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    Husain, Muhammed Omair Chaudhry, Imran B. Mehmood, Nasir Rehman, Raza ur Kazmi, Ajmal Hamirani, Munir Kiran, Tayyeba Bukhsh, Ameer Bassett, Paul Husain, Muhammad Ishrat Naeem, Farooq and Husain, Nusrat 2017. Pilot randomised controlled trial of culturally adapted cognitive behavior therapy for psychosis (CaCBTp) in Pakistan. BMC Health Services Research, Vol. 17, Issue. 1,

    Irfan, Muhammad Saeed, Sofiya Awan, Naila Riaz Gul, Mirrat Aslam, Muhammad and Naeem, Farooq 2017. Psychological Healing in Pakistan: From Sufism to Culturally Adapted Cognitive Behaviour Therapy. Journal of Contemporary Psychotherapy, Vol. 47, Issue. 2, p. 119.

    Leavey, Katie and Hawkins, Russell 2017. Is cognitive behavioural therapy effective in reducing suicidal ideation and behaviour when delivered face-to-face or via e-health? A systematic review and meta-analysis. Cognitive Behaviour Therapy, Vol. 46, Issue. 5, p. 353.

    Gøtzsche, Peter C and Gøtzsche, Pernille K 2017. Cognitive behavioural therapy halves the risk of repeated suicide attempts: systematic review. Journal of the Royal Society of Medicine, Vol. 110, Issue. 10, p. 404.

    Husain, Muhammad Ishrat Chaudhry, Imran B. Rahman, Raza R. Hamirani, Munir M. Mehmood, Nasir Haddad, Peter M. Hodsoll, John Young, Allan H. Naeem, Farooq and Husain, Nusrat 2017. Pilot study of a culturally adapted psychoeducation (CaPE) intervention for bipolar disorder in Pakistan. International Journal of Bipolar Disorders, Vol. 5, Issue. 1,

    Kreuze, Elizabeth and Lamis, Dorian A. 2017. A Review of Psychometrically Tested Instruments Assessing Suicide Risk in Adults. OMEGA - Journal of Death and Dying, p. 003022281668815.

    Carter, Gregory Page, Andrew Large, Matthew Hetrick, Sarah Milner, Allison Joy Bendit, Nick Walton, Carla Draper, Brian Hazell, Philip Fortune, Sarah Burns, Jane Patton, George Lawrence, Mark Dadd, Lawrence Robinson, Jo and Christensen, Helen 2016. Royal Australian and New Zealand College of Psychiatrists clinical practice guideline for the management of deliberate self-harm. Australian & New Zealand Journal of Psychiatry, Vol. 50, Issue. 10, p. 939.

    Meerwijk, Esther L Parekh, Amrita Oquendo, Maria A Allen, I Elaine Franck, Linda S and Lee, Kathryn A 2016. Direct versus indirect psychosocial and behavioural interventions to prevent suicide and suicide attempts: a systematic review and meta-analysis. The Lancet Psychiatry, Vol. 3, Issue. 6, p. 544.

    Hall, Gordon C. Nagayama Ibaraki, Alicia Yee Huang, Ellen R. Marti, C. Nathan and Stice, Eric 2016. A Meta-Analysis of Cultural Adaptations of Psychological Interventions. Behavior Therapy, Vol. 47, Issue. 6, p. 993.

    Hawton, Keith Witt, Katrina G Taylor Salisbury, Tatiana L Arensman, Ella Gunnell, David Hazell, Philip Townsend, Ellen and van Heeringen, Kees 2016. Psychosocial interventions for self-harm in adults. Cochrane Database of Systematic Reviews,

    Hawton, Keith Witt, Katrina G Salisbury, Tatiana L Taylor Arensman, Ella Gunnell, David Hazell, Philip Townsend, Ellen and van Heeringen, Kees 2016. Psychosocial interventions following self-harm in adults: a systematic review and meta-analysis. The Lancet Psychiatry, Vol. 3, Issue. 8, p. 740.

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Brief psychological intervention after self-harm: randomised controlled trial from Pakistan

  • Nusrat Husain (a1), Salahuddin Afsar (a2), Jamal Ara (a3), Hina Fayyaz (a4), Raza ur Rahman (a2), Barbara Tomenson (a5), Munir Hamirani (a6), Nasim Chaudhry (a1), Batool Fatima (a7), Meher Husain (a8), Farooq Naeem (a9) and Imran B. Chaudhry (a1)...
Abstract
Background

Self-harm is a major risk factor for completed suicide.

 Aims

To determine the efficacy of a brief psychological intervention – culturally adapted manual-assisted problem-solving training (C-MAP) – delivered following an episode of self-harm compared with treatment as usual (TAU).

 Method

The study was a randomised controlled assessor-masked clinical trial (trial registration: ClinicalTrials.gov NCT01308151). All patients admitted after an episode of self-harm during the previous 7 days to the participating medical units of three university hospitals in Karachi, Pakistan, were included in the study. A total of 250 patients were screened and 221 were randomly allocated to C-MAP plus treatment as usual (TAU) or to TAU alone. All patients were assessed at baseline, at 3 months (end of intervention) and at 6 months after baseline. The primary outcome measure was reduction in suicidal ideation at 3 months. The secondary outcome measures included hopelessness, depression, coping resources and healthcare utilisation.

 Results

A total of 108 patients were randomised to the C-MAP group and 113 to the TAU group. Patients in the C-MAP group showed statistically significant improvement on the Beck Scale for Suicide Ideation and Beck Hopelessness Inventory, which was sustained at 3 months after the completion of C-MAP. There was also a significant reduction in symptoms of depression compared with patients receiving TAU.

 Conclusions

The positive outcomes of this brief psychological intervention in patients attempting self-harm are promising and suggest that C-MAP may have a role in suicide prevention.
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Copyright
COPYRIGHT: © Royal College of Psychiatrists, 2014 
Corresponding author
Nusrat Husain, University of Manchester, The Lantern Centre, Fulwood, Preston PR2 8DY, UK. Email: nusrat.husain@manchester.ac.uk
Footnotes
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This study was jointly funded by the University of Manchester and Pakistan Institute of Learning and Living. The sponsor of the study had no role in the study design, data collection, analysis of the data, data interpretation or writing of the manuscript.

Declaration of interest

None.

Footnotes
References
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  • Cited by 11
  • Cited by
    Crossref Citations
    Crossref logo
    This article has been cited by the following publications. This list is generated based on data provided by CrossRef.

    Husain, Muhammed Omair Chaudhry, Imran B. Mehmood, Nasir Rehman, Raza ur Kazmi, Ajmal Hamirani, Munir Kiran, Tayyeba Bukhsh, Ameer Bassett, Paul Husain, Muhammad Ishrat Naeem, Farooq and Husain, Nusrat 2017. Pilot randomised controlled trial of culturally adapted cognitive behavior therapy for psychosis (CaCBTp) in Pakistan. BMC Health Services Research, Vol. 17, Issue. 1,

    Irfan, Muhammad Saeed, Sofiya Awan, Naila Riaz Gul, Mirrat Aslam, Muhammad and Naeem, Farooq 2017. Psychological Healing in Pakistan: From Sufism to Culturally Adapted Cognitive Behaviour Therapy. Journal of Contemporary Psychotherapy, Vol. 47, Issue. 2, p. 119.

    Leavey, Katie and Hawkins, Russell 2017. Is cognitive behavioural therapy effective in reducing suicidal ideation and behaviour when delivered face-to-face or via e-health? A systematic review and meta-analysis. Cognitive Behaviour Therapy, Vol. 46, Issue. 5, p. 353.

    Gøtzsche, Peter C and Gøtzsche, Pernille K 2017. Cognitive behavioural therapy halves the risk of repeated suicide attempts: systematic review. Journal of the Royal Society of Medicine, Vol. 110, Issue. 10, p. 404.

    Husain, Muhammad Ishrat Chaudhry, Imran B. Rahman, Raza R. Hamirani, Munir M. Mehmood, Nasir Haddad, Peter M. Hodsoll, John Young, Allan H. Naeem, Farooq and Husain, Nusrat 2017. Pilot study of a culturally adapted psychoeducation (CaPE) intervention for bipolar disorder in Pakistan. International Journal of Bipolar Disorders, Vol. 5, Issue. 1,

    Kreuze, Elizabeth and Lamis, Dorian A. 2017. A Review of Psychometrically Tested Instruments Assessing Suicide Risk in Adults. OMEGA - Journal of Death and Dying, p. 003022281668815.

    Carter, Gregory Page, Andrew Large, Matthew Hetrick, Sarah Milner, Allison Joy Bendit, Nick Walton, Carla Draper, Brian Hazell, Philip Fortune, Sarah Burns, Jane Patton, George Lawrence, Mark Dadd, Lawrence Robinson, Jo and Christensen, Helen 2016. Royal Australian and New Zealand College of Psychiatrists clinical practice guideline for the management of deliberate self-harm. Australian & New Zealand Journal of Psychiatry, Vol. 50, Issue. 10, p. 939.

    Meerwijk, Esther L Parekh, Amrita Oquendo, Maria A Allen, I Elaine Franck, Linda S and Lee, Kathryn A 2016. Direct versus indirect psychosocial and behavioural interventions to prevent suicide and suicide attempts: a systematic review and meta-analysis. The Lancet Psychiatry, Vol. 3, Issue. 6, p. 544.

    Hall, Gordon C. Nagayama Ibaraki, Alicia Yee Huang, Ellen R. Marti, C. Nathan and Stice, Eric 2016. A Meta-Analysis of Cultural Adaptations of Psychological Interventions. Behavior Therapy, Vol. 47, Issue. 6, p. 993.

    Hawton, Keith Witt, Katrina G Taylor Salisbury, Tatiana L Arensman, Ella Gunnell, David Hazell, Philip Townsend, Ellen and van Heeringen, Kees 2016. Psychosocial interventions for self-harm in adults. Cochrane Database of Systematic Reviews,

    Hawton, Keith Witt, Katrina G Salisbury, Tatiana L Taylor Arensman, Ella Gunnell, David Hazell, Philip Townsend, Ellen and van Heeringen, Kees 2016. Psychosocial interventions following self-harm in adults: a systematic review and meta-analysis. The Lancet Psychiatry, Vol. 3, Issue. 8, p. 740.

    ×
  • Access

Brief psychological intervention after self-harm: randomised controlled trial from Pakistan

  • Nusrat Husain (a1), Salahuddin Afsar (a2), Jamal Ara (a3), Hina Fayyaz (a4), Raza ur Rahman (a2), Barbara Tomenson (a5), Munir Hamirani (a6), Nasim Chaudhry (a1), Batool Fatima (a7), Meher Husain (a8), Farooq Naeem (a9) and Imran B. Chaudhry (a1)...
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