Risk of Suicide and Severity of Depression in Patients with Severe Mental Disorders Receiving Home Care Along with Psychological Training, Anger Management, and Life Skills Training Versus Usual Clinical Care

Rahim Badrfam; Vandad Sharifi; Atefeh  Zandifar; Zahra Hooshyari; Homayoun Amini

doi:10.18502/jimc.v5i3.10934

Rahim Badrfam Department of Psychiatry, Roozbeh Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
Vandad Sharifi Department of Psychiatry, Roozbeh Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
Atefeh Zandifar Department of Psychiatry, Imam Hossein Hospital, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
Zahra Hooshyari Department of Geriatric Medicine, Ziaeian Hospital, Tehran University of Medical Sciences (TUMS), Tehran, Iran
Homayoun Amini Department of Psychiatry, Roozbeh Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/jimc.v5i3.10934

Keywords: Ambulatory care, Depression, Depressive disorder, Home care services, Suicide

Abstract

Background: Severe mental disorders impose a significant burden of illness directly on the patient and their caregivers. In this study, the prevalence of suicidal ideation and the severity of depression in patients who received home care were evaluated in comparison with other patients who experienced usual outpatient care.

Methods: The study design was cross-sectional and the sample was assigned in two groups. Structured scale and inventory were used to evaluate the prevalence of suicidal thoughts and severity of depression among the patients. Beck Depression Inventoryand Ideation for Suicide Beck Scale were utilized for this evaluation. The study was conducted from June 2019 to June 2020.

Results: The total number of participants in the study was 71 patients. The results of multivariate analysis showed that the observed difference between the two groups in all components and in the total score of Beck Suicide Scale and Beck Depression Scale was statistically significant. Regarding Ideation for Suicide Beck Scale, the mean in the home visit group was 0.94 (standard deviation (SD)= 4.24) and in the Treatment as Usual (TAU) group was 3.83(SD =5.44) (p-value=0.016). Regarding Beck Depression Scale, the mean in the home visit group was 6.14(SD= 7.75) and in the TAU group was 11.17(SD= 9.18) (p-value=0.015).

Conclusion: It seems that home care for patients with severe mental disorders may be more effective than outpatient care in reducing suicidal ideation and severe depression. The use of longitudinal and multicenter studies with larger sample sizes can be effective in assessing the impact of home care on improving indicators of suicidal ideation and severity of depression.