Category: Suicide and Self-Injury

Symposium

Cognitive Therapy for the Prevention of Suicide Attempts in Community Settings: A Randomized Controlled Trial

Friday, November 17
1:45 PM - 3:15 PM
Location: Cobalt 502, Level 5, Cobalt Level

Keywords: Suicide | Community-Based Assessment / Intervention
Presentation Type: Symposium

Background: Suicide attempts are a robust predictor of death by suicide. Prior research has demonstrated efficacy for several interventions specifically designed to prevent suicide attempts, yet few studies have examined the effectiveness of these treatments delivered in community settings. The primary objective of the current study was to determine the effectiveness of one such intervention, Cognitive Therapy for Suicide Prevention (CT-SP), a 10-session treatment focused on preventing suicide attempts in adults.


Methods: A total of 140 adults who recently attempted suicide were recruited from hospital emergency departments or psychiatric inpatient units. Participants were randomly assigned to receive either CT-SP plus enhanced care or enhanced care alone in outpatient community mental health centers. Repeat suicide attempts, suicide ideation, hopelessness, and depression severity were assessed at baseline, 1, 3, 6, 12, 18, and 24 months.


Results: The total number of repeat attempts during follow-up, unadjusted for dropout, was 37 for the intervention condition and 62 for the control condition. Among those who reattempted over the follow-up period, a zero-inflated Poisson analysis showed that the rate of attempts for the control condition was significantly greater than for the intervention condition (z = -2.33, p = 0.02). Furthermore, those in the control condition had twice the number of reattempts as compared to those in the intervention condition (incident to re-attempt rate ratio = 0.50, 95% CI: 0.28, 0.90). There was no significant difference between study conditions in the proportion of patients who reattempted suicide (log-rank χ2=0.46, df =1, p=.50). Depression was significantly lower for the intervention group than the control group at 12 months for self-reported (p=0.03) and clinician-assessed depression (p=0.02). There were no significant differences between conditions on the severity of hopelessness or rates of suicidal ideation at any assessment point.


Conclusions: CT-SP was effective in lowering the incidence of repeat attempt rates among adult suicide attempters seen in the community by non-expert therapists. 

Shari Jager-Hyman

University of Pennsylvania

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