Psychological Medicine

Original Articles

The effect of referral for brief intervention for alcohol misuse on repetition of deliberate self-harm: an exploratory randomized controlled trial

M. J. Crawforda1 c1, E. Csipkea1, A. Browna2, S. Reida2, K. Nilsena2, J. Redheada3 and R. Touqueta3

a1 Department of Psychological Medicine, Imperial College London, UK

a2 Central and North West London NHS Foundation Trust, UK

a3 Imperial College Healthcare NHS Trust, London, UK


Background Referral for brief intervention among people who misuse alcohol is reported to be effective but its impact among those who present to services following deliberate self-harm (DSH) has not been examined.

Method Consecutive patients who presented to an Emergency Department (ED) following an episode of DSH were screened for alcohol misuse. Those found to be misusing alcohol were randomly assigned to brief intervention plus a health information leaflet or to a health information leaflet alone. The primary outcome was whether the patient reattended an ED following a further episode of DSH during the subsequent 6 months. Secondary outcomes were alcohol consumption, mental health and satisfaction with care measured 3 and 6 months after randomization.

Results One hundred and three people took part in the study. Follow-up data on our primary outcome were obtained for all subjects and on 63% for secondary outcomes. Half those referred for brief intervention received it. Repetition of DSH was strongly associated with baseline alcohol consumption, but not influenced by treatment allocation. There was a non-significant trend towards the number of units of alcohol consumed per drinking day being lower among those randomized to brief intervention.

Conclusions Referral for brief intervention for alcohol misuse following an episode of DSH may not influence the likelihood of repetition of self-harm. Longer-term interventions may be needed to help people who deliberately harm themselves and have evidence of concurrent alcohol misuse.

(Received April 21 2009)

(Revised October 13 2009)

(Accepted October 14 2009)

(Online publication January 05 2010)


c1 Address for correspondence: Dr M. J. Crawford, Reader in Mental Health Services Research, Department of Psychological Medicine, Imperial College London, Claybrook Centre, 37, Claybrook Road, London W6 8LN, UK. (Email: