Most suicide attempters suffer from psychiatric disorders, which are often comorbid with personality disorders. The effects of intervention on patients who have attempted suicide with comorbid Axis I and II diagnoses have not been fully elucidated. We evaluated whether assertive case management can reduce the repetition of suicidal behaviours in patients who had attempted suicide with comorbid Axis I and II diagnoses. This study was a secondary analysis of a randomised controlled trial investigating whether assertive case management could reduce the repetition of suicide attempts, compared with enhanced usual care. Subjects were divided into those who had comorbid Axis I and II diagnoses (Axis I + II group), and those who had an Axis I diagnosis without Axis II comorbidity (Axis I group). Outcome measures were compared between patients receiving a case management intervention and patients receiving enhanced usual care, as allocated. The primary outcome measure was the incidence proportion of the first episode of recurrent suicidal behaviour at 6 months after randomisation. We calculated risk ratios (RR) with 95% confidence intervals (CI) at 6 months and 12 months after randomisation of patients in the Axis I and Axis I + II groups. Of 914 enrolled patients, 120 (13.1%) were in the Axis I + II group, and 794 (86.9%) were in the Axis I group. Assertive case management was significantly effective for the Axis I group on the primary outcome at 6 months (risk ratio [RR] 0.51, 95% confidence intervals [CI] 0.31 to 0.84). The RR of the Axis I + II group was 0.44 (95% CI 0.14 to 1.40). Assertive case management not only had an effect on patients who had attempted suicide with only Axis I disorders but may also have a similar effect on patients with comorbid Axis I and II disorders.

中文翻译：

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主观病例管理干预对合并有I类和II类Axis精神病学诊断的自杀未遂者的影响：随机对照试验的二次分析。

大多数企图自杀的人患有精神疾病，通常与人格障碍并存。尚未完全阐明干预措施对尝试合并I型和II型Axis自杀的患者的影响。我们评估了积极的病例管理是否可以减少在合并了I类和II类Axis诊断的自杀未遂患者中重复自杀行为。这项研究是对一项随机对照试验的二级分析，该试验调查了与加强常规护理相比，肯定的病例管理是否可以减少自杀未遂的重复。将受试者分为那些患有Axis I和II合并症的诊断者（Axis I + II组）和那些诊断为没有Axis II合并症的Axis I诊断者（Axis I组）。比较了接受病例管理干预的患者和接受分配的常规护理的患者的结果指标。主要结局指标是随机分组后6个月内首次复发自杀行为的发生比例。在第I轴和Axis I + II组患者随机分组后的6个月和12个月，我们以95％的置信区间（CI）计算了风险比（RR）。在914例入组患者中，轴I + II组为120（13.1％），轴I组为794（86.9％）。在第6个月时，对于第一轴的主要结局，肯定的病例管理非常有效（风险比[RR]为0.51，95％置信区间[CI]为0.31至0.84）。I + II轴组的RR为0.44（95％CI为0.14至1.40）。