re-attempts in each group, evolution of Beck's suicidal ideation score, etc ...)
Assessing the maintenance of the algorithm is effectiveness on suicidal behaviour at 13 months
Evaluating the differences in the delay of SA repetition within the two groups during the deployment of the algorithm at 6 months and 13 months
Finally, a more qualitative assessment may propose different responding profiles according to the psychopathology spotted by MINI, the character of being first-attempters or not, sex, etc...
For ALGOS patients group
1. Delivery of a «Crisis Card»
2. Telephone contact
Ordinary call (the most common): the treatment plan is still actual and valid, or the crisis situation that the participant lived improves. In this case, no help or advice seems necessary.
Participant in difficulty or non compliant: the treatment plan is no longer valid or not followed, unwillingness exists, or the subject is in psychological difficulty: a new treatment plan is eventually suggested, which is already tried during the phone call. In addition, the concerned contact centre will send "postcards" during the following five months.
Identification of participant at high risk of suicide: the patient is still victim of intrusive suicidal thoughts, asking or not for help. The investigator asks the patient to go to the ED where he was originally treated, to be received by a doctor informed by the concerned contact centre. In case of refusal by the participant, his general practitioner or the mobile emergency medical teams "SAMU/Centre 15" are called. The concerned contact centre will send "postcards" during the following five months.
3. Postcard sending
Participants candidate for telephone contact but not available.
Participants contacted by telephone but refusing further care, or non-compliant.
Participants identified during the phone call as in difficulty or experiencing suicidal crisis.
Control group = process as usual
Benefits and Risks
Research for Loss of Contact
Sample Size Calculation
Control and descriptive analysis of data: numerical parameters will be summarized by their mean, standard deviation and median. The frequencies percentage will be provided with their confidence interval at 95%.
Comparisons of means will be realized using Student test (t test) or analysis of variance for comparisons according to several factors. In case of multiple comparisons, Bonferroni correction will be applied. Comparisons of frequency percentage will be performed using the Chi square test or exact Fischer if necessary.
Analysis of predictive factors of SA repetition will be performed using logistic regressions. An approach by a decisional tree (CHAID) will also be considered.
Analysis of time delay of SA repetition will be performed using conventional methods of survival analysis: Kaplan-Meyer method, log-rank test and Cox model for multifactorial models.
The research for specific profiles will be conducted using classification methods to identify clusters with atypical profiles.
The concomitant drug treatments, particularly psychotropic drugs will be taken into consideration in subsequent analysis to ensure that they do not induce bias in the results.