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Self Harm in Females of South Asian Family Origin

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ClinicalTrials.gov Identifier: NCT00884078
Recruitment Status : Unknown
Verified April 2009 by Lancashire Care NHS Foundation Trust.
Recruitment status was:  Not yet recruiting
First Posted : April 20, 2009
Last Update Posted : April 20, 2009
Information provided by:

Study Description
Brief Summary:
Aim of the study is to adapt and develop a culturally appropriate psychological intervention and to pilot test it's feasibility, and acceptability for the adult South Asian females presenting to general hospital emergency department following self-harm. Primary hypothesis for the study is to determine whether a brief psychological intervention compared with treatment as usual for self-harm results in decreased hopelessness and suicidal ideation. Further to this to collect necessary information on recruitment, the assessment instruments, effect size, the optimal delivery and acceptability of the intervention in preparation for a definitive RCT using repetition of self harm and cost effectiveness as the primary outcome measures.

Condition or disease Intervention/treatment
Self Harm Suicidal Idealtion Hopelessness Other: Culturally adapted manualized problem solving training

  Show Detailed Description

Study Design

Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 20 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Prevention
Official Title: Exploratory RCT of Culturally Adapted Manual Assisted Problem Solving Training (C-MAP) for Self Harm in Females of South Asian Family Origin
Study Start Date : May 2009
Estimated Primary Completion Date : October 2009
Estimated Study Completion Date : December 2009
Arms and Interventions

Arm Intervention/treatment
Experimental: 1
C-MAPS (Culturally adapted manualized problem solving training) will be a brief problem focused therapy comprising of 8 sessions within three months after a self-harm episode. We will have two engagement sessions before the actual therapy. The adapted therapy/training will be delivered by therapists/trained counselors in the patient's home/GP practice depending upon patient's choice. Sessions will be offered weekly in the first month and than fortnightly and will last 50 minutes.
Other: Culturally adapted manualized problem solving training
The areas covered by the manual include an evaluation of the self-harm attempt, crisis skills, problem solving, and basic cognitive techniques to manage emotions and negative thinking and relapse prevention strategies. The treatment will be structured around patient's current problems with the relevant sections of the manual helping the patient to deal with specific problems leading to the self-harm act. Between the sessions the manual can be used for homework tasks by the patient. We will be able to linguistically match the therapist and the participant in three most common languages spoken and understood in South Asian population i.e. Urdu, Hindi and Punjabi.
No Intervention: 2 Control group
Patients who will be randomized to the "treatment as usual" arm will receive routine care. In most cases this consists of an assessment by a casualty doctor or a junior psychiatrist in the emergency department, on the basis of which about one third patients are referred for follow up as a psychiatry outpatient, a small number are referred to addiction services, and the remainder are advised to consult their own general practitioner (Kapur 1998) this is particularly so in case of Asian females (Cooper et al, 2006). No patients are routinely referred to psychotherapy or psychology services. Participants will receive an initial assessment along with treatment as usual (TAU) as ascertained by the general practitioner or mental health professional any type of treatment apart from C-MAPS will be permitted. We will record the degree of patient adherence to standard care.

Outcome Measures

Primary Outcome Measures :
  1. Suicidal Ideation (Beck scale for suicidal ideation) [ Time Frame: 6 months ]
  2. Hopelessness (Beck hopelessness scale) [ Time Frame: 6 months ]
  3. Time to self-reported repetition of self harm (estimate for RCT) [ Time Frame: 6 months ]

Secondary Outcome Measures :
  1. Depressive symptoms assessed by Beck Depression Inventory [ Time Frame: 6 months ]

Eligibility Criteria

Information from the National Library of Medicine

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Ages Eligible for Study:   16 Years to 65 Years   (Child, Adult)
Sexes Eligible for Study:   Female
Accepts Healthy Volunteers:   No

Inclusion Criteria:

All females of self ascribe south Asian family origin presenting to an emergency department of the proposed study centers after an episode of self-harm.

  • By self harm we mean self inflicted injury, and/or ingestion of drugs in excess of the recommended therapeutic dose, with some intention of ending one's life (Vajda and Steinbeck 2000).
  • Age: 16 - 65 years
  • Resident in the trial site catchment area

Exclusion Criteria:

Participants will not be excluded based on limited knowledge of English.

  • Temporary resident unlikely to be available for follow up.
  • ICD 10 diagnosis organic (F.0), of alcohol and drug dependence (F.1x.2) Schizophrenia (F.2) or Bipolar Affective Disorder (F.31) because these patients require a different treatment approach.
  • Psychiatric admission required after deliberate self-harm.
Contacts and Locations

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00884078

Contact: Nusrat Husain 00441772 773502 nusrat.husain@manchester.ac.uk

United Kingdom
Manchester Royal Infirmary Not yet recruiting
Manchester, Greater Manchester, United Kingdom, M13 9WL
Contact: Nusrat Husain, Consultant Psychiatrist    004401772 773502    nusrat.husain@manchester.ac.uk   
Sub-Investigator: Stewart Duriraj, Registrar         
Sub-Investigator: Kalyani Kodimela, Registrar         
North Manchester General Hospital Not yet recruiting
Manchester, Greater Manchester, United Kingdom, M8 5RB
Contact: Nasim Chaudhry, Consultant Psychiatrist       nasimchaudhry@btinternet.com   
Principal Investigator: Nasim Chaudhry, Consultant Psychiatrist         
Royal Blackburn Hospital Not yet recruiting
Blackburn, Lancashire, United Kingdom, BB2 3HH
Contact: Nusrat Husain, Consultant Psychiatrist    00441772 773502    nusrat.husain@manchester.ac.uk   
Contact: Diwakar Nagaraj, Registrar    00441254 226253    drdiwakarnagaraj@gmail.com   
Principal Investigator: Nusrat Husain, Consultant Psychiatrist         
Sub-Investigator: Diwakar Nagaraj, Registrar         
Sub-Investigator: Sarrah Khan, Research assistant         
Sponsors and Collaborators
Lancashire Care NHS Foundation Trust
Principal Investigator: Nusrat Husain, Consultant Psychiatrist LCFT
More Information

Responsible Party: Louise Worrell, LCFT
ClinicalTrials.gov Identifier: NCT00884078     History of Changes
Other Study ID Numbers: 08/H1013/6
First Posted: April 20, 2009    Key Record Dates
Last Update Posted: April 20, 2009
Last Verified: April 2009

Keywords provided by Lancashire Care NHS Foundation Trust:
Self harm in south asian women
suicidal ideations
problem solving training