TY - JOUR AB - We carried out a randomized controlled trial to determine whether an intensive intervention after a suicide attempt could decrease by half the risk of a repeat attempt in the following two years. After initial assessment and randomization, experimental subjects attended 18 therapy appointments over one year, including one home visit, and measures to improve attendance. Control subjects received the usual care. Of 63 experimental subjects, 35% made a repeat attempt, and so did 30% of 63 control subjects. The study had a 99% power to detect the desired decrease of risk (30% to 15%). Clearly, the intervention did not achieve its objective. AD - Department of Community Health, Saint-Luc Hospital, Montréal, Canada. AN - 1440744 AU - Allard, R. AU - Marshall, M. AU - Plante, M. C. DA - Fall DP - NLM ET - 1992/01/01 IS - 3 KW - Adult Aged Borderline Personality Disorder Female Humans Life Style Male Marital Status Middle Aged Recurrence Socioeconomic Factors Suicide/prevention & control *Suicide, Attempted L1 - internal-pdf://3042640907/Allard-1992-Intensive follow-up does not decre.pdf LA - eng N1 - Allard, R Marshall, M Plante, M C Clinical Trial Journal Article Randomized Controlled Trial Research Support, Non-U.S. Gov't England Suicide Life Threat Behav. 1992 Fall;22(3):303-14. PY - 1992 SN - 0363-0234 (Print) 0363-0234 SP - 303-14 ST - Intensive follow-up does not decrease the risk of repeat suicide attempts T2 - Suicide Life Threat Behav TI - Intensive follow-up does not decrease the risk of repeat suicide attempts UR - https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/j.1943-278X.1992.tb00735.x?download=true VL - 22 ID - 232 ER - TY - JOUR AB - The World Health Organization Suicide trends in at-risk territories study is a multi-site regional research program operating first in French Polynesia and countries of the Western Pacific, then extended to the world. The aims of the study were to establish a monitoring system for suicidal behaviors and to conduct a randomised control trial intervention for non-fatal suicidal behaviors. The latter part is the purpose of the present article. Over the period 2008-2010, 515 patients were admitted at the Emergency Department of the Centre Hospitalier de Polynésie Française for suicidal behavior. Those then hospitalized in the Psychiatry Emergency Unit were asked to be involved in the study and randomly allocated to either Treatment As Usual (TAU) or TAU plus Brief Intervention and Contact (BIC), which provides a psycho-education session and a follow-up of 9 phone contacts over an 18-months period. One hundred persons were assigned to TAU, while 100 participants were allocated to the BIC group. At the end of the follow-up there were no significant differences between the two groups in terms of number of presentations to the hospital for repeated suicidal behaviors. Although the study could not demonstrate the superiority of a treatment over the other, nevertheless - given its importance - the investigation captured public attention and was able to contribute to the awareness of the need of suicide prevention in French Polynesia. The BIC model of intervention seemed to particularly suit the geographical and health care context of the country. AN - 26605034 AU - Amadéo, Stéphane AU - Rereao, Moerani AU - Malogne, Aurelia AU - Favro, Patrick AU - Nguyen, Ngoc Lam AU - Jehel, Louis AU - Milner, Allison AU - Kolves, Kairi AU - De Leo, Diego DB - PubMed DO - 10.4081/mi.2015.5818 IS - 2 J2 - Ment Illn KW - Tahiti prevention randomized trial suicide LA - eng N1 - 26605034[pmid] PMC4620282[pmcid] PY - 2015 SN - 2036-7457 2036-7465 SP - 5818-5818 ST - Testing Brief Intervention and Phone Contact among Subjects with Suicidal Behavior: A Randomized Controlled Trial in French Polynesia in the Frames of the World Health Organization/Suicide Trends in At-Risk Territories Study T2 - Mental illness TI - Testing Brief Intervention and Phone Contact among Subjects with Suicidal Behavior: A Randomized Controlled Trial in French Polynesia in the Frames of the World Health Organization/Suicide Trends in At-Risk Territories Study UR - https://pubmed.ncbi.nlm.nih.gov/26605034 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4620282/ VL - 7 ID - 669 ER - TY - JOUR AB - BACKGROUND: Many psychological treatments have shown effect on reducing self-harm in adults with borderline personality disorder. There is a need of brief psychotherapeutical treatment alternative for suicide prevention in specialized outpatient clinics. METHODS/DESIGN: The DiaS trial was designed as a pragmatic single-center, two-armed, parallel-group observer-blinded, randomized clinical superiority trial. The participants had at least two criteria from the borderline personality disorder diagnosis and a recent suicide attempt (within a month). The participants were offered 16 weeks of dialectical behavior therapy (DBT) versus up to 16 weeks of collaborative assessment and management of suicidality (CAMS) treatment. The primary composite outcome was the number of participants with a new self-harm (nonsuicidal self-injury [NSSI] or suicide attempt) at week 28 from baseline. Other exploratory outcomes were: severity of borderline symptoms, depressive symptoms, hopelessness, suicide ideation, and self-esteem. RESULTS: At 28 weeks, the number of participants with new self-harm in the DBT group was 21 of 57 (36.8%) versus 12 of 51 (23.5%) in the CAMS treatment (OR: 1.90; 95% CI: 0.80-4.40; P = .14). When assessing the effect of DBT versus CAMS treatment on the individual components of the primary outcome, we observed no significant differences in the number of NSSI (OR: 1.60; 95% CI: 0.70-3.90; P = .31) or number of attempted suicides (OR: 2.24; 95% CI: 0.80-7.50; P = .12). CONCLUSION: In adults with borderline personality traits and disorder and a recent suicide attempt, DBT does not seem superior compared with CAMS for reduction of number of self-harm or suicide attempts. However, further randomized clinical trials may be needed. AD - Research Unit, Mental Health Center Copenhagen, Faculty of Health Science, University of Copenhagen, Copenhagen, Denmark. Research Unit, Mental Health Center North Zealand, University of Copenhagen, Copenhagen, Denmark. The Copenhagen Trial Unit, Center for Clinical Intervention Research, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. Mental Health Center Amager, Copenhagen, Denmark. AN - 26854478 AU - Andreasson, K. AU - Krogh, J. AU - Wenneberg, C. AU - Jessen, H. K. AU - Krakauer, K. AU - Gluud, C. AU - Thomsen, R. R. AU - Randers, L. AU - Nordentoft, M. DA - Jun DO - 10.1002/da.22472 DP - NLM ET - 2016/02/09 IS - 6 KW - Adult Behavior Therapy/*methods Borderline Personality Disorder/*therapy Female Humans Male Middle Aged *Outcome Assessment, Health Care Self-Injurious Behavior/*therapy Young Adult *borderline personality disorder *collaborative assessment and management of suicidality *dialectical behavior therapy *self-harm *suicide prevention LA - eng N1 - 1520-6394 Andreasson, Kate Krogh, Jesper Wenneberg, Christina Jessen, Helle K L Krakauer, Kristine Gluud, Christian Thomsen, Rasmus R Randers, Lasse Nordentoft, Merete Comparative Study Journal Article Pragmatic Clinical Trial United States Depress Anxiety. 2016 Jun;33(6):520-30. doi: 10.1002/da.22472. Epub 2016 Feb 8. PY - 2016 SN - 1091-4269 SP - 520-30 ST - EFFECTIVENESS OF DIALECTICAL BEHAVIOR THERAPY VERSUS COLLABORATIVE ASSESSMENT AND MANAGEMENT OF SUICIDALITY TREATMENT FOR REDUCTION OF SELF-HARM IN ADULTS WITH BORDERLINE PERSONALITY TRAITS AND DISORDER-A RANDOMIZED OBSERVER-BLINDED CLINICAL TRIAL T2 - Depress Anxiety TI - EFFECTIVENESS OF DIALECTICAL BEHAVIOR THERAPY VERSUS COLLABORATIVE ASSESSMENT AND MANAGEMENT OF SUICIDALITY TREATMENT FOR REDUCTION OF SELF-HARM IN ADULTS WITH BORDERLINE PERSONALITY TRAITS AND DISORDER-A RANDOMIZED OBSERVER-BLINDED CLINICAL TRIAL VL - 33 ID - 2380 ER - TY - JOUR AB - To determine whether ambulatory psychotherapy targeted to abandonment experiences and fears can reduce suicidality and improve outcome in borderline patients referred to the emergency room with major depressive disorder and self-destructive behavior severe enough to require medical/surgical treatment and a brief psychiatric hospitalization. A total of 170 subjects were randomized at hospital discharge into three treatment groups: treatment as usual (TAU), abandonment psychotherapy delivered by certified psychotherapists, and abandonment psychotherapy delivered by nurses. Assessments were performed before randomization and at 3-month follow-up. Continued suicidality and other outcome measures were significantly worse in the treatment-as-usual as compared to both abandonment psychotherapy groups, but there were no differences between the two psychotherapy groups. These results suggest the efficacy of manualized psychotherapy that specifically targets the abandonment fears and experiences that are so common as precipitants to suicidal and self-destructive acts in borderline patients. It does not appear that formal psychotherapy training is associated with better outcomes. AD - Psychiatry Department, University of Geneva, Service de liaison psychiatrique et d'intervention de crise, Geneva University Hospital, Geneva, Switzerland. Duke University, Durham, North Carolina (Emeritus). AN - 26111250 AU - Andreoli, A. AU - Burnand, Y. AU - Cochennec, M. F. AU - Ohlendorf, P. AU - Frambati, L. AU - Gaudry-Maire, D. AU - Di Clemente, T. AU - Hourton, G. AU - Lorillard, S. AU - Canuto, A. AU - Frances, A. DA - Apr DO - 10.1521/pedi_2015_29_196 DP - NLM ET - 2015/06/26 IS - 2 KW - Adult Ambulatory Care Borderline Personality Disorder/*psychology/*therapy Depressive Disorder, Major/psychology Emergency Service, Hospital Female Follow-Up Studies Humans *Love Male Psychotherapy/*methods Referral and Consultation Self-Injurious Behavior/psychology Suicidal Ideation Suicide/*psychology Treatment Outcome Young Adult LA - eng N1 - 1943-2763 Andreoli, A Burnand, Y Cochennec, M-F Ohlendorf, P Frambati, L Gaudry-Maire, D Di Clemente, Th Hourton, G Lorillard, S Canuto, A Frances, A Journal Article Randomized Controlled Trial United States J Pers Disord. 2016 Apr;30(2):271-87. doi: 10.1521/pedi_2015_29_196. Epub 2015 Jun 25. PY - 2016 SN - 0885-579x SP - 271-87 ST - Disappointed Love and Suicide: A Randomized Controlled Trial of "Abandonment Psychotherapy" Among Borderline Patients T2 - J Pers Disord TI - Disappointed Love and Suicide: A Randomized Controlled Trial of "Abandonment Psychotherapy" Among Borderline Patients VL - 30 ID - 2381 ER - TY - JOUR AB - OBJECTIVE: This study attempted to determine if Housing First (HF) decreased suicidal ideation and attempts compared to treatment as usual (TAU) amongst homeless persons with mental disorders, a population with a demonstrably high risk of suicidal behaviour. METHOD: The At Home/Chez Soi project is an unblinded, randomised control trial conducted across 5 Canadian cities (Vancouver, Winnipeg, Toronto, Montreal, Moncton) from 2009 to 2013. Homeless adults with a diagnosed major mental health disorder were recruited through community agencies and randomised to HF ( n = 1265) and TAU ( n = 990). HF participants were provided with private housing units and received case management support services. TAU participants retained access to existing community supports. Past-month suicidal ideation was measured at baseline and 6, 12, 18, and 21/24 months. A history of suicide attempts was measured at baseline and the 21/24-month follow-up. RESULTS: Compared to baseline, there was an overall trend of decreased past-month suicidal ideation (estimate = -.57, SE = .05, P < 0.001), with no effect of treatment group (i.e., HF vs. TAU; estimate = -.04, SE = .06, P = 0.51). Furthermore, there was no effect of treatment status (estimate = -.10, SE = .16, P = 0.52) on prevalence of suicide attempts (HF = 11.9%, TAU = 10.5%) during the 2-year follow-up period. CONCLUSION: This study failed to find evidence that HF is superior to TAU in reducing suicidal ideation and attempts. We suggest that HF interventions consider supplemental psychological treatments that have proven efficacy in reducing suicidal behaviour. It remains to be determined what kind of suicide prevention interventions (if any) are specifically effective in further reducing suicidal risk in a housing-first intervention. Publisher: Abstract available from the publisher. fre AD - 1 Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba. 2 Department of Psychology, University of Oregon, Eugene, Oregon, USA. 3 Institute of Urban Studies, University of Winnipeg, Winnipeg, Manitoba. 4 Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba. 5 Faculty of Education, Université de Moncton, Moncton, New Brunswick. 6 Department of Psychiatry, Psychology and Community Health Sciences, University of Manitoba, Winnipeg, Manitoba. 7 Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba. 8 Manitoba Centre for Health Policy, Winnipeg, Manitoba. 9 Faculty of Health Sciences, Simon Fraser University, Vancouver, British Columbia. 10 Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, Ontario. 11 School of Population and Public Health, University of British Columbia, Vancouver, British Columbia. AN - 28683228 AU - Aquin, J. P. AU - Roos, L. E. AU - Distasio, J. AU - Katz, L. Y. AU - Bourque, J. AU - Bolton, J. M. AU - Bolton, S. L. AU - Wong, J. Y. AU - Chateau, D. AU - Somers, J. M. AU - Enns, M. W. AU - Hwang, S. W. AU - Frankish, J. C. AU - Sareen, J. C2 - PMC5528985 DA - Jul DO - 10.1177/0706743717694836 DP - NLM ET - 2017/07/07 IS - 7 KW - Adult Canada *Case Management/statistics & numerical data Female *Homeless Persons/statistics & numerical data Humans Male Mental Disorders/*rehabilitation Middle Aged *Public Housing/statistics & numerical data *Suicidal Ideation Suicide, Attempted/*prevention & control *Housing First *community mental health services *homelessness *longitudinal study *randomised controlled trial *suicide LA - eng N1 - 1497-0015 Aquin, Joshua P Roos, Leslie E Distasio, Jino Katz, Laurence Y Bourque, Jimmy Bolton, James M Bolton, Shay-Lee Wong, Jacquelyne Y Chateau, Dan Somers, Julian M Enns, Murray W Hwang, Stephen W Frankish, James C Sareen, Jitender At Home/Chez Soi Investigators Journal Article Randomized Controlled Trial Research Support, Non-U.S. Gov't Can J Psychiatry. 2017 Jul;62(7):473-481. doi: 10.1177/0706743717694836. Epub 2017 Jan 1. PY - 2017 SN - 0706-7437 (Print) 0706-7437 SP - 473-481 ST - Effect of Housing First on Suicidal Behaviour: A Randomised Controlled Trial of Homeless Adults with Mental Disorders T2 - Can J Psychiatry TI - Effect of Housing First on Suicidal Behaviour: A Randomised Controlled Trial of Homeless Adults with Mental Disorders VL - 62 ID - 2387 ER - TY - JOUR AB - This article describes the results of an eight-month follow-up investigation from a randomized controlled trial of day hospital psychotherapy (DHP) compared with outpatient individual psychotherapy (OIP) for patients with personality disorders (N=114). The patients were randomly assigned to either 18 weeks of day hospital treatment followed by long-term conjoint group and individual therapy (DHP), or outpatient individual psychotherapy (OIP). The main outcome measures were attrition rate, suicide attempts, suicidal thoughts, self-injury, psychosocial functioning, symptom distress, and interpersonal and personality problems. The study showed a low dropout rate and a moderate improvement on a broad range of clinical measures for both treatments. However, there was no indication of the superiority of one treatment over the other. Neither was there any indication that day hospital treatment was better for the most poorly functioning patients. Further studies will follow this group of patients for the next few years, the results of which may have implications for resource allocation and the organization of mental health services for patients with personality disorders. AD - Department for Personality Psychiatry, Ullevål University Hospital, 0407 Oslo, Norway. espenarn@ulrik.uio.no AN - 19097870 AU - Arnevik, E. AU - Wilberg, T. AU - Urnes, O. AU - Johansen, M. AU - Monsen, J. T. AU - Karterud, S. DA - Mar DO - 10.1016/j.eurpsy.2008.09.004 DP - NLM ET - 2008/12/23 IS - 2 KW - Adult Ambulatory Care/methods/*statistics & numerical data Day Care, Medical/methods/*statistics & numerical data Female Follow-Up Studies Hospitals, University/*statistics & numerical data Humans Interpersonal Relations Male Mental Health Services/statistics & numerical data Middle Aged Norway/epidemiology Outpatients/statistics & numerical data Patient Dropouts/statistics & numerical data Personality Disorders/epidemiology/*therapy Psychotherapy/methods/*statistics & numerical data Psychotherapy, Group/methods/*statistics & numerical data Self-Injurious Behavior/epidemiology/prevention & control Suicide, Attempted/statistics & numerical data Treatment Outcome LA - eng N1 - Arnevik, Espen Wilberg, Theresa Urnes, Oyvind Johansen, Merete Monsen, Jon T Karterud, Sigmund Comparative Study Journal Article Randomized Controlled Trial Research Support, Non-U.S. Gov't England Eur Psychiatry. 2009 Mar;24(2):71-8. doi: 10.1016/j.eurpsy.2008.09.004. Epub 2008 Dec 19. PY - 2009 SN - 0924-9338 (Print) 0924-9338 SP - 71-8 ST - Psychotherapy for personality disorders: short-term day hospital psychotherapy versus outpatient individual therapy - a randomized controlled study T2 - Eur Psychiatry TI - Psychotherapy for personality disorders: short-term day hospital psychotherapy versus outpatient individual therapy - a randomized controlled study VL - 24 ID - 284 ER - TY - JOUR AB - Aims: The treatment of suicidal behaviour remains limited in efficacy. This pilot study assessed the effectiveness of a time-limited, group-based problem-solving therapy intervention compared with a treatment as usual control group, in females who self-poison. Method: A total of 18 clients were equally randomised to treatment or control groups. All clients were assessed using standardised questionnaires for depression, hopelessness, suicidal ideation and social problem-solving skills, at pre-treatment, post-treatment and two months follow-up. Results: The treatment group experienced significant reductions in levels of depression, hopelessness, suicidal ideation and improvements in self-assessed social problem-solving skills. Improvements in mental health and aspects of self-assessed problem-solving skills for the treatment group continued to be evident at two months follow-up. The control group did not change significantly over time on mental health measures or social problem solving abilities. Conclusion: Although limited by small sample size, the results suggest that group-based problem-solving therapy is effective in the management of deliberate self-poisoning. This paper is a unique contribution in that it examines the implementation of problem solving therapy with a homogenous population and in a group format. Methodological concerns and directions for future research are discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved) AD - Bannan, Noreen: Connolly Hospital, Dublin, Ireland, 15, noreen.bannan@hse.ie AU - Bannan, Noreen DO - 10.1080/14733140903337292 IS - 3 KW - *Group Psychotherapy *Problem Solving *Self-Injurious Behavior *Self-Poisoning Human Females PY - 2010 SN - 1746-1405(Electronic),1473-3145(Print) SP - 201-213 ST - Group-based problem-solving therapy in self-poisoning females: A pilot study T2 - Counselling & Psychotherapy Research TI - Group-based problem-solving therapy in self-poisoning females: A pilot study VL - 10 ID - 671 ER - TY - JOUR AB - OBJECTIVE: This study compared the effectiveness of psychoanalytically oriented partial hospitalization with standard psychiatric care for patients with borderline personality disorder. METHOD: Thirty-eight patients with borderline personality disorder, diagnosed according to standardized criteria, were allocated either to a partially hospitalized group or to a standard psychiatric care (control) group in a randomized controlled design. Treatment, which included individual and group psychoanalytic psychotherapy, was for a maximum of 18 months. Outcome measures included the frequency of suicide attempts and acts of self-harm, the number and duration of inpatient admissions, the use of psychotropic medication, and self-report measures of depression, anxiety, general symptom distress, interpersonal function, and social adjustment. Data analysis used repeated measures analysis of covariance and nonparametric tests of trend. RESULTS: Patients who were partially hospitalized showed a statistically significant decrease on all measures in contrast to the control group, which showed limited change or deterioration over the same period. An improvement in depressive symptoms, a decrease in suicidal and self-mutilatory acts, reduced inpatient days, and better social and interpersonal function began at 6 months and continued until the end of treatment at 18 months. CONCLUSIONS: Psychoanalytically oriented partial hospitalization is superior to standard psychiatric care for patients with borderline personality disorder. Replication is needed with larger groups, but these results suggest that partial hospitalization may offer an alternative to inpatient treatment. AD - Halliwick Day Unit, St. Ann's Hospital. anthony@mullins.demon.co.uk AN - 10518167 AU - Bateman, A. AU - Fonagy, P. DA - Oct DO - 10.1176/ajp.156.10.1563 DP - NLM ET - 1999/10/13 IS - 10 KW - Adult Anxiety Disorders/diagnosis Borderline Personality Disorder/psychology/*therapy *Day Care, Medical Depressive Disorder/diagnosis Female Health Status Hospitalization Humans Interpersonal Relations Length of Stay London/epidemiology Male Personality Inventory/statistics & numerical data Psychiatric Status Rating Scales/statistics & numerical data *Psychoanalytic Therapy Psychotherapy, Group Psychotropic Drugs/administration & dosage Self Mutilation/epidemiology/psychology Social Adjustment Suicide, Attempted/psychology/statistics & numerical data Treatment Outcome LA - eng N1 - Bateman, A Fonagy, P Clinical Trial Comparative Study Journal Article Randomized Controlled Trial United States Am J Psychiatry. 1999 Oct;156(10):1563-9. doi: 10.1176/ajp.156.10.1563. PY - 1999 SN - 0002-953X (Print) 0002-953x SP - 1563-9 ST - Effectiveness of partial hospitalization in the treatment of borderline personality disorder: a randomized controlled trial T2 - Am J Psychiatry TI - Effectiveness of partial hospitalization in the treatment of borderline personality disorder: a randomized controlled trial VL - 156 ID - 672 ER - TY - JOUR AB - OBJECTIVE: The aim of this study was to determine whether the substantial gains made by patients with borderline personality disorder following completion of a psychoanalytically oriented partial hospitalization program, in comparison to patients treated with standard psychiatric care, were maintained over an 18-month follow-up period. METHOD: Forty-four patients who participated in the original study were assessed every 3 months after completion of the treatment phase. Outcome measures included frequency of suicide attempts and acts of self-harm, number and duration of inpatient admissions, service utilization, and self-reported measures of depression, anxiety, general symptom distress, interpersonal functioning, and social adjustment. RESULTS: Patients who completed the partial hospitalization program not only maintained their substantial gains but also showed a statistically significant continued improvement on most measures in contrast to the patients treated with standard psychiatric care, who showed only limited change during the same period. CONCLUSIONS: The superiority of psychoanalytically oriented partial hospitalization over standard psychiatric treatment found in a previous randomized, controlled trial was maintained over an 18-month follow-up period. Continued improvement in social and interpersonal functioning suggests that longer-term changes were stimulated. AD - Halliwick Day Unit, St. Ann's Hospital, University College London, London, UK. anthony@mullins.demon.co.uk AN - 11136631 AU - Bateman, A. AU - Fonagy, P. DA - Jan DO - 10.1176/appi.ajp.158.1.36 DP - NLM ET - 2001/01/04 IS - 1 KW - Borderline Personality Disorder/diagnosis/epidemiology/*therapy Comorbidity *Day Care, Medical Depressive Disorder/diagnosis/epidemiology/psychology Follow-Up Studies Hospitalization Humans Interpersonal Relations Length of Stay Personality Inventory/statistics & numerical data *Psychoanalytic Therapy Self-Injurious Behavior/diagnosis/epidemiology Social Adjustment Suicide, Attempted/statistics & numerical data Treatment Outcome LA - eng N1 - Bateman, A Fonagy, P Clinical Trial Comparative Study Journal Article Randomized Controlled Trial United States Am J Psychiatry. 2001 Jan;158(1):36-42. doi: 10.1176/appi.ajp.158.1.36. PY - 2001 SN - 0002-953X (Print) 0002-953x SP - 36-42 ST - Treatment of borderline personality disorder with psychoanalytically oriented partial hospitalization: an 18-month follow-up T2 - Am J Psychiatry TI - Treatment of borderline personality disorder with psychoanalytically oriented partial hospitalization: an 18-month follow-up VL - 158 ID - 551 ER - TY - JOUR AB - OBJECTIVE: This study evaluated the effect of mentalization-based treatment by partial hospitalization compared to treatment as usual for borderline personality disorder 8 years after entry into a randomized, controlled trial and 5 years after all mentalization-based treatment was complete. METHOD: Interviewing was by research psychologists blind to original group allocation and structured review of medical notes of 41 patients from the original trial. Multivariate analysis of variance, chi-square, univariate analysis of variance, and nonparametric Mann-Whitney statistics were used to contrast the two groups depending on the distribution of the data. RESULTS: Five years after discharge from mentalization-based treatment, the mentalization-based treatment by partial hospitalization group continued to show clinical and statistical superiority to treatment as usual on suicidality (23% versus 74%), diagnostic status (13% versus 87%), service use (2 years versus 3.5 years of psychiatric outpatient treatment), use of medication (0.02 versus 1.90 years taking three or more medications), global function above 60 (45% versus 10%), and vocational status (employed or in education 3.2 years versus 1.2 years). CONCLUSIONS: Patients with 18 months of mentalization-based treatment by partial hospitalization followed by 18 months of maintenance mentalizing group therapy remain better than those receiving treatment as usual, but their general social function remains impaired. AD - Halliwick Unit, St. Ann's Hospital, Barnet, Enfield, and Haringey Mental Health Trust, London, UK N15 3TH. anthony@abate.org.uk AN - 18347003 AU - Bateman, A. AU - Fonagy, P. DA - May DO - 10.1176/appi.ajp.2007.07040636 DP - NLM ET - 2008/03/19 IS - 5 KW - Adult Borderline Personality Disorder/drug therapy/epidemiology/*therapy Double-Blind Method Drug Therapy/*methods/*statistics & numerical data Female Follow-Up Studies Hospitalization/*statistics & numerical data Humans Psychotherapy/*methods/*statistics & numerical data Suicide, Attempted/psychology LA - eng N1 - 1535-7228 Bateman, Anthony Fonagy, Peter Case Reports Journal Article Randomized Controlled Trial Research Support, Non-U.S. Gov't United States Am J Psychiatry. 2008 May;165(5):631-8. doi: 10.1176/appi.ajp.2007.07040636. Epub 2008 Mar 17. PY - 2008 SN - 0002-953x SP - 631-8 ST - 8-year follow-up of patients treated for borderline personality disorder: mentalization-based treatment versus treatment as usual T2 - Am J Psychiatry TI - 8-year follow-up of patients treated for borderline personality disorder: mentalization-based treatment versus treatment as usual VL - 165 ID - 186 ER - TY - JOUR AB - OBJECTIVE: This randomized controlled trial tested the effectiveness of an 18-month mentalization-based treatment (MBT) approach in an outpatient context against a structured clinical management (SCM) outpatient approach for treatment of borderline personality disorder. METHOD: Patients (N=134) consecutively referred to a specialist personality disorder treatment center and meeting selection criteria were randomly allocated to MBT or SCM. Eleven mental health professionals equal in years of experience and training served as therapists. Independent evaluators blind to treatment allocation conducted assessments every 6 months. The primary outcome was the occurrence of crisis events, a composite of suicidal and severe self-injurious behaviors and hospitalization. Secondary outcomes included social and interpersonal functioning and self-reported symptoms. Outcome measures, assessed at 6-month intervals, were analyzed using mixed effects logistic regressions for binary data, Poisson regression models for count data, and mixed effects linear growth curve models for self-report variables. RESULTS: Substantial improvements were observed in both conditions across all outcome variables. Patients randomly assigned to MBT showed a steeper decline of both self-reported and clinically significant problems, including suicide attempts and hospitalization. CONCLUSIONS: Structured treatments improve outcomes for individuals with borderline personality disorder. A focus on specific psychological processes brings additional benefits to structured clinical support. Mentalization-based treatment is relatively undemanding in terms of training so it may be useful for implementation into general mental health services. Further evaluations by independent research groups are now required. AD - Consultant Psychiatrist in Psychotherapy, Barnet Enfield and Haringey Mental Health NHS Trust, Halliwick Psychological Therapies Service, St Ann's Hospital, St Ann's Road, London. anthony@mullins.plus.com AN - 19833787 AU - Bateman, A. AU - Fonagy, P. DA - Dec DO - 10.1176/appi.ajp.2009.09040539 DP - NLM ET - 2009/10/17 IS - 12 KW - Adolescent Adult Aged Ambulatory Care/*methods Borderline Personality Disorder/epidemiology/psychology/*therapy Cognitive Behavioral Therapy/methods Comorbidity Double-Blind Method Female Follow-Up Studies Hospitalization Humans Male Mental Disorders/diagnosis/epidemiology Middle Aged Psychiatric Status Rating Scales Psychotherapy/*methods Psychotherapy, Group Self-Injurious Behavior/therapy Suicide, Attempted/psychology/statistics & numerical data Treatment Outcome LA - eng N1 - 1535-7228 Bateman, Anthony Fonagy, Peter Comparative Study Journal Article Randomized Controlled Trial Research Support, Non-U.S. Gov't United States Am J Psychiatry. 2009 Dec;166(12):1355-64. doi: 10.1176/appi.ajp.2009.09040539. Epub 2009 Oct 15. PY - 2009 SN - 0002-953x SP - 1355-64 ST - Randomized controlled trial of outpatient mentalization-based treatment versus structured clinical management for borderline personality disorder T2 - Am J Psychiatry TI - Randomized controlled trial of outpatient mentalization-based treatment versus structured clinical management for borderline personality disorder VL - 166 ID - 161 ER - TY - JOUR AB - The aim of this study was to compare the efficacy of two doses of monthly intramuscular (i.m.) injections of fluphenazine decanoate in reducing self-harm behaviours in outpatients with histories of multiple suicide attempts. Fifty-eight patients who presented to a psychiatric emergency service after an attempted suicide and who had histories of multiple suicide attempts, were randomized to receive monthly i.m. injections of fluphenazine decanoate. Thirty patients received monthly 12.5 mg ('low' dose), and 28 patients received monthly 1.5 mg ('ultra low' dose) under double-blind conditions. DSM-III-R diagnoses were obtained on all patients using the Structured Clinical Interview for DSM-III-R-Patient Version (SCID-P) and SCID for DSM-III-R Personality Disorders (SCID-II). Outcomes were assessed by the Parasuicide History Inventory and the Abnormal Involuntary Movement Scale, collected monthly for 6 months. Patients had an average of six current Axis I and 2.6 Axis II diagnoses, with borderline personality (85%) and alcohol dependence (58%) occurring most frequently in the sample. Both the low dose and ultra-low dose groups showed a marked reduction in self-harm behaviours. For 'serious' self-harm behaviours, there was a trend for a greater effect of the low dose over the ultra-low dose group, however, the differences did not reach statistical significance. A survival analysis indicated that the presence of 'acute' stressors at baseline and female sex were risk factors for continuing (post-randomization) 'serious' self-harm behaviours, while younger age and the absence of concurrent general medical conditions were risk factors for all self-harm behaviours. AD - Alaska Psychiatric Institute, Anchorage, USA. AN - 10565804 AU - Battaglia, J. AU - Wolff, T. K. AU - Wagner-Johnson, D. S. AU - Rush, A. J. AU - Carmody, T. J. AU - Basco, M. R. DA - Nov DO - 10.1097/00004850-199911000-00007 DP - NLM ET - 1999/11/24 IS - 6 KW - Adult Antipsychotic Agents/administration & dosage/*therapeutic use Delayed-Action Preparations Double-Blind Method Emergency Treatment Female Fluphenazine/administration & dosage/*therapeutic use Humans Interview, Psychological Male Personality Assessment Psychiatric Status Rating Scales Recurrence Retrospective Studies Risk Factors Self-Injurious Behavior/drug therapy/psychology Suicide, Attempted/*prevention & control/*psychology LA - eng N1 - Battaglia, J Wolff, T K Wagner-Johnson, D S Rush, A J Carmody, T J Basco, M R MH-53799/MH/NIMH NIH HHS/United States Clinical Trial Journal Article Randomized Controlled Trial Research Support, Non-U.S. Gov't Research Support, U.S. Gov't, P.H.S. England Int Clin Psychopharmacol. 1999 Nov;14(6):361-72. doi: 10.1097/00004850-199911000-00007. PY - 1999 SN - 0268-1315 (Print) 0268-1315 SP - 361-72 ST - Structured diagnostic assessment and depot fluphenazine treatment of multiple suicide attempters in the emergency department T2 - Int Clin Psychopharmacol TI - Structured diagnostic assessment and depot fluphenazine treatment of multiple suicide attempters in the emergency department VL - 14 ID - 2404 ER - TY - JOUR AB - BACKGROUND: Self‐harm and suicidal behaviour are common reasons for emergency department presentation. Those who present with self‐harm have an elevated risk of further suicidal behaviour and death. AIMS: To examine whether a postcard intervention reduces self‐harm re‐presentations in individuals presenting to the emergency department. METHOD: Randomised controlled trial conducted in Christchurch, New Zealand. The intervention consisted of six postcards mailed during the 12 months following an index emergency department attendance for self‐harm. Outcome measures were the proportion of participants re‐presenting with self‐harm and the number of re‐presentations for self‐harm in the 12 months following the initial presentation. RESULTS: After adjustment for prior self‐harm, there were no significant differences between the control and intervention groups in the proportion of participants re‐presenting with self‐harm or in the total number of re‐presentations for self‐harm. CONCLUSIONS: The postcard intervention did not reduce further self‐harm. Together with previous results this finding suggests that the postcard intervention may be effective only for selected subgroups. AN - CN-00759523 AU - Beautrais, A. L. AU - Gibb, S. J. AU - Faulkner, A. AU - Fergusson, D. M. AU - Mulder, R. T. DO - 10.1192/bjp.bp.109.075754 IS - 1 KW - Adolescent Adult Correspondence as Topic Emergency Service, Hospital [statistics & numerical data] Female Humans Male Patient Acceptance of Health Care [statistics & numerical data] Postal Service Secondary Prevention Self‐Injurious Behavior [*prevention & control] Suicide, Attempted [prevention & control] Young Adult M3 - Journal Article; Randomized Controlled Trial; Research Support, Non‐U.S. Gov't PY - 2010 SP - 55‐60 ST - Postcard intervention for repeat self-harm: randomised controlled trial T2 - British journal of psychiatry TI - Postcard intervention for repeat self-harm: randomised controlled trial UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00759523/full VL - 197 ID - 582 ER - TY - JOUR AB - BACKGROUND: Those with first-episode psychosis are at high-risk of suicide. AIMS: To identify predictive factors for suicidal thoughts, plans and attempts, and to investigate the rate of suicides and other deaths during the 5 years after first diagnosis and initiation of treatment. METHOD: A longitudinal, prospective, 5-year follow-up study of 547 individuals with first-episode schizophrenia spectrum psychosis. Individuals presenting for their first treatment in mental health services in two circumscribed urban areas in Denmark were included in a randomised controlled trial of integrated v. standard treatment. All participants were followed in the Danish Cause of Death Register for 5 years. Suicidal behaviour and clinical and social status were assessed using validated interviews and rating scales at entry, and at 1- and 2-year follow-ups. RESULTS: Sixteen participants died during the follow-up. We found a strong association between suicidal thoughts, plans and previous attempts, depressive and psychotic symptoms and young age, and with suicidal plans and attempts at 1- and 2-year follow-up. CONCLUSIONS: In this first-episode cohort depressive and psychotic symptoms, especially hallucinations, predicted suicidal plans and attempts, and persistent suicidal behaviour and ideation were associated with high risk of attempted suicide. AD - Bispebjerg Hospital, Department of Psychiatry, Bispebjerg Bakke 23, 2400 Copenhagen NV, Denmark. AN - 18055932 AU - Bertelsen, M. AU - Jeppesen, P. AU - Petersen, L. AU - Thorup, A. AU - Øhlenschlaeger, J. AU - le Quach, P. AU - Christensen, TØ AU - Krarup, G. AU - Jørgensen, P. AU - Nordentoft, M. DA - Dec DO - 10.1192/bjp.191.51.s140 DP - NLM ET - 2008/01/19 KW - Adolescent Adult Delivery of Health Care/methods Delivery of Health Care, Integrated/methods Depression/psychology Epidemiologic Methods Female Humans Male Middle Aged Psychotic Disorders/*psychology/therapy Schizophrenia/therapy *Schizophrenic Psychology Suicide/*psychology Suicide, Attempted/psychology LA - eng N1 - Bertelsen, Mette Jeppesen, Pia Petersen, Lone Thorup, Anne Øhlenschlaeger, Johan le Quach, Phuong Christensen, Torben Østergaard Krarup, Gertrud Jørgensen, Per Nordentoft, Merete Journal Article Multicenter Study Randomized Controlled Trial Research Support, Non-U.S. Gov't England Br J Psychiatry Suppl. 2007 Dec;51:s140-6. doi: 10.1192/bjp.191.51.s140. PY - 2007 SN - 0960-5371 (Print) 0960-5371 SP - s140-6 ST - Suicidal behaviour and mortality in first-episode psychosis: the OPUS trial T2 - Br J Psychiatry Suppl TI - Suicidal behaviour and mortality in first-episode psychosis: the OPUS trial VL - 51 ID - 526 ER - TY - JOUR AB - BACKGROUND: Attempted suicide is a strong risk factor for subsequent suicidal behaviors. Innovative strategies to deal with people who have attempted suicide are needed, particularly in resource‐poor settings. AIMS: To evaluate a brief educational intervention and periodic follow‐up contacts (BIC) for suicide attempters in five culturally different sites (Campinas, Brazil; Chennai, India; Colombo, Sri Lanka; Karaj, Islamic Republic of Iran; and Yuncheng, People's Republic of China) as part of the WHO Multisite Intervention Study on Suicidal Behaviors (SUPRE‐MISS). METHODS: Among the 1,867 suicide attempters enrolled in the emergency departments of the participating sites, 922 (49.4%) were randomly assigned to a brief intervention and contact (BIC) group and 945 (50.6%) to a treatment as usual (TAU) group. Repeated suicide attempts over the 18 months following the index attempt ‐ the secondary outcome measure presented in this paper ‐ were identified by follow‐up calls or visits. Subsequent completed suicide ‐ the primary outcome measure ‐ has been reported in a previous paper. RESULTS: Overall, the proportion of subjects with repeated suicide attempts was similar in the BIC and TAU groups (7.6% vs. 7.5%, chi(2) = 0.013; p = .909), but there were differences in rates across the five sites. CONCLUSIONS: This study from five low‐ and middle‐income countries does not confirm the effectiveness of brief educational intervention and follow‐up contacts for suicide attempters in reducing subsequent repetition of suicide attempts up to 18 months after discharge from emergency departments. AN - CN-00769088 AU - Bertolote, J. M. AU - Fleischmann, A. AU - De Leo, D. AU - Phillips, M. R. AU - Botega, N. J. AU - Vijayakumar, L. AU - De Silva, D. AU - Schlebusch, L. AU - Nguyen, V. T. AU - Sisask, M. AU - et al. DO - 10.1027/0027-5910/a000052 IS - 4 KW - Adult Brazil [epidemiology] China [epidemiology] Developed Countries [statistics & numerical data] Emergency Service, Hospital [statistics & numerical data] Female Humans India [epidemiology] Iran [epidemiology] Male Psychiatric Status Rating Scales Psychotherapy Secondary Prevention Sri Lanka [epidemiology] Suicide, Attempted [economics, prevention & control, psychology, *statistics & numerical data] Young Adult M3 - Journal Article; Randomized Controlled Trial; Research Support, Non‐U.S. Gov't PY - 2010 SP - 194‐201 ST - Repetition of suicide attempts: data from emergency care settings in five culturally different low- and middle-income countries participating in the WHO SUPRE-MISS Study T2 - Crisis TI - Repetition of suicide attempts: data from emergency care settings in five culturally different low- and middle-income countries participating in the WHO SUPRE-MISS Study UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00769088/full VL - 31 ID - 586 ER - TY - JOUR AB - BACKGROUND: People with borderline personality disorder frequently experience crises. To date, no randomised controlled trials (RCTs) of crisis interventions for this population have been published. AIMS: To examine the feasibility of recruiting and retaining adults with borderline personality disorder to a pilot RCT investigating the potential efficacy and cost-effectiveness of using a joint crisis plan. METHOD: An RCT of joint crisis plans for community-dwelling adults with borderline personality disorder (trial registration: ISRCTN12440268). The primary outcome measure was the occurrence of self-harming behaviour over the 6-month period following randomisation. Secondary outcomes included depression, anxiety, engagement and satisfaction with services, quality of life, well-being and cost-effectiveness. RESULTS: In total, 88 adults out of the 133 referred were eligible and were randomised to receive a joint crisis plan in addition to treatment as usual (TAU; n = 46) or TAU alone (n = 42). This represented approximately 75% of our target sample size and follow-up data were collected on 73 (83.0%) participants. Intention-to-treat analysis revealed no significant differences in the proportion of participants who reported self-harming (odds ratio (OR) = 1.9, 95% CI 0.53-6.5, P = 0.33) or the frequency of self-harming behaviour (rate ratio (RR) = 0.74, 95% CI 0.34-1.63, P = 0.46) between the two groups at follow-up. No significant differences were observed between the two groups on any of the secondary outcome measures or costs. CONCLUSIONS: It is feasible to recruit and retain people with borderline personality disorder to a trial of joint crisis plans and the intervention appears to have high face validity with this population. However, we found no evidence of clinical efficacy in this feasibility study. AD - Health Services & Population Research Department, Institute of Psychiatry, King's College London, UK. AN - 23637110 AU - Borschmann, R. AU - Barrett, B. AU - Hellier, J. M. AU - Byford, S. AU - Henderson, C. AU - Rose, D. AU - Slade, M. AU - Sutherby, K. AU - Szmukler, G. AU - Thornicroft, G. AU - Hogg, J. AU - Moran, P. DA - May DO - 10.1192/bjp.bp.112.117762 DP - NLM ET - 2013/05/03 IS - 5 KW - Adult Anxiety/psychology Borderline Personality Disorder/complications/economics/*therapy Cost-Benefit Analysis Crisis Intervention/economics/*methods Depression/psychology Feasibility Studies Female Humans Interpersonal Relations Male Mental Health Services/statistics & numerical data Patient Acceptance of Health Care/statistics & numerical data Patient Satisfaction Pilot Projects Quality of Life Self-Injurious Behavior/psychology Single-Blind Method Social Welfare/economics/statistics & numerical data Treatment Outcome LA - eng N1 - 1472-1465 Borschmann, Rohan Barrett, Barbara Hellier, Jennifer M Byford, Sarah Henderson, Claire Rose, Diana Slade, Mike Sutherby, Kim Szmukler, George Thornicroft, Graham Hogg, Joanna Moran, Paul G0601660/Medical Research Council/United Kingdom G0701752/Medical Research Council/United Kingdom NF-SI-0611-10053/Department of Health/United Kingdom 85397/MRC_/Medical Research Council/United Kingdom Journal Article Randomized Controlled Trial Research Support, Non-U.S. Gov't England Br J Psychiatry. 2013 May;202(5):357-64. doi: 10.1192/bjp.bp.112.117762. Epub 2013 Apr 11. PY - 2013 SN - 0007-1250 SP - 357-64 ST - Joint crisis plans for people with borderline personality disorder: feasibility and outcomes in a randomised controlled trial T2 - Br J Psychiatry TI - Joint crisis plans for people with borderline personality disorder: feasibility and outcomes in a randomised controlled trial VL - 202 ID - 2418 ER - TY - JOUR AB - Objective: Although the months following discharge from psychiatric hospitalization are a period of acute risk for veterans, there is a dearth of empirically supported treatments tailored to veterans in acute psychiatric hospitalization.Method: We conducted a randomized controlled trial to test the efficacy of Motivational Interviewing to Address Suicidal Ideation (MI-SI) that explored and resolved ambivalence, and a revised MI-SI (MI-SI-R) that resolved ambivalence, on suicidal ideation (SI) in hospitalized veterans who scored > 2 on the Scale for Suicidal Ideation. Participants were randomized to receive MI-SI plus treatment as usual (TAU), MI-SI-R+TAU, or TAU alone. MI-SI+TAU and MI-SI-R+TAU included two in-hospital therapy sessions and one telephone booster session. Participants completed follow-up assessments over 6 months.Results: Participants in all groups experienced reductions in the presence and severity of SI, but there were no significant differences among the groups. For the presence of SI, results were in the hypothesized direction for both MI-SI+TAU conditions.Conclusions: Results are nondefinitive, but the effect size of both versions of MI-SI+TAU on the presence of SI was consistent with prior MI findings. Exploratory analyses suggest MI-SI-R may be preferable to MI-SI. More intensive MI-SI-R with a greater number of follow-ups may increase its effectiveness. AD - VISN 2 Center of Excellence for Suicide Prevention, Department of Veterans Affairs, Canandaigua Medical Center, Canandaigua NY, USA Department of Psychiatry, University of Rochester Medical Center, Rochester NY, USA Center for Integrated Healthcare, Department of Veterans Affairs, Syracuse Medical Center, Syracuse NY, USA Department of Psychology, Syracuse University, Syracuse NY, USA AN - 141722006. Language: English. Entry Date: 20201021. Revision Date: 20210922. Publication Type: journal article AU - Britton, Peter C. AU - Conner, Kenneth R. AU - Chapman, Benjamin P. AU - Maisto, Stephen A. DB - CINAHL Complete DO - 10.1111/sltb.12581 DP - EBSCOhost IS - 1 KW - Suicidal Ideation Veterans -- Psychosocial Factors Suicide -- Prevention and Control Motivational Interviewing Adult Female Middle Age Suicide -- Psychosocial Factors Male Treatment Outcomes Validation Studies Comparative Studies Evaluation Research Multicenter Studies Questionnaires Funding Source Human Random Assignment N1 - research; tables/charts; randomized controlled trial. Journal Subset: Biomedical; Blind Peer Reviewed; Editorial Board Reviewed; Expert Peer Reviewed; Peer Reviewed; USA. Grant Information: IK2CX000641//U.S. Department of Veterans Affairs/. NLM UID: 7608054. PMID: NLM31393029. PY - 2020 SN - 0363-0234 SP - 233-248 ST - Motivational Interviewing to Address Suicidal Ideation: A Randomized Controlled Trial in Veterans T2 - Suicide & Life-Threatening Behavior TI - Motivational Interviewing to Address Suicidal Ideation: A Randomized Controlled Trial in Veterans UR - https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=141722006&site=ehost-live VL - 50 ID - 1033 ER - TY - JOUR AB - CONTEXT: Suicide attempts constitute a major risk factor for completed suicide, yet few interventions specifically designed to prevent suicide attempts have been evaluated. OBJECTIVE: To determine the effectiveness of a 10‐session cognitive therapy intervention designed to prevent repeat suicide attempts in adults who recently attempted suicide. DESIGN, SETTING, AND PARTICIPANTS: Randomized controlled trial of adults (N = 120) who attempted suicide and were evaluated at a hospital emergency department within 48 hours of the attempt. Potential participants (N = 350) were consecutively recruited from October 1999 to September 2002; 66 refused to participate and 164 were ineligible. Participants were followed up for 18 months. INTERVENTION: Cognitive therapy or enhanced usual care with tracking and referral services. MAIN OUTCOME MEASURES: Incidence of repeat suicide attempts and number of days until a repeat suicide attempt. Suicide ideation (dichotomized), hopelessness, and depression severity at 1, 3, 6, 12, and 18 months. RESULTS: From baseline to the 18‐month assessment, 13 participants (24.1%) in the cognitive therapy group and 23 participants (41.6%) in the usual care group made at least 1 subsequent suicide attempt (asymptotic z score, 1.97; P = .049). Using the Kaplan‐Meier method, the estimated 18‐month reattempt‐free probability in the cognitive therapy group was 0.76 (95% confidence interval [CI], 0.62‐0.85) and in the usual care group was 0.58 (95% CI, 0.44‐0.70). Participants in the cognitive therapy group had a significantly lower reattempt rate (Wald chi2(1) = 3.9; P = .049) and were 50% less likely to reattempt suicide than participants in the usual care group (hazard ratio, 0.51; 95% CI, 0.26‐0.997). The severity of self‐reported depression was significantly lower for the cognitive therapy group than for the usual care group at 6 months (P= .02), 12 months (P = .009), and 18 months (P = .046). The cognitive therapy group reported significantly less hopelessness than the usual care group at 6 months (P = .045). There were no significant differences between groups based on rates of suicide ideation at any assessment point. CONCLUSION: Cognitive therapy was effective in preventing suicide attempts for adults who recently attempted suicide. AN - CN-00523633 AU - Brown, G. K. AU - Ten Have, T. AU - Henriques, G. R. AU - Xie, S. X. AU - Hollander, J. E. AU - Beck, A. T. DO - 10.1001/jama.294.5.563 IS - 5 KW - Adult Cognitive Behavioral Therapy Female Humans Male Proportional Hazards Models Suicide, Attempted [*prevention & control] M3 - Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, P.H.S. PY - 2005 SP - 563‐570 ST - Cognitive therapy for the prevention of suicide attempts: a randomized controlled trial T2 - JAMA TI - Cognitive therapy for the prevention of suicide attempts: a randomized controlled trial UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00523633/full VL - 294 ID - 588 ER - TY - JOUR AB - OBJECTIVE: To evaluate the effectiveness of crisis response planning for the prevention of suicide attempts. METHOD: Randomized clinical trial of active duty Army Soldiers (N=97) at Fort Carson, Colorado, presenting for an emergency behavioral health appointment. Participants were randomly assigned to receive a contract for safety, a standard crisis response plan, or an enhanced crisis response plan. Incidence of suicide attempts during follow-up was assessed with the Suicide Attempt Self-Injury Interview. Inclusion criteria were the presence of suicidal ideation during the past week and/or a lifetime history of suicide attempt. Exclusion criteria were the presence of a medical condition that precluded informed consent (e.g., active psychosis, mania). Survival curve analyses were used to determine efficacy on time to first suicide attempt. Longitudinal mixed effects models were used to determine efficacy on severity of suicide ideation and follow-up mental health care utilization. RESULTS: From baseline to the 6-month follow-up, 3 participants receiving a crisis response plan (estimated proportion: 5%) and 5 participants receiving a contract for safety (estimated proportion: 19%) attempted suicide (log-rank χ(2)(1)=4.85, p=0.028; hazard ratio=0.24, 95% CI=0.06-0.96), suggesting a 76% reduction in suicide attempts. Crisis response planning was associated with significantly faster decline in suicide ideation (F(3,195)=18.64, p<0.001) and fewer inpatient hospitalization days (F(1,82)=7.41, p<0.001). There were no differences between the enhanced and standard crisis response plan conditions. CONCLUSION: Crisis response planning was more effective than a contract for safety in preventing suicide attempts, resolving suicide ideation, and reducing inpatient hospitalization among high-risk active duty Soldiers. AD - National Center for Veterans Studies, USA; The University of Utah, USA. Electronic address: craig.bryan@utah.edu. University of Texas Health Science Center at San Antonio, USA. National Center for Veterans Studies, USA; The University of Utah, USA. US Army MEDDAC, Fort Carson, CO, USA. National Center for Veterans Studies, USA; The University of Memphis, USA. AN - 28142085 AU - Bryan, C. J. AU - Mintz, J. AU - Clemans, T. A. AU - Leeson, B. AU - Burch, T. S. AU - Williams, S. R. AU - Maney, E. AU - Rudd, M. D. DA - Apr 1 DO - 10.1016/j.jad.2017.01.028 DP - NLM ET - 2017/02/01 KW - Adult *Crisis Intervention Female Hospitalization Humans Incidence Male Military Personnel/*psychology Risk Factors Self-Injurious Behavior Suicidal Ideation Suicide/psychology Suicide, Attempted/*prevention & control/statistics & numerical data United States *Contract for safety *Crisis response plan *Military *Psychotherapy *Safety plan *Suicide LA - eng N1 - 1573-2517 Bryan, Craig J Mintz, Jim Clemans, Tracy A Leeson, Bruce Burch, T Scott Williams, Sean R Maney, Emily Rudd, M David Journal Article Randomized Controlled Trial Netherlands J Affect Disord. 2017 Apr 1;212:64-72. doi: 10.1016/j.jad.2017.01.028. Epub 2017 Jan 23. PY - 2017 SN - 0165-0327 SP - 64-72 ST - Effect of crisis response planning vs. contracts for safety on suicide risk in U.S. Army Soldiers: A randomized clinical trial T2 - J Affect Disord TI - Effect of crisis response planning vs. contracts for safety on suicide risk in U.S. Army Soldiers: A randomized clinical trial VL - 212 ID - 84 ER - TY - JOUR AB - OBJECTIVE: The authors compared the efficacy of standard-of-care treatment plus intranasal esketamine or placebo for rapid reduction of symptoms of major depression, including suicidality, among individuals at imminent suicide risk. METHOD: In a double-blind, multicenter, proof-of-concept study, 68 participants were randomly assigned to receive esketamine (84 mg) or placebo twice weekly for 4 weeks, in addition to comprehensive standard-of-care treatment. The primary efficacy endpoint was change in score from baseline to 4 hours after initial dose on the Montgomery-Åsberg Depression Rating Scale (MADRS). Clinician global judgment of suicide risk (from the Suicide Ideation and Behavior Assessment Tool) was also assessed. Secondary endpoints included these measures at 24 hours and double-blind endpoint at day 25. RESULTS: A significantly greater improvement in MADRS score was observed in the esketamine group compared with the placebo group at 4 hours (least-square mean difference=-5.3, SE=2.10; effect size=0.61) and at ∼24 hours (least-square mean difference=-7.2, SE=2.85; effect size=0.65), but not at day 25 (least-square mean difference=-4.5, SE=3.14; effect size=0.35). Significantly greater improvement was also observed in the esketamine group on the MADRS suicidal thoughts item score at 4 hours (effect size=0.67), but not at 24 hours (effect size=0.35) or at day 25 (effect size=0.29). Between-group reductions in clinician global judgment of suicide risk scores were not statistically different at any time point. The most common adverse events among participants in the esketamine group were nausea, dizziness, dissociation, unpleasant taste, and headache. CONCLUSIONS: These preliminary findings indicate that intranasal esketamine compared with placebo, given in addition to comprehensive standard-of-care treatment, may result in significantly rapid improvement in depressive symptoms, including some measures of suicidal ideation, among depressed patients at imminent risk for suicide. AD - From Janssen Research and Development, Titusville, N.J., and San Diego; Janssen Scientific Affairs, Titusville, N.J.; and the Department of Psychiatry, Yale School of Medicine, New Haven, Conn. AN - 29656663 AU - Canuso, C. M. AU - Singh, J. B. AU - Fedgchin, M. AU - Alphs, L. AU - Lane, R. AU - Lim, P. AU - Pinter, C. AU - Hough, D. AU - Sanacora, G. AU - Manji, H. AU - Drevets, W. C. DA - Jul 1 DO - 10.1176/appi.ajp.2018.17060720 DP - NLM ET - 2018/04/17 IS - 7 KW - Administration, Intranasal Adult Antidepressive Agents/administration & dosage/*therapeutic use Depressive Disorder, Major/*drug therapy Double-Blind Method Female Humans Ketamine/administration & dosage/*therapeutic use Male Psychiatric Status Rating Scales Risk Factors Suicide/*prevention & control *Depression *Esketamine *Rapid Antidepressant *Suicidality LA - eng N1 - 1535-7228 Canuso, Carla M Singh, Jaskaran B Fedgchin, Maggie Alphs, Larry Lane, Rosanne Lim, Pilar Pinter, Christine Hough, David Sanacora, Gerard Manji, Husseini Drevets, Wayne C Journal Article Multicenter Study Randomized Controlled Trial Research Support, Non-U.S. Gov't United States Am J Psychiatry. 2018 Jul 1;175(7):620-630. doi: 10.1176/appi.ajp.2018.17060720. Epub 2018 Apr 16. PY - 2018 SN - 0002-953x SP - 620-630 ST - Efficacy and Safety of Intranasal Esketamine for the Rapid Reduction of Symptoms of Depression and Suicidality in Patients at Imminent Risk for Suicide: Results of a Double-Blind, Randomized, Placebo-Controlled Study T2 - Am J Psychiatry TI - Efficacy and Safety of Intranasal Esketamine for the Rapid Reduction of Symptoms of Depression and Suicidality in Patients at Imminent Risk for Suicide: Results of a Double-Blind, Randomized, Placebo-Controlled Study VL - 175 ID - 273 ER - TY - JOUR AB - OBJECTIVE: To determine whether an intervention using postcards (postcards from the EDge project) reduces repetitions of hospital treated deliberate self poisoning. DESIGN: Randomised controlled trial. SETTING: Regional referral service for general hospital treated deliberate self poisoning in Newcastle, Australia. PARTICIPANTS: 772 patients aged over 16 years with deliberate self poisoning. INTERVENTION: Non-obligatory intervention using eight postcards over 12 months along with standard treatment compared with standard treatment alone. MAIN OUTCOME MEASURES: Proportion of patients with one or more repeat episodes of deliberate self poisoning and the number of repeat episodes for deliberate self poisoning per person in 12 months. RESULTS: The proportion of repeaters with deliberate self poisoning in the intervention group did not differ significantly from that in the control group (57/378, 15.1%, 95% confidence interval 11.5% to 18.7% v 68/394, 17.3%, 13.5% to 21.0%: difference between groups -2%, -7% to 3%). In unadjusted analysis the number of repetitions were significantly reduced (incidence risk ratio 0.55, 0.35 to 0.87). CONCLUSION: A postcard intervention reduced repetitions of deliberate self poisoning, although it did not significantly reduce the proportion of individual repeaters. AD - Suicide Prevention Research Unit, Centre for Mental Health Studies, Faculty of Health, University of Newcastle, Newcastle, Australia. gregory.carter@newcastle.edu.au AN - 16183654 AU - Carter, G. L. AU - Clover, K. AU - Whyte, I. M. AU - Dawson, A. H. AU - D'Este, C. C2 - PMC1246077 DA - Oct 8 DO - 10.1136/bmj.38579.455266.E0 DP - NLM ET - 2005/09/27 IS - 7520 KW - Adolescent Adult Aged *Correspondence as Topic Female Humans Male Middle Aged New South Wales Poisoning/*prevention & control Postal Service *Reminder Systems Risk Factors Secondary Prevention Self-Injurious Behavior/*prevention & control LA - eng N1 - 1756-1833 Carter, Gregory L Clover, Kerrie Whyte, Ian M Dawson, Andrew H D'Este, Catherine Clinical Trial Comparative Study Journal Article Randomized Controlled Trial Research Support, Non-U.S. Gov't BMJ. 2005 Oct 8;331(7520):805. doi: 10.1136/bmj.38579.455266.E0. Epub 2005 Sep 23. PY - 2005 SN - 0959-8138 (Print) 0959-8138 SP - 805 ST - Postcards from the EDge project: randomised controlled trial of an intervention using postcards to reduce repetition of hospital treated deliberate self poisoning T2 - Bmj TI - Postcards from the EDge project: randomised controlled trial of an intervention using postcards to reduce repetition of hospital treated deliberate self poisoning VL - 331 ID - 677 ER - TY - JOUR AB - BACKGROUND: Repetition of self‐poisoning is common. AIMS: To report the 24‐month outcomes of a non‐obligatory postcard intervention (plus treatment as usual) compared with treatment as usual. METHOD: In a randomised‐controlled trial (Zelen design) conducted in Newcastle, Australia, eight postcards were sent to participants over a 12‐month period. The principal outcomes were the proportion of participants with one or more repeat episodes of self‐poisoning and the number of repeat episodes per person. RESULTS: No significant reduction was observed in the proportion of people repeating self‐poisoning in the intervention group (21.2%, 95% CI 17.0‐25.3) compared with the control group (22.8%, 95% CI 18.7‐27.0; chi(2)=0.32, d.f.=1, P=0.57); the difference between groups was ‐1.7% (95% CI ‐7.5 to 4.2). There was a significant reduction in the rate of repetition, with an incidence risk ratio of 0.49 (95% CI 0.33‐0.73). CONCLUSIONS: A postcard intervention maintained the halving of the rate of repetition of hospital‐treated self‐poisoning events over a 2‐year period, although it did not significantly reduce the proportion of individuals who repeated self‐poisoning. AN - CN-00628627 AU - Carter, G. L. AU - Clover, K. AU - Whyte, I. M. AU - Dawson, A. H. AU - D'Este, C. DO - 10.1192/bjp.bp.107.038406 KW - Adult Correspondence as Topic Female Humans Male New South Wales Poisoning [*prevention & control, psychology] Risk Factors Secondary Prevention Self‐Injurious Behavior [*prevention & control, psychology] Treatment Outcome M3 - Journal Article; Randomized Controlled Trial PY - 2007 SP - 548‐553 ST - Postcards from the EDge: 24-month outcomes of a randomised controlled trial for hospital-treated self-poisoning T2 - British journal of psychiatry TI - Postcards from the EDge: 24-month outcomes of a randomised controlled trial for hospital-treated self-poisoning UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00628627/full VL - 191 ID - 589 ER - TY - JOUR AB - Background Repetition of hospital-treated self-poisoning and admission to psychiatric hospital are both common in individuals who self-poison. Aims To evaluate efficacy of postcard intervention after 5 years. Method A randomised controlled trial of individuals who have self-poisoned: postcard intervention (eight in 12 months) plus treatment as usual v. treatment as usual. Our primary outcomes were self-poisoning admissions and psychiatric admissions (proportions and event rates). Results There was no difference between groups for any repeat-episode self-poisoning admission (intervention group: 24.9%, 95% CI 20.6-29.5; control group: 27.2%, 95% CI 22.8-31.8) but there was a significant reduction in event rates (incidence risk ratio (IRR)=0.54, 95% CI 0.37-0.81), saving 306 bed days. There was no difference for any psychiatric admission (intervention group: 38.1%, 95% CI 33.1-43.2; control group: 35.5%, 95% CI 30.8-40.5) but there was a significant reduction in event rates (IRR=0.66, 95% CI 0.47-0.91), saving 2565 bed days. Conclusions A postcard intervention halved self-poisoning events and reduced psychiatric admissions by a third after 5 years. Substantial savings occurred in general hospital and psychiatric hospital bed days. AU - Carter, Gregory L. AU - Clover, Kerrie AU - Whyte, Ian M. AU - Dawson, Andrew H. AU - D'Este, Catherine DB - Cambridge Core DO - 10.1192/bjp.bp.112.112664 DP - Cambridge University Press ET - 2018/01/02 IS - 5 PY - 2013 SN - 0007-1250 SP - 372-380 ST - Postcards from the EDge: 5-year outcomes of a randomised controlled trial for hospital-treated self-poisoning T2 - British Journal of Psychiatry TI - Postcards from the EDge: 5-year outcomes of a randomised controlled trial for hospital-treated self-poisoning UR - https://www.cambridge.org/core/article/postcards-from-the-edge-5year-outcomes-of-a-randomised-controlled-trial-for-hospitaltreated-selfpoisoning/CC4BA0FFF830E58FA2D1F0EB57462C4B VL - 202 ID - 521 ER - TY - JOUR AB - OBJECTIVE: Deliberate self-harm (DSH), general hospital admission and psychiatric hospital admission are common in women meeting criteria for borderline personality disorder (BPD). Dialectical behaviour therapy (DBT) has been reported to be effective in reducing DSH and hospitalization. METHOD: A randomized controlled trial of 73 female subjects meeting criteria for BPD was carried out with intention-to-treat analyses and per-protocol analyses. The intervention was DBT and the control condition was treatment as usual plus waiting list for DBT (TAU+WL), with outcomes measured after 6 months. Primary outcomes were differences in proportions and event rates of: any DSH; general hospital admission for DSH and any psychiatric admission; and mean difference in length of stay for any hospitalization. Secondary outcomes were disability and quality of life measures. RESULTS: Both groups showed a reduction in DSH and hospitalizations, but there were no significant differences in DSH, hospital admissions or length of stay in hospital between groups. Disability (days spent in bed) and quality of life (Physical, Psychological and Environmental domains) were significantly improved for the DBT group. CONCLUSION: DBT produced non-significant reductions in DSH and hospitalization when compared to the TAU+WL control, due in part to the lower than expected rates of hospitalization in the control condition. Nevertheless, DBT showed significant benefits for the secondary outcomes of improved disability and quality of life scores, a clinically useful result that is also in keeping with the theoretical constructs of the benefits of DBT. AD - Centre for Brain and Mental Health Research, University of Newcastle, New South Wales, Australia. gregory.carter@newcastle.edu.au AN - 20113305 AU - Carter, G. L. AU - Willcox, C. H. AU - Lewin, T. J. AU - Conrad, A. M. AU - Bendit, N. DA - Feb DO - 10.3109/00048670903393621 DP - NLM ET - 2010/02/02 IS - 2 KW - Adult Analysis of Variance *Behavior Therapy Borderline Personality Disorder/diagnosis/psychology/*therapy Chi-Square Distribution Female Hospitalization Humans Intention to Treat Analysis Length of Stay Quality of Life Self-Injurious Behavior/*therapy Treatment Outcome L1 - internal-pdf://0410628143/Carter-2010-Hunter DBT project_ randomized con.pdf LA - eng N1 - 1440-1614 Carter, Gregory L Willcox, Christopher H Lewin, Terry J Conrad, Agatha M Bendit, Nick Journal Article Randomized Controlled Trial England Aust N Z J Psychiatry. 2010 Feb;44(2):162-73. doi: 10.3109/00048670903393621. PY - 2010 SN - 0004-8674 SP - 162-73 ST - Hunter DBT project: randomized controlled trial of dialectical behaviour therapy in women with borderline personality disorder T2 - Aust N Z J Psychiatry TI - Hunter DBT project: randomized controlled trial of dialectical behaviour therapy in women with borderline personality disorder UR - https://journals.sagepub.com/doi/pdf/10.3109/00048670903393621 VL - 44 ID - 210 ER - TY - JOUR AB - Ambivalence to treatment and repeated suicidal behaviour are well‐known problems in suicide attempters. A randomised controlled study was performed to investigate the influence of repeated telephone contacts on treatment attendance, repetition of suicidal behaviour and mental health the year after a suicide attempt. SUBJECTS AND METHODS: One month after their suicide attempt 216 patients were randomised to either two telephone interventions in addition to treatment as usual, or no such intervention during the subsequent year. The interventions included motivational support to attend and/or to stay in treatment. At 1 month and again after 12 months the following measurements were used: GSI (SCL‐90), GAF and SSI. RESULTS: At follow‐up treatment attendance was high and did not differ between the randomised groups. Among those with an initial treatment contact other than psychiatric, more patients in the intervention group had such contact at follow‐up. The randomised groups did not differ in repetition of suicide attempts during follow‐up or in improvement in GSI (SCL‐90), GAF and SSI. In individuals with no initial treatment the intervention group improved more in certain psychological symptom dimensions (SCL‐90). CONCLUSION: Telephone interventions seem to have an effect on patients who at their suicide attempt had other treatment than psychiatric and in those with no treatment. AN - CN-00379725 AU - Cedereke, M. AU - Monti, K. AU - Ojehagen, A. DO - 10.1016/s0924-9338(02)00632-6 IS - 2 KW - Adult Community Mental Health Services Crisis Intervention [methods] Female Humans Interview, Psychological Male Mental Disorders [psychology] Middle Aged Psychiatric Status Rating Scales Statistics, Nonparametric Suicide, Attempted [*psychology] Sweden Telephone Time Factors M3 - Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non‐U.S. Gov't PY - 2002 SP - 82‐91 ST - Telephone contact with patients in the year after a suicide attempt: does it affect treatment attendance and outcome? A randomised controlled study T2 - European psychiatry TI - Telephone contact with patients in the year after a suicide attempt: does it affect treatment attendance and outcome? A randomised controlled study UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00379725/full VL - 17 ID - 590 ER - TY - JOUR AB - BACKGROUND: Positive psychological constructs have been associated with reduced suicidal ideation, and interventions to cultivate positive feelings have the potential to reduce suicide risk. This study compares the efficacy of a 6-week, telephone-based positive psychology (PP) intervention against a cognition-focused (CF) control intervention among patients recently hospitalized for depression and suicidal ideation or behavior. METHOD: A total of 65 adults with a current major depressive episode reporting suicidal ideation or a recent suicide attempt were enrolled from participating in-patient psychiatric units. Prior to discharge, participants were randomized to the PP (n = 32) or CF (n = 33) intervention. In both interventions, participants received a treatment manual, performed weekly PP (e.g. gratitude letter) or CF (e.g. recalling daily events) exercises, and completed weekly one-on-one telephone sessions over 6 weeks. Between-group differences in hopelessness (primary outcome), depression, suicidality and positive psychological constructs at 6 and 12 weeks were tested using mixed-effects models accounting for intensity of post-hospitalization psychiatric treatment. RESULTS: Compared with PP, the CF intervention was associated with significantly greater improvements in hopelessness at 6 weeks (β = -3.15, 95% confidence interval -6.18 to -0.12, effect size = -0.84, p = 0.04), but not 12 weeks. Similarly, the CF intervention led to greater improvements in depression, suicidal ideation, optimism and gratitude at 6 and 12 weeks. CONCLUSIONS: Contrary to our hypothesis, the CF intervention was superior to PP in improving hopelessness, other suicide risk factors and positive psychological constructs during a key post-discharge period among suicidal patients with depression. Further study of this CF intervention is warranted in populations at high suicide risk. AD - Harvard Medical School,Boston, MA,USA. Department of Psychiatry,Massachusetts General Hospital,Boston, MA,USA. AN - 27876105 AU - Celano, C. M. AU - Beale, E. E. AU - Mastromauro, C. A. AU - Stewart, J. G. AU - Millstein, R. A. AU - Auerbach, R. P. AU - Bedoya, C. A. AU - Huffman, J. C. C2 - PMC5340604 C6 - NIHMS839288 DA - Apr DO - 10.1017/s0033291716002798 DP - NLM ET - 2016/11/24 IS - 5 KW - Adult Cognitive Behavioral Therapy/*methods Depressive Disorder, Major/*therapy Female Humans Male Middle Aged *Outcome Assessment, Health Care Single-Blind Method Suicide/*prevention & control Young Adult Cognition depression optimism positive psychology suicide LA - eng N1 - 1469-8978 Celano, C M Beale, E E Mastromauro, C A Stewart, J G Millstein, R A Auerbach, R P Bedoya, C A Huffman, J C K23 HL123607/HL/NHLBI NIH HHS/United States K23 MH097786/MH/NIMH NIH HHS/United States R01 HL113272/HL/NHLBI NIH HHS/United States Journal Article Randomized Controlled Trial Psychol Med. 2017 Apr;47(5):810-821. doi: 10.1017/S0033291716002798. Epub 2016 Nov 23. PY - 2017 SN - 0033-2917 (Print) 0033-2917 SP - 810-821 ST - Psychological interventions to reduce suicidality in high-risk patients with major depression: a randomized controlled trial T2 - Psychol Med TI - Psychological interventions to reduce suicidality in high-risk patients with major depression: a randomized controlled trial VL - 47 ID - 2443 ER - TY - JOUR AB - BACKGROUND: Suicide attempts constitute a serious clinical problem and have important implications for healthcare resources. The aim of the present study was to evaluate the effectiveness of case management using crisis postcards over a 6-month follow-up period. METHOD: A randomised controlled trial was conducted in Kaohsiung, Taiwan. Prevention of further suicide attempts was compared between two groups with and without the postcard intervention. The intervention group consisted of 373 participants (139 males, 234 females; age: 39.8 ± 14.0 yrs.). The control group consisted of 388 participants (113 males, 275 females; age: 40.0 ± 16.0 yrs.). A survival analysis was used to test the effectiveness of the crisis postcard intervention for the prevention of suicide reattempts. Per-protocol and intention-to-treat analyses were conducted. RESULTS: The intention-to-treat analysis indicated that the crisis postcard had no effect (hazard ratio = 0.84; 95% CI = 0.56 - 1.29), whereas the per-protocol analysis showed a strong benefit for the crisis postcard (hazard ratio = 0.39; 95% CI = 0.21 - 0.72). CONCLUSION: Although the results of the present study indicated that the postcard intervention did not reduce subsequent suicide behaviour, our study provides an alteration to the postcard intervention. Further studies need to be conducted to clarify whether this type of intervention can reduce subsequent suicidal behaviour, with a particular focus on reducing the rate of loss to follow-up. AN - 23865947 AU - Chen, W. J. AU - Ho, C. K. AU - Shyu, S. S. AU - Chen, C. C. AU - Lin, G. G. AU - Chou, L. S. AU - Fang, Y. J. AU - Yeh, P. Y. AU - Chung, T. C. AU - Chou, F. H. C2 - PMC3720180 DA - Jul 17 DO - 10.1186/1471-244x-13-191 DP - NLM ET - 2013/07/20 KW - Adult *Case Management Crisis Intervention/*methods Female Humans Incidence Male Middle Aged *Suicidal Ideation Suicide/*prevention & control/statistics & numerical data Suicide, Attempted/*prevention & control/statistics & numerical data Survival Analysis Taiwan Therapeutics Young Adult LA - eng N1 - 1471-244x Chen, Wei-Jen Ho, Chi-Kung Shyu, Shi-Sen Chen, Cheng-Chung Lin, Guei-Ging Chou, Li-Shiu Fang, Yun-Ju Yeh, Pin-Yang Chung, Tieh-Chi Chou, Frank Huang-Chih Journal Article Randomized Controlled Trial Research Support, Non-U.S. Gov't BMC Psychiatry. 2013 Jul 17;13:191. doi: 10.1186/1471-244X-13-191. PY - 2013 SN - 1471-244x SP - 191 ST - Employing crisis postcards with case management in Kaohsiung, Taiwan: 6-month outcomes of a randomised controlled trial for suicide attempters T2 - BMC Psychiatry TI - Employing crisis postcards with case management in Kaohsiung, Taiwan: 6-month outcomes of a randomised controlled trial for suicide attempters VL - 13 ID - 314 ER - TY - JOUR AB - Background: The Accident & Emergency Department is an important gateway to psychiatric nursing services for patients presenting following deliberate self‐harm. To date, there are few systematic assessments of such services. Aims: To compare routine management enhanced by nurse‐led case management with routine management only. Method: Randomised controlled trial. Results: It was estimated that 20% of the study population were likely to be readmitted to A&E within 12 months of the index episode following a subsequent episode of self‐harm. A power analysis determined that to show a statistically significant 50% reduction in this rate a minimum sample size of 438 was required. Four hundred and sixty‐seven patients were identified over a 12‐month period: 220 were allocated to the intervention group and 247 to the comparison group. One hundred and seven (49%) of eligible patients received the intervention being evaluated. Overall, readmission rates did not vary between the intervention group (9%) and the comparison group (10%). Conclusions: The intervention did not result in a significant reduction in the readmission rate overall. Declaration of interest: Funded by the participating health authority. AN - CN-00395678 AU - Clarke, T. AU - Baker, P. AU - Watts, C. J. AU - Williams, K. AU - Feldman, R. A. AU - Sherr, L. DO - 10.1080/09638230020023561 IS - 2 KW - *nursing *suicidal behavior /therapy Adult Article Clinical trial Controlled study Female Hospital admission Human Intermethod comparison Major clinical study Male Medical care Mental health care Patient care Randomized controlled trial Suicide Treatment outcome M3 - Journal: Article PY - 2002 SP - 167‐176 ST - Self-harm in adults: a randomised controlled trial of nurse-led case management versus routine care only T2 - Journal of mental health (abingdon, england) TI - Self-harm in adults: a randomised controlled trial of nurse-led case management versus routine care only UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00395678/full VL - 11 ID - 591 ER - TY - JOUR AB - BACKGROUND: Despite the ubiquity of suicidality in behavioral health settings, empirically supported interventions for suicidality are surprisingly rare. Given the importance of resolving suicidality and therapists' anxieties about treating suicidal patients, there is a clear need for innovative services and clinical approaches. The purpose of the current study was an attempt to address some of these needs by examining the feasibility and use of a new intervention called the "Collaborative Assessment and Management of Suicidality" (CAMS) within a "Next-Day Appointment" (NDA) outpatient treatment setting. METHODS: As part of a larger feasibility study, n = 32 suicidal patients were randomly assigned to CAMS care versus Enhanced Care as Usual (E-CAU) in an outpatient crisis intervention setting attached to a safety net hospital. Intent to treat suicidal patients were seen and assessed before, during, and after treatment (with follow-up assessments conducted at 2, 4, 6, and 12 months). RESULTS: The feasibility of using CAMS in the NDA setting was clear; both groups appeared to initially benefit from their respective treatments in terms of decreased suicidal ideation and overall symptom distress. Although patients rated both treatments favorably, the CAMS group had significantly higher satisfaction and better treatment retention than E-CAU. At 12 months post-treatment, CAMS patients showed significantly better and sustained reductions in suicidal ideation, overall symptom distress, and increased hope in comparison to E-CAU patients. CONCLUSIONS: CAMS was both feasible in this NDA setting and effective in treating suicidal ideation, distress, and hopelessness (particularly at 12 months followup). AD - University of Washington, Seattle, Washington, USA. comtois@uw.edu AN - 21948348 AU - Comtois, K. A. AU - Jobes, D. A. AU - S, S. O' Connor AU - Atkins, D. C. AU - Janis, K. AU - C, E. Chessen AU - Landes, S. J. AU - Holen, A. AU - Yuodelis-Flores, C. DA - Nov DO - 10.1002/da.20895 DP - NLM ET - 2011/09/29 IS - 11 KW - Adult Ambulatory Care Appointments and Schedules Crisis Intervention/methods *Disease Management Feasibility Studies Female Follow-Up Studies Humans Male Mental Disorders/*therapy Middle Aged Patient Satisfaction Psychotherapy/*methods Risk *Suicidal Ideation Suicide/prevention & control/*psychology Treatment Outcome Young Adult L1 - internal-pdf://0072261646/Comtois-2011-Collaborative assessment and mana.pdf LA - eng N1 - 1520-6394 Comtois, Katherine Anne Jobes, David A S O'Connor, Stephen Atkins, David C Janis, Karin E Chessen, Chloe Landes, Sara J Holen, Anna Yuodelis-Flores, Christine Comparative Study Journal Article Randomized Controlled Trial Research Support, Non-U.S. Gov't United States Depress Anxiety. 2011 Nov;28(11):963-72. doi: 10.1002/da.20895. Epub 2011 Sep 21. PY - 2011 SN - 1091-4269 SP - 963-72 ST - Collaborative assessment and management of suicidality (CAMS): feasibility trial for next-day appointment services T2 - Depress Anxiety TI - Collaborative assessment and management of suicidality (CAMS): feasibility trial for next-day appointment services UR - https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/da.20895?download=true VL - 28 ID - 211 ER - TY - JOUR AB - IMPORTANCE: Accessible and cost-effective interventions for suicidality are needed to address high rates of suicidal behavior among military service members. Caring Contacts are brief periodic messages that express unconditional care and concern and have been previously shown to prevent suicide deaths, attempts, ideation, and hospitalizations. OBJECTIVE: To test the effectiveness of augmenting standard military health care with Caring Contacts delivered via text message to reduce suicidal thoughts and behaviors over 12 months. DESIGN, SETTING, AND PARTICIPANTS: This randomized clinical trial was conducted at 3 military installations in the southern and western United States. Soldiers and Marines identified as being at risk of suicide were recruited between April 2013 and September 2016. The final follow-up was in September 2017. INTERVENTIONS: Both groups received standard care, and the Caring Contacts group also received consisted of 11 text messages delivered on day 1, at week 1, at months 1, 2, 3, 4, 6, 8, 10, and 12, and on participants' birthdays. MAIN OUTCOMES AND MEASURES: Primary outcomes were current suicidal ideation and suicide risk incidents (hospitalization or medical evacuation). Secondary outcomes were worst-point suicidal ideation, emergency department visits, and suicide attempts. Suicidal ideation was measured by the Scale for Suicide Ideation, suicide risk incidents, and emergency department visits by the Treatment History Interview; attempted suicide was measured by the Suicide Attempt Self-Injury Count. RESULTS: Among 658 randomized participants (329 randomizely assigned to each group), data were analyzed for 657 individuals (mean [SD] age, 25.2 [6.1] years; 539 men [82.0%]). All participants reported suicidal ideation at baseline, and 291 (44.3%) had previously attempted suicide. Of the 657 participants, 461 (70.2%) were assessed at 12 months. Primary outcomes were nonsignificant. There was no significant effect on likelihood or severity of current suicidal ideation or likelihood of a suicide risk incident; there was also no effect on emergency department visits. However, participants who received Caring Contacts (172 of 216 participants [79.6%]) had lower odds than those receiving standard care alone (179 of 204 participants [87.7%]) of experiencing any suicidal ideation between baseline and follow-up (odds ratio, 0.56 [95% CI, 0.33-0.95]; P = .03) and fewer had attempted suicide since baseline (21 of 233 [9.0%] in the group receiving Caring Contacts vs 34 of 228 [14.9%] in the standard-care group; odds ratio, 0.52 [95% CI, 0.29-0.92]; P = .03). CONCLUSIONS AND RELEVANCE: This trial provides inconsistent results on the effectiveness of caring text messages between primary and secondary outcomes, but this inexpensive and scalable intervention offers promise for preventing suicide attempts and ideation in military personnel. Additional research is needed. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT01829620. AD - Department of Psychiatry & Behavioral Sciences, School of Medicine, University of Washington, Seattle. Womack Army Medical Center, Fort Bragg, North Carolina. Naval Medical Center Camp Lejeune, Camp Lejeune, North Carolina. AN - 30758491 AU - Comtois, K. A. AU - Kerbrat, A. H. AU - DeCou, C. R. AU - Atkins, D. C. AU - Majeres, J. J. AU - Baker, J. C. AU - Ries, R. K. C2 - PMC6495345 reported receiving research funding from the Military Suicide Research Consortium during the conduct of the study. Dr DeCou received funding from the National Institute of Child Health and Development of the National Institutes of Health (grant T32HD057822) during the conduct of the study. Dr Atkins is also a cofounder with equity stake in a technology company, Lyssn.io, focused on tools to support training, supervision, and quality assurance of psychotherapy and counseling. No other disclosures were reported. DA - May 1 DO - 10.1001/jamapsychiatry.2018.4530 DP - NLM ET - 2019/02/14 IS - 5 KW - Adult Female Humans Male Military Health Military Personnel/*psychology Suicidal Ideation Suicide/*prevention & control/psychology Suicide, Attempted/prevention & control/statistics & numerical data *Text Messaging Young Adult LA - eng N1 - 2168-6238 Comtois, Katherine Anne Kerbrat, Amanda H DeCou, Christopher R Atkins, David C Majeres, Justine J Baker, Justin C Ries, Richard K T32 HD057822/HD/NICHD NIH HHS/United States Journal Article Randomized Controlled Trial Research Support, N.I.H., Extramural Research Support, U.S. Gov't, Non-P.H.S. JAMA Psychiatry. 2019 May 1;76(5):474-483. doi: 10.1001/jamapsychiatry.2018.4530. PY - 2019 SN - 2168-622X (Print) 2168-622x SP - 474-483 ST - Effect of Augmenting Standard Care for Military Personnel With Brief Caring Text Messages for Suicide Prevention: A Randomized Clinical Trial T2 - JAMA Psychiatry TI - Effect of Augmenting Standard Care for Military Personnel With Brief Caring Text Messages for Suicide Prevention: A Randomized Clinical Trial VL - 76 ID - 316 ER - TY - JOUR AB - The Attempted Suicide Short Intervention Program (ASSIP) was adapted for hospital delivery and to address substance use problems as well as evaluated for feasibility, acceptability, and therapist fidelity in a series of preparatory steps (n = 28) and in a pilot randomized controlled trial, RCT (n = 34). In the RCT, patients with suicide attempts and substance use problem(s) with sufficient lengths of stay to deliver three ASSIP therapy sessions in hospital were randomized to adapted ASSIP or treatment as usual control. A blinded assessor identified suicide reattempts over 6-month follow-up with the Columbia-Suicide Severity Rating Scale (C-SSRS) and a comprehensive multi-source method. Treatment process measures and the Scale for Suicidal Ideation (SSI) were also administered. Median hospital stay was 13 days. ASSIP subjects reported high satisfaction with the treatment and high therapeutic alliance. Study therapists showed high fidelity to the modified ASSIP intervention. Repetition of suicide attempt was common in both study groups including a combined 9 (26%) subjects with reattempt based on C-SSRS and 13 (38%) subjects with reattempt based on multiple sources. Adult suicide attempt patients with substance use problems who require lengthy hospitalizations are at exceptionally high risk and may require additional strategies to lower risk. AD - University of Rochester Medical Center, Rochester, NY, USA Department of Psychology, University of Rochester, Rochester, NY, USA Center of Excellence for Suicide Prevention, Finger Lakes VA Healthcare System, Canandaigua, NY, USA University Hospital of Psychiatry, Bern, Switzerland Translational Research Centre, University Hospital of Psychiatry, University of Bern, Switzerland Unit for Clinical Suicide Research, Department of Clinical Sciences, Psychiatry, Faculty of Medicine, Lund University, Sweden University of Leipzig, Department of Medical Psychology and Medical Sociology, Germany Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA AN - 152428233. Language: English. Entry Date: 20210920. Revision Date: 20210920. Publication Type: Article AU - Conner, Kenneth R. AU - Kearns, Jaclyn C. AU - Esposito, Erika C. AU - Pizzarello, Edmund AU - Wiegand, Timothy J. AU - Britton, Peter C. AU - Michel, Konrad AU - Gysin-Maillart, Anja C. AU - Goldston, David B. DB - CINAHL Complete DO - 10.1016/j.genhosppsych.2021.07.002 DP - EBSCOhost KW - Hospitalization Substance Abusers -- Psychosocial Factors -- In Adulthood Suicide, Attempted -- Therapy Psychotherapy -- Methods Substance Abuse -- Prevention and Control Suicide, Attempted -- Prevention and Control Treatment Outcomes Human Pilot Studies Randomized Controlled Trials Random Assignment Scales Length of Stay Multimethod Studies Descriptive Statistics Psychotherapists -- Psychosocial Factors Health Care Delivery Recurrence -- Prevention and Control Inpatients Adult Program Implementation Program Evaluation N1 - research; randomized controlled trial. Journal Subset: Biomedical; Peer Reviewed; USA. Instrumentation: Scale for Suicidal Ideation (SSI); Columbia-Suicide Severity Rating Scale (C-SSRS). NLM UID: 7905527. PY - 2021 SN - 0163-8343 SP - 66-72 ST - Pilot RCT of the Attempted Suicide Short Intervention Program (ASSIP) adapted for rapid delivery during hospitalization to adult suicide attempt patients with substance use problems T2 - General Hospital Psychiatry TI - Pilot RCT of the Attempted Suicide Short Intervention Program (ASSIP) adapted for rapid delivery during hospitalization to adult suicide attempt patients with substance use problems UR - https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=152428233&site=ehost-live VL - 72 ID - 1129 ER - TY - JOUR AB - BACKGROUND: To date, there have been no studies comparing cognitive therapy (CT) with Rogerian supportive therapy (RST) in borderline personality disorder. METHOD: Sixty-five DSM-IV borderline personality disorder outpatients were recruited at 2 centres: Lyon and Marseille. Thirty-three patients were randomly allocated to CT and 32 to RST. The therapists were the same in both groups. Both treatments shared the same duration (1 year) and amount of therapy. Assessment by independent evaluators utilised the Clinical Global Impression (CGI) Scale, the Hamilton Depression Scale, Beck Depression Inventory, Beck Anxiety Inventory, Hopelessness Scale, Young Schema Questionnaire II, Eysenck Impulsivity Venturesomeness Empathy (IVE) Inventory, a self-harming behaviours checklist and scales measuring quality of life and the therapeutic relationship. The response criterion was a score of 3 or less on the CGI, associated with a Hopelessness Scale score of <8. RESULTS: No patient committed suicide during the trial. Fifty-one patients were evaluated at week 24, 38 at week 52 and 21 at week 104. Cognitive therapy retained the patients in therapy for a longer time. The response criterion found no significant between-group differences at any measurement point in the completers. However, at week 24, CT was better than RST on the Hopelessness Scale, IVE scale and regarding the therapeutic relationship. At week 104, the CGI improvement (patient and evaluator) was significantly better in CT than in RST. High baseline depression and impulsivity predicted dropouts. CONCLUSIONS: CT retained the patients in therapy longer, showed earlier positive effects on hopelessness and impulsivity, and demonstrated better long-term outcomes on global measures of improvement. AD - Hospices Civils de Lyon, Hôpital Neurologique, Lyon, France. cottraux@univ-lyon1.fr AN - 19628959 AU - Cottraux, J. AU - Note, I. D. AU - Boutitie, F. AU - Milliery, M. AU - Genouihlac, V. AU - Yao, S. N. AU - Note, B. AU - Mollard, E. AU - Bonasse, F. AU - Gaillard, S. AU - Djamoussian, D. AU - Guillard Cde, M. AU - Culem, A. AU - Gueyffier, F. DO - 10.1159/000229769 DP - NLM ET - 2009/07/25 IS - 5 KW - Adult Borderline Personality Disorder/complications/diagnosis/*therapy Cognitive Behavioral Therapy/*methods Female Follow-Up Studies Humans Impulsive Behavior/complications/psychology/therapy Male Person-Centered Psychotherapy/*methods Pilot Projects Psychiatric Status Rating Scales/statistics & numerical data Quality of Life/psychology Suicide/prevention & control Treatment Outcome LA - eng N1 - 1423-0348 Cottraux, Jean Note, Ivan Druon Boutitie, Florent Milliery, Maud Genouihlac, Virginie Yao, Sai Nan Note, Brigitte Mollard, Evelyne Bonasse, Françoise Gaillard, Ségolène Djamoussian, Diane Guillard, Chantal de Mey Culem, Alain Gueyffier, François Comparative Study Journal Article Randomized Controlled Trial Research Support, Non-U.S. Gov't Switzerland Psychother Psychosom. 2009;78(5):307-16. doi: 10.1159/000229769. Epub 2009 Jul 24. PY - 2009 SN - 0033-3190 SP - 307-16 ST - Cognitive therapy versus Rogerian supportive therapy in borderline personality disorder. Two-year follow-up of a controlled pilot study T2 - Psychother Psychosom TI - Cognitive therapy versus Rogerian supportive therapy in borderline personality disorder. Two-year follow-up of a controlled pilot study VL - 78 ID - 286 ER - TY - JOUR AB - 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. AN - CN-00772075 AU - Crawford, M. J. AU - Csipke, E. AU - Brown, A. AU - Reid, S. AU - Nilsen, K. AU - Redhead, J. AU - Touquet, R. DO - 10.1017/S0033291709991899 IS - 11 KW - Adult Alcohol Drinking Alcoholism [psychology, *therapy] Female Humans Male Patient Satisfaction Psychotherapy, Brief Referral and Consultation Self‐Injurious Behavior [psychology, *therapy] Single‐Blind Method Treatment Outcome M3 - Journal Article; Randomized Controlled Trial; Research Support, Non‐U.S. Gov't PY - 2010 SP - 1821‐1828 ST - The effect of referral for brief intervention for alcohol misuse on repetition of deliberate self-harm: an exploratory randomized controlled trial T2 - Psychological medicine TI - The effect of referral for brief intervention for alcohol misuse on repetition of deliberate self-harm: an exploratory randomized controlled trial UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00772075/full VL - 40 ID - 594 ER - TY - JOUR AB - The incidence of suicide attempts (fatal and non-fatal) was analysed in a prospective cohort of patients with schizophrenia randomly assigned to sertindole (4905 patients) or risperidone (4904 patients) in a parallel-group open-label study with blinded classification of outcomes (the sertindole cohort prospective study--SCoP). The total exposure was 6978 and 7975 patient-years in the sertindole and risperidone groups, respectively. Suicide mortality in the study was low (0.21 and 0.28 per 100 patients per year with sertindole and risperidone, respectively). The majority (84%) of suicide attempts occurred within the first year of treatment. Cox's proportional hazards model analysis of the time to the first suicide attempt, reported by treating psychiatrists and blindly reviewed by an independent expert group according to the Columbia Classification Algorithm of Suicide Assessment (both defining suicide attempts by association of suicidal act and intent to die), showed a lower risk of suicide attempt for sertindole-treated patients than for risperidone-treated patients. The effect was statistically significant with both evaluation methods during the first year of randomized treatment (hazard ratios [95% CI]: 0.5 [0.31-0.82], p=0.006; and 0.57 [0.35-0.92], p=0.02, respectively). With classification by an independent safety committee using a broader definition including all incidences of intentional self-harm, also those without clear suicidal intent, the results were not significant. A history of previous suicide attempts was significantly associated with attempted suicides in both treatment groups. AD - Centre Hospitalier, BP29, 68250 Rouffach, France. macrocq@aol.com AN - 20926264 AU - Crocq, M. A. AU - Naber, D. AU - Lader, M. H. AU - Thibaut, F. AU - Drici, M. AU - Everitt, B. AU - Hall, G. C. AU - Le Jeunne, C. AU - Mittoux, A. AU - Peuskens, J. AU - Priori, S. AU - Sturkenboom, M. AU - Thomas, S. H. AU - Tanghøj, P. AU - Toumi, M. AU - Mann, R. AU - Moore, N. D. DA - Dec DO - 10.1016/j.euroneuro.2010.09.001 DP - NLM ET - 2010/10/12 IS - 12 KW - Adolescent Adult Aged Aged, 80 and over Cohort Studies Female Humans Imidazoles/*therapeutic use Indoles/*therapeutic use Male Middle Aged Prospective Studies Risk Factors Risperidone/*therapeutic use Schizophrenia/complications/*drug therapy Single-Blind Method Suicide/*prevention & control/psychology Suicide, Attempted/*prevention & control/psychology Treatment Outcome Young Adult LA - eng N1 - 1873-7862 Crocq, M A Naber, D Lader, M H Thibaut, F Drici, M Everitt, B Hall, G C Le Jeunne, C Mittoux, A Peuskens, J Priori, S Sturkenboom, M Thomas, S H L Tanghøj, P Toumi, M Mann, R Moore, N D Comparative Study Journal Article Multicenter Study Randomized Controlled Trial Research Support, Non-U.S. Gov't Netherlands Eur Neuropsychopharmacol. 2010 Dec;20(12):829-38. doi: 10.1016/j.euroneuro.2010.09.001. PY - 2010 SN - 0924-977x SP - 829-38 ST - Suicide attempts in a prospective cohort of patients with schizophrenia treated with sertindole or risperidone T2 - Eur Neuropsychopharmacol TI - Suicide attempts in a prospective cohort of patients with schizophrenia treated with sertindole or risperidone VL - 20 ID - 2456 ER - TY - JOUR AB - BACKGROUND: Depression, a common psychiatric disorder in elderly, serves as a remarkable precipitating factor for suicide among the elderly people. Here, a randomized double-blinded study was performed to investigate the efficacy of repetitive transcranial magnetic stimulation (rTMS) on improving the clinical symptoms and reducing suicidal ideation in elderly patients with depression. METHODS: In this study, 103 elderly patients with depression and suicidal ideation were randomly divided into 2 groups, 48 cases in the rTMS group and 55 cases in the control group (sham rTMS). Both groups received routine drug therapy with rTMS or sham rTMS. The patients received evaluation by Hamilton depression scale and self-rating idea of suicide scale before treatment and after 2 and 4 weeks of treatment, respectively. RESULTS: The measurement from the present study demonstrated that Hamilton depression scale and self-rating idea of suicide scale scores decreased to varying degrees in the 2 groups after treatment, and the decrease was more significant in rTMS group. The rate of marked effectiveness was much higher in rTMS group after 2 weeks of treatment compared with the control group. Furthermore, the rate of moderate effectiveness at 4 weeks after treatment was significantly higher in rTMS group compared with the control group. CONCLUSION: Together, the present study shows that rTMS with routine drug therapy exhibited effect with quick onset to improve the clinical symptoms and reduce suicidal ideation in elderly patients with depression. AU - Dai, Lilei AU - Wang, Peng AU - Zhang, Panpan AU - Guo, Qingshan AU - Du, Hui AU - Li, Fen AU - He, Xinfu AU - Luan, Rongrong DA - 2020/08/07/ DO - 10.1097/MD.0000000000021493 IS - 32 J2 - Medicine (Baltimore) KW - *Suicidal Ideation Female Humans Male Middle Aged Aged Psychiatric Status Rating Scales Treatment Outcome Combined Modality Therapy Aged, 80 and over Double-Blind Method Antidepressive Agents/*therapeutic use Depression/psychology/*therapy Transcranial Magnetic Stimulation/*methods LA - eng PY - 2020 SN - 1536-5964 0025-7974 SP - e21493 ST - The therapeutic effect of repetitive transcranial magnetic stimulation in elderly depression patients T2 - Medicine TI - The therapeutic effect of repetitive transcranial magnetic stimulation in elderly depression patients VL - 99 ID - 1171 ER - TY - JOUR AB - The outcome of a randomized controlled trial of cognitive behavior therapy in addition to treatment as usual (CBT plus TAU) compared with TAU alone (TAU) in one hundred and six participants meeting diagnostic criteria for borderline personality disorder is described. We anticipated that CBT plus TAU would decrease the number of participants with in-patient psychiatric hospitalizations or accident and emergency room contact or suicidal acts over twelve months treatment and twelve months follow-up, compared with TAU. We also anticipated that CBT plus TAU would lead to improvement in a range of secondary outcomes of mental health and social functioning compared to TAU. Of the 106 participants randomized, follow-up data on 102 (96%) was obtained at two years. Those randomized to CBT were offered an average of 27 sessions over 12 months and attended on average 16 (range 0 to 35). We found that the global odds ratio of a participant in the CBT plus TAU group compared with the TAU alone group having any of the outcomes of a suicidal act, in-patient hospitalization, or accident and emergency contact in the 24 months following randomization was 0.86 (95% confidence interval [CI] 0.45 to 1.66, p = 0.66). The corresponding global odds ratio, excluding accident and emergency room contact, was 0.75 (95% CI 0.37 to 1.54, p = 0.44). In terms of the number of suicidal acts, there was a significant reduction over the two years in favor of CBT plus TAU over TAU, with a mean difference of -0.91 (95% CI -1.67 to -0.15, p = 0.020). Across both treatment arms there was gradual and sustained improvement in both primary and secondary outcomes, with evidence of benefit for the addition of CBT on the positive symptom distress index at one year, and on state anxiety, dysfunctional beliefs and the quantity of suicidal acts at two year follow-up. CBT can deliver clinically important changes in relatively few clinical sessions in real clinical settings. AD - Psychological Medicine, University of Glasgow. k.davidson@clinmed.gla.ac.uk AN - 17032158 AU - Davidson, K. AU - Norrie, J. AU - Tyrer, P. AU - Gumley, A. AU - Tata, P. AU - Murray, H. AU - Palmer, S. C2 - PMC1852259 C6 - UKMS366 DA - Oct DO - 10.1521/pedi.2006.20.5.450 DP - NLM ET - 2006/10/13 IS - 5 KW - Adult Aged Ambulatory Care/*methods Anxiety/etiology/prevention & control Borderline Personality Disorder/complications/psychology/*therapy Cognitive Behavioral Therapy/*methods Confidence Intervals Female Follow-Up Studies Humans Male Middle Aged Odds Ratio Outpatients/*psychology Professional-Patient Relations Psychiatric Status Rating Scales Quality of Life Reproducibility of Results Research Design Self-Injurious Behavior/etiology/prevention & control Severity of Illness Index Social Adjustment Suicide/prevention & control Treatment Outcome LA - eng N1 - 1943-2763 Davidson, Kate Norrie, John Tyrer, Peter Gumley, Andrew Tata, Philip Murray, Heather Palmer, Stephen 064027/WT_/Wellcome Trust/United Kingdom HSRU1/CSO_/Chief Scientist Office/United Kingdom 064027/Z01/Z/WT_/Wellcome Trust/United Kingdom Comparative Study Journal Article Multicenter Study Randomized Controlled Trial Research Support, Non-U.S. Gov't J Pers Disord. 2006 Oct;20(5):450-65. doi: 10.1521/pedi.2006.20.5.450. PY - 2006 SN - 0885-579X (Print) 0885-579x SP - 450-65 ST - The effectiveness of cognitive behavior therapy for borderline personality disorder: results from the borderline personality disorder study of cognitive therapy (BOSCOT) trial T2 - J Pers Disord TI - The effectiveness of cognitive behavior therapy for borderline personality disorder: results from the borderline personality disorder study of cognitive therapy (BOSCOT) trial VL - 20 ID - 164 ER - TY - JOUR AB - Aims and method: To assess the feasibility of conducting a larger, definitive randomised controlled trial of manual‐assisted cognitive therapy (MACT), a brief focused therapy to address self‐harm and promote engagement in services. We established recruitment, randomisation and assessment of outcome within a sample of these complex patients admitted to a general hospital following self‐harm. We assessed symptoms of depressed mood, anxiety and suicidality at baseline and at 3 months' follow‐up. Results: Twenty patients were randomised to the trial following an index episode of self‐harm, and those allocated to MACT demonstrated improvement in anxiety, depression and suicidal ideation. Clinical implications: It is feasible to recruit a sample of these complex patients to a randomised controlled trial of MACT following an index episode of self‐harm. There is preliminary support that MACT could be an acceptable and effective intervention in patients with personality disorder and substance misuse. AN - CN-01731601 AU - Davidson, K. M. AU - Brown, T. M. AU - James, V. AU - Kirk, J. AU - Richardson, J. DO - 10.1192/pb.bp.113.043109 IS - 3 KW - *automutilation /therapy *cognitive therapy *manual assisted cognitive therapy *personality disorder *substance abuse Adult Aged Alcohol abuse Alcohol consumption Anxiety Article Borderline state Clinical article Clinical assessment Controlled study Depression Drug misuse Follow up Hospital admission Human Outcome assessment Paranoid personality disorder Pilot study Randomized controlled trial Suicidal ideation M3 - Journal: Article PY - 2014 SP - 108‐111 ST - Manual-assisted cognitive therapy for self-harm in personality disorder and substance misuse: a feasibility trial T2 - Psychiatric bulletin (London, England) TI - Manual-assisted cognitive therapy for self-harm in personality disorder and substance misuse: a feasibility trial UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-01731601/full VL - 38 ID - 595 ER - TY - JOUR AB - BACKGROUND: Longer-term follow-up of patients with borderline personality disorder have found favourable clinical outcomes, with long-term reduction in symptoms and diagnosis. AIMS: We examined the 6-year outcome of patients with borderline personality disorder who were randomised to 1 year of cognitive-behavioural therapy for personality disorders (CBT-PD) or treatment as usual (TAU) in the BOSCOT trial, in three centres across the UK (trial registration: ISRCTN86177428). METHOD: In total, 106 participants met criteria for borderline personality disorder in the original trial. Patients were interviewed at follow-up by research assistants masked to the patient's original treatment group, CBT-PD or TAU, using the same measures as in the original randomised trial. Statistical analyses of data for the group as a whole are based on generalised linear models with repeated measures analysis of variance type models to examine group differences. RESULTS: Follow-up data were obtained for 82% of patients at 6 years. Over half the patients meeting criteria for borderline personality disorder at entry into the study no longer did so 6 years later. The gains of CBT-PD over TAU in reduction of suicidal behaviour seen after 1-year follow-up were maintained. Length of hospitalisation and cost of services were lower in the CBT-PD group compared with the TAU group. CONCLUSIONS: Although the use of CBT-PD did not demonstrate a statistically significant cost-effective advantage, the findings indicate the potential for continued long-term cost-offsets that accrue following the initial provision of 1 year of CBT-PD. However, the quality of life and affective disturbance remained poor. AD - Centre for Population and HealthSciences, University of Glasgow, UK. kate.davidson@glasgow.ac.uk AN - 21119151 AU - Davidson, K. M. AU - Tyrer, P. AU - Norrie, J. AU - Palmer, S. J. AU - Tyrer, H. DA - Dec DO - 10.1192/bjp.bp.109.074286 DP - NLM ET - 2010/12/02 IS - 6 KW - Adult Borderline Personality Disorder/economics/psychology/*therapy *Cognitive Behavioral Therapy Cost-Benefit Analysis Emergency Service, Hospital/economics/statistics & numerical data Female Follow-Up Studies Health Care Costs/statistics & numerical data Hospitalization/economics/statistics & numerical data Humans Male *Outcome Assessment, Health Care Psychiatric Status Rating Scales *Quality of Life Self-Injurious Behavior/*epidemiology State Medicine Suicide, Attempted/statistics & numerical data United Kingdom LA - eng N1 - 1472-1465 Davidson, Kate M Tyrer, Peter Norrie, John Palmer, Stephen J Tyrer, Helen CZH/4/435/Chief Scientist Office/United Kingdom Journal Article Multicenter Study Randomized Controlled Trial England Br J Psychiatry. 2010 Dec;197(6):456-62. doi: 10.1192/bjp.bp.109.074286. PY - 2010 SN - 0007-1250 SP - 456-62 ST - Cognitive therapy v. usual treatment for borderline personality disorder: prospective 6-year follow-up T2 - Br J Psychiatry TI - Cognitive therapy v. usual treatment for borderline personality disorder: prospective 6-year follow-up VL - 197 ID - 165 ER - TY - JOUR AB - Suicide risk is high in the first week, month and year following discharge from psychiatric inpatient settings. The decrease in care following discharge has been considered as contributing to the excessive suicide rate in this population. The aim of this research was to evaluate the impact of an intensive case management follow-up of these high-risk people for one year. Sixty males with a history of suicide attempts and psychiatric illness were recruited at discharge from a psychiatric inpatient setting at the Gold Coast Hospital, Queensland. Participants were randomly assigned to one of two conditions: Intensive Case Management (ICM) or Treatment As Usual (TAU). ICM featured weekly face-to-face contact with a community case manager and outreach telephone calls from experienced telephone counsellors. TAU participants were discharged under existing hospital practices. All participants completed assessment interviews at baseline, six and twelve months post-discharge. At the end of the twelve-month treatment phase, there was a dropout rate of 53.3% in the ICM condition, and 73.3% in the TAU condition, leaving a final sample of 22 (ICM=14, TAU=8). People in the ICM condition had significant improvements in depression scores, suicide ideation, and quality of life. ICM participants reported more contacts with mental and allied health services, had better relationships with therapists, and were more satisfied with the services that they did receive. No suicides were recorded in the twelve-month follow-up period. A few participants engaged in self-harming behaviours, though there were no differences between treatment conditions with regard to this aspect. Despite the high attrition rate and subsequent low sample size, initial indications are that intensive case management may be beneficial in assisting the post-discharge phase of high-risk psychiatric patients. AU - De Leo, Diego AU - Heller, Travis DO - https://doi.org/10.1071/PY07038 IS - 3 PY - 2007 SP - 49-58 ST - Intensive Case Management in Suicide Attempters Following Discharge from Psychiatric Care T2 - Australian Journal of Primary Health TI - Intensive Case Management in Suicide Attempters Following Discharge from Psychiatric Care UR - https://www.publish.csiro.au/paper/PY07038 VL - 13 ID - 682 ER - TY - JOUR AB - In Amsterdam in the Netherlands, in 1993, an intensive case management project was initiated. This article describes this well-known Dutch project as it was tested in a randomised clinical trial using regular outpatient and inpatient care as the control conditions. All the patients in this project are very ill and most of them suffer from schizophrenia. The new form of care has the same effect on everyday problems as regular care. The basis of this data is too narrow for the drawing of conclusions about the risk of suicide. Longer follow-up would be advisable in order to improve our understanding of this problem. There has been no drop in compulsory admissions. On the other hand, there has been a spectacular decrease in the number of bed days (a reduction of 66% in the second year of the ACT programme). AD - Mentrum, Mental Health Organisation Amsterdam. AN - 12236412 AU - Dekker, J. AU - Wijdenes, W. AU - Koning, Y. A. AU - Gardien, R. AU - Hermandes-Willenborg, L. AU - Nusselder, H. DA - Oct DO - 10.1023/a:1019816613834 DP - NLM ET - 2002/09/19 IS - 5 KW - Analysis of Variance *Assertiveness *Behavior Therapy Hospitalization/statistics & numerical data Humans Inpatients Netherlands Outpatients Program Evaluation Schizophrenia/*therapy LA - eng N1 - Dekker, J Wijdenes, W Koning, Y A Gardien, R Hermandes-Willenborg, L Nusselder, H Clinical Trial Comparative Study Journal Article Randomized Controlled Trial United States Community Ment Health J. 2002 Oct;38(5):425-34. doi: 10.1023/a:1019816613834. PY - 2002 SN - 0010-3853 (Print) 0010-3853 SP - 425-34 ST - Assertive community treatment in Amsterdam T2 - Community Ment Health J TI - Assertive community treatment in Amsterdam VL - 38 ID - 527 ER - TY - JOUR AB - Objectives: The Imaginator study tested the feasibility of a short mental imagery‐based psychological intervention for young people who self‐harm and used a stepped‐wedge design to investigate effects on self‐harm frequency reduction at 3 and 6 months. Method: A total of 38 participants aged 16–25 were recruited via community self‐referral and mental health services. Participants were randomized to immediate delivery of Functional Imagery Training (FIT) or usual care followed by delayed delivery after 3 months. FIT comprised two face‐to‐face sessions, five phone sessions, and use of a smartphone app. Outcomes’ assessment was blind to allocation. Results: Three quarters of those who began treatment completed face‐to‐face sessions, and 57% completed five or more sessions in total. Self‐harm frequency data were obtained on 76% of the sample at 3 months (primary outcome) and 63% at 6 months. FIT produced moderate reductions in self‐harm frequency at 3 months after immediate (d = 0.65) and delayed delivery (d = 0.75). The Immediate FIT group maintained improvements from 3 to 6 months (d = 0.05). Participants receiving usual care also reduced self‐harm (d = 0.47). Conclusions: A brief mental imagery‐based psychological intervention targeting self‐harm in young people is feasible and may comprise a novel transdiagnostic treatment for self‐harm. (PsycInfo Database Record (c) 2020 APA, all rights reserved) AD - Di Simplicio, Martina: Division of Psychiatry, Imperial College London, 7th Floor Commonwealth Building, Du Cane Road, London, United Kingdom, W12 0NN, m.di-simplicio@imperial.ac.uk AU - Di Simplicio, Martina AU - Appiah‐Kusi, Elizabeth AU - Wilkinson, Paul AU - Watson, Peter AU - Meiser‐Stedman, Caroline AU - Kavanagh, David J. AU - Holmes, Emily A. DO - 10.1111/sltb.12620 IS - 3 KW - *Adolescent Psychotherapy *Imagery *Psychotherapeutic Outcomes *Self-Injurious Behavior Intervention Prevention Self-Referral Suicide Prevention Emerging Adulthood Smartphones PY - 2020 SN - 1943-278X(Electronic),0363-0234(Print) SP - 724-740 ST - Imaginator: A proof-of-concept feasibility trial of a brief imagery-based psychological intervention for young people who self-harm T2 - Suicide and Life-Threatening Behavior TI - Imaginator: A proof-of-concept feasibility trial of a brief imagery-based psychological intervention for young people who self-harm VL - 50 ID - 1205 ER - TY - JOUR AB - BACKGROUND: Transference-focused psychotherapy is a manualised treatment for borderline personality disorder. AIMS: To compare transference-focused psychotherapy with treatment by experienced community psychotherapists. METHOD: In a randomised controlled trial (NCT00714311) 104 female out-patients were treated for 1 year with either transference-focused psychotherapy or by an experienced community psychotherapist. RESULTS: Significantly fewer participants dropped out of the transference-focused psychotherapy group (38.5% v. 67.3%) and also significantly fewer attempted suicide (d = 0.8, P = 0.009). Transference-focused psychotherapy was significantly superior in the domains of borderline symptomatology (d = 1.6, P = 0.001), psychosocial functioning (d = 1.0, P = 0.002), personality organisation (d = 1.0, P = 0.001) and psychiatric in-patient admissions (d = 0.5, P = 0.001). Both groups improved significantly in the domains of depression and anxiety and the transference-focused psychotherapy group in general psychopathology, all without significant group differences (d = 0.3-0.5). Self-harming behaviour did not change in either group. CONCLUSIONS: Transference-focused psychotherapy is more efficacious than treatment by experienced community psychotherapists in the domains of borderline symptomatology, psychosocial functioning, and personality organisation. Moreover, there is preliminary evidence for a superiority in the reduction of suicidality and need for psychiatric in-patient treatment. AD - Department of Prosthodontics and Material Sciences, University of Muenster, Waldeyerstrasse 30 48149 Muenster, Germany. Stephan.doering@ukmuenster.de AN - 20435966 AU - Doering, S. AU - Hörz, S. AU - Rentrop, M. AU - Fischer-Kern, M. AU - Schuster, P. AU - Benecke, C. AU - Buchheim, A. AU - Martius, P. AU - Buchheim, P. DA - May DO - 10.1192/bjp.bp.109.070177 DP - NLM ET - 2010/05/04 IS - 5 KW - Adolescent Adult Borderline Personality Disorder/drug therapy/*therapy Combined Modality Therapy Community Mental Health Services/methods Female Humans Middle Aged Psychiatric Status Rating Scales Psychotherapy/*methods Psychotropic Drugs/therapeutic use *Transference, Psychology Treatment Outcome Young Adult LA - eng N1 - 1472-1465 Doering, Stephan Hörz, Susanne Rentrop, Michael Fischer-Kern, Melitta Schuster, Peter Benecke, Cord Buchheim, Anna Martius, Philipp Buchheim, Peter Comparative Study Journal Article Multicenter Study Randomized Controlled Trial Research Support, Non-U.S. Gov't England Br J Psychiatry. 2010 May;196(5):389-95. doi: 10.1192/bjp.bp.109.070177. PY - 2010 SN - 0007-1250 SP - 389-95 ST - Transference-focused psychotherapy v. treatment by community psychotherapists for borderline personality disorder: randomised controlled trial T2 - Br J Psychiatry TI - Transference-focused psychotherapy v. treatment by community psychotherapists for borderline personality disorder: randomised controlled trial VL - 196 ID - 288 ER - TY - JOUR AB - BACKGROUND: Depressed patients presenting to emergency departments with acute suicidal ideation are a major public health concern. Ketamine, a rapidly acting antidepressant with antisuicidal properties, might offer relief. METHODS: In a randomized, double-blind, placebo-controlled, proof-of-concept trial, 18 depressed subjects with acute suicidal ideation, who required hospitalization, were randomized to either an intravenous ketamine 0.2 mg/kg group or a saline placebo group. Safety and efficacy evaluations were scheduled for 15, 30, 60, 90, 120, 180, and 240 min, and on Days 1, 2, 3, 7, and 14 after infusion. The main outcome measure was suicidal ideation with secondary measures of depression. RESULTS: Nine subjects were randomized to each group. There were no differences between groups at baseline in any demographic or assessment scales. A reduction in suicidal ideation was noted at 90-180 min (p < .05). Ninety minutes after infusion, 88% of the ketamine group had achieved remission of suicidal ideation compared with 33% in the placebo group (p < .05). No serious adverse events were noted. CONCLUSIONS: Ketamine was safe and effective for rapid reduction in suicidal ideation in depressed, highly suicidal subjects presenting to the emergency department. Our results support further study of ketamine for acute suicidal ideation. AD - Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, Ohio. Department of Psychiatry, Tel Aviv Sourasky Medical Centre, Tel-Aviv, Israel. Sackler School of Medicine, Tel Aviv University, Tel-Aviv, Israel. Department of Psychiatry and Behavioral Neurobiology, University of Alabama, Birmingham, Alabama. Department of Psychiatry, College of Medicine and Life Sciences, University of Toledo, Toledo, Ohio. AN - 31733088 AU - Domany, Y. AU - Shelton, R. C. AU - McCullumsmith, C. B. DA - Mar DO - 10.1002/da.22975 DP - NLM ET - 2019/11/17 IS - 3 KW - *Depressive Disorder, Major/drug therapy Double-Blind Method Emergency Service, Hospital *Excitatory Amino Acid Antagonists/therapeutic use Humans *Ketamine/therapeutic use Psychiatric Status Rating Scales *Suicidal Ideation *acute suicidal ideation *anxiety *depression *hopelessness *ketamine *suicide LA - eng N1 - 1520-6394 Domany, Yoav Orcid: 0000-0002-7663-1584 Shelton, Richard C McCullumsmith, Cheryl B Journal Article Randomized Controlled Trial United States Depress Anxiety. 2020 Mar;37(3):224-233. doi: 10.1002/da.22975. Epub 2019 Nov 16. PY - 2020 SN - 1091-4269 SP - 224-233 ST - Ketamine for acute suicidal ideation. An emergency department intervention: A randomized, double-blind, placebo-controlled, proof-of-concept trial T2 - Depress Anxiety TI - Ketamine for acute suicidal ideation. An emergency department intervention: A randomized, double-blind, placebo-controlled, proof-of-concept trial VL - 37 ID - 683 ER - TY - JOUR AB - No intervention has been shown to be effective in preventing repetition of self‐harm. In the 6‐month follow‐up of a large randomised controlled trial, we previously reported no effectiveness of the provision of a card offering 24‐h crisis telephone consultation on repetition of self‐harm. However, there was a possible benefit among those presenting following a first episode (OR=0.64, 95% CI 0.34‐1.22). Here we report the 12‐month follow‐up of the trial. The results confirm no overall benefit of the intervention (OR=1.19, 95% CI 0.85‐1.67). Among those with a first episode of self‐harm, the possible benefit of the intervention had diminished (OR=0.89, 95% CI 0.52‐1.52), although a modest effect cannot be excluded. AN - CN-00529218 AU - Evans, J. AU - Evans, M. AU - Morgan, H. G. AU - Hayward, A. AU - Gunnell, D. DO - 10.1192/bjp.187.2.186 KW - *automutilation *crisis intervention Article Clinical trial Cognitive therapy Consultation Controlled clinical trial Controlled study Crisis Intervention [*methods] Follow up Follow‐Up Studies Health care delivery Health care quality Hotlines Human Humans Major clinical study Mental health care Randomized Controlled Trials as Topic Randomized controlled trial Recurrence Remote Consultation [*methods] Self report Self‐Injurious Behavior [*prevention & control] Telephone M3 - Journal Article; Randomized Controlled Trial PY - 2005 SP - 186‐187 ST - Crisis card following self-harm: 12-month follow-up of a randomised controlled trial T2 - British journal of psychiatry TI - Crisis card following self-harm: 12-month follow-up of a randomised controlled trial UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00529218/full VL - 187 ID - 598 ER - TY - JOUR AB - BACKGROUND: The treatment of deliberate self‐harm (parasuicide) remains limited in efficacy. Despite a range of psychosocial, educational and pharmacological interventions only one approach, dialectical behaviour therapy, a form of cognitive‐behaviour therapy (CBT), has been shown to reduce repeat episodes, but this is lengthy and intensive and difficult to extrapolate to busy clinical practice. We investigated the effectiveness of a new manual‐based treatment varying from bibliotherapy (six self‐help booklets) alone to six sessions of cognitive therapy linked to the booklets, which contained elements of dialectical behaviour therapy. METHODS: Thirty‐four patients, aged between 16 and 50, seen after an episode of deliberate self‐harm, with personality disturbance within the flamboyant cluster and a previous parasuicide episode within the past 12 months, were randomly assigned to treatment with manual‐assisted cognitive‐behaviour therapy (MACT N = 18) or treatment as usual (TAU N = 16). Assessment of clinical symptoms and social function were made at baseline and repeated by an independent assessor masked to treatment allocation at 6 months. The number and rate of all parasuicide attempts, time to next episode and costs of care were also determined. RESULTS: Thirty‐two patients (18 MACT; 14 TAU) were seen at follow‐up and 10 patients in each group (56% MACT and 71% TAU) had a suicidal act during the 6 months. The rate of suicidal acts per month was lower with MACT (median 0.17/month MACT; 0.37/month TAU; P = 0.11) and self‐rated depressive symptoms also improved (P = 0.03). The treatment involved a mean of 2.7 sessions and the observed average cost of care was 46% less with MACT (P = 0.22). CONCLUSIONS: Although limited by the small sample, the results of this pilot study suggest that this new form of cognitive‐behaviour therapy is promising in its efficacy and feasible in clinical practice. AN - CN-00160661 AU - Evans, K. AU - Tyrer, P. AU - Catalan, J. AU - Schmidt, U. AU - Davidson, K. AU - Dent, J. AU - Tata, P. AU - Thornton, S. AU - Barber, J. AU - Thompson, S. DO - 10.1017/s003329179800765x IS - 1 KW - Adolescent Adult Bibliotherapy [*methods] Cognitive Behavioral Therapy [*methods] Depressive Disorder [diagnosis, psychology] Female Follow‐Up Studies Humans Male Middle Aged Personality Disorders [complications, psychology] Pilot Projects Recurrence Self‐Injurious Behavior [psychology, *therapy] Surveys and Questionnaires Time Factors Treatment Outcome M3 - Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non‐U.S. Gov't PY - 1999 SP - 19‐25 ST - Manual-assisted cognitive-behaviour therapy (MACT): a randomized controlled trial of a brief intervention with bibliotherapy in the treatment of recurrent deliberate self-harm T2 - Psychological medicine TI - Manual-assisted cognitive-behaviour therapy (MACT): a randomized controlled trial of a brief intervention with bibliotherapy in the treatment of recurrent deliberate self-harm UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00160661/full VL - 29 ID - 599 ER - TY - JOUR AB - BACKGROUND: No interventions have been shown to be effective in reducing deliberate self‐harm (DSH) repetition in this group of patients as a whole. AIMS: To investigate the effect on repetition of offering emergency telephone support in a group of hospital‐admitted DSH patients. METHOD: A total of 827 DSH patients admitted to medical wards were randomly allocated to either control or intervention (green card) groups. In addition to treatment as usual, the intervention group was offered telephone support should any further crises occur. The main outcome measure was DSH repetition within six months of the index event. RESULTS: The intervention had no significant effect on the overall DSH repetition rate (odds ratio 1.20, 95% CI 0.82‐1.75). Sub‐group analysis suggested that response to the intervention differed according to the past history of DSH‐‐subjects with a previous history repeating more often and first‐timers appearing to benefit. CONCLUSIONS: No overall effect of the intervention was shown. Conclusions concerning sub‐groups must be regarded as speculative, but they suggest that further assessment of the value of telephone support in first‐timer DSH patients is indicated. AN - CN-00214775 AU - Evans, M. O. AU - Morgan, H. G. AU - Hayward, A. AU - Gunnell, D. J. DO - 10.1192/bjp.175.1.23 KW - *automutilation *consultation *telephone Link to the Ovid Full Text or citation: http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=emed4&AN=1999231914 Adult Article Cause of Death Clinical trial Controlled clinical trial Controlled study Female Health care availability Health program Hotlines [*organization & administration] Human Humans Major clinical study Male Patient counseling Randomized controlled trial Self‐Injurious Behavior [*prevention & control] Suicide M3 - Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non‐U.S. Gov't PY - 1999 SP - 23‐27 ST - Crisis telephone consultation for deliberate self-harm patients: effects on repetition T2 - British journal of psychiatry TI - Crisis telephone consultation for deliberate self-harm patients: effects on repetition UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00214775/full VL - 175 ID - 600 ER - TY - JOUR AB - OBJECTIVES: Dialectical behavioral therapy (DBT) has gained widespread popularity as a treatment for borderline personality disorder (BPD), and its efficacy has been demonstrated in several trials. The aim of this study was to evaluate the effectiveness of DBT delivered by staff with a level of training readily achievable in National Health Service care settings for individuals with a Cluster B personality disorder. DESIGN: Randomized control trial methodology was used to compare DBT to treatment as usual (TAU). METHOD: Forty-two participants entered the trial. Diagnostic and outcome measures were undertaken at assessment, at 6 months, and at 1 year. The clinical outcomes in routine evaluation--outcome measure (CORE-OM) were utilized as the primary outcome measure. RESULTS: Both the DBT and TAU groups improved on the range of measures employed. The DBT group showed a slightly greater decrease in CORE-OM risk scores, suicidality, and post-traumatic stress disorder symptom severity. However, the TAU group showed comparable reductions in all measures and a larger decrease in para-suicidal behaviours and risk. CONCLUSIONS: DBT may be an effective treatment delivered by community outpatient services for individuals with a Cluster B personality disorder. Further studies are needed to consider the impact of experience and adherence to DBT in improving outcome. AD - Research Department of Clinical, Educational, and Health Psychology, University College London, UK. j.feigenbaum@ucl.ac.uk AN - 22574799 AU - Feigenbaum, J. D. AU - Fonagy, P. AU - Pilling, S. AU - Jones, A. AU - Wildgoose, A. AU - Bebbington, P. E. DA - Jun DO - 10.1111/j.2044-8260.2011.02017.x DP - NLM ET - 2012/05/12 IS - 2 KW - Adult Antisocial Personality Disorder/*therapy Behavior Therapy/*methods Borderline Personality Disorder/*therapy Community Health Services Female Humans Male Middle Aged Outpatients Personality Disorders/*therapy State Medicine Treatment Outcome United Kingdom LA - eng N1 - Feigenbaum, Janet D Fonagy, Peter Pilling, Stephen Jones, Alan Wildgoose, Amanda Bebbington, Paul E Comparative Study Journal Article Randomized Controlled Trial Research Support, Non-U.S. Gov't England Br J Clin Psychol. 2012 Jun;51(2):121-41. doi: 10.1111/j.2044-8260.2011.02017.x. Epub 2011 May 20. PY - 2012 SN - 0144-6657 (Print) 0144-6657 SP - 121-41 ST - A real-world study of the effectiveness of DBT in the UK National Health Service T2 - Br J Clin Psychol TI - A real-world study of the effectiveness of DBT in the UK National Health Service VL - 51 ID - 2485 ER - TY - JOUR AB - OBJECTIVE: To determine whether brief intervention and contact is effective in reducing subsequent suicide mortality among suicide attempters in low and middle‐income countries. METHODS: Suicide attempters (n = 1867) identified by medical staff in the emergency units of eight collaborating hospitals in five culturally different sites (Campinas, Brazil; Chennai, India; Colombo, Sri Lanka; Karaj, Islamic Republic of Iran; and Yuncheng, China) participated, from January 2002 to October 2005, in a randomized controlled trial to receive either treatment as usual, or treatment as usual plus brief intervention and contact (BIC), which included patient education and follow‐up. Overall, 91% completed the study. The primary study outcome measurement was death from suicide at 18‐month follow‐up. FINDINGS: Significantly fewer deaths from suicide occurred in the BIC than in the treatment‐as‐usual group (0.2% versus 2.2%, respectively; chi2 = 13.83, P < 0.001). CONCLUSION: This low‐cost brief intervention may be an important part of suicide prevention programmes for underresourced low‐ and middle‐income countries. AN - CN-00665620 AU - Fleischmann, A. AU - Bertolote, J. M. AU - Wasserman, D. AU - De Leo, D. AU - Bolhari, J. AU - Botega, N. J. AU - De Silva, D. AU - Phillips, M. AU - Vijayakumar, L. AU - Värnik, A. AU - et al. DO - 10.2471/blt.07.046995 IS - 9 KW - Adult Brazil China Female Humans India Iran Male Mental Disorders [*therapy] Professional‐Patient Relations Social Support Sri Lanka Suicide, Attempted [*prevention & control, psychology] Young Adult M3 - Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non‐U.S. Gov't PY - 2008 SP - 703‐709 ST - Effectiveness of brief intervention and contact for suicide attempters: a randomized controlled trial in five countries T2 - Bulletin of the World Health Organization TI - Effectiveness of brief intervention and contact for suicide attempters: a randomized controlled trial in five countries UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00665620/full VL - 86 ID - 601 ER - TY - JOUR AB - INTRODUCTION: The aim of the present study was to investigate the effects of mindfulness-based cognitive therapy (MBCT) on suicidal ideation in an open-label randomised controlled trial of patients with residual depressive symptoms. Furthermore, this study aimed at examining whether an effect of MBCT on suicidal ideation was dependent on a reduction in depression severity, worry and rumination, or an increase in mindfulness. METHODS: One hundred and thirty participants were randomised to a treatment arm (treatment as usual plus MBCT) or a wait list arm. Change in depression, change in worry, change in rumination and change in mindfulness were entered as covariates in a repeated measures ANOVA in order to assess to what degree MBCT-induced changes in suicidal ideation were independent from changes in these parameters. RESULTS: There was a significant group×time (pre vs. post) interaction on suicidal ideation indicating a significant reduction of suicidal ideation in the MBCT group, but not in the control group. The interaction remained significant after addition of the above covariates. Change in worry was the only covariate associated with change in suicidal ideation, causing a moderate reduction in the interaction effect size. CONCLUSIONS: The results suggest that MBCT may affect suicidal ideation in patients with residual depressive symptoms and that this effect may be mediated, in part, by participants' enhanced capacity to distance themselves from worrying thoughts. AD - Institute of Medical Psychology and Medical Sociology, University Hospital of RWTH Aachen University, Pauwelsstraße 19, 52074 Aachen, Germany. Electronic address: tforkmann@ukaachen.de. Department of Psychiatry and Psychology, Maastricht University Medical Centre, School for Mental Health and Neuroscience, The Netherlands. Electronic address: m.wichers@maastrichtuniversity.nl. Faculty of Psychology and Neuroscience, Maastricht University, The Netherlands. Electronic address: nicole.geschwind@maastrichtuniversity.nl. Department of Psychiatry and Psychology, Maastricht University Medical Centre, School for Mental Health and Neuroscience, The Netherlands. Electronic address: f.peeters@maastrichtuniversity.nl. Department of Psychiatry and Psychology, Maastricht University Medical Centre, School for Mental Health and Neuroscience, The Netherlands; King's College London, King's Health Partners, Department of Psychosis Studies, Institute of Psychiatry, De Crespigny Park, London SE5 8AF, UK. Electronic address: j.vanos@maastrichtuniversity.nl. Institute of Medical Psychology and Medical Sociology, University Hospital of RWTH Aachen University, Pauwelsstraße 19, 52074 Aachen, Germany. Electronic address: vmainz@ukaachen.de. Department of Psychiatry and Psychology, Maastricht University Medical Centre, School for Mental Health and Neuroscience, The Netherlands. Electronic address: d.collip@maastrichtuniversity.nl. AN - 25218397 AU - Forkmann, T. AU - Wichers, M. AU - Geschwind, N. AU - Peeters, F. AU - van Os, J. AU - Mainz, V. AU - Collip, D. DA - Nov DO - 10.1016/j.comppsych.2014.08.043 DP - NLM ET - 2014/09/15 IS - 8 KW - Adult Depression/physiopathology/*therapy Female Humans Male Middle Aged Mindfulness/*methods Psychotherapy, Group/methods *Suicidal Ideation Treatment Outcome LA - eng N1 - 1532-8384 Forkmann, Thomas Wichers, Marieke Geschwind, Nicole Peeters, Frenk van Os, Jim Mainz, Verena Collip, Dina Journal Article Randomized Controlled Trial Research Support, Non-U.S. Gov't United States Compr Psychiatry. 2014 Nov;55(8):1883-90. doi: 10.1016/j.comppsych.2014.08.043. Epub 2014 Aug 15. PY - 2014 SN - 0010-440x SP - 1883-90 ST - Effects of mindfulness-based cognitive therapy on self-reported suicidal ideation: results from a randomised controlled trial in patients with residual depressive symptoms T2 - Compr Psychiatry TI - Effects of mindfulness-based cognitive therapy on self-reported suicidal ideation: results from a randomised controlled trial in patients with residual depressive symptoms VL - 55 ID - 2496 ER - TY - JOUR AB - OBJECTIVE: Self-injurious thoughts and behaviors (SITBs) are a major public health problem that traditional interventions have been unable to address on a large scale. The goal of this series of studies was to take initial steps toward developing an effective SITB treatment that can be easily delivered on a very large scale. METHOD: We created a brief (1-2 min), game-like app called Therapeutic Evaluative Conditioning (TEC), designed to increase aversion to SITBs and decrease aversion to the self. In 3 separate studies, we recruited participants with recent and severe histories of SITBs from web forums focused on self-injury and psychopathology (Ns = 114, 131, and 163) and randomly assigned them to receive access to the mobile treatment TEC app or a control app for 1 month. We tested the effect of TEC on the frequency of self-cutting, nonsuicidal self-injury more generally, suicide ideation, suicide plans, and suicidal behaviors. RESULTS: Analyses showed that, compared with the control app, TEC produced moderate reductions for all SITBs except suicide ideation. Across studies, the largest and most consistent reductions were for self-cutting episodes (32%-40%), suicide plans (21%-59%), and suicidal behaviors (33%-77%). Two of the 3 studies showed that TEC impacted its intended treatment targets and that greater change in these targets was associated with greater SITB reductions. TEC effects were not maintained at the 1-month posttreatment follow-up. CONCLUSIONS: Future versions of brief, mobile interventions like that tested here may have the potential to reduce SITBs and related behaviors on a large scale. (PsycINFO Database Record AD - Department of Psychology, Harvard University. AN - 27018530 AU - Franklin, J. C. AU - Fox, K. R. AU - Franklin, C. R. AU - Kleiman, E. M. AU - Ribeiro, J. D. AU - Jaroszewski, A. C. AU - Hooley, J. M. AU - Nock, M. K. DA - Jun DO - 10.1037/ccp0000093 DP - NLM ET - 2016/03/29 IS - 6 KW - Adolescent Adult Female Humans Male *Mobile Applications Self-Injurious Behavior/*prevention & control *Suicidal Ideation Suicide, Attempted/*prevention & control Treatment Outcome Young Adult LA - eng N1 - 1939-2117 Franklin, Joseph C Fox, Kathryn R Franklin, Christopher R Kleiman, Evan M Ribeiro, Jessica D Jaroszewski, Adam C Hooley, Jill M Nock, Matthew K Journal Article Randomized Controlled Trial United States J Consult Clin Psychol. 2016 Jun;84(6):544-57. doi: 10.1037/ccp0000093. Epub 2016 Mar 28. PY - 2016 SN - 0022-006x SP - 544-57 ST - A brief mobile app reduces nonsuicidal and suicidal self-injury: Evidence from three randomized controlled trials T2 - J Consult Clin Psychol TI - A brief mobile app reduces nonsuicidal and suicidal self-injury: Evidence from three randomized controlled trials VL - 84 ID - 689 ER - TY - JOUR AB - OBJECTIVE: To compare esketamine to placebo, each in addition to standard-of-care treatment, for rapidly reducing major depressive disorder symptoms, including suicidal ideation. METHODS: This phase 3, double-blind, multicenter study (ASPIRE I), conducted between June 2017 and December 2018, enrolled 226 adults having major depressive disorder based on Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5) criteria, active suicidal ideation with intent, and need for psychiatric hospitalization. Patients were randomized 1:1 to esketamine 84 mg or placebo nasal spray twice-weekly for 4 weeks, each with comprehensive standard-of-care treatment (initial psychiatric hospitalization and newly initiated or optimized oral antidepressant[s] therapy). Change from baseline to 24 hours post-first dose in Montgomery-Asberg Depression Rating Scale (MADRS) total score (primary endpoint) was analyzed using analysis of covariance (ANCOVA), and change in Clinical Global Impression of Severity of Suicidality Revised version (CGI-SS-r; key secondary endpoint) score was analyzed using ANCOVA on ranks with treatment difference estimated using the Hodges-Lehmann estimate. RESULTS: Greater improvement in MADRS total score was observed with esketamine + standard-of-care versus placebo + standard-of-care at 24 hours (least-squares mean difference [SE]: -3.8 [1.39]; 95% CI, -6.56 to -1.09; 2-sided P = .006), as well as at earlier (4 hours) and later time points during 4-week double-blind treatment. The difference between groups in the severity of suicidality was not statistically significant (median of treatment difference [95% CI]: 0.0 [-1.00 to 0.00]; 2-sided P = .107). The most common adverse events among esketamine-treated patients were dizziness, dissociation, headache, nausea, and somnolence. CONCLUSIONS: These findings demonstrate rapid and robust efficacy of esketamine nasal spray in reducing depressive symptoms in severely ill patients with major depressive disorder who have active suicidal ideation with intent. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT03039192. AU - Fu, Dong-Jing AU - Ionescu, Dawn F. AU - Li, Xiang AU - Lane, Rosanne AU - Lim, Pilar AU - Sanacora, Gerard AU - Hough, David AU - Manji, Husseini AU - Drevets, Wayne C. AU - Canuso, Carla M. DA - 2020/05/12/ DO - 10.4088/JCP.19m13191 IS - 3 J2 - J Clin Psychiatry KW - *Suicidal Ideation Adolescent Adult Female Humans Male Middle Aged Young Adult Administration, Intranasal Double-Blind Method Depressive Disorder, Major/*drug therapy/psychology Antidepressive Agents/administration & dosage/adverse effects/*therapeutic use Ketamine/administration & dosage/adverse effects/*therapeutic use Nasal Sprays LA - eng PY - 2020 SN - 1555-2101 0160-6689 ST - Esketamine Nasal Spray for Rapid Reduction of Major Depressive Disorder Symptoms in Patients Who Have Active Suicidal Ideation With Intent: Double-Blind, Randomized Study (ASPIRE I) T2 - The Journal of clinical psychiatry TI - Esketamine Nasal Spray for Rapid Reduction of Major Depressive Disorder Symptoms in Patients Who Have Active Suicidal Ideation With Intent: Double-Blind, Randomized Study (ASPIRE I) VL - 81 ID - 1305 ER - TY - JOUR AB - BACKGROUND: Self‐harm is an important risk factor for subsequent suicide and repetition of self‐harm, and a common cause of emergency department presentations. However, there still remains limited evidence on intervention in emergency department settings for individuals who self‐harm. METHODS: This multicentre, randomised controlled trial was conducted at 17 general hospitals in Japan. In total, 914 adult patients admitted to emergency departments for a suicide attempt and had a DSM‐IV‐TR axis I disorder were randomly assigned to two groups, to receive either assertive case management (intervention) or enhanced usual care (control). Assertive case management was introduced by the case manager during emergency department admissions for suicide attempts, and continued after discharge. Interventions were provided until the end of the study period (for at least 18 months and up to 5 years). RESULTS: The number of overall self‐harm episodes per person‐year was significantly lower in the intervention group (adjusted incidence risk ratio (IRR) 0.88, 95%CI 0.80‐0.96, p=0.0031). Subgroup analysis showed a greater reduction of overall self‐harm episodes among patients with no previous suicide attempt at baseline (adjusted IRR 0.73, 95% CI 0.53‐0.98, p=0.037). LIMITATIONS: Patients younger than 20 years and patients who self‐harmed but were not admitted to an emergency department were excluded. CONCLUSIONS: The present study showed that assertive case management following emergency admission for a suicide attempt reduced the incident rate of repeat overall self‐harm. AN - CN-01418345 AU - Furuno, T. AU - Nakagawa, M. AU - Hino, K. AU - Yamada, T. AU - Kawashima, Y. AU - Matsuoka, Y. AU - Shirakawa, O. AU - Ishizuka, N. AU - Yonemoto, N. AU - Kawanishi, C. AU - et al. DO - 10.1016/j.jad.2017.08.071 KW - *automutilation *case management *suicide attempt Adult Article Case Management [*organization & administration] Controlled study Crisis Intervention [*methods] DSM‐IV‐TR Emergency Service, Hospital Emergency ward Female Follow up General hospital Human Humans Japan Major clinical study Male Middle Aged Multicenter study Priority journal Randomized controlled trial Risk Factors Self‐Injurious Behavior [*therapy] Suicide [*prevention & control, psychology] Suicide, Attempted [*prevention & control] M3 - Journal Article; Randomized Controlled Trial PY - 2018 SP - 460‐465 ST - Effectiveness of assertive case management on repeat self-harm in patients admitted for suicide attempt: findings from ACTION-J study T2 - Journal of affective disorders TI - Effectiveness of assertive case management on repeat self-harm in patients admitted for suicide attempt: findings from ACTION-J study UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-01418345/full VL - 225 ID - 602 ER - TY - JOUR AB - BACKGROUND: Suicide attempts and completed suicides are common, yet there are no proven acute medication or device treatments for treating a suicidal crisis. Repeated daily left prefrontal repetitive transcranial magnetic stimulation (rTMS) for 4-6 weeks is a new FDA-approved treatment for acute depression. Some open-label rTMS studies have found rapid reductions in suicidality. DESIGN: This study tests whether a high dose of rTMS to suicidal inpatients is feasible and safe, and also whether this higher dosing might rapidly improve suicidal thinking. This prospective, 2-site, randomized, active sham-controlled (1:1 randomization) design incorporated 9 sessions of rTMS over 3 days as adjunctive to usual inpatient suicidality treatment. The setting was two inpatient military hospital wards (one VA, the other DOD). PATIENTS: Research staff screened approximately 377 inpatients, yielding 41 adults admitted for suicidal crisis. Because of the funding source, all patients also had either post-traumatic stress disorder, mild traumatic brain injury, or both. TMS METHODS: Repetitive TMS (rTMS) was delivered to the left prefrontal cortex with a figure-eight solid core coil at 120% motor threshold, 10 Hertz (Hz), 5 second (s) train duration, 10 s intertrain interval for 30 minutes (6000 pulses) 3 times daily for 3 days (total 9 sessions; 54,000 stimuli). Sham rTMS used a similar coil that contained a metal insert blocking the magnetic field and utilized electrodes on the scalp, which delivered a matched somatosensory sensation. MAIN OUTCOME MEASURE: Primary outcomes were the daily change in severity of suicidal thinking as measured by the Beck Scale of Suicidal Ideation (SSI) administered at baseline and then daily, as well as subjective visual analog scale measures before and after each TMS session. Mixed model repeated measures (MMRM) analysis was performed on modified intent to treat (mITT) and completer populations. RESULTS: This intense schedule of rTMS with suicidal inpatients was feasible and safe. Minimal side effects occurred, none differing by arm, and the 3-day retention rate was 88%. No one died of suicide within the 6 month followup. From the mITT analyses, SSI scores declined rapidly over the 3 days for both groups (sham change -15.3 points, active change -15.4 points), with a trend for more rapid decline on the first day with active rTMS (sham change -6.4 points, active -10.7 points, P = 0.12). This decline was more pronounced in the completers subgroup [sham change -5.9 (95% CI: -10.1, -1.7), active -13 points (95% CI: -18.7, -7.4); P = 0.054]. Subjective ratings of 'being bothered by thoughts of suicide' declined non-significantly more with active rTMS than with sham at the end of 9 sessions of treatment in the mITT analysis [sham change -31.9 (95% CI: -41.7, -22.0), active change -42.5 (95% CI: -53.8, -31.2); P = 0.17]. There was a significant decrease in the completers sample [sham change -24.9 (95% CI: -34.4, -15.3), active change -43.8 (95% CI: -57.2, -30.3); P = 0.028]. CONCLUSIONS: Delivering high doses of left prefrontal rTMS over three days (54,000 stimuli) to suicidal inpatients is possible and safe, with few side effects and no worsening of suicidal thinking. The suggestions of a rapid anti-suicide effect (day 1 SSI data, Visual Analogue Scale data over the 3 days) need to be tested for replication in a larger sample. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01212848, TMS for suicidal ideation. AD - Ralph H. Johnson VA Medical Center, Charleston, SC, USA; Brain Stimulation Division, Department of Psychiatry, Medical University of South Carolina, Charleston, SC, USA. Electronic address: georgem@musc.edu. Department of Psychiatry, University of California at San Diego (UCSD), USA. Walter Reed National Military Medical Center, USA. Ralph H. Johnson VA Medical Center, Charleston, SC, USA; Brain Stimulation Division, Department of Psychiatry, Medical University of South Carolina, Charleston, SC, USA. AN - 24731434 AU - George, M. S. AU - Raman, R. AU - Benedek, D. M. AU - Pelic, C. G. AU - Grammer, G. G. AU - Stokes, K. T. AU - Schmidt, M. AU - Spiegel, C. AU - Dealmeida, N. AU - Beaver, K. L. AU - Borckardt, J. J. AU - Sun, X. AU - Jain, S. AU - Stein, M. B. DA - May-Jun DO - 10.1016/j.brs.2014.03.006 DP - NLM ET - 2014/04/16 IS - 3 KW - Adult Affect Depressive Disorder/*therapy Female Hospitalization Hospitals, Military Hospitals, Veterans Humans Inpatients Male Middle Aged Outcome Assessment, Health Care Pain Pain Measurement Prefrontal Cortex/*physiopathology Prospective Studies Stress Disorders, Post-Traumatic Suicide, Attempted/*prevention & control Transcranial Magnetic Stimulation/*methods Treatment Outcome Magnetic Prefrontal Suicide Tms Transcranial LA - eng N1 - 1876-4754 George, Mark S Raman, Rema Benedek, David M Pelic, Christopher G Grammer, Geoffrey G Stokes, Karen T Schmidt, Matthew Spiegel, Chad Dealmeida, Nancy Beaver, Kathryn L Borckardt, Jeffrey J Sun, Xiaoying Jain, Sonia Stein, Murray B Journal Article Multicenter Study Randomized Controlled Trial Research Support, U.S. Gov't, Non-P.H.S. United States Brain Stimul. 2014 May-Jun;7(3):421-31. doi: 10.1016/j.brs.2014.03.006. Epub 2014 Mar 19. PY - 2014 SN - 1876-4754 SP - 421-31 ST - A two-site pilot randomized 3 day trial of high dose left prefrontal repetitive transcranial magnetic stimulation (rTMS) for suicidal inpatients T2 - Brain Stimul TI - A two-site pilot randomized 3 day trial of high dose left prefrontal repetitive transcranial magnetic stimulation (rTMS) for suicidal inpatients VL - 7 ID - 2508 ER - TY - JOUR AB - OBJECTIVE: Individuals with a recent suicidal crisis are typically admitted for inpatient psychiatric care. However, targeted inpatient interventions for suicide prevention remain sparse. Thus, this pilot randomized controlled trial evaluated a brief inpatient cognitive behavioral protocol, Post‐Admission Cognitive Therapy (PACT) for the prevention of suicide. METHODS: United States service members and beneficiaries (N=24) psychiatrically hospitalized at a military medical center due to a recent suicidal crisis were randomized to receive either PACT plus Enhanced Usual Care (PACT+EUC) or EUC alone. Blinded follow‐up assessments were conducted at one‐, two‐, and three‐months post discharge. The degree of change and variability of response to PACT for repeat suicide attempt(s) (primary outcome), as well as depression, hopelessness, and suicide ideation (secondary outcomes) were examined. RESULTS: Significant between‐group differences in re‐attempt status were not found. Reliable Change Index analyses indicated that among the most clinically severe participants, a greater proportion of PACT+EUC participants compared with EUC participants met criteria for clinically significant reductions on depression (40% versus 25%), hopelessness (67% versus 50%), suicide ideation (45% versus 33%), and posttraumatic stress symptomatology (40% versus 25%). CONCLUSIONS: PACT is a promising inpatient cognitive behavioral intervention for suicide risk reduction. The efficacy of PACT is currently being evaluated in a well‐powered multi‐site randomized controlled trial. AN - CN-02094242 AU - Ghahramanlou-Holloway, M. AU - LaCroix, J. M. AU - Perera, K. U. AU - Neely, L. AU - Grammer, G. AU - Weaver, J. AU - Novak, L. A. AU - Colborn, V. AU - Lee-Tauler, S. Y. DA - 2020 DO - 10.1016/j.genhosppsych.2018.11.006 J2 - General hospital psychiatry KW - Suicidal Ideation Adolescent Military Personnel Adult Female Humans Male Suicide, Attempted [*prevention & control] Young Adult Single‐Blind Method Pilot Projects Follow‐Up Studies Inpatients Cognitive Behavioral Therapy [methods] Hospitalization Hospitals, Military Military Family Outcome Assessment, Health Care Psychotherapy, Brief PY - 2020 SP - 46-53 ST - Inpatient psychiatric care following a suicide-related hospitalization: a pilot trial of Post-Admission Cognitive Therapy in a military medical center T2 - General hospital psychiatry TI - Inpatient psychiatric care following a suicide-related hospitalization: a pilot trial of Post-Admission Cognitive Therapy in a military medical center UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-02094242/full VL - 63 ID - 1343 ER - TY - JOUR AB - BACKGROUND: As lithium treatment might be effective in reducing the risk of deliberate self-harm (DSH) in adult patients with unipolar affective disorders, we designed a pragmatic randomised trial to assess its efficacy in more than 200 patients with treatment-resistant depression. However, we randomised 56 patients only. The aim of this report is therefore twofold: first, to disseminate the results of this underpowered study which may be incorporated into future meta-analytical reviews; second, to analyse some critical aspects of the study which might explain failure to reach the target sample size. METHODS: We carried out a randomised, parallel group, assessor-blinded superiority clinical trial. Adults with a diagnosis of major depression, an episode of DSH in the previous 12 months and inadequate response to at least two antidepressants given sequentially at an adequate dose for an adequate time for the current depressive episode were allocated to add lithium to usual care (intervention arm) versus usual care alone (control arm). Suicide completion and acts of DSH during the 12 months of follow-up constituted the composite primary outcome. RESULTS: Of 58 patients screened for inclusion, 29 were allocated to lithium plus usual care and 27 were assigned to usual care without lithium. Six patients in the lithium plus usual care group and seven in the usual care group committed acts of DSH during the follow-up phase. The survival probability did not differ between the two treatment arms (Chi2 = 0.17, p =0.676). With regard to changes in the severity of depressive symptomatology from baseline to endpoint, no significant differences were detected. CONCLUSIONS: The present study failed to achieve the minimum sample size needed to detect a clinically meaningful difference between the two treatment arms. Consequently, the finding that lithium, in addition to usual care, did not exert a positive effect in terms of reduction of DSH after 12 months of follow-up is likely due to the lack of sufficient statistical power to detect a difference, if a difference existed. The dissemination of the results of this underpowered study will inform future meta-analytical reviews on lithium and suicide-related outcomes. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT00927550. AD - Dipartimento di Sanità Pubblica e Medicina di Comunità, Sezione di Psichiatria, Università di Verona, Verona, Italy. corrado.barbui@univr.it. AN - 25326163 AU - Girlanda, F. AU - Cipriani, A. AU - Agrimi, E. AU - Appino, M. G. AU - Barichello, A. AU - Beneduce, R. AU - Bighelli, I. AU - Bisoffi, G. AU - Bisogno, A. AU - Bortolaso, P. AU - Boso, M. AU - Calandra, C. AU - Cascone, L. AU - Castellazzi, M. AU - Corbascio, C. AU - Parise, V. F. AU - Gardellin, F. AU - Gennaro, D. AU - Hanife, B. AU - Lintas, C. AU - Lorusso, M. AU - Luca, A. AU - Luca, M. AU - Luchetta, C. AU - Lucii, C. AU - Maio, F. AU - Marsilio, A. AU - Mattei, C. AU - Moretti, D. AU - Nosè, M. AU - Occhionero, G. AU - Papanti, D. AU - Pecile, D. AU - Percudani, M. AU - Prestia, D. AU - Purgato, M. AU - Restaino, F. AU - Romeo, S. AU - Sciarma, T. AU - Strizzolo, S. AU - Tamborini, S. AU - Todarello, O. AU - Tozzi, F. AU - Ziero, S. AU - Zotos, S. AU - Barbui, C. C2 - PMC4210495 DA - Oct 17 DO - 10.1186/1756-0500-7-731 DP - NLM ET - 2014/10/19 KW - Adult Affect/drug effects Antidepressive Agents/*therapeutic use Antimanic Agents/*therapeutic use Antipsychotic Agents/therapeutic use Depression/diagnosis/*drug therapy/mortality/psychology Drug Therapy, Combination Female Humans Italy Kaplan-Meier Estimate Lithium Compounds/*therapeutic use Male Psychiatric Status Rating Scales *Research Design Sample Size Severity of Illness Index *Suicidal Ideation Suicide/*prevention & control/psychology Time Factors Treatment Outcome LA - eng N1 - 1756-0500 Girlanda, Francesca Cipriani, Andrea Agrimi, Emilia Appino, Maria Grazia Barichello, Andrea Beneduce, Rossella Bighelli, Irene Bisoffi, Giulia Bisogno, Alfredo Bortolaso, Paola Boso, Marianna Calandra, Carmela Cascone, Liliana Castellazzi, Mariasole Corbascio, Caterina Parise, Vincenzo Fricchione Gardellin, Francesco Gennaro, Daniele Hanife, Batul Lintas, Camilla Lorusso, Marina Luca, Antonina Luca, Maria Luchetta, Chiara Lucii, Claudio Maio, Francesca Marsilio, Alessandra Mattei, Chiara Moretti, Daniele Nosè, Michela Occhionero, Guglielmo Papanti, Duccio Pecile, Damiano Percudani, Mauro Prestia, Davide Purgato, Marianna Restaino, Francesco Romeo, Salvatore Sciarma, Tiziana Strizzolo, Stefania Tamborini, Stefania Todarello, Orlando Tozzi, Fiorella Ziero, Simona Zotos, Spyridon Barbui, Corrado Journal Article Multicenter Study Pragmatic Clinical Trial Randomized Controlled Trial Research Support, Non-U.S. Gov't BMC Res Notes. 2014 Oct 17;7:731. doi: 10.1186/1756-0500-7-731. PY - 2014 SN - 1756-0500 SP - 731 ST - Effectiveness of lithium in subjects with treatment-resistant depression and suicide risk: results and lessons of an underpowered randomised clinical trial T2 - BMC Res Notes TI - Effectiveness of lithium in subjects with treatment-resistant depression and suicide risk: results and lessons of an underpowered randomised clinical trial VL - 7 ID - 272 ER - TY - JOUR AB - OBJECTIVE: Despite advances in suicide prevention implemented throughout the US Department of Veterans Affairs (VA) including the hiring of Suicide Prevention Coordinators (SPCs) at every VA hospital, enhanced monitoring, and the availability of 24-hour crisis hotline services, suicide by veterans remains a critical problem affecting 20 veterans daily. Few empirically based treatment strategies for suicide prevention for postdeployment military personnel exist. This study aimed to test whether dialectical behavior therapy (DBT), one of the few psychosocial treatments with proven efficacy in diminishing suicidal behavior in individuals with personality disorder, can be applied to veterans irrespective of personality diagnosis. METHODS: From January 2010 to December 2014, 91 nonpsychotic veterans at high risk for suicide (61 men, 30 women) were randomly assigned to a 6-month treatment trial at a veterans' medical center comparing standard DBT to treatment as usual (TAU) and followed for 6 months after trial completion. Primary outcome was suicide attempts, measured with the Columbia-Suicide Severity Rating Scale, and secondary outcomes were suicide ideation, depression, hopelessness, and anxiety. There were no exclusions pertaining to substance abuse, homelessness, or medical comorbidity. RESULTS: Both DBT and TAU resulted in improvements in suicidal ideation, depression, and anxiety during the course of the 6-month treatment trial that did not differ between treatment arms. Survival analyses for suicide attempts and hospitalizations did not differ between treatment arms. However, DBT subjects utilized significantly more individual mental health services than TAU subjects (28.5 ± 19.6 vs 14.7 ± 10.9, F₁,₇₇ = 11.60, P = .001). CONCLUSIONS: This study is the first to examine 6-month DBT in a mostly male, veteran population. Increased mental health treatment service delivery, which included enhanced monitoring, outreach, and availability of a designated SPC, did not yield statistically significant differences in outcome for veterans at risk for suicide in TAU as compared to the DBT treatment arm. However, both treatments had difficulty with initial engagement post-hospitalization. Future studies examining possible sex differences and strategies to boost retention in difficult-to-engage, homeless, and substance-abusing populations are indicated. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT02462694. AD - MIRECC, Room 6A-44, James J. Peters VA Medical Center, Bronx, NY 10468. marianne.goodman@va.gov. Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA. VISN 3 Mental Illness Research, Education, and Clinical Center (MIRECC), James J. Peters VA Medical Center, Bronx, New York, USA. Outpatient Psychiatry, James J. Peters VA Medical Center, Bronx, New York, USA. Center for Intensive Treatment of Personality Disorders, Mount Sinai-St Luke's/Roosevelt, New York, New York, USA. Division of Clinical Phenomenology, New York State Psychiatric Institute, New York, USA. Columbia University, College of Physicians and Surgeons, New York, New York, USA. AN - 27780335 AU - Goodman, M. AU - Banthin, D. AU - Blair, N. J. AU - Mascitelli, K. A. AU - Wilsnack, J. AU - Chen, J. AU - Messenger, J. W. AU - Perez-Rodriguez, M. M. AU - Triebwasser, J. AU - Koenigsberg, H. W. AU - Goetz, R. R. AU - Hazlett, E. A. AU - New, A. S. DA - Dec DO - 10.4088/JCP.15m10235 DP - NLM ET - 2016/10/26 IS - 12 KW - Adult Anxiety/*therapy Behavior Therapy/*methods Depression/*therapy Female Follow-Up Studies Hope Humans Male Mental Health Services/*statistics & numerical data Middle Aged *Outcome and Process Assessment, Health Care Psychotherapy, Group *Suicidal Ideation Suicide, Attempted/*prevention & control Veterans/*psychology LA - eng N1 - 1555-2101 Goodman, Marianne Banthin, David Blair, Nicholas J Mascitelli, Kathryn A Wilsnack, Jaime Chen, Jennifer Messenger, Julie W Perez-Rodriguez, M Mercedes Triebwasser, Joseph Koenigsberg, Harold W Goetz, Raymond R Hazlett, Erin A New, Antonia S Journal Article Randomized Controlled Trial United States J Clin Psychiatry. 2016 Dec;77(12):e1591-e1600. doi: 10.4088/JCP.15m10235. PY - 2016 SN - 0160-6689 SP - e1591-e1600 ST - A Randomized Trial of Dialectical Behavior Therapy in High-Risk Suicidal Veterans T2 - J Clin Psychiatry TI - A Randomized Trial of Dialectical Behavior Therapy in High-Risk Suicidal Veterans VL - 77 ID - 85 ER - TY - JOUR AB - Despite growing evidence for the efficacy of Gratz and colleagues' emotion regulation group therapy (ERGT) for deliberate self‐harm (DSH) among women with borderline personality disorder (BPD), the proposed mechanism of change in this treatment (i.e., emotion regulation) remains largely unexamined. This study examined change in emotion dysregulation as a mediator of the effects of this ERGT on DSH and BPD symptoms, as well as the extent to which change in emotion dysregulation during treatment predicts further improvements in DSH during a 9‐month follow‐up. Participants included 61 female outpatients with BPD and recent DSH who were randomly assigned to receive this ERGT in addition to their ongoing outpatient therapy immediately (n = 31) or after 14 weeks (n = 30). Measures of emotion dysregulation, DSH, and BPD symptoms were administered pre‐ and post‐treatment or ‐waitlist, and at 9‐months post‐treatment (for participants in both conditions who received ERGT). Results from a series of mediation analyses provide further support for emotion regulation as a mechanism of change in this treatment. Specifically, results revealed that improvements in emotion dysregulation over the course of treatment mediated the observed reductions in BPD cognitive and affective symptoms during treatment and predicted further improvements in DSH during follow‐up. AN - CN-01054028 AU - Gratz, K. L. AU - Bardeen, J. R. AU - Levy, R. AU - Dixon-Gordon, K. L. AU - Tull, M. T. DO - 10.1016/j.brat.2014.12.005 KW - *automutilation /complication /therapy *behavior change *borderline state /therapy *deliberate self harm /complication /therapy *emotion regulation group therapy *group therapy Adult Article Assessment of humans Borderline Personality Disorder [*complications, psychology] Clinical effectiveness Cognitive defect /complication /therapy Controlled study Deliberate Self Harm Inventory Difficulties in Emotion Regulation Scale Emotion dysregulation /complication /therapy Emotional disorder /complication /therapy Emotions [*physiology] Female Follow up Human Human relation Humans Impulsiveness Major clinical study Middle Aged Mood disorder /complication /therapy Outcome assessment Outpatient Outpatient care Psychotherapy, Group [*methods] Randomized controlled trial Randomized controlled trial (topic) Self‐Injurious Behavior [complications, psychology, *therapy] Symptom Treatment Outcome Young Adult Zanarini Rating Scale for Borderline Personality Disorder M3 - Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural PY - 2015 SP - 29‐35 ST - Mechanisms of change in an emotion regulation group therapy for deliberate self-harm among women with borderline personality disorder T2 - Behaviour research and therapy TI - Mechanisms of change in an emotion regulation group therapy for deliberate self-harm among women with borderline personality disorder UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-01054028/full VL - 65 ID - 605 ER - TY - JOUR AB - Borderline personality disorder (BPD) and deliberate self‐harm are clinically important conditions for which additional economically and clinically feasible interventions are needed. Literature on both the emotion regulating and experientially avoidant function of self‐harm and the role of emotional dysfunction in BPD provided the rationale for developing a group intervention targeting emotion dysregulation among self‐harming women with BPD. This study provides preliminary data on the efficacy of this new, 14‐week, emotion regulation group intervention, designed to teach self‐harming women with BPD more adaptive ways of responding to their emotions so as to reduce the frequency of their self‐harm behavior. Participants were matched on level of emotion dysregulation and lifetime frequency of self‐harm and randomly assigned to receive this group in addition to their current outpatient therapy (N = 12), or to continue with their current outpatient therapy alone for 14 weeks (N = 10). Results indicate that the group intervention had positive effects on self‐harm, emotion dysregulation, experiential avoidance, and BPD‐specific symptoms, as well as symptoms of depression, anxiety, and stress. Participants in the group treatment condition evidenced significant changes over time on all measures, and reached normative levels of functioning on most. While these preliminary results are promising, the study's limitations require their replication in a larger‐scale randomized controlled trial. 2006 Association for Behavioral and Cognitive Therapies. AN - CN-00613003 AU - Gratz, K. L. AU - Gunderson, J. G. DO - 10.1016/j.beth.2005.03.002 IS - 1 KW - *borderline state *emotion Adult Anxiety Article Avoidance behavior Behavior disorder Clinical article Depression Female Harm reduction Human Outpatient care Randomization Statistical significance Stress M3 - Journal: Article PY - 2006 SP - 25‐35 ST - Preliminary Data on an Acceptance-Based Emotion Regulation Group Intervention for Deliberate Self-Harm Among Women With Borderline Personality Disorder T2 - Behavior therapy TI - Preliminary Data on an Acceptance-Based Emotion Regulation Group Intervention for Deliberate Self-Harm Among Women With Borderline Personality Disorder UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00613003/full VL - 37 ID - 607 ER - TY - JOUR AB - A randomized controlled trial was conducted to determine whether a manual-based psychodynamic treatment, labeled dynamic deconstructive psychotherapy (DDP), would be feasible and effective for individuals with co-occurring borderline personality disorder (BPD) and alcohol use disorder. Thirty participants were assessed every 3 months during a year of treatment with either DDP or treatment as usual (TAU) in the community. DDP participants showed statistically significant improvement in parasuicide behavior, alcohol misuse, institutional care, depression, dissociation, and core symptoms of BPD, and treatment retention was 67% to 73%. Although TAU participants received higher average treatment intensity, they showed only limited change during the same period. The results support the feasibility, tolerability, and efficacy of DDP for the co-occurring subgroup and highlight the need for further research. (PsycINFO Database Record (c) 2010 APA, all rights reserved). AD - Department of Psychiatry, SUNY Upstate Medical University. SUNY Upstate Medical University. AN - 22122363 AU - Gregory, R. J. AU - Chlebowski, S. AU - Kang, D. AU - Remen, A. L. AU - Soderberg, M. G. AU - Stepkovitch, J. AU - Virk, S. DA - Mar DO - 10.1037/0033-3204.45.1.28 DP - NLM ET - 2008/03/01 IS - 1 LA - eng N1 - Gregory, Robert J Chlebowski, Susan Kang, David Remen, Anna L Soderberg, Maureen G Stepkovitch, Jason Virk, Subhdeep Journal Article United States Psychotherapy (Chic). 2008 Mar;45(1):28-41. doi: 10.1037/0033-3204.45.1.28. PY - 2008 SN - 0033-3204 (Print) 0033-3204 SP - 28-41 ST - A controlled trial of psychodynamic psychotherapy for co-occurring borderline personality disorder and alcohol use disorder T2 - Psychotherapy (Chic) TI - A controlled trial of psychodynamic psychotherapy for co-occurring borderline personality disorder and alcohol use disorder VL - 45 ID - 2524 ER - TY - JOUR AB - OBJECTIVE: To assess whether systematic follow‐up by general practitioners (GPs) of cases of deliberate self‐poisoning (DSP) by their patients decreases psychiatric symptoms and suicidal behaviour compared with current practice. DESIGN: Randomised clinical trial with two parallel groups. SETTING: General practices in Oslo and the eastern part of Akershus County. PARTICIPANTS: Patients aged 18‐75 years admitted to hospital for DSP. We excluded patients diagnosed with psychoses, without a known GP, those not able to complete a questionnaire, and patients admitted to psychiatric in‐patient care or other institutions where their GP could not follow them immediately after discharge. INTERVENTION: The GPs received a written guideline, contacted the patients and scheduled a consultation within one week after discharge, and then provided regular consultations for six months. We randomised the patients to either intervention (n = 78) or treatment as usual (n = 98). MAIN OUTCOME MEASURES: Primary outcome measure was the Beck Scale for Suicide Ideation (SSI). Secondary outcomes were Beck Depression Inventory (BDI) and Beck Hopelessness Scale (BHS), self‐reported further self‐harm and treatment for DSP in a general hospital or an emergency medical agency (EMA). We assessed patients on entry to the trial and at three and six months. We collected data from interviews, self‐report questionnaires, and hospital and EMA medical records. RESULTS: There were no significant differences between the groups in SSI, BDI, or BHS mean scores or change from baseline to three or six months. During follow‐up, self‐reported DSP was 39.5% in the intervention group vs. 15.8% in controls (P = 0.009). Readmissions to general hospitals were similar (13% in both groups (P = 0.963), while DSP episodes treated at EMAs were 17% in the intervention group and 7% in the control group (P = 0.103). CONCLUSION: Structured follow‐up by GPs after an episode of DSP had no significant effect on suicide ideation, depression or hopelessness. There was no significant difference in repeated episodes of DSP in hospitals or EMAs. However, the total number of incidents of deliberate self‐harm reported by the patients was significantly higher in the intervention group. TRIAL REGISTRATION: Trial registration ClinicalTrials.gov Identifier: NCT01342809. AN - CN-01168802 AU - Grimholt, T. K. AU - Jacobsen, D. AU - Haavet, O. R. AU - Sandvik, L. AU - Jorgensen, T. AU - Norheim, A. B. AU - Ekeberg, O. DO - 10.1371/journal.pone.0143934 IS - 12 KW - *deliberate self poisoning/th [Therapy] *follow up *general practitioner *suicide/th [Therapy] Adolescent Adult Aged Appointments and Schedules Article Beck Depression Inventory Beck Hopelessness Scale Beck scale for suicide ideation Clinical practice Consultation Controlled study Depression Depression [prevention & control] Female Follow‐Up Studies General Practitioners Hope Hopelessness Hospital admission Hospital discharge Hospital readmission Human Humans Major clinical study Male Mental disease Mental disease assessment Mental health care Middle Aged Norway Outcome assessment Parallel design Patient Discharge Patient counseling Poisoning [*psychology, therapy] Practice guideline Psychosis Psychotherapy Randomized controlled trial Self report Self‐Injurious Behavior [*psychology, therapy] Suicidal Ideation Young Adult M3 - Journal Article; Randomized Controlled Trial; Research Support, Non‐U.S. Gov't PY - 2015 SP - e0143934 ST - Effect of Systematic Follow-Up by General Practitioners after Deliberate Self-Poisoning: a Randomised Controlled Trial T2 - PloS one TI - Effect of Systematic Follow-Up by General Practitioners after Deliberate Self-Poisoning: a Randomised Controlled Trial UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-01168802/full VL - 10 ID - 608 ER - TY - JOUR AB - BACKGROUND: General Practitioners (GPs) play an important role in the follow‐up of patients after deliberate self‐poisoning (DSP). The aim was to examine whether structured follow‐up by GPs increased the content of, adherence to, and satisfaction with treatment after discharge from emergency departments. METHODS: This was a multicentre, randomised trial with blinded assignment. Five emergency departments and general practices in the catchment area participated. 202 patients discharged from emergency departments after DSP were assigned. The intervention was structured follow‐up by the GP over a 6‐month period with a minimum of five consultations, accompanied by written guidelines for the GPs with suggestions for motivating patients to follow treatment, assessing personal problems and suicidal ideation, and availability in the case of suicidal crisis. Outcome measures were data retrieved from the Register for the control and payment of reimbursements to health service providers (KUHR) and by questionnaires mailed to patients and GPs. After 3 and 6 months, the frequency and content of GP contact, and adherence to GP consultations and treatment in general were registered. Satisfaction with general treatment received and with the GP was measured by the EUROPEP scale. RESULTS: Patients in the intervention group received significantly more consultations than the control group (mean 6.7 vs. 4.5 (p = 0.004)). The intervention group was significantly more satisfied with the time their GP took to listen to their personal problems (93.1% vs. 59.4% (p = 0.002)) and with the fact that the GP included them in medical decisions (87.5% vs. 54. 8% (p = 0.009)). The intervention group was significantly more satisfied with the treatment in general than the control group (79% vs. 51% (p = 0.026)). CONCLUSIONS: Guidelines and structured, enhanced follow‐up by the GP after the discharge of the DSP patient increased the number of consultations and satisfaction with aftercare in general practice. Consistently with previous research, there is still a need for interventional studies. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01342809. Registered 18 April 2011. AN - CN-01169417 AU - Grimholt, T. K. AU - Jacobsen, D. AU - Haavet, O. R. AU - Sandvik, L. AU - Jorgensen, T. AU - Norheim, A. B. AU - Ekeberg, O. DO - 10.1186/s12888-015-0635-2 KW - Adult Aftercare Emergency Medical Services [*methods] Female Follow‐Up Studies General Practice [*methods] Humans Male Outcome Assessment, Health Care Patient Compliance Patient Satisfaction Poisoning [*psychology] Referral and Consultation Single‐Blind Method Surveys and Questionnaires M3 - Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non‐U.S. Gov't PY - 2015 SP - 245 ST - Structured follow-up by general practitioners after deliberate self-poisoning: a randomised controlled trial T2 - BMC psychiatry TI - Structured follow-up by general practitioners after deliberate self-poisoning: a randomised controlled trial UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-01169417/full VL - 15 ID - 609 ER - TY - JOUR AB - Randomized controlled trials in depressed patients selected for elevated suicidal risk are rare. The resultant lack of data leaves uncertainty about treatment in this population. This study compared a serotonin reuptake inhibitor with a noradrenergic/dopaminergic antidepressant in major depression with elevated suicidal risk factors. We conducted a double-blind, randomized, clinical pilot trial of paroxetine (N=36) or bupropion (N=38) in DSM IV major depression with a suicide attempt history or current suicidal ideation. The effects during acute (8 weeks) and continuation treatment (up to 16 weeks) were measured. Main outcomes were suicidal behavior and ideation. The secondary outcome was modified 17-item Hamilton Depression Rating Scale score subtracting the suicide item (mHDRS-17). Treatment was not associated with time to a suicidal event and no treatment main effect or treatment × time interaction on suicidal ideation or mHDRS-17 was found. Exploratory model selection showed modest advantages for paroxetine on: (1) mHDRS-17 (p=0.02); and (2) in a separate model adjusted for baseline depression, for suicidal ideation measured with the Beck Scale for Suicidal Ideation (p=0.03), with benefit increasing with baseline severity. Depressed patients with greater baseline suicidal ideation treated with paroxetine compared with bupropion appeared to experience greater acute improvement in suicidal ideation, after adjusting for global depression. Given the lack of evidence-based pharmacotherapy guidelines for suicidal, depressed patients-an important public health population-this preliminary finding merits further study. AD - Department of Psychiatry, Columbia University and New York State Psychiatric Institute, New York, NY 10032, USA. mfg14@columbia.edu AN - 21993207 AU - Grunebaum, M. F. AU - Ellis, S. P. AU - Duan, N. AU - Burke, A. K. AU - Oquendo, M. A. AU - John Mann, J. C2 - PMC3260969 DA - Feb DO - 10.1038/npp.2011.247 DP - NLM ET - 2011/10/14 IS - 3 KW - Adolescent Adult Affect/*drug effects Aged Bupropion/pharmacology/*therapeutic use Depressive Disorder, Major/*drug therapy/psychology Dopamine Uptake Inhibitors/*therapeutic use Double-Blind Method Female Humans Male Middle Aged Paroxetine/*therapeutic use Pilot Projects Serotonin Uptake Inhibitors/*therapeutic use *Suicidal Ideation *Suicide Treatment Outcome LA - eng N1 - 1740-634x Grunebaum, Michael F Ellis, Steven P Duan, Naihua Burke, Ainsley K Oquendo, Maria A John Mann, J MH62185/MH/NIMH NIH HHS/United States MH48514/MH/NIMH NIH HHS/United States P50 MH062185/MH/NIMH NIH HHS/United States K23 MH076049/MH/NIMH NIH HHS/United States R01 MH048514/MH/NIMH NIH HHS/United States Comparative Study Journal Article Randomized Controlled Trial Research Support, N.I.H., Extramural Neuropsychopharmacology. 2012 Feb;37(3):697-706. doi: 10.1038/npp.2011.247. Epub 2011 Oct 12. PY - 2012 SN - 0893-133X (Print) 0893-133x SP - 697-706 ST - Pilot randomized clinical trial of an SSRI vs bupropion: effects on suicidal behavior, ideation, and mood in major depression T2 - Neuropsychopharmacology TI - Pilot randomized clinical trial of an SSRI vs bupropion: effects on suicidal behavior, ideation, and mood in major depression VL - 37 ID - 133 ER - TY - JOUR AB - OBJECTIVES: To evaluate feasibility and effects of a sub-anesthetic infusion dose of ketamine versus midazolam on suicidal ideation in bipolar depression. Neurocognitive, blood and saliva biomarkers were explored. METHODS: Sixteen participants with bipolar depression and a Scale for Suicidal Ideation (SSI) score of ≥4 were randomized to ketamine (0.5 mg/kg) or midazolam (0.02 mg/kg). Current pharmacotherapy was maintained excluding benzodiazepines within 24 hours. The primary clinical outcome was SSI score on day 1 post-infusion. RESULTS: Results supported feasibility. Mean reduction of SSI after ketamine infusion was almost 6 points greater than after midazolam, although this was not statistically significant (estimate=5.84, SE=3.01, t=1.94, P=.074, 95% confidence interval ([CI)]=-0.65 to 12.31). The number needed to treat for response (SSI <4 and at least 50% below baseline) was 2.2, and for remission (SSI=0) was 3.2. The strongest neurocognitive correlation was between memory improvement on the Selective Reminding Test (SRT) and reduction in SSI score on day 1 after ketamine (ρ=-.89, P=.007). Pre- to post-infusion decrease in serum brain derived neurotrophic factor (BDNF) correlated with reduction in SSI from baseline to day 1 after ketamine (n=5, ρ=0.90, P=.037) but not midazolam (P=.087). CONCLUSIONS: The study demonstrated feasibility. Suicidal thoughts were lower after ketamine than after midazolam at a trend level of significance, likely due to the small pilot sample. Memory improvement and BDNF are promising biomarkers. Replication is needed in an adequately powered full-scale trial. AD - Molecular Imaging and Neuropathology Division, Department of Psychiatry, Columbia University Medical Center (CUMC) and New York State Psychiatric Institute, New York, NY, USA. Department of Anesthesiology, CUMC, New York, NY, USA. Analytical Psychopharmacology Laboratory, Nathan Kline Institute, Research Foundation for Mental Hygiene of New York State, Orangeburg, NY, USA. Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA. AN - 28452409 AU - Grunebaum, M. F. AU - Ellis, S. P. AU - Keilp, J. G. AU - Moitra, V. K. AU - Cooper, T. B. AU - Marver, J. E. AU - Burke, A. K. AU - Milak, M. S. AU - Sublette, M. E. AU - Oquendo, M. A. AU - Mann, J. J. DA - May DO - 10.1111/bdi.12487 DP - NLM ET - 2017/04/30 IS - 3 KW - Adult Anesthetics, Dissociative/administration & dosage/adverse effects Biomarkers/analysis *Bipolar Disorder/diagnosis/drug therapy/psychology Brain-Derived Neurotrophic Factor/analysis Dose-Response Relationship, Drug Double-Blind Method Drug Monitoring/methods Female GABA Modulators/administration & dosage/adverse effects Humans *Ketamine/administration & dosage/adverse effects Male Memory/*drug effects *Midazolam/administration & dosage/adverse effects Middle Aged *Suicidal Ideation Treatment Outcome *bipolar disorder *depression *ketamine *midazolam LA - eng N1 - 1399-5618 Grunebaum, Michael F Orcid: 0000-0001-5940-3478 Ellis, Steven P Keilp, John G Moitra, Vivek K Cooper, Thomas B Marver, Julia E Burke, Ainsley K Milak, Matthew S Sublette, M Elizabeth Oquendo, Maria A Mann, J John Journal Article Randomized Controlled Trial Denmark Bipolar Disord. 2017 May;19(3):176-183. doi: 10.1111/bdi.12487. Epub 2017 Apr 28. PY - 2017 SN - 1398-5647 SP - 176-183 ST - Ketamine versus midazolam in bipolar depression with suicidal thoughts: A pilot midazolam-controlled randomized clinical trial T2 - Bipolar Disord TI - Ketamine versus midazolam in bipolar depression with suicidal thoughts: A pilot midazolam-controlled randomized clinical trial VL - 19 ID - 694 ER - TY - JOUR AB - OBJECTIVES: To determine the effects of a brief psychological intervention (brief psychodynamic interpersonal therapy) for patients after deliberate self poisoning compared with usual treatment. To compare the impact of the active intervention and usual treatment on patients' satisfaction with care. DESIGN: Randomised controlled trial. PARTICIPANTS: 119 adults who had deliberately poisoned themselves and presented to the emergency department of a teaching hospital. SETTING: Community based study. INTERVENTION: Four sessions of therapy delivered in the patient's home. Control patients received "treatment as usual," which in most cases consisted of referral back to their general practitioner. OUTCOME MEASURES: Severity of suicidal ideation six months after treatment as assessed by the Beck scale for suicidal ideation. Secondary outcome measures at six month follow up included depressive symptoms as measured by the Beck depression inventory, patient satisfaction with treatment, and self reported subsequent attempts at self harm. Results: Participants randomised to the intervention had a significantly greater reduction in suicidal ideation at six month follow up compared with those in the control group (reduction in the mean (SD) Beck scale 8.0 v 1.5). They were more satisfied with their treatment and were less likely to report repeated attempts to harm themselves at follow up (proportion repeating 9% v 28% in control group; difference 19%, 95% confidence interval 9% to 30 %, P=0.009). CONCLUSION: Brief psychodynamic interpersonal therapy may be a valuable treatment after people have deliberately tried to poison themselves. AN - CN-00349542 AU - Guthrie, E. AU - Kapur, N. AU - Mackway-Jones, K. AU - Chew-Graham, C. AU - Moorey, J. AU - Mendel, E. AU - Marino-Francis, F. AU - Sanderson, S. AU - Turpin, C. AU - Boddy, G. AU - et al. DO - 10.1136/bmj.323.7305.135 IS - 7305 KW - Adolescent Adult Aged Female Follow‐Up Studies Home Care Services, Hospital‐Based Humans Male Middle Aged Patient Satisfaction Poisoning [nursing, *prevention & control] Psychiatric Status Rating Scales Psychotherapy, Brief Self‐Injurious Behavior [prevention & control] Suicide [*prevention & control] Treatment Outcome M3 - Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non‐U.S. Gov't PY - 2001 SP - 135‐138 ST - Randomised controlled trial of brief psychological intervention after deliberate self poisoning T2 - BMJ (Clinical research ed.) TI - Randomised controlled trial of brief psychological intervention after deliberate self poisoning UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00349542/full VL - 323 ID - 610 ER - TY - JOUR AB - Background: The development of individual coping strategies for suicidal crises is essential for suicide prevention. However, the influence of a brief intervention and the effect on coping strategies is largely unknown. This study aimed to investigate the influence of the Attempted Suicide Short Intervention Program on the development of coping strategies, in comparison to a control group. Method: In this secondary analysis of a 24‐month follow‐up randomised controlled study, 120 patients (55% female; mean age of 36) with a history of suicide attempts were randomly allocated to either the ASSIP group or to a control group, in addition to treatment as usual. Results: The present study identified 11% less dysfunctional coping in the ASSIP group and 6% more problem‐focussed coping compared to the control group after 24‐months. The analysis of broader strategies showed a statistically significant group difference regarding self‐distraction (after 12‐months) and self‐blame (after 24‐months). In regard to the long‐term association between coping strategies and suicidal ideation, active coping and substance use were negatively associated with suicidal ideation in the ASSIP group. Whereas, in the control group, behavioural disengagement and positive reframing were positively and self‐distraction was negatively related to suicidal ideation. Limitation: The receipt of a clinical interview and suicide risk assessment in the control group could have potentially had an effect on participants’ coping mechanisms. Conclusion: These results indicate that ASSIP may have an impact on the development of problem‐focussed coping strategies. Although a reduction in dysfunctional coping seems to be essential in overcoming suicidal crises. AN - CN-02051958 AU - Gysin-Maillart, A. AU - Soravia, L. AU - Schwab, S. DO - 10.1016/j.jad.2019.11.059 KW - *coping behavior *suicidal ideation *suicide attempt Adaptation, Psychological Adult Article Behavior Therapy Controlled study Crisis Intervention Female Follow up Human Humans Interview Major clinical study Male Randomized controlled trial Risk assessment Secondary analysis Substance use Suicidal Ideation Suicide, Attempted M3 - Journal Article; Randomized Controlled Trial PY - 2020 SP - 393‐399 ST - Attempted suicide short intervention program influences coping among patients with a history of attempted suicide T2 - Journal of affective disorders TI - Attempted suicide short intervention program influences coping among patients with a history of attempted suicide UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-02051958/full VL - 264 ID - 612 ER - TY - JOUR AB - BACKGROUND: Trials have demonstrated benefits of long-chain omega-3 essential fatty acid (n-3 EFA) supplementation in a variety of psychiatric disorders. AIMS: To assess the efficacy of n-3 EFAs in improving psychological well-being in patients with recurrent self-harm. METHOD: Patients (n=49) presenting after an act of repeated self-harm were randomised to receive 1.2 g eicosapentaenoic acid plus 0.9 g decosahexaenoic acid (n=22) or placebo (n=27) for 12 weeks in addition to standard psychiatric care. Six psychological domains were measured at baseline and end point. RESULTS: At 12 weeks, the n-3 EFA group had significantly greater improvements in scores for depression, suicidality and daily stresses. Scores for impulsivity, aggression and hostility did not differ. CONCLUSIONS: Supplementation achieved substantial reductions in surrogate markers of suicidal behaviour and improvements in well-being. Larger studies are warranted to determine if insufficient dietary intake of n-3 EFAs is a reversible risk factor for self-harm. AD - Department of Psychiatry, Beaumont Hospital and The Royal College of Surgeons in Ireland, Ireland. AN - 17267927 AU - Hallahan, B. AU - Hibbeln, J. R. AU - Davis, J. M. AU - Garland, M. R. DA - Feb DO - 10.1192/bjp.bp.106.022707 DP - NLM ET - 2007/02/03 KW - Adult *Dietary Supplements Docosahexaenoic Acids/*administration & dosage Double-Blind Method Eicosapentaenoic Acid/*administration & dosage Female Humans Male Psychiatric Status Rating Scales Recurrence Risk Factors Self-Injurious Behavior/*prevention & control Treatment Outcome LA - eng N1 - Hallahan, Brian Hibbeln, Joseph R Davis, John M Garland, Malcolm R Journal Article Randomized Controlled Trial England Br J Psychiatry. 2007 Feb;190:118-22. doi: 10.1192/bjp.bp.106.022707. PY - 2007 SN - 0007-1250 (Print) 0007-1250 SP - 118-22 ST - Omega-3 fatty acid supplementation in patients with recurrent self-harm. Single-centre double-blind randomised controlled trial T2 - Br J Psychiatry TI - Omega-3 fatty acid supplementation in patients with recurrent self-harm. Single-centre double-blind randomised controlled trial VL - 190 ID - 142 ER - TY - JOUR AB - This study examined the efficacy of dialectical behavior therapy (DBT) in reducing behaviors commonly used as exclusion criteria for posttraumatic stress disorder (PTSD) treatment. The sample included 51 suicidal and/or self-injuring women with borderline personality disorder (BPD), 26 (51%) of whom met criteria for PTSD. BPD clients with and without PTSD were equally likely to eliminate the exclusionary behaviors during 1 year of DBT. By posttreatment, 50-68% of the BPD clients with PTSD would have been suitable candidates for PTSD treatment. Borderline personality disorder clients with PTSD who began treatment with a greater number of recent suicide attempts and more severe PTSD were significantly less likely to become eligible for PTSD treatment. AD - Behavioral Research and Therapy Clinics, Department of Psychology, University of Washington, 3935 University Way NE, Seattle, WA 98105, USA. mharned@u.washington.edu AN - 20648564 AU - Harned, M. S. AU - Jackson, S. C. AU - Comtois, K. A. AU - Linehan, M. M. DA - Aug DO - 10.1002/jts.20553 DP - NLM ET - 2010/07/22 IS - 4 KW - Adult Borderline Personality Disorder/diagnosis/psychology/*therapy Cognitive Behavioral Therapy/*methods Comorbidity Dissociative Disorders/diagnosis/psychology/therapy Female Follow-Up Studies Humans Meditation/*methods/psychology Personality Inventory Self-Injurious Behavior/diagnosis/psychology/*therapy Stress Disorders, Post-Traumatic/diagnosis/psychology/*therapy Substance-Related Disorders/diagnosis/psychology/therapy Suicide, Attempted/*prevention & control/psychology Treatment Outcome Young Adult LA - eng N1 - 1573-6598 Harned, Melanie S Jackson, Safia C Comtois, Katherine A Linehan, Marsha M MH01593/MH/NIMH NIH HHS/United States MH34486/MH/NIMH NIH HHS/United States Journal Article Randomized Controlled Trial Research Support, N.I.H., Extramural United States J Trauma Stress. 2010 Aug;23(4):421-9. doi: 10.1002/jts.20553. PY - 2010 SN - 0894-9867 SP - 421-9 ST - Dialectical behavior therapy as a precursor to PTSD treatment for suicidal and/or self-injuring women with borderline personality disorder T2 - J Trauma Stress TI - Dialectical behavior therapy as a precursor to PTSD treatment for suicidal and/or self-injuring women with borderline personality disorder VL - 23 ID - 548 ER - TY - JOUR AB - OBJECTIVE: This study evaluates the efficacy of integrating PTSD treatment into Dialectical Behavior Therapy (DBT) for women with borderline personality disorder, PTSD, and intentional self‐injury. METHODS: Participants were randomized to DBT (n=9) or DBT with the DBT Prolonged Exposure (DBT PE) protocol (n=17) and assessed at 4‐month intervals during the treatment year and 3‐months post‐treatment. RESULTS: Treatment expectancies, satisfaction, and completion did not differ by condition. In DBT+DBT PE, the DBT PE protocol was feasible to implement for a majority of treatment completers. Compared to DBT, DBT+DBT PE led to larger and more stable improvements in PTSD and doubled the remission rate among treatment completers (80% vs. 40%). Patients who completed the DBT PE protocol were 2.4 times less likely to attempt suicide and 1.5 times less likely to self‐injure than those in DBT. Among treatment completers, moderate to large effect sizes favored DBT+DBT PE for dissociation, trauma‐related guilt cognitions, shame, anxiety, depression, and global functioning. CONCLUSIONS: DBT with the DBT PE protocol is feasible, acceptable, and safe to administer, and may lead to larger improvements in PTSD, intentional self‐injury, and other outcomes than DBT alone. The findings require replication in a larger sample. AN - CN-00981984 AU - Harned, M. S. AU - Korslund, K. E. AU - Linehan, M. M. DO - 10.1016/j.brat.2014.01.008 KW - *automutilation/th [Therapy] *behavior therapy *borderline state/th [Therapy] *dialectical behavior therapy *long term exposure *posttraumatic stress disorder/th [Therapy] *suicide attempt/th [Therapy] Adult Anxiety Article Behavior Therapy [*methods] Borderline Personality Disorder [complications, *therapy] Clinical article Clinical effectiveness Clinical protocol Cognition Combined Modality Therapy Controlled study Depression Feasibility study Female Guilt Human Humans Implosive Therapy [*methods] Mental dissociation Middle Aged Outcome assessment Patient Compliance Patient safety Patient satisfaction Pilot Projects Pilot study Randomized controlled trial Remission Self‐Injurious Behavior [complications, *therapy] Shame Stress Disorders, Post‐Traumatic [complications, *therapy] Suicide, Attempted Treatment Outcome Young Adult M3 - Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural PY - 2014 SP - 7‐17 ST - A pilot randomized controlled trial of Dialectical Behavior Therapy with and without the Dialectical Behavior Therapy Prolonged Exposure protocol for suicidal and self-injuring women with borderline personality disorder and PTSD T2 - Behaviour research and therapy TI - A pilot randomized controlled trial of Dialectical Behavior Therapy with and without the Dialectical Behavior Therapy Prolonged Exposure protocol for suicidal and self-injuring women with borderline personality disorder and PTSD UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00981984/full VL - 55 ID - 613 ER - TY - JOUR AB - BACKGROUND: Hospital‐treated self‐poisoning is common, with limited effective interventions for reducing subsequent suicidal behaviour. AIMS: To test the efficacy of a postcard intervention to reduce suicidal behaviour. METHOD: Randomised controlled trial of individuals who self‐poisoned (n = 2300), the intervention consisted of nine postcards sent over 12 months versus usual treatment. Outcomes assessed at 12 months (n = 2113) were suicidal ideation, suicide attempts and self‐cutting (proportion and event rates). RESULTS: There was a significant reduction in any suicidal ideation (relative risk reduction (RRR) = 0.31, 95% CI 0.22‐0.38), any suicide attempt (RRR = 0.42, 95% CI 0.11‐0.63) and number of attempts (incidence rate ratios (IRR) = 0.64, 95% CI 0.42‐0.97). There was no significant reduction in any self‐cutting (RRR = 0.14, 95% CI ‐0.29 to 0.42) or self‐cutting events (IRR = 1.03 95% CI 0.76‐1.39). CONCLUSIONS: A postcard intervention reduced suicidal ideation and suicide attempts in a non‐Western population. Sustained, brief contact by mail may reduce suicidal ideation and suicide attempts in individuals who self‐poison. AN - CN-00783880 AU - Hassanian-Moghaddam, H. AU - Sarjami, S. AU - Kolahi, A. A. AU - Carter, G. L. DO - 10.1192/bjp.bp.109.067199 IS - 4 KW - Adolescent Aftercare [methods] Correspondence as Topic Female Hospitalization Humans Iran [epidemiology] Male Outcome Assessment, Health Care [statistics & numerical data] Persia Poisoning [psychology, *therapy] Secondary Prevention Self‐Injurious Behavior [*prevention & control, psychology, therapy] Suicidal Ideation Suicide, Attempted [*prevention & control, psychology] Time Factors Young Adult M3 - Journal Article; Randomized Controlled Trial; Research Support, Non‐U.S. Gov't PY - 2011 SP - 309‐316 ST - Postcards in Persia: randomised controlled trial to reduce suicidal behaviours 12 months after hospital-treated self-poisoning T2 - British journal of psychiatry TI - Postcards in Persia: randomised controlled trial to reduce suicidal behaviours 12 months after hospital-treated self-poisoning UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00783880/full VL - 198 ID - 614 ER - TY - JOUR AB - This study reports the outcomes, during follow‐up, of a low‐cost postcard intervention in a Randomized Control Trial of hospital‐treated self‐poisoning (n = 2300). The intervention was 9 postcards over 12 months (plus usual treatment) versus usual treatment. Three binary endpoints at 12‐24 months (n = 2001) were: any suicidal ideation, suicide attempt, or self‐cutting. There was a significant reduction in any suicidal ideation (RRR 0.20 CI 95% 0.13‐0.27), (NNT 8, 6‐13), and any suicide attempt (RRR 0.31, 0.06‐0.50), (NNT 35, 19‐195), in this non‐western population. However, there was no effect on self‐cutting (RRR ‐0.01, ‐1.05‐0.51). Sustained, brief contact by mail may reduce some forms of suicidal behavior in self‐poisoning patients during the post intervention phase. AN - CN-01464488 AU - Hassanian-Moghaddam, H. AU - Sarjami, S. AU - Kolahi, A. A. AU - Lewin, T. AU - Carter, G. DO - 10.1080/13811118.2015.1004473 IS - 1 KW - *procedures *publication *suicidal ideation Adolescent Adult Aftercare Automutilation/th [Therapy] Controlled study Female Follow up Human Iran Male Psychology Randomized controlled trial Suicide Suicide attempt Young adult M3 - Article PY - 2017 SP - 138‐154 ST - Postcards in Persia: a Twelve to Twenty-four Month Follow-up of a Randomized Controlled Trial for Hospital-Treated Deliberate Self-Poisoning T2 - Archives of suicide research TI - Postcards in Persia: a Twelve to Twenty-four Month Follow-up of a Randomized Controlled Trial for Hospital-Treated Deliberate Self-Poisoning UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-01464488/full VL - 21 ID - 615 ER - TY - JOUR AB - Objective: Previous suicide interventional studies are controversial in their results. The present study compared brief intervention and contact (BIC), with treatment as usual (TAU) in their influence on the repetition of suicide attempts 6‐month after the index suicide attempt. Methods: Adults who had attempted suicide were assigned two groups randomly: 311 in the TAU and 321 in the BIC. The brief intervention and contact contained a brief one‐hour psycho‐educational session combined with follow‐up contacts by phone calls or visits after discharge. We used Mann‐Whitney U test, ANOVA, and Chi‐Square for analysis of variables. Results: The brief intervention and contact did not significantly reduce the repeated suicide attempts, but the patients' need to get support increased significantly (alpha value = 63.67, p<0.001) compared to the treatment as usual group. Also, the brief intervention and contact group patients tried to get support from outpatient/inpatient services, relatives, friends or by telephone contact to a significantly larger extent (alpha value = 69.2, p<0.001) compared to the treatment as usual group. Conclusion: brief intervention and contact seems to have an effect on the patients' attitude towards seeking support from outpatient/inpatient services, relatives and friends. AN - CN-00789664 AU - Hassanzadeh, M. AU - Khajeddin, N. AU - Nojomi, M. AU - Fleischmann, A. AU - Eshrati, T. IS - 2 KW - *suicide attempt Adult Article Controlled study Female Follow up Health service Human Iran Major clinical study Male Patient counseling Psychoeducation Support group M3 - Journal: Article PY - 2010 SP - 5‐12 ST - Brief intervention and contact after deliberate self-harm: an Iranian randomized controlled trial T2 - Iranian journal of psychiatry and behavioral sciences TI - Brief intervention and contact after deliberate self-harm: an Iranian randomized controlled trial UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00789664/full VL - 4 ID - 616 ER - TY - JOUR AB - PURPOSE: Indigenous people have high rates of suicide and self‐harm compared to other population groups. AIM: The aim of this trial was to see if a package of interventions delivered in a culturally appropriate way improved outcomes at one year in Maori who presented with intentional self‐harm to emergency departments. METHODS: Participants were Maori who presented with intentional self‐harm to emergency departments in New Zealand. The study design was a double consent Zelen randomised controlled trial. The intervention included regular postcards, problem solving therapy, patient support, risk management, improved access to primary care and cultural assessment in addition to usual care. The control group received usual care. The main outcome measure was the self‐rated change in scores on the Beck Hopelessness Scale at one year. RESULTS: 182 people were randomized to the intervention group 95 of whom consented to take part in the study. 183 people were randomized to the control group 72 of whom consented to take part in the study. For those who consented comparing the intervention group with the control group there was a statistically significant greater change in hopelessness scores at 3 months (difference ‐1.7 95 % CI ‐3.4 to ‐0.01, p = 0.05) but not at one year (difference ‐1.6 95 % CI ‐3.4 to 0.3, p = 0.11). Maori who consented and received the intervention were also significantly less likely to present to hospital for non‐self‐harm reasons in the year after the index episode (44.2 vs. 61.1 %, p = 0.03). Those participants randomised to the intervention were less likely to re‐present with self‐harm at 3 months (10.4 vs. 18 %, p = 0.04) but not at 12 months compared to the control group. CONCLUSIONS: In Maori who presented to hospital with intentional self‐harm a culturally informed intervention had an effect on hopelessness and re‐presentation with self‐harm in the short term but not at 12 months. There was a significant decrease in hospital presentations for non‐self harm over the next year. TRIAL REGISTRATION: Australian and New Zealand Clinical Trials Registry ACTRN12609000952246. AN - CN-01369013 AU - Hatcher, S. AU - Coupe, N. AU - Wikiriwhi, K. AU - Durie, S. M. AU - Pillai, A. DO - 10.1007/s00127-016-1194-7 IS - 6 KW - Adult Culturally Competent Care [*methods] Female Humans Male Mental Health Services Middle Aged New Zealand [ethnology] Outcome and Process Assessment, Health Care Self‐Injurious Behavior [*ethnology, *prevention & control] M3 - Journal Article; Randomized Controlled Trial PY - 2016 SP - 885‐894 ST - Te Ira Tangata: a Zelen randomised controlled trial of a culturally informed treatment compared to treatment as usual in Māori who present to hospital after self-harm T2 - Social psychiatry and psychiatric epidemiology TI - Te Ira Tangata: a Zelen randomised controlled trial of a culturally informed treatment compared to treatment as usual in Māori who present to hospital after self-harm UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-01369013/full VL - 51 ID - 617 ER - TY - JOUR AB - Background The problem of people presenting to hospitals with self‐harm is important because such presentations are common, there is a clear link to suicide and a high premature mortality. However, the best treatment for this population is unclear. Aims To see whether a package of measures, that included regular postcards and problem‐solving therapy, improved outcomes at 1 year compared with usual care in people who presented to hospital with self‐harm (the ACCESS study: trial registration Australian and New Zealand Clinical Trials Registry ACTRN12609000641291). Method The design of the study was a Zelen randomised controlled trial. The primary outcome was re‐presentation to hospital with self‐harm within 12 months of the index episode. Results There were no significant differences in the primary outcome and most of the secondary outcomes between the two groups. About half the people offered problem‐solving therapy did not receive it, for various reasons. Conclusions The package as offered had little effect on the proportion of people re‐presenting to hospital with self‐harm. The dose of problem‐solving therapy may have been too small to have an effect and there was a difficulty engaging participants in active treatment. AN - CN-01069142 AU - Hatcher, S. AU - Sharon, C. AU - House, A. AU - Collins, N. AU - Collings, S. AU - Pillai, A. DO - 10.1192/bjp.bp.113.135780 IS - 3 KW - *automutilation/th [Therapy] *hospital care Adult Article Controlled study Female Hospitals Human Humans Male Outcome assessment Primary medical care Problem solving Psychotherapy Randomized controlled trial Recurrence Self poisoning Self‐Injurious Behavior [*therapy] Time Factors Treatment Outcome Young Adult M3 - Journal Article; Randomized Controlled Trial PY - 2015 SP - 229‐236 ST - The ACCESS study: zelen randomised controlled trial of a package of care for people presenting to hospital after self-harm T2 - British journal of psychiatry TI - The ACCESS study: zelen randomised controlled trial of a package of care for people presenting to hospital after self-harm UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-01069142/full VL - 206 ID - 618 ER - TY - JOUR AB - BACKGROUND: Presentations to hospital with self‐harm are common, associated with suicide and have an increased mortality, yet there is no accepted effective intervention. AIMS: To investigate whether problem‐solving therapy would improve outcomes in adults presenting to hospital with self‐harm, compared with usual care. METHOD: A Zelen randomised controlled trial was conducted in four district health boards in New Zealand. A second hospital presentation with self‐harm at 1 year for all episodes, plus separate comparisons of first‐time and repeat presentations at the index episode, were the a priori primary outcomes. The trial registration number was ACTRN12605000337673. RESULTS: In an intention‐to‐treat analysis of all randomised patients (n = 1094) there was no significant difference at 12 months in the proportion of people who had presented again with self‐harm when comparing all episodes (intervention 13.4%, usual care 14.1%; relative risk reduction RR = 0.05, 95% CI ‐0.28 to 0.30, P = 0.79) or where the index episode was the first episode (intervention 13.4%, usual care 9.4%, RR = ‐0.42, 95% CI ‐1.17 to 0.08, P = 0.37). Where the index episode was repeated self‐harm, those who received therapy were less likely to present again with self‐harm (intervention 13.5%, usual care 22.1%, RR = 0.39, 95% CI 0.07 to 0.60, number needed to treat 12, P = 0.03). CONCLUSIONS: Problem‐solving therapy is not recommended for everyone who presents to hospital with self‐harm. Among adults with a history of self‐harm it may be an effective intervention. AN - CN-00804504 AU - Hatcher, S. AU - Sharon, C. AU - Parag, V. AU - Collins, N. DO - 10.1192/bjp.bp.110.090126 IS - 4 KW - Adult Behavior Therapy [*methods] Emergency Service, Hospital Female Humans Intention to Treat Analysis Male Mental Health Services [statistics & numerical data] New Zealand Problem Solving Psychiatric Status Rating Scales Recurrence Self‐Injurious Behavior [psychology, *therapy] Treatment Outcome M3 - Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non‐U.S. Gov't PY - 2011 SP - 310‐316 ST - Problem-solving therapy for people who present to hospital with self-harm: zelen randomised controlled trial T2 - British journal of psychiatry TI - Problem-solving therapy for people who present to hospital with self-harm: zelen randomised controlled trial UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00804504/full VL - 199 ID - 619 ER - TY - JOUR AB - In a study of domiciliary and out‐patient treatment of self‐poisoning patients, using a brief problem‐orientated approach, it was found that domiciliary treatment resulted in much higher attendance rates but no difference in outcome. Patients who completed out‐patient treatment had a better outcome than those who failed to attend treatment sessions. Completion of out‐patient treatment was more frequent among higher social class patients. Domiciliary treatment may be more appropriate in some cases for married patients and for those of lower social class. Medical and non‐medical staff proved to be equally effective therapists. Future research should be concerned with evaluation of alternative methods of provision of help and further identification of patients who are most likely to benefit from treatment AN - CN-00214111 AU - Hawton, K. AU - Bancroft, J. AU - Catalan, J. AU - Kingston, B. AU - Stedeford, A. AU - Welch, N. IS - 1 PY - 1981 SP - 169‐177 ST - Domiciliary and out-patient treatment of self-poisoning patients by medical and non-medical staff T2 - Psychological medicine TI - Domiciliary and out-patient treatment of self-poisoning patients by medical and non-medical staff UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00214111/full VL - 11 ID - 620 ER - TY - JOUR AB - In a randomized prospective treatment study, 80 overdose patients (not requiring intensive psychiatric intervention) received either brief out‐patient counselling or were returned to the care of their general practitioners with advice on management. There was little difference in outcome between the two groups. However, two sub‐groups of patients benefited more from out‐patient counselling than from general practitioner care, these were: (a) women, and (b) patients with dyadic problems. Counselling following overdoses should be focused on groups of patients such as these who are most likely to benefit from it. Further work is needed to identify treatment approaches that will help other groups who take overdoses, especially men. AN - CN-00049821 AU - Hawton, K. AU - McKeown, S. AU - Day, A. AU - Martin, P. AU - O'Connor, M. AU - Yule, J. DO - 10.1017/s0033291700025988 IS - 3 KW - Adult Aftercare Ambulatory Care Attitude to Health Counseling Female Humans Male Outcome and Process Assessment, Health Care Physicians, Family Poisoning [*psychology] Prospective Studies Sex Factors Substance‐Related Disorders [*therapy] Suicide, Attempted [*psychology] M3 - Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non‐U.S. Gov't PY - 1987 SP - 751‐761 ST - Evaluation of out-patient counselling compared with general practitioner care following overdoses T2 - Psychological medicine TI - Evaluation of out-patient counselling compared with general practitioner care following overdoses UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00049821/full VL - 17 ID - 621 ER - TY - JOUR AB - Background: Self‐harm is a major risk factor for completed suicide. Aims: To determine the efficacy of a brief psychological intervention ‐ culturally adapted manual‐assisted problem‐solving training (C‐MAP) ‐ delivered following an episode of self‐harm compared with treatment as usual (TAU). Method: The study was a randomised controlled assessor‐masked clinical trial (trial registration: ClinicalTrials.gov NCT01308151). All patients admitted after an episode of self‐harm during the previous 7 days to the participating medical units of three university hospitals in Karachi, Pakistan, were included in the study. A total of 250 patients were screened and 221 were randomly allocated to C‐MAP plus treatment as usual (TAU) or to TAU alone. All patients were assessed at baseline, at 3 months (end of intervention) and at 6 months after baseline. The primary outcome measure was reduction in suicidal ideation at 3 months. The secondary outcome measures included hopelessness, depression, coping resources and healthcare utilisation. Results: A total of 108 patients were randomised to the C‐MAP group and 113 to the TAU group. Patients in the C‐MAP group showed statistically significant improvement on the Beck Scale for Suicide Ideation and Beck Hopelessness Inventory, which was sustained at 3 months after the completion of C‐MAP. There was also a significant reduction in symptoms of depression compared with patients receiving TAU. Conclusions: The positive outcomes of this brief psychological intervention in patients attempting self‐harm are promising and suggest that C‐MAP may have a role in suicide prevention. AN - CN-01001460 AU - Husain, N. AU - Afsar, S. AU - Ara, J. AU - Fayyaz, H. AU - Rahman, R. U. AU - Tomenson, B. AU - Hamirani, M. AU - Chaudhry, N. AU - Fatima, B. AU - Husain, M. AU - et al. DO - 10.1192/bjp.bp.113.138370 IS - 6 KW - *automutilation/th [Therapy] Adaptation, Psychological Adolescent Adult Article Beck Hopelessness Inventory Beck Scale for Suicide Ideation Cognitive Behavioral Therapy [*methods] Coping behavior Depression Female Follow‐Up Studies Health care utilization Hopelessness Human Humans Major clinical study Male Middle Aged Named inventories, questionnaires and rating scales Pakistan Problem Solving Psychotherapy Risk factor Self‐Injurious Behavior [*therapy] Suicidal ideation Treatment Outcome Young Adult M3 - Journal Article; Randomized Controlled Trial; Research Support, Non‐U.S. Gov't PY - 2014 SP - 462‐470 ST - Brief psychological intervention after self-harm: randomised controlled trial from Pakistan T2 - British journal of psychiatry TI - Brief psychological intervention after self-harm: randomised controlled trial from Pakistan UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-01001460/full VL - 204 ID - 622 ER - TY - JOUR AB - Repetition after attempted suicide is high but only few effect studies have been carried out. The Baerum Model from Norway offers practical and affordable intervention for those not being offered psychiatric treatment. During a period from 2005‐2007, all attempted suicide patients except those with major psychiatric diagnoses (schizophrenia, bipolar disorder, severe/psychotic depression), were offered participation. The intervention group received the OPAC programme (outreach, problem solving, adherence, continuity) and the control group received treatment as usual (TAU). The intervention period was 6 months. After this intervention period, all patients were followed passively for an extra 6 months. The design was an intent‐to‐treat one. The outcomes were: 1) repetition of attempted suicide or suicide, and 2) total number of suicidal acts. A total of 200 patients were offered participation, 67 refused. Of the 133 participants, 69 were randomized to the OPAC programme and 64 to the (non‐intervention) control group. Four in each group dropped out after initial participation. There was a significant lower proportion who repeated a suicide attempt the intervention group (proportion 8.7%) than in the control group (proportion 21.9%) and the number of repetitive acts was also significant lower (eight repetitions in the intervention group vs. 22 in the control group). In conclusion, our findings suggest a protective effect of the OPAC programme on the proportion who repeated a suicide attempt and on the total number of repetitions during the follow‐up. AN - CN-00812914 AU - Hvid, M. AU - Vangborg, K. AU - Sørensen, H. J. AU - Nielsen, I. K. AU - Stenborg, J. M. AU - Wang, A. G. DO - 10.3109/08039488.2010.544404 IS - 5 KW - Female Follow‐Up Studies Humans Male Norway Patient Compliance Problem Solving Psychotherapy Recurrence Suicide, Attempted [*prevention & control, psychology] M3 - Journal Article; Randomized Controlled Trial; Research Support, Non‐U.S. Gov't PY - 2011 SP - 292‐298 ST - Preventing repetition of attempted suicide--II. The Amager project, a randomized controlled trial T2 - Nordic journal of psychiatry TI - Preventing repetition of attempted suicide--II. The Amager project, a randomized controlled trial UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00812914/full VL - 65 ID - 623 ER - TY - JOUR AB - OBJECTIVE: This study describes a randomized controlled trial called "Operation Worth Living" (OWL) which compared the use of the Collaborative Assessment and Management of Suicidality (CAMS) to enhanced care as usual (E-CAU). We hypothesized that CAMS would be more effective than E-CAU for reducing suicidal ideation (SI) and suicide attempts (SA), along with secondary behavioral health and health care utilization markers for U.S. Army Soldier outpatients with significant SI (i.e., > 13 on Beck's Scale for Suicide Ideation). METHOD: Study participants were 148 Soldiers who presented to a military outpatient behavioral health clinic. There were 73 Soldiers in the experimental arm of the trial who received adherent CAMS; 75 Soldiers received E-CAU. Nine a-priori treatment outcomes (SI, past year SA, suicide-related emergency department (ED) admits, behavioral health-related ED admits, suicide-related inpatient psychiatric unit (IPU) days, behavioral health-related IPU days, mental health, psychiatric distress, resiliency) were measured through assessments at Baseline and at 1, 3, 6, and 12 months post-Baseline (with a 78% retention of intent-to-treat participants at 12 months). RESULTS: Soldiers in both arms of the trial responded to study treatments in terms of all primary and secondary outcomes (effect sizes ranged from 0.63 to 12.04). CAMS participants were significantly less likely to have any suicidal thoughts by 3 months in comparison to those in E-CAU (Cohen's d = 0.93, p=.028). CONCLUSIONS: Soldiers receiving CAMS and E-CAU significantly improved post-treatment. Those who received CAMS were less likely to report SI at 3 months; further group differences were not otherwise seen. AN - 29466107 AU - Jobes, D. A. AU - Comtois, K. A. AU - Gutierrez, P. M. AU - Brenner, L. A. AU - Huh, D. AU - Chalker, S. A. AU - Ruhe, G. AU - Kerbrat, A. H. AU - Atkins, D. C. AU - Jennings, K. AU - Crumlish, J. AU - Corona, C. D. AU - Connor, S. O. AU - Hendricks, K. E. AU - Schembari, B. AU - Singer, B. AU - Crow, B. DA - Winter DO - 10.1080/00332747.2017.1354607 DP - NLM ET - 2018/02/22 IS - 4 KW - Adult Female Humans Male Military Personnel/*psychology *Outcome Assessment, Health Care Psychotherapy/*methods Risk Assessment/*methods *Suicidal Ideation Suicide, Attempted/*prevention & control *Therapeutic Alliance LA - eng N1 - 1943-281x Jobes, David A Comtois, Katherine Anne Gutierrez, Peter M Brenner, Lisa A Huh, David Chalker, Samantha A Orcid: 0000-0002-9523-4197 Ruhe, Gretchen Kerbrat, Amanda H Atkins, David C Jennings, Keith Crumlish, Jennifer Corona, Christopher D Connor, Stephen O' Hendricks, Karin E Schembari, Blaire Singer, Bradley Crow, Bruce Orcid: 0000-0001-9337-7808 Journal Article Randomized Controlled Trial Research Support, U.S. Gov't, Non-P.H.S. United States Psychiatry. 2017 Winter;80(4):339-356. doi: 10.1080/00332747.2017.1354607. PY - 2017 SN - 0033-2747 SP - 339-356 ST - A Randomized Controlled Trial of the Collaborative Assessment and Management of Suicidality versus Enhanced Care as Usual With Suicidal Soldiers T2 - Psychiatry TI - A Randomized Controlled Trial of the Collaborative Assessment and Management of Suicidality versus Enhanced Care as Usual With Suicidal Soldiers VL - 80 ID - 297 ER - TY - JOUR AU - Jones, Gemma AU - Gavrilovic, Jelena Jankovic AU - McCabe, Rosemarie AU - Becktas, Canan AU - Priebe, Stefan IS - 4 PY - 2008 SN - 0963-8237 SP - 375-387 ST - Treating suicidal patients in an acute psychiatric day hospital: A challenge to assumptions about risk and overnight care T2 - Journal of mental health TI - Treating suicidal patients in an acute psychiatric day hospital: A challenge to assumptions about risk and overnight care VL - 17 ID - 2560 ER - TY - JOUR AB - Studies of therapeutic contact following self‐harm have had mixed results. We carried out a pilot randomised controlled trial comparing an intervention (information leaflet listing sources of help, two telephone calls soon after presentation and a series of letters over 12 months) to usual treatment alone in 66 adults presenting with self‐harm to two hospitals. We found that our methodology was feasible, recruitment was challenging and repeat self‐harm was more common in those who received the intervention (12‐month repetition rate 34.4% v. 12.5%). AN - CN-00963269 AU - Kapur, N. AU - Gunnell, D. AU - Hawton, K. AU - Nadeem, S. AU - Khalil, S. AU - Longson, D. AU - Jordan, R. AU - Donaldson, I. AU - Emsley, R. AU - Cooper, J. DO - 10.1192/bjp.bp.113.126425 IS - 1 KW - Adult Female Focus Groups Humans Male Pilot Projects Qualitative Research Self‐Injurious Behavior [psychology, *therapy] Suicide, Attempted [*psychology] Treatment Outcome M3 - Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, Non‐U.S. Gov't PY - 2013 SP - 73‐74 ST - Messages from Manchester: pilot randomised controlled trial following self-harm T2 - British journal of psychiatry TI - Messages from Manchester: pilot randomised controlled trial following self-harm UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00963269/full VL - 203 ID - 624 ER - TY - JOUR AB - Non‐fatal suicide attempt is the most important risk factor for later suicide. Emergency department visits for attempted suicide are increasingly recognised as opportunities for intervention. However, no strong evidence exists that any intervention is effective at preventing repeated suicide attempts. We aimed to investigate whether assertive case management can reduce repetition of suicide attempts in people with mental health problems who had attempted suicide and were admitted to emergency departments. Methods: In this multicentre, randomised controlled trial in 17 hospital emergency departments in Japan, we randomly assigned people aged 20 years and older with mental health problems who had attempted suicide to receive either assertive case management (based on psychiatric diagnoses, social risks, and needs of the patients) or enhanced usual care (control), using an internet‐based randomisation system. Interventions were provided until the end of the follow‐up period (ie, at least 18 months and up to 5 years). Outcome assessors were masked to group allocation, but patients and case managers who provided the interventions were not. The primary outcome was the incidence of first recurrent suicidal behaviour (attempted suicide or completed suicide); secondary outcomes included completed suicide and all‐cause mortality. This study is registered at ClinicalTrials.gov (NCT00736918) and UMIN‐CTR (C000000444). Findings: Between July 1, 2006, and Dec 31, 2009, 914 eligible participants were randomly assigned, 460 to the assertive case management group and 456 to the enhanced usual care group. We noted no significant difference in incidence of first recurrent suicidal behaviour between the assertive case management group and the enhanced usual care group over the full study period (log‐rank p=0·258). Because the proportional hazards assumption did not hold, we did ad‐hoc analyses for cumulative incidence of the primary outcome at months 1, 3, 6, 12, and 18 after randomisation, adjusting for multiplicity with the Bonferroni method. Assertive case management significantly reduced the incidence of first recurrent suicidal behaviour up to the 6‐month timepoint (6‐month risk ratio 0·50, 95% CI 0·32‐0·80; p=0·003), but not at the later timepoints. Prespecified subgroup analyses showed that the intervention had a greater effect in women (up to 18 months), and in participants younger than 40 years and those with a history of previous suicide attempts (up to 6 months). We did not identify any differences between the intervention and control groups for completed suicide (27 [6%] of 460 vs 30 [7%] of 454, log‐rank p=0·660) or all‐cause mortality (46 [10%] of 460 vs 42 [9%] of 454, log‐rank p=0·698). Interpretation: Our results suggest that assertive case management is feasible in real‐world clinical settings. Although it was not effective at reducing the incidence of repetition of suicide attempts in the long term, the results of our ad‐hoc analyses suggested that it was effective for up to 6 months. This finding should be investigated in future research. Funding: The Ministry of Health, Labour, and Welfare of Japan. AN - CN-01040256 AU - Kawanishi, C. AU - Aruga, T. AU - Ishizuka, N. AU - Yonemoto, N. AU - Otsuka, K. AU - Kamijo, Y. AU - Okubo, Y. AU - Ikeshita, K. AU - Sakai, A. AU - Miyaoka, H. AU - et al. DO - 10.1016/S2215-0366(14)70259-7 IS - 3 KW - *case management *emergency ward *mental health care *suicide attempt Adjustment disorder Article Beck Hopelessness Scale Case manager Controlled study Female General practitioner Human Incidence Japan Major clinical study Male Masking Mental health Mood disorder Mortality Multicenter study Psychiatrist Psychoeducation Randomization Randomized controlled trial Schizophrenia Social worker Suicidal behavior Welfare M3 - Journal: Article PY - 2014 SP - 193‐201 ST - Assertive case management versus enhanced usual care for people with mental health problems who had attempted suicide and were admitted to hospital emergency departments in Japan (ACTION-J): a multicentre, randomised controlled trial T2 - The lancet psychiatry TI - Assertive case management versus enhanced usual care for people with mental health problems who had attempted suicide and were admitted to hospital emergency departments in Japan (ACTION-J): a multicentre, randomised controlled trial UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-01040256/full VL - 1 ID - 625 ER - TY - JOUR AB - INTRODUCTION: Studies comparing the antidepressant effects of electroconvulsive therapy (ECT) and repetitive transcranial magnetic stimulation (rTMS) have reported mixed results. This study compared the efficacy of rTMS and ECT in adult patients with refractory major depressive disorder (MDD). METHODS: This randomized, ECT-controlled, parallel-group clinical trial analyzed the antidepressant effects of ECT and rTMS in 73 patients with MDD diagnosed according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria. The Beck Depression Inventory and Hamilton Depression Rating Scale were used to measure depression. RESULTS: Both ECT and rTMS significantly improved depression and suicidal behavior scores. However, ECT reduced depression and suicidal behavior scores more than rTMS. There were no significant adverse effects in the rTMS group. DISCUSSION: Both ECT and rTMS improved MDD in the short term, but the antidepressant efficacy of ECT was greater than rTMS. Moreover, ECT led to greater reductions in suicidal behavior than rTMS. Until strong evidence for the safety and efficacy of rTMS is available, further studies are needed to compare ECT and rTMS in terms of the long-term relapse rate and quality of life. AD - Department of Psychiatry, Shiraz University of Medical Sciences, Hafez Hospital, Shiraz, Iran. AN - 22080240 AU - Keshtkar, M. AU - Ghanizadeh, A. AU - Firoozabadi, A. DA - Dec DO - 10.1097/YCT.0b013e318221b31c DP - NLM ET - 2011/11/15 IS - 4 KW - Adult Depressive Disorder, Major/*therapy *Electroconvulsive Therapy Female Humans Male Suicide/prevention & control *Transcranial Magnetic Stimulation LA - eng N1 - 1533-4112 Keshtkar, Mitra Ghanizadeh, Ahmad Firoozabadi, Ali Clinical Trial Comparative Study Journal Article Randomized Controlled Trial Research Support, Non-U.S. Gov't United States J ECT. 2011 Dec;27(4):310-4. doi: 10.1097/YCT.0b013e318221b31c. PY - 2011 SN - 1095-0680 SP - 310-4 ST - Repetitive transcranial magnetic stimulation versus electroconvulsive therapy for the treatment of major depressive disorder, a randomized controlled clinical trial T2 - J ect TI - Repetitive transcranial magnetic stimulation versus electroconvulsive therapy for the treatment of major depressive disorder, a randomized controlled clinical trial VL - 27 ID - 274 ER - TY - JOUR AB - The assumption that antidepressants may reduce suicide risk by reducing depressive symptoms is not based on data. Further, it is unclear if the retrospectively based anti-suicidal effects of lithium can be prospectively evaluated using lithium as an augmenting agent to antidepressants. To verify our hypothesis, we designed and conducted an exploratory proof of concept trial of four weeks duration using a randomized, double-blind, parallel group method. Forty patients were assigned to citalopram + lithium and 40 were assigned to citalopram + placebo. The primary dependent measures were the Sheehan-Suicidality Tracking Scale (S-STS) and the Montgomery-Asberg Depression Rating Scale (MADRS). The reduction of S-STS scores was large (43%) and twice that seen in MADRS scores (25%) among the eighty patients included in the trial. Both response (χ(2) = 8.8, p < 0.01) and remission (χ(2) = 4.6, p = 0.03) rates showed similar patterns. There were no significant differences in mean total S-STS change scores among patients assigned to citalopram with placebo (4.8 ± 5.1) and patients assigned to citalopram with lithium (5.1 ± 5.2). When explored further, a subgroup of the patients assigned to citalopram and lithium achieved therapeutic serum levels and had significantly higher S-STS remission rates (45% compared to 19%, p < 0.05). There were no deaths by suicide or other causes indicating that trials enrolling acutely suicidal patients are feasible. These results suggest that citalopram may have a direct therapeutic effect on suicidal thoughts and behaviors. Further, lithium when used in therapeutic doses may augment such effects. These data warrant further exploration of lithium and an antidepressant combination for anti-suicidal effects. AD - Northwest Clinical Research Center, Bellevue, WA 98007, USA. akhan@nwcrc.net AN - 21752394 AU - Khan, A. AU - Khan, S. R. AU - Hobus, J. AU - Faucett, J. AU - Mehra, V. AU - Giller, E. L. AU - Rudolph, R. L. DA - Nov DO - 10.1016/j.jpsychires.2011.06.016 DP - NLM ET - 2011/07/15 IS - 11 KW - Adolescent Adult Affect/*drug effects Aged Antidepressive Agents/administration & dosage/*therapeutic use Citalopram/administration & dosage/*therapeutic use Depressive Disorder, Major/*drug therapy/psychology Double-Blind Method Drug Therapy, Combination Female Humans Lithium Compounds/administration & dosage/*therapeutic use Male Middle Aged Placebos Suicidal Ideation Suicide/*prevention & control Suicide, Attempted/prevention & control Treatment Outcome Young Adult LA - eng N1 - 1879-1379 Khan, Arif Khan, Shirin R F Hobus, Joy Faucett, James Mehra, Vishaal Giller, Earl L Rudolph, Richard L Journal Article Randomized Controlled Trial Research Support, Non-U.S. Gov't England J Psychiatr Res. 2011 Nov;45(11):1489-96. doi: 10.1016/j.jpsychires.2011.06.016. Epub 2011 Jul 12. PY - 2011 SN - 0022-3956 SP - 1489-96 ST - Differential pattern of response in mood symptoms and suicide risk measures in severely ill depressed patients assigned to citalopram with placebo or citalopram combined with lithium: role of lithium levels T2 - J Psychiatr Res TI - Differential pattern of response in mood symptoms and suicide risk measures in severely ill depressed patients assigned to citalopram with placebo or citalopram combined with lithium: role of lithium levels VL - 45 ID - 267 ER - TY - JOUR AB - BACKGROUND: Psychotherapy for depression and antidepressant medications have both been associated with decreases in suicidal ideation. Studies have not examined whether adding psychotherapy to antidepressant medications further reduces suicidal ideation relative to medications alone in adults. METHODS: Participants (N = 452) were randomized to 7 months of treatment with antidepressant medications or combined treatment with both medications and cognitive therapy for depression. We examined change in the suicide items from the Beck Depression Inventory (BDI) and Hamilton Depression Rating Scale (HDRS) across treatment using Bayesian generalized linear mixed models for non-continuous outcomes. RESULTS: Suicidal ideation decreased across treatment. When measured with the BDI, participants receiving both cognitive therapy and antidepressant medications showed 17% greater reductions in suicidal ideation relative to those receiving medications alone; this effect remained significant when controlling for depression severity. While the same pattern was observed when suicidal ideation was measured with the HDRS, the effect was smaller (7%) and not statistically significant. When BDI and HDRS scores were combined, participants receiving both therapy and medications showed 9% greater reductions in suicidal ideation relative to those receiving medications alone; this effect was marginally significant when controlling for depression severity. LIMITATIONS: This is a secondary analysis of a randomized clinical trial designed to treat depression, in which suicidal ideation was assessed using single-item measures. CONCLUSIONS: Adding cognitive therapy to antidepressant medications may reduce suicidal ideation to a greater extent than medications alone. Pending replication, combination treatment may be preferred for individuals with suicidal ideation. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00057577. AU - Khazanov, Gabriela K. AU - Xu, Colin AU - Hollon, Steven D. AU - DeRubeis, Robert J. AU - Thase, Michael E. DA - 2021/02/15/ DO - 10.1016/j.jad.2020.12.032 J2 - J Affect Disord KW - Suicidal Ideation Adult Humans *depression *Depressive Disorder, Major/drug therapy *Suicidal ideation *Cognitive Behavioral Therapy *cognitive therapy Antidepressive Agents/therapeutic use *antidepressant medications *treatment outcome Bayes Theorem LA - eng PY - 2021 SN - 1573-2517 0165-0327 SP - 183-191 ST - Adding cognitive therapy to antidepressant medications decreases suicidal ideation T2 - Journal of affective disorders TI - Adding cognitive therapy to antidepressant medications decreases suicidal ideation VL - 281 ID - 1554 ER - TY - JOUR AU - Koons, Cedar R AU - Robins, Clive J AU - Tweed, J Lindsey AU - Lynch, Thomas R AU - Gonzalez, Alicia M AU - Morse, Jennifer Q AU - Bishop, G Kay AU - Butterfield, Marian I AU - Bastian, Lori A IS - 2 PY - 2001 SN - 0005-7894 SP - 371-390 ST - Efficacy of dialectical behavior therapy in women veterans with borderline personality disorder T2 - Behavior therapy TI - Efficacy of dialectical behavior therapy in women veterans with borderline personality disorder VL - 32 ID - 2587 ER - TY - JOUR AB - Suicide remains a significant public health problem for the United States military. Trauma-related diagnoses such as acute stress disorder (ASD) or posttraumatic stress disorder (PTSD) may exacerbate suicide risk, particularly among service members psychiatrically hospitalized following suicide-related events. To date, treatments to address suicide risk and trauma symptomatology among service members within inpatient milieus have been nonexistent. To address this gap, a randomized controlled pilot trial of Post-Admission Cognitive Therapy (PACT) was conducted to evaluate a targeted cognitive-behavioral program among traumatized military personnel (N = 36) hospitalized following a recent suicide attempt. All participants met criteria for ASD or PTSD and were randomly assigned to receive either PACT and enhanced usual care (PACT + EUC) or EUC alone. PACT consisted of six 60- to 90-min individual psychotherapy sessions, adapted from Brown et al.'s (2005) cognitive therapy protocol for suicide prevention. Blinded follow-up assessments were conducted at 1-, 2-, and 3-months postpsychiatric discharge. The primary outcome was days until repeat suicide attempt. Secondary outcomes included depression, hopelessness, suicide ideation, and PTSD symptoms. Participants did not significantly differ in reattempt status. However, based on reliable change index analyses, a greater proportion of PACT + EUC versus EUC participants met criteria for clinically significant change on measures of depression (100% vs. 78%), hopelessness (83% vs. 57%), and PTSD symptom severity (100% vs. 38%), but not for suicide ideation (60% vs. 67%). PACT is an innovative inpatient protocol, currently under evaluation in a well-powered multisite RCT for its efficacy in reducing subsequent suicidal behaviors. (PsycINFO Database Record AD - Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences. AN - 30080085 AU - LaCroix, J. M. AU - Perera, K. U. AU - Neely, L. L. AU - Grammer, G. AU - Weaver, J. AU - Ghahramanlou-Holloway, M. DA - Aug DO - 10.1037/ser0000224 DP - NLM ET - 2018/08/07 IS - 3 KW - Adult *Cognitive Behavioral Therapy Female Humans Inpatients/*psychology Male Military Personnel/*psychology Pilot Projects Suicidal Ideation Suicide/*prevention & control/psychology Suicide, Attempted/psychology Treatment Outcome Young Adult LA - eng N1 - 1939-148x LaCroix, Jessica M Orcid: 0000-0002-4040-4275 Perera, Kanchana U Neely, Laura L Grammer, Geoffrey Weaver, Jennifer Ghahramanlou-Holloway, Marjan Orcid: 0000-0001-8377-3698 Office of the Congressionally Directed Medical Research Programs (CD-MRP); Department of Defense (DoD) Post-Traumatic Stress Disorder/Traumatic Brain Injury Research Program (PTSD/TBI)/ Journal Article Randomized Controlled Trial United States Psychol Serv. 2018 Aug;15(3):279-288. doi: 10.1037/ser0000224. PY - 2018 SN - 1541-1559 SP - 279-288 ST - Pilot trial of post-admission cognitive therapy: Inpatient program for suicide prevention T2 - Psychol Serv TI - Pilot trial of post-admission cognitive therapy: Inpatient program for suicide prevention VL - 15 ID - 303 ER - TY - JOUR AB - BACKGROUND: The Amager Project was initiated as a quasi-experimental study in 2005, based on an active outreach suicide preventive intervention inspired by the Norwegian Baerum Model. A 1-year follow-up study was conducted as a randomized controlled trial showing that this kind of active outreach to suicide attempters had a significant preventive effect on the prevalence of suicide attempts and significantly reduced the number of patients repeating a suicide attempt. AIMS: In this 5-year RCT follow-up the aim was to investigate the sustainability of the suicide preventive effect shown in a 1-year follow-up study. METHOD: One hundred and thirty-three suicide attempters were included at this 5-year follow-up RCT study at Copenhagen University Hospital, Amager, and randomized to a rapid outreach suicide preventive intervention (OPAC) or TAU. RESULTS: Offering OPAC intervention to patients after a suicide attempt has a significant preventive effect on the total of suicide attempts and significantly reduces the number of patients repeating a suicide attempt. The suicide preventive effect lasts up to 265 weeks. After 3-4 years the effect on the number of patients repeating a suicide attempt is no longer sustainable, while the effect on the number of repetitive events remains significant. CONCLUSION: This study emphasizes the importance of a rapid and active outreach intervention and points out that the effect on the number of patients repeating a suicide attempt wears off and is no longer sustainable after 3-4 years, suggesting the need for a follow-up intervention. AD - a Centre of Suicide Prevention, Department of Psychiatry Amager , Copenhagen University Hospital , Copenhagen S , Denmark. AN - 27187267 AU - Lahoz, T. AU - Hvid, M. AU - Wang, A. G. DA - Oct DO - 10.1080/08039488.2016.1180711 DP - NLM ET - 2016/05/18 IS - 7 KW - Adult Female Follow-Up Studies Humans Male Middle Aged Norway *Outcome Assessment, Health Care Psychotherapy/*methods/standards Recurrence Suicide, Attempted/*prevention & control/statistics & numerical data Suicide effectiveness research follow-up prevention randomized controlled trial LA - eng N1 - 1502-4725 Lahoz, Titia Hvid, Marianne Wang, August G Journal Article Randomized Controlled Trial England Nord J Psychiatry. 2016 Oct;70(7):547-53. doi: 10.1080/08039488.2016.1180711. Epub 2016 May 17. PY - 2016 SN - 0803-9488 SP - 547-53 ST - Preventing repetition of attempted suicide-III. The Amager Project, 5-year follow-up of a randomized controlled trial T2 - Nord J Psychiatry TI - Preventing repetition of attempted suicide-III. The Amager Project, 5-year follow-up of a randomized controlled trial VL - 70 ID - 311 ER - TY - JOUR AB - OBJECTIVE: Evidence based on controlled studies is still limited for treatment strategies that prevent recurrence of suicide attempts. Findings from observational as well as meta-analytic studies strongly suggest that lithium may have suicide-protective properties. METHOD: Patients with a recent suicide attempt in the context of an affective spectrum disorder (n = 167) were treated with either lithium or placebo during a 12-month period. RESULTS: Survival analysis showed no significant difference of suicidal acts between lithium and placebo-treated individuals (adjusted hazard ratio 0.517; 95% CI 0.18-1.43). However, post hoc analysis revealed that all completed suicides had occurred in the placebo group accounting for a significant difference in incidence rates (P = 0.049). CONCLUSION: Results indicate that lithium treatment might be effective in reducing the risk of completed suicide in adult patients with affective disorders. Our findings contribute to the growing body of evidence suggesting a specific antisuicidal effect of lithium. AD - Department of Psychiatry and Psychotherapy, University of Schleswig-Holstein, Campus Luebeck, Luebeck, Germany. erik.lauterbach@charite.de AN - 18808400 AU - Lauterbach, E. AU - Felber, W. AU - Müller-Oerlinghausen, B. AU - Ahrens, B. AU - Bronisch, T. AU - Meyer, T. AU - Kilb, B. AU - Lewitzka, U. AU - Hawellek, B. AU - Quante, A. AU - Richter, K. AU - Broocks, A. AU - Hohagen, F. DA - Dec DO - 10.1111/j.1600-0447.2008.01266.x DP - NLM ET - 2008/09/24 IS - 6 KW - Adjustment Disorders/blood/diagnosis/*drug therapy/psychology Adult Antidepressive Agents/adverse effects/pharmacokinetics/*therapeutic use Comorbidity Cross-Sectional Studies Depressive Disorder, Major/blood/diagnosis/*drug therapy/psychology Dysthymic Disorder/blood/diagnosis/*drug therapy/psychology Female Follow-Up Studies Humans Kaplan-Meier Estimate Lithium Carbonate/adverse effects/pharmacokinetics/*therapeutic use Male Middle Aged Personality Assessment Secondary Prevention Suicide/*prevention & control/psychology/statistics & numerical data Suicide, Attempted/*prevention & control/psychology/statistics & numerical data L1 - internal-pdf://4075715571/Lauterbach-2008-Adjunctive lithium treatment i.pdf LA - eng N1 - 1600-0447 Lauterbach, E Felber, W Müller-Oerlinghausen, B Ahrens, B Bronisch, T Meyer, T Kilb, B Lewitzka, U Hawellek, B Quante, A Richter, K Broocks, A Hohagen, F Journal Article Multicenter Study Randomized Controlled Trial Research Support, Non-U.S. Gov't United States Acta Psychiatr Scand. 2008 Dec;118(6):469-79. doi: 10.1111/j.1600-0447.2008.01266.x. Epub 2008 Sep 18. PY - 2008 SN - 0001-690x SP - 469-79 ST - Adjunctive lithium treatment in the prevention of suicidal behaviour in depressive disorders: a randomised, placebo-controlled, 1-year trial T2 - Acta Psychiatr Scand TI - Adjunctive lithium treatment in the prevention of suicidal behaviour in depressive disorders: a randomised, placebo-controlled, 1-year trial UR - https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/j.1600-0447.2008.01266.x?download=true VL - 118 ID - 225 ER - TY - JOUR AB - A behavior therapy package was compared with insight‐oriented therapy in a clinical trial for repeated suicide attempters. Self‐report measures of depression, anxiety, and assertiveness were obtained before and after ten days of inpatient treatment and at follow‐up intervals for nine moths. Interviews with patients during a two‐year follow‐up period elicited frequency of suicidal attempts and ideation. Results indicated the superiority of the behavior therapy package, with the structured, brief hospitalization and assertive follow‐up likely contributing to the main effects. AN - CN-00026253 AU - Liberman, R. P. AU - Eckman, T. DO - 10.1001/archpsyc.1981.01780350060007 IS - 10 KW - Adolescent Adult Behavior Therapy Clinical Trials as Topic Depression [psychology] Female Humans Male Middle Aged Psychological Tests Psychotherapy Random Allocation Suicide, Attempted M3 - Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, U.S. Gov't, P.H.S. PY - 1981 SP - 1126‐1130 ST - Behavior therapy vs insight-oriented therapy for repeated suicide attempters T2 - Archives of general psychiatry TI - Behavior therapy vs insight-oriented therapy for repeated suicide attempters UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00026253/full VL - 38 ID - 628 ER - TY - JOUR AB - A randomized clinical trial was conducted to evaluate the effectiveness of a cognitive‐behavioral therapy, ie, dialectical behavior therapy, for the treatment of chronically parasuicidal women who met criteria for borderline personality disorder. The treatment lasted 1 year, with assessment every 4 months. The control condition was "treatment as usual" in the community. At most assessment points and during the entire year, the subjects who received dialectical behavior therapy had fewer incidences of parasuicide and less medically severe parasuicides, were more likely to stay in individual therapy, and had fewer inpatient psychiatric days. There were no between‐group differences on measures of depression, hopelessness, suicide ideation, or reasons for living although scores on all four measures decreased throughout the year. AN - CN-00093791 AU - Linehan, M. M. AU - Armstrong, H. E. AU - Suarez, A. AU - Allmon, D. AU - Heard, H. L. DO - 10.1001/archpsyc.1991.01810360024003 IS - 12 KW - Adolescent Adult Borderline Personality Disorder [psychology, *therapy] Chronic Disease Cognitive Behavioral Therapy Female Hospitalization Humans Length of Stay Middle Aged Psychotherapy Self Mutilation [psychology] Self‐Injurious Behavior [*therapy] Suicide [*psychology, statistics & numerical data] Suicide, Attempted [psychology, statistics & numerical data] Treatment Outcome M3 - Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, U.S. Gov't, P.H.S. PY - 1991 SP - 1060‐1064 ST - Cognitive-behavioral treatment of chronically parasuicidal borderline patients T2 - Archives of general psychiatry TI - Cognitive-behavioral treatment of chronically parasuicidal borderline patients UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00093791/full VL - 48 ID - 629 ER - TY - JOUR AB - CONTEXT: Dialectical behavior therapy (DBT) is a treatment for suicidal behavior and borderline personality disorder with well‐documented efficacy. OBJECTIVE: To evaluate the hypothesis that unique aspects of DBT are more efficacious compared with treatment offered by non‐behavioral psychotherapy experts. DESIGN: One‐year randomized controlled trial, plus 1 year of posttreatment follow‐up. SETTING: University outpatient clinic and community practice. PARTICIPANTS: One hundred one clinically referred women with recent suicidal and self‐injurious behaviors meeting DSM‐IV criteria, matched to condition on age, suicide attempt history, negative prognostic indication, and number of lifetime intentional self‐injuries and psychiatric hospitalizations. INTERVENTION: One year of DBT or 1 year of community treatment by experts (developed to maximize internal validity by controlling for therapist sex, availability, expertise, allegiance, training and experience, consultation availability, and institutional prestige). MAIN OUTCOME MEASURES: Trimester assessments of suicidal behaviors, emergency services use, and general psychological functioning. Measures were selected based on previous outcome studies of DBT. Outcome variables were evaluated by blinded assessors. RESULTS: Dialectical behavior therapy was associated with better outcomes in the intent‐to‐treat analysis than community treatment by experts in most target areas during the 2‐year treatment and follow‐up period. Subjects receiving DBT were half as likely to make a suicide attempt (hazard ratio, 2.66; P = .005), required less hospitalization for suicide ideation (F(1,92) = 7.3; P = .004), and had lower medical risk (F(1,50) = 3.2; P = .04) across all suicide attempts and self‐injurious acts combined. Subjects receiving DBT were less likely to drop out of treatment (hazard ratio, 3.2; P < .001) and had fewer psychiatric hospitalizations (F(1,92) = 6.0; P = .007) and psychiatric emergency department visits (F(1,92) = 2.9; P = .04). CONCLUSIONS: Our findings replicate those of previous studies of DBT and suggest that the effectiveness of DBT cannot reasonably be attributed to general factors associated with expert psychotherapy. Dialectical behavior therapy appears to be uniquely effective in reducing suicide attempts. AN - CN-00557213 AU - Linehan, M. M. AU - Comtois, K. A. AU - Murray, A. M. AU - Brown, M. Z. AU - Gallop, R. J. AU - Heard, H. L. AU - Korslund, K. E. AU - Tutek, D. A. AU - Reynolds, S. K. AU - Lindenboim, N. DO - 10.1001/archpsyc.63.7.757 IS - 7 KW - *borderline state/th [Therapy] *suicidal behavior/th [Therapy] Adaptation, Psychological Adult Anamnesis Article Automutilation Behavior Therapy [*methods] Behavior therapy Borderline Personality Disorder [*diagnosis, *psychology, *therapy] Clinical trial Community Mental Health Services [methods, standards] Controlled clinical trial Controlled study Diagnostic and Statistical Manual of Mental Disorders Emergency Services, Psychiatric [statistics & numerical data] Female Follow up Follow‐Up Studies Hospitalization Hospitals, Psychiatric Human Humans Longitudinal Studies Major clinical study Male Outcome assessment Outpatient Prognosis Psychiatric Status Rating Scales Psychotherapy [*methods, standards] Randomized controlled trial Reproducibility of Results Self‐Injurious Behavior [prevention & control, psychology, therapy] Suicide [*prevention & control, psychology] Suicide, Attempted [prevention & control, psychology] Treatment Outcome University hospital M3 - Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural PY - 2006 SP - 757‐766 ST - Two-year randomized controlled trial and follow-up of dialectical behavior therapy vs therapy by experts for suicidal behaviors and borderline personality disorder T2 - Archives of general psychiatry TI - Two-year randomized controlled trial and follow-up of dialectical behavior therapy vs therapy by experts for suicidal behaviors and borderline personality disorder UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00557213/full VL - 63 ID - 630 ER - TY - JOUR AB - BACKGROUND: A randomized clinical trial was conducted to evaluate whether the superior performance of dialectical behavior therapy (DBT), a psychosocial treatment for borderline personality disorder, compared with treatment‐as‐usual in the community, is maintained during a 1‐year posttreatment follow‐up. METHODS: We analyzed 39 women who met criteria for borderline personality disorder, defined by Gunderson's Diagnostic Interview for Borderline Personality Disorder and DSM‐III‐R criteria, and who had a history of parasuicidal behavior. Subjects were randomly assigned either to 1 year of DBT, a cognitive behavioral therapy that combines individual psychotherapy with group behavioral skills training, or to treatment‐as‐usual, which may or may not have included individual psychotherapy. Efficacy was measured on parasuicidal behavior (Parasuicide History Interview), psychiatric inpatient days (Treatment History Interview), anger (State‐Trait Anger Scale), global functioning (Global Assessment Scale), and social adjustment (Social Adjustment Scale‐‐Interview and Social Adjustment Scale‐‐Self‐Report). Subjects were assessed at 6 and 12 months into the follow‐up year. RESULTS: Comparison of the two conditions revealed that throughout the follow‐up year, DBT subjects had significantly higher Global Assessment Scale scores. During the initial 6 months of the follow‐up, DBT subjects had significantly less parasuicidal behavior, less anger, and better self‐reported social adjustment. During the final 6 months, DBT subjects had significantly fewer psychiatric inpatient days and better interviewer‐rated social adjustment. CONCLUSION: In general, the superiority of DBT over treatment‐as‐usual, found in previous studies at the completion of 1 year of treatment, was retained during a 1‐year follow‐up. AN - CN-00097448 AU - Linehan, M. M. AU - Heard, H. L. AU - Armstrong, H. E. DO - 10.1001/archpsyc.1993.01820240055007 IS - 12 KW - Adolescent Adult Anger Behavior Therapy Borderline Personality Disorder [diagnosis, psychology, *therapy] Chronic Disease Female Follow‐Up Studies Hospitalization Humans Middle Aged Personality Inventory Psychiatric Status Rating Scales Psychotherapy Social Adjustment Suicide [*psychology] M3 - Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, U.S. Gov't, P.H.S. PY - 1993 SP - 971‐974 ST - Naturalistic follow-up of a behavioral treatment for chronically parasuicidal borderline patients T2 - Archives of general psychiatry TI - Naturalistic follow-up of a behavioral treatment for chronically parasuicidal borderline patients UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00097448/full VL - 50 ID - 631 ER - TY - JOUR AB - IMPORTANCE: Dialectical behavior therapy (DBT) is an empirically supported treatment for suicidal individuals. However, DBT consists of multiple components, including individual therapy, skills training, telephone coaching, and a therapist consultation team, and little is known about which components are needed to achieve positive outcomes. OBJECTIVE: To evaluate the importance of the skills training component of DBT by comparing skills training plus case management (DBT‐S), DBT individual therapy plus activities group (DBT‐I), and standard DBT which includes skills training and individual therapy. DESIGN, SETTING, AND PARTICIPANTS: We performed a single‐blind randomized clinical trial from April 24, 2004, through January 26, 2010, involving 1 year of treatment and 1 year of follow‐up. Participants included 99 women (mean age, 30.3 years; 69 [71%] white) with borderline personality disorder who had at least 2 suicide attempts and/or nonsuicidal self‐injury (NSSI) acts in the last 5 years, an NSSI act or suicide attempt in the 8 weeks before screening, and a suicide attempt in the past year. We used an adaptive randomization procedure to assign participants to each condition. Treatment was delivered from June 3, 2004, through September 29, 2008, in a university‐affiliated clinic and community settings by therapists or case managers. Outcomes were evaluated quarterly by blinded assessors. We hypothesized that standard DBT would outperform DBT‐S and DBT‐I. INTERVENTIONS: The study compared standard DBT, DBT‐S, and DBT‐I. Treatment dose was controlled across conditions, and all treatment providers used the DBT suicide risk assessment and management protocol. MAIN OUTCOMES AND MEASURES: Frequency and severity of suicide attempts and NSSI episodes. RESULTS: All treatment conditions resulted in similar improvements in the frequency and severity of suicide attempts, suicide ideation, use of crisis services due to suicidality, and reasons for living. Compared with the DBT‐I group, interventions that included skills training resulted in greater improvements in the frequency of NSSI acts (F1,85 = 59.1 [P < .001] for standard DBT and F1,85 = 56.3 [P < .001] for DBT‐S) and depression (t399 = 1.8 [P = .03] for standard DBT and t399 = 2.9 [P = .004] for DBT‐S) during the treatment year. In addition, anxiety significantly improved during the treatment year in standard DBT (t94 = ‐3.5 [P < .001]) and DBT‐S (t94 = ‐2.6 [P = .01]), but not in DBT‐I. Compared with the DBT‐I group, the standard DBT group had lower dropout rates from treatment (8 patients [24%] vs 16 patients [48%] [P = .04]), and patients were less likely to use crisis services in follow‐up (ED visits, 1 [3%] vs 3 [13%] [P = .02]; psychiatric hospitalizations, 1 [3%] vs 3 [13%] [P = .03]). CONCLUSIONS AND RELEVANCE: A variety of DBT interventions with therapists trained in the DBT suicide risk assessment and management protocol are effective for reducing suicide attempts and NSSI episodes. Interventions that include DBT skills training are more effective than DBT without skills training, and standard DBT may be superior in some areas. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00183651. AN - CN-01075046 AU - Linehan, M. M. AU - Korslund, K. E. AU - Harned, M. S. AU - Gallop, R. J. AU - Lungu, A. AU - Neacsiu, A. D. AU - McDavid, J. AU - Comtois, K. A. AU - Murray-Gregory, A. M. DO - 10.1001/jamapsychiatry.2014.3039 IS - 5 KW - *behavior therapy *borderline state/th [Therapy] *case management *dialectical behavior therapy *group therapy *personalized medicine *skills training *suicide attempt/th [Therapy] Adaptation, Psychological Adult Anxiety Anxiety [prevention & control] Article Automutilation Behavior Therapy [*methods] Borderline Personality Disorder [*psychology, *therapy] Controlled study Depression Depression [prevention & control] Emergency ward Female Follow up Hospitalization Human Humans Intermethod comparison Major clinical study Male Mental health Middle Aged Nonsuicidal self injury Randomized controlled trial Risk Assessment Risk Factors Self‐Injurious Behavior [*prevention & control, psychology, therapy] Severity of Illness Index Single blind procedure Single‐Blind Method Suicidal Ideation Suicide [*prevention & control, psychology] Suicide, Attempted [prevention & control] Time to treatment Treatment Outcome M3 - Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural PY - 2015 SP - 475‐482 ST - Dialectical behavior therapy for high suicide risk in individuals with borderline personality disorder: a randomized clinical trial and component analysis T2 - JAMA psychiatry TI - Dialectical behavior therapy for high suicide risk in individuals with borderline personality disorder: a randomized clinical trial and component analysis UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-01075046/full VL - 72 ID - 632 ER - TY - JOUR AB - Objective: The purpose of this multisite study was to conduct a randomized controlled trial of an e-mail version of the caring letters (CL) suicide prevention intervention to determine whether the intervention is efficacious in preventing suicide behaviors among U.S. service members and veterans.Method: Psychiatric inpatients (N = 1,318) were recruited from four military medical centers and two VA hospitals and randomized to receive either 13 caring e-mails over two years or usual care.Results: There were 10 deaths from any cause in the CL group (three suicides) and 14 in the usual care group (seven suicides) during the individual two-year follow-up intervals. There was no statistically significant difference in the rate of all-cause hospital readmission between the study groups (RR = 1.13; 95% CI = 0.94, 1.36). There were no differences observed between groups on self-reported psychiatric hospital readmissions, self-reported suicide attempts, or other measures associated with risk for suicide.Conclusions: No firm conclusions about the efficacy of the intervention can be made because the study was inadequately powered. There were no adverse events associated with the intervention, and implementation of the procedures was feasible in the military and veteran hospital settings. These results provide important methodological considerations for caring contact trials in military populations. AD - National Center for Telehealth & Technology, Joint Base Lewis‐McChord, Tacoma WA, USA University of Washington School of Medicine, Seattle WA, USA Defense Health Agency, Psychological Health Center of Excellence, Tacoma WA, USA VA Palo Alto Health Care System, Palo Alto CA, USA Stanford University, Palo Alto CA, USA AN - 141722014. Language: English. Entry Date: 20201021. Revision Date: 20210922. Publication Type: journal article AU - Luxton, David D. AU - Smolenski, Derek J. AU - Reger, Mark A. AU - Relova, Rona Margaret V. AU - Skopp, Nancy A. DB - CINAHL Complete DO - 10.1111/sltb.12589 DP - EBSCOhost IS - 1 KW - Suicide -- Prevention and Control Empathy Military Personnel -- Psychosocial Factors Veterans -- Psychosocial Factors Young Adult Female Aged Adult Adolescence Middle Age Hospitalization Suicide, Attempted -- Psychosocial Factors Suicide -- Psychosocial Factors Human Treatment Outcomes Comparative Studies Multicenter Studies Randomized Controlled Trials Random Assignment Funding Source N1 - research; tables/charts; randomized controlled trial. Journal Subset: Biomedical; Blind Peer Reviewed; Editorial Board Reviewed; Expert Peer Reviewed; Peer Reviewed; USA. Grant Information: W81XWH-11-2-0123//Medical Research and Materiel Command/. NLM UID: 7608054. PMID: NLM31562660. PY - 2020 SN - 0363-0234 SP - 300-314 ST - Caring E-mails for Military and Veteran Suicide Prevention: A Randomized Controlled Trial T2 - Suicide & Life-Threatening Behavior TI - Caring E-mails for Military and Veteran Suicide Prevention: A Randomized Controlled Trial UR - https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=141722014&site=ehost-live VL - 50 ID - 1685 ER - TY - JOUR AB - Background: A previous suicide attempt is one of the strongest risk factors for subsequent suicide. Effective care following a suicide attempt may reduce the risk of suicide reattempts. Aims: We aimed to investigate the effect of a brief educational intervention and contact program on suicide reattempts. Method: This study was performed as a randomized clinical trial (RCT) recruiting 305 individuals who had attempted suicide (brief intervention and contact = 153 individuals, BIC; treatment as usual = 152 individuals, TAU) who were referred to Baharlu Hospital in Tehran. The SUPRE-MISS questionnaire and a discharge follow-up questionnaire were used for data collection. Cox proportional hazard models and log-rank tests were used to assess the association of the variable with the event (reattempt). Kaplan–Meier curves were used to depict the time to the event of reattempt. Results: In the BIC group, 11% of the individuals had attempted suicide once, and 25% of the TAU group had attempted suicide once (12.4%), twice (9.3%), and three times (3.8%), respectively. The results of Kaplan–Meier analysis indicated the mean time of reattempt in the BIC (0.76) and TAU groups (0.25) as the fourth and second months of follow-up, respectively (log rank, χ² = 12.48, p < .001). The hazard ratio for the TAU group was 2.57 (95% CI [1.4, 5.9]). Limitations: Loss to follow-up due to stigma is one of the serious problems of follow-up services. Conclusion: Implementing a brief educational intervention and contact program on suicide reattempts is feasible and effective in reducing the rate of reattempt; however, it should be accommodated within the mental health services of the county. (PsycInfo Database Record (c) 2021 APA, all rights reserved) AU - Malakouti, Seyed Kazem AU - Nojomi, Marzieh AU - Ghanbari, Behrooz AU - Rasouli, Nafee AU - Khaleghparast, Shiva AU - Farahani, Ida Ghaemmagham DA - 2021 DO - 10.1027/0227-5910/a000754 KW - *Aftercare *Attempted Suicide *Suicide Prevention Training Telephone Systems Hot Line Services Posttreatment Followup PY - 2021 SN - 2151-2396(Electronic),0227-5910(Print) SP - No-Pagination Specified-No Pagination Specified ST - Aftercare and suicide reattempt prevention in Tehran, Iran: Outcome of 12-month randomized controlled study T2 - Crisis: The Journal of Crisis Intervention and Suicide Prevention TI - Aftercare and suicide reattempt prevention in Tehran, Iran: Outcome of 12-month randomized controlled study ID - 1705 ER - TY - JOUR AB - We conducted a randomized controlled trial to test whether a Brief Mobile Treatment (BMT) intervention could improve outcomes relative to usual care among suicide attempters. The intervention included training in problem solving therapy, meditation, a brief intervention to increase social support as well as advice on alcohol and other drugs, and mobile phone follow‐up. The effect of the intervention was measured in terms of a reduction in suicidal ideation, depression and self‐harm at Baseline, six and 12 months. A wait‐list control group received usual care. A total of 68 participants was recruited from a Sri Lankan hospital following a suicide attempt. Participants who received the intervention were found to achieve significant improvements in reducing suicidal ideation and depression than those receiving usual care. The BMT group also experienced a significant improvement of social support when compared to the control group. However, the BMT group did not demonstrate a significant effect in reducing actual self‐harm and most substance use, and differential effects on alcohol use were restricted to men. Although the present study was limited in revealing which component of the intervention was more effective in preventing suicide, it showed its efficacy in reducing suicide as a whole. AN - CN-00853004 AU - Marasinghe, R. B. AU - Edirippulige, S. AU - Kavanagh, D. AU - Smith, A. AU - Jiffry, M. T. DO - 10.1258/jtt.2012.SFT107 IS - 3 KW - Adult Cell Phone Female Humans Male Psychiatric Status Rating Scales Psychotherapy, Brief [*methods] Social Support Sri Lanka Suicide [*prevention & control, psychology] Telemedicine [*methods] Treatment Outcome M3 - Journal Article; Randomized Controlled Trial; Research Support, Non‐U.S. Gov't PY - 2012 SP - 151‐155 ST - Effect of mobile phone-based psychotherapy in suicide prevention: a randomized controlled trial in Sri Lanka T2 - Journal of telemedicine and telecare TI - Effect of mobile phone-based psychotherapy in suicide prevention: a randomized controlled trial in Sri Lanka UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00853004/full VL - 18 ID - 633 ER - TY - JOUR AB - BACKGROUND: Rates of self‐harm are high and have recently increased. This trend and the repetitive nature of self‐harm pose a significant challenge to mental health services. AIMS: To determine the efficacy of a structured group problem‐solving skills training (PST) programme as an intervention approach for self‐harm in addition to treatment as usual (TAU) as offered by mental health services. METHOD: A total of 433 participants (aged 18‐64 years) were randomly assigned to TAU plus PST or TAU alone. Assessments were carried out at baseline and at 6‐week and 6‐month follow‐up and repeated hospital‐treated self‐harm was ascertained at 12‐month follow‐up. RESULTS: The treatment groups did not differ in rates of repeated self‐harm at 6‐week, 6‐month and 12‐month follow‐up. Both treatment groups showed significant improvements in psychological and social functioning at follow‐up. Only one measure (needing and receiving practical help from those closest to them) showed a positive treatment effect at 6‐week (P = 0.004) and 6‐month (P = 0.01) follow‐up. Repetition was not associated with waiting time in the PST group. CONCLUSIONS: This brief intervention for self‐harm is no more effective than treatment as usual. Further work is required to establish whether a modified, more intensive programme delivered sooner after the index episode would be effective. AN - CN-00988060 AU - McAuliffe, C. AU - McLeavey, B. C. AU - Fitzgerald, T. AU - Corcoran, P. AU - Carroll, B. AU - Ryan, L. AU - O'Keeffe, B. AU - Fitzgerald, E. AU - Hickey, P. AU - O'Regan, M. AU - et al. DO - 10.1192/bjp.bp.111.101816 KW - *education program *group therapy *problem solving *suicidal behavior/th [Therapy] Adolescent Adult Article Clinical assessment Cognitive Behavioral Therapy [*methods] Controlled study Female Follow up Harm reduction Human Humans Intervention study Major clinical study Male Mental Health Services Mental health service Middle Aged Problem Solving Program effectiveness Psychological aspect Psychotherapy, Group [*methods] Randomized controlled trial Self help Self‐Injurious Behavior [psychology, *therapy] Social interaction Treatment Outcome Watchful waiting Young Adult M3 - Journal Article; Randomized Controlled Trial; Research Support, Non‐U.S. Gov't PY - 2014 SP - 383‐390 ST - Group problem-solving skills training for self-harm: randomised controlled trial T2 - British journal of psychiatry TI - Group problem-solving skills training for self-harm: randomised controlled trial UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00988060/full VL - 204 ID - 634 ER - TY - JOUR AB - The present study evaluated the effectiveness of interpersonal problem-solving skills training (IPSST) for the treatment of self-poisoning patients. Thirty-nine self-poisoning patients were assigned randomly either to IPSST or to a control treatment condition (a brief problem-oriented approach). Both conditions were equally effective in reducing the number of presenting problems and in reducing hopelessness levels. However, the IPSST condition was significantly more effective than the control condition as determined by other outcome measures (measures of interpersonal cognitive problem solving, self-rated personal problem-solving ability, perceived ability to cope with ongoing problems, and self-perception). Follow-up studies showed maintenance of IPSST treatment gains at 6 months and a greater reduction of repetition of self-poisoning in the IPSST group at 1 year posttreatment. AD - Professional Psychiatric Unit, Cork Regional Hospital, Ireland. AN - 7740595 AU - McLeavey, B. C. AU - Daly, R. J. AU - Ludgate, J. W. AU - Murray, C. M. DA - Winter DP - NLM ET - 1994/01/01 IS - 4 KW - Adolescent Adult Alcoholism/psychology/therapy Dependent Personality Disorder/psychology/therapy Depressive Disorder/psychology/therapy Drug Overdose/prevention & control/*psychology Female Humans *Interpersonal Relations Male Motivation Patient Care Team Personality Inventory *Problem Solving Risk Factors Suicide, Attempted/prevention & control/*psychology LA - eng N1 - McLeavey, B C Daly, R J Ludgate, J W Murray, C M Clinical Trial Journal Article Randomized Controlled Trial England Suicide Life Threat Behav. 1994 Winter;24(4):382-94. PY - 1994 SN - 0363-0234 (Print) 0363-0234 SP - 382-94 ST - Interpersonal problem-solving skills training in the treatment of self-poisoning patients T2 - Suicide Life Threat Behav TI - Interpersonal problem-solving skills training in the treatment of self-poisoning patients VL - 24 ID - 2624 ER - TY - JOUR AB - OBJECTIVE: Evidence‐based therapies for borderline personality disorder (BPD) are lengthy and scarce. Data on brief interventions are limited, and their role in the treatment of BPD is unclear. Our aim was therefore to evaluate the clinical effectiveness of brief dialectical behaviour therapy (DBT) skills training as an adjunctive intervention for high suicide risk in patients with BPD. METHOD: Eighty‐four out‐patients were randomized to 20 weeks of DBT skills (n = 42) or a waitlist (WL; n = 42). The primary outcome was frequency of suicidal or non‐suicidal self‐injurious (NSSI) episodes. Assessments were conducted at baseline 10, 20 and 32 weeks. RESULTS: DBT participants showed greater reductions than the WL participants on suicidal and NSSI behaviours between baseline and 32 weeks (P < 0.0001). DBT participants showed greater improvements than controls on measures of anger, distress tolerance and emotion regulation at 32 weeks. CONCLUSIONS: This abbreviated intervention is a viable option that may be a useful adjunctive intervention for the treatment of high‐risk behaviour associated with the acute phase of BPD. AN - CN-01301300 AU - McMain, S. F. AU - Guimond, T. AU - Barnhart, R. AU - Habinski, L. AU - Streiner, D. L. DO - 10.1111/acps.12664 IS - 2 KW - *automutilation *behavior therapy *borderline state *skill *suicide Adult Anger Behavior Therapy [*methods] Borderline Personality Disorder [*psychology] Comparative effectiveness Controlled clinical trial Controlled study Distress syndrome Emotionality Evidence‐Based Medicine Female High risk behavior Human Humans Major clinical study Male Middle Aged Outpatient Prospective Studies Randomized controlled trial Self‐Injurious Behavior [*epidemiology, psychology] Suicidal Ideation Suicide [psychology, *statistics & numerical data] Treatment Outcome Young Adult M3 - Journal Article; Randomized Controlled Trial PY - 2017 SP - 138‐148 ST - A randomized trial of brief dialectical behaviour therapy skills training in suicidal patients suffering from borderline disorder T2 - Acta psychiatrica Scandinavica TI - A randomized trial of brief dialectical behaviour therapy skills training in suicidal patients suffering from borderline disorder UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-01301300/full VL - 135 ID - 635 ER - TY - JOUR AB - OBJECTIVE: The authors conducted a 2‐year prospective naturalistic follow‐up study to evaluate posttreatment clinical outcomes in outpatients who were randomly selected to receive 1 year of either dialectical behavior therapy or general psychiatric management for borderline personality disorder. METHOD: Patients were assessed by blind raters 6, 12, 18, and 24 months after treatment. The clinical effectiveness of treatment was assessed on measures of suicidal and nonsuicidal self‐injurious behaviors, health care utilization, general symptom distress, depression, anger, quality of life, social adjustment, borderline psychopathology, and diagnostic status. The authors conducted between‐group comparisons using generalized estimating equation, mixed‐effects models, or chi‐square statistics, depending on the distribution and nature of the data. RESULTS: Both treatment groups showed similar and statistically significant improvements on the majority of outcomes 2 years after discharge. The original effects of treatment did not diminish for any outcome domain, including suicidal and nonsuicidal self‐injurious behaviors. Further improvements were seen on measures of depression, interpersonal functioning, and anger. However, even though two‐thirds of the participants achieved diagnostic remission and significant increases in quality of life, 53% were neither employed nor in school, and 39% were receiving psychiatric disability support after 36 months. CONCLUSIONS: One year of either dialectical behavior therapy or general psychiatric management was associated with long‐lasting positive effects across a broad range of outcomes. Despite the benefits of these specific treatments, one important finding that replicates previous research is that participants continued to exhibit high levels of functional impairment. The effectiveness of adjunctive rehabilitation strategies to improve general functioning deserves additional study. AN - CN-00842281 AU - McMain, S. F. AU - Guimond, T. AU - Streiner, D. L. AU - Cardish, R. J. AU - Links, P. S. DO - 10.1176/appi.ajp.2012.11091416 IS - 6 KW - Adult Behavior Therapy [*methods] Borderline Personality Disorder [drug therapy, *therapy] Combined Modality Therapy Female Follow‐Up Studies Humans Male Psychiatric Status Rating Scales Self‐Injurious Behavior [epidemiology] Suicide [statistics & numerical data] Treatment Outcome M3 - Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non‐U.S. Gov't PY - 2012 SP - 650‐661 ST - Dialectical behavior therapy compared with general psychiatric management for borderline personality disorder: clinical outcomes and functioning over a 2-year follow-up T2 - American journal of psychiatry TI - Dialectical behavior therapy compared with general psychiatric management for borderline personality disorder: clinical outcomes and functioning over a 2-year follow-up UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00842281/full VL - 169 ID - 636 ER - TY - JOUR AB - OBJECTIVE: The authors sought to evaluate the clinical efficacy of dialectical behavior therapy compared with general psychiatric management, including a combination of psychodynamically informed therapy and symptom‐targeted medication management derived from specific recommendations in APA guidelines for borderline personality disorder. METHOD: This was a single‐blind trial in which 180 patients diagnosed with borderline personality disorder who had at least two suicidal or nonsuicidal self‐injurious episodes in the past 5 years were randomly assigned to receive 1 year of dialectical behavior therapy or general psychiatric management. The primary outcome measures, assessed at baseline and every 4 months over the treatment period, were frequency and severity of suicidal and nonsuicidal self‐harm episodes. RESULTS: Both groups showed improvement on the majority of clinical outcome measures after 1 year of treatment, including significant reductions in the frequency and severity of suicidal and nonsuicidal self‐injurious episodes and significant improvements in most secondary clinical outcomes. Both groups had a reduction in general health care utilization, including emergency visits and psychiatric hospital days, as well as significant improvements in borderline personality disorder symptoms, symptom distress, depression, anger, and interpersonal functioning. No significant differences across any outcomes were found between groups. CONCLUSIONS: These results suggest that individuals with borderline personality disorder benefited equally from dialectical behavior therapy and a well‐specified treatment delivered by psychiatrists with expertise in the treatment of borderline personality disorder. AN - CN-00732074 AU - McMain, S. F. AU - Links, P. S. AU - Gnam, W. H. AU - Guimond, T. AU - Cardish, R. J. AU - Korman, L. AU - Streiner, D. L. DO - 10.1176/appi.ajp.2009.09010039 IS - 12 KW - Adolescent Adult Behavior Therapy [*methods] Borderline Personality Disorder [diagnosis, psychology, *therapy] Cognitive Behavioral Therapy [methods] Female Humans Male Middle Aged Outcome Assessment, Health Care Psychiatry [methods] Psychotherapy, Group [methods] Self‐Injurious Behavior [therapy] Single‐Blind Method Suicide Treatment Outcome Young Adult M3 - Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non‐U.S. Gov't PY - 2009 SP - 1365‐1374 ST - A randomized trial of dialectical behavior therapy versus general psychiatric management for borderline personality disorder T2 - American journal of psychiatry TI - A randomized trial of dialectical behavior therapy versus general psychiatric management for borderline personality disorder UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00732074/full VL - 166 ID - 637 ER - TY - JOUR AB - BACKGROUND: Approximately 50% of patients with schizophrenia or schizoaffective disorder attempt suicide, and approximately 10% die of suicide. Study results suggest that clozapine therapy significantly reduces suicidal behavior in these patients. METHODS: A multicenter, randomized, international, 2-year study comparing the risk for suicidal behavior in patients treated with clozapine vs olanzapine was conducted in 980 patients with schizophrenia or schizoaffective disorder, 26.8% of whom were refractory to previous treatment, who were considered at high risk for suicide because of previous suicide attempts or current suicidal ideation. To equalize clinical contact across treatments, all patients were seen weekly for 6 months and then biweekly for 18 months. Subsequent to randomization, unmasked clinicians at each site could make any interventions necessary to prevent the occurrence of suicide attempts. Suicidal behavior was assessed at each visit. Primary end points included suicide attempts (including those that led to death), hospitalizations to prevent suicide, and a rating of "much worsening of suicidality" from baseline. Masked raters, including an independent suicide monitoring board, determined when end point criteria were achieved. RESULTS: Suicidal behavior was significantly less in patients treated with clozapine vs olanzapine (hazard ratio, 0.76; 95% confidence interval, 0.58-0.97; P =.03). Fewer clozapine-treated patients attempted suicide (34 vs 55; P =.03), required hospitalizations (82 vs 107; P =.05) or rescue interventions (118 vs 155; P =.01) to prevent suicide, or required concomitant treatment with antidepressants (221 vs 258; P =.01) or anxiolytics or soporifics (301 vs 331; P =.03). Overall, few of these high-risk patients died of suicide during the study (5 clozapine vs 3 olanzapine-treated patients; P =.73). CONCLUSIONS: Clozapine therapy demonstrated superiority to olanzapine therapy in preventing suicide attempts in patients with schizophrenia and schizoaffective disorder at high risk for suicide. Use of clozapine in this population should lead to a significant reduction in suicidal behavior. AD - Psychiatric Hospital at Vanderbilt, 1601 23rd Ave S, Suite 306, Nashville, TN 37212, USA. herbert.meltzer@mcmail.vanderbilt.edu AN - 12511175 AU - Meltzer, H. Y. AU - Alphs, L. AU - Green, A. I. AU - Altamura, A. C. AU - Anand, R. AU - Bertoldi, A. AU - Bourgeois, M. AU - Chouinard, G. AU - Islam, M. Z. AU - Kane, J. AU - Krishnan, R. AU - Lindenmayer, J. P. AU - Potkin, S. DA - Jan DO - 10.1001/archpsyc.60.1.82 DP - NLM ET - 2003/01/07 IS - 1 KW - Adolescent Adult Antipsychotic Agents/*therapeutic use Benzodiazepines Clozapine/*therapeutic use Female Humans Male Middle Aged Olanzapine Outcome Assessment, Health Care Patient Dropouts Pirenzepine/*analogs & derivatives/therapeutic use Psychotic Disorders/diagnosis/drug therapy/psychology Risk Factors Schizophrenia/diagnosis/*drug therapy Schizophrenic Psychology Severity of Illness Index Suicide/*prevention & control/psychology Suicide, Attempted/prevention & control/psychology Treatment Outcome LA - eng N1 - Meltzer, Herbert Y Alphs, Larry Green, Alan I Altamura, A Carlo Anand, Ravi Bertoldi, Alberto Bourgeois, Marc Chouinard, Guy Islam, M Zahur Kane, John Krishnan, Ranga Lindenmayer, J P Potkin, Steven International Suicide Prevention Trial Study Group Clinical Trial Comparative Study Journal Article Multicenter Study Randomized Controlled Trial Research Support, Non-U.S. Gov't United States Arch Gen Psychiatry. 2003 Jan;60(1):82-91. doi: 10.1001/archpsyc.60.1.82. PY - 2003 SN - 0003-990X (Print) 0003-990x SP - 82-91 ST - Clozapine treatment for suicidality in schizophrenia: International Suicide Prevention Trial (InterSePT) T2 - Arch Gen Psychiatry TI - Clozapine treatment for suicidality in schizophrenia: International Suicide Prevention Trial (InterSePT) VL - 60 ID - 790 ER - TY - JOUR AB - Backgroun:d Brief contact interventions (BCIs) might be reliable suicide prevention strategies. BCI efficacy trials, however, gave equivocal results. AlgoS trial is a composite BCI that yielded inconclusive results when analyzed with Intention‐To‐Treat strategy. In order to elicit intervention strengths and weaknesses, post‐hoc analyses of AlgoS data were performed. Methods: AlgoS was a randomized controlled trial conducted in 23 French hospitals. Suicide attempters were randomly assigned to either the intervention group (AlgoS) or the control group (Treatment as usual TAU). In the AlgoS arm, first‐time suicide attempters received crisis cards; non first‐time suicide attempters received a phone call, and post‐cards if the call could not be completed, or if the participant was in crisis and/or non‐compliant with the post‐discharge treatment. An As Treated strategy, accounting for the actual intervention received, was combined with subgroup analyses. Results: 1,040 patients were recruited and randomized into two groups of N = 520, from which 53 withdrew participation; 15 were excluded after inclusion/exclusion criteria reassessment. AlgoS first attempters were less likely to reiterate suicide attempt (SA) than their TAU counterparts at 6 and 13‐14 months (RR [95% CI]: 0.46 [0.25‐0.85] and 0.50 [0.31‐0.81] respectively). AlgoS non‐first attempters had similar SA rates as their TAU counterparts at 6 and 13‐14 months (RR [95% CI]: 0.84 [0.57‐1.25] and 1.00 [0.73‐1.37] respectively). SA rates were dissimilar within the AlgoS non‐first attempter group. Conclusions: This new set of analysis suggests that crisis cards could be efficacious to prevent new SA attempts among first‐time attempters, while phone calls were probably not significantly efficacious among multi‐attempters. Importantly, phone calls were informative of new SA risk, thus a key component of future interventions. AN - CN-01917114 AU - Messiah, A. AU - Notredame, C. E. AU - Demarty, A. L. AU - Duhem, S. AU - Vaiva, G. DO - 10.1371/journal.pone.0210778 IS - 2 KW - *algorithm *risk reduction *suicidal behavior /prevention *suicide reattempt /prevention Adolescent Adult Algorithms Article Clinical effectiveness Consultation Controlled study Crisis card Female Follow up Follow‐Up Studies Hotlines Human Humans Interpersonal communication Major clinical study Male Middle Aged Multicenter study Outcome assessment Patient attitude Post card Post hoc analysis Postcards as Topic Randomized controlled trial Risk assessment Suicide attempt Suicide, Attempted [*prevention & control, psychology] Telephone call Time to treatment M3 - Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non‐U.S. Gov't PY - 2019 SP - e0210778 ST - Combining green cards, telephone calls and postcards into an intervention algorithm to reduce suicide reattempt (AlgoS): p-hoc analyses of an inconclusive randomized controlled trial T2 - PloS one TI - Combining green cards, telephone calls and postcards into an intervention algorithm to reduce suicide reattempt (AlgoS): p-hoc analyses of an inconclusive randomized controlled trial UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-01917114/full VL - 14 ID - 638 ER - TY - JOUR AB - A description of and pilot data for a new adjunctive intervention designed to reduce suicidal behavior among high-risk individuals are presented. The Coping Long Term with Active Suicide Program (CLASP) has three major components: (1) three individual, in-person meetings, (2) one significant other/family meeting, and (3) 11 brief (15-30 minute) phone contacts with the patient and his/her significant other. Open trial and pilot randomized trial data provide preliminary evidence that CLASP is a feasible, acceptable, and efficacious intervention to reduce suicidal behavior. AD - Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, USA. Butler Hospital, Providence, RI, USA. AN - 27038050 AU - Miller, I. W. AU - Gaudiano, B. A. AU - Weinstock, L. M. C2 - PMC5047846 C6 - NIHMS756171 DA - Dec DO - 10.1111/sltb.12247 DP - NLM ET - 2016/04/03 IS - 6 KW - *Adaptation, Psychological Adult Female Humans Male Pilot Projects Program Evaluation *Psychological Techniques Suicidal Ideation *Suicide/prevention & control/psychology LA - eng N1 - 1943-278x Miller, Ivan W Gaudiano, Brandon A Weinstock, Lauren M R34 MH073625/MH/NIMH NIH HHS/United States Journal Article Randomized Controlled Trial Suicide Life Threat Behav. 2016 Dec;46(6):752-761. doi: 10.1111/sltb.12247. Epub 2016 Apr 2. PY - 2016 SN - 0363-0234 (Print) 0363-0234 SP - 752-761 ST - The Coping Long Term with Active Suicide Program: Description and Pilot Data T2 - Suicide Life Threat Behav TI - The Coping Long Term with Active Suicide Program: Description and Pilot Data VL - 46 ID - 2632 ER - TY - JOUR AB - Males employed in the construction industry are at greater risk of suicide than other employed males. It is plausible that a high level of stigma against mental health problems explains the elevated rates of suicide among this group. This study sought to test the effectiveness of an electronic mental health stigma intervention on suicide ideation, communication about suicide and attempts. Participants were randomly assigned to receive either a series of brief contact interventions over a 6-week period or a wait list control. Suicidal ideation, communication about suicide and suicide attempts were assessed using the Suicidal Behaviors Questionnaire-Revised at post-intervention. We used linear regression to assess effectiveness at post-intervention, adjusting for relevant covariates using both conventional methods and a propensity score approach. Results indicate that the intervention had no significant impact on suicidal thoughts, communication or suicide attempts. There was some indication that individuals in the intervention group reported a slight increase in attempts and communication about suicide. These observations underscore an urgent need for more research to understand the complex and nuanced relationship between stigma and suicide in non-clinical populations. AD - Melbourne School of Population and Global Health, Centre for Health Equity, University of Melbourne, Australia. School of Health and Social Development, Centre for Population Health Research, Deakin University, Australia. Incolink - Victoria, 1 Pelham Street, Carlton, VIC 3053, Australia. Turning Point, Eastern Health Clinical School, Monash University, Australia. Orygen, the National Centre of Excellence in Youth Mental Health, Australia. AN - 31081030 AU - Milner, A. AU - Aitken, Z. AU - Law, P. C. F. AU - LaMontagne, A. D. AU - Mann, C. AU - Cooper, T. AU - Witt, K. DA - Jun 1 DO - 10.1093/heapro/daz034 DP - NLM ET - 2019/05/14 IS - 3 KW - Adult Construction Industry Health Promotion/*methods Humans Male Middle Aged *Smartphone *Social Stigma Suicidal Ideation Suicide/*prevention & control Suicide, Attempted/prevention & control/psychology Surveys and Questionnaires Victoria construction self-harm stigma suicide suicide attempt suicide ideation thoughts about suicide LA - eng N1 - 1460-2245 Milner, A Aitken, Z Law, P C F LaMontagne, A D Mann, C Cooper, T Witt, K Journal Article Randomized Controlled Trial England Health Promot Int. 2020 Jun 1;35(3):478-485. doi: 10.1093/heapro/daz034. PY - 2020 SN - 0957-4824 SP - 478-485 ST - The relationship between an electronic mental health stigma campaign and suicidal thoughts and behaviours: a two-arm randomized controlled trial in the Australian construction industry T2 - Health Promot Int TI - The relationship between an electronic mental health stigma campaign and suicidal thoughts and behaviours: a two-arm randomized controlled trial in the Australian construction industry UR - https://academic.oup.com/heapro/article-abstract/35/3/478/5488487?redirectedFrom=fulltext VL - 35 ID - 37 ER - TY - CHAP AU - Möller, H-J AU - Bürk, F AU - Kurz, A AU - Torhorst, A AU - Wächtler, C AU - Lauter, H C5 - Fox 2020, PB - Springer PY - 1987 SP - 67-76 ST - An empirical study of different aftercare strategies for patients who attempted suicide: the effect of psychotherapy on compliance and outcome T2 - Psychological Treatment of Mental Illness TI - An empirical study of different aftercare strategies for patients who attempted suicide: the effect of psychotherapy on compliance and outcome ID - 2638 ER - TY - JOUR AB - Recurrent brief depression (RBD) fulfills DSM-III-R symptom criteria for major depression but the episodes are of shorter duration than the 2 weeks required by DSM-III-R. The clinical importance of the disorder has been observed in prophylactic studies of suicidal behavior. The possibility that antidepressants with selective action on the reuptake of serotonin might be effective in preventing recurrences of brief depression has been investigated. Fluoxetine in a dose of 120 mg a week, administered biweekly, had no effect on the recurrence rate, which was maintained at approximately the same rate on fluoxetine (1 every 18.7 days) as with placebo (1 every 17.6 days). In a group of patients with two or more prior episodes of suicidal behavior, there were 18 attempted suicides in the 54 patients treated with fluoxetine and the same number in the 53 patients treated with placebo. Fluoxetine neither raised nor lowered the suicide attempt rate as compared with placebo, providing no evidence to support the drug's role in either suicide provocation or prevention. Since fluoxetine is clearly effective with recurrent major depression, it would appear that recurrent brief depression has a different pharmacology. AD - Department of Psychiatry, St Mary's Hospital Medical School, London, England. AN - 7888419 AU - Montgomery, D. B. AU - Roberts, A. AU - Green, M. AU - Bullock, T. AU - Baldwin, D. AU - Montgomery, S. A. DO - 10.1007/bf02190400 DP - NLM ET - 1994/01/01 IS - 4 KW - Bipolar Disorder/diagnosis/*drug therapy/psychology Depressive Disorder/diagnosis/*drug therapy/psychology Dose-Response Relationship, Drug Double-Blind Method Drug Administration Schedule Fluoxetine/adverse effects/*therapeutic use Humans Psychiatric Status Rating Scales Recurrence Suicide, Attempted/*prevention & control/psychology Treatment Outcome LA - eng N1 - Montgomery, D B Roberts, A Green, M Bullock, T Baldwin, D Montgomery, S A Clinical Trial Journal Article Randomized Controlled Trial Germany Eur Arch Psychiatry Clin Neurosci. 1994;244(4):211-5. doi: 10.1007/BF02190400. PY - 1994 SN - 0940-1334 (Print) 0940-1334 SP - 211-5 ST - Lack of efficacy of fluoxetine in recurrent brief depression and suicidal attempts T2 - Eur Arch Psychiatry Clin Neurosci TI - Lack of efficacy of fluoxetine in recurrent brief depression and suicidal attempts VL - 244 ID - 2639 ER - TY - JOUR AB - 1 There have been few controlled prospective investigations into the prevention of suicidal behaviour and by and large they have failed to demonstrate the efficacy of social work, psychotherapy or psychiatric treatment. 2 A group of 58 high-risk patients with multiple episodes of suicidal behaviour was treated with mianserin 30 mg at night or placebo in a six month double-blind trial of the efficacy of an antidepressant in reducing suicidal behaviour. 3 Patients were screened for depression, schizophrenia and organic disease. Patients were diagnosed as suffering from personality disorders according to DSM-III criteria mainly borderline or histrionic. 4 There was no significant difference in outcome between the mianserin and placebo treated group at any point in the six month study. 5 An item analysis of the MADRS showed that at entry the item 'reduced appetite' predicted subsequent suicidal attempt. The total MADRS score did not predict further suicidal acts at entry but was highly significant at four weeks. At four weeks the items 'reduced sleep' and 'reduced appetite' were highly significant predictors of further suicidal acts and the items 'lassitude', 'suicidal thoughts', 'inability to feel' and 'pessimistic thoughts' were significant predictors. AN - 6824553 AU - Montgomery, S. A. AU - Roy, D. AU - Montgomery, D. B. C2 - PMC1427879 DO - 10.1111/j.1365-2125.1983.tb05864.x DP - NLM ET - 1983/01/01 IS - Suppl 2 KW - Adult Borderline Personality Disorder/drug therapy Depressive Disorder/drug therapy Dibenzazepines/*therapeutic use Female Histrionic Personality Disorder/drug therapy Humans Male Mianserin/*therapeutic use Psychiatric Status Rating Scales Recurrence Suicide/*prevention & control LA - eng N1 - 1365-2125 Montgomery, S A Roy, D Montgomery, D B Clinical Trial Controlled Clinical Trial Journal Article Br J Clin Pharmacol. 1983;15 Suppl 2(Suppl 2):183S-188S. doi: 10.1111/j.1365-2125.1983.tb05864.x. PY - 1983 SN - 0306-5251 (Print) 0306-5251 SP - 183s-188s ST - The prevention of recurrent suicidal acts T2 - Br J Clin Pharmacol TI - The prevention of recurrent suicidal acts VL - 15 Suppl 2 ID - 2642 ER - TY - JOUR AB - In an attempt to address the low compliance with offers of treatment shown by patients after episodes of non-fatal deliberate self-harm (DSH), patients who had harmed themselves for the first time were offered rapid, easy access to on-call trainee psychiatrists in the event of further difficulties, and they were encouraged to seek help at an early stage should such problems arise. The follow-up data obtained after one year showed a significant reduction of actual or seriously threatened DSH in the experimental group, who also made considerably less demands on medical and psychiatric services, when compared with controls. British Journal of Psychiatry (1993), 163, 111–112 AU - Morgan, H. G. AU - Jones, E. M. AU - Owen, J. H. DB - Cambridge Core DO - 10.1192/bjp.163.1.111 DP - Cambridge University Press ET - 2018/01/02 IS - 1 PY - 1993 SN - 0007-1250 SP - 111-112 ST - Secondary Prevention of Non-fatal Deliberate Self-harm: The Green Card Study T2 - British Journal of Psychiatry TI - Secondary Prevention of Non-fatal Deliberate Self-harm: The Green Card Study UR - https://www.cambridge.org/core/article/secondary-prevention-of-nonfatal-deliberate-selfharm/A984DF65478597613F6329DD841E046A VL - 163 ID - 710 ER - TY - JOUR AB - OBJECTIVE: People with substance use disorders who present with suicidal behavior are at high risk of subsequent suicide. There are few effective treatments specifically tailored for this population that diminish this risk. We aimed to assess the impact of an opportunistic cognitive behavioral intervention package (OCB) among adult outpatients with a substance use and comorbid suicide risk. METHOD: A randomized controlled trial was conducted across 2 sites in which 185 patients presenting with suicide risk and concurrent substance use received either OCB (8 sessions plus group therapy) or treatment as usual (TAU) over a 6-month period. Primary outcomes were suicidal behavior (suicide attempts, suicidal intent and presence of suicide ideation) and level of drug and alcohol consumption. Secondary outcomes were changes in psychological measures of suicide ideation, depression, anxiety, and self-efficacy. RESULTS: There were no completed suicides, and only 2 participants reported suicide attempts at follow-up. Suicide ideation, alcohol consumption, and cannabis use fell over time but no significant Treatment × Time differences were found. There were also no differences between OCB and TAU over time on psychological measures of depression, anxiety, or self-efficacy. Suicide ideation at 6-month follow-up was predicted by cannabis use and higher scores on the Brief Psychiatric Rating Scale at baseline. CONCLUSIONS: The opportunistic cognitive behavioral intervention package did not appear to be beneficial in reducing suicide ideation, drug and alcohol consumption, or depression relative to treatment as usual. AD - National Health and Medical Research Council (NHMRC) Centre for Research Excellence in Mental Health and Substance Use, Discipline of Addiction Medicine, University of Sydney. Department of Health Sciences, University of Sydney. NHMRC Centre for Research Excellence in Mental Health and Substance Use, Discipline of Addiction Medicine, University of Sydney. Concord Centre for Mental Health, Concord Hospital. Department of Psychiatry, Sydney Medical School, University of Sydney. AN - 24364795 AU - Morley, K. C. AU - Sitharthan, G. AU - Haber, P. S. AU - Tucker, P. AU - Sitharthan, T. DA - Feb DO - 10.1037/a0035310 DP - NLM ET - 2013/12/25 IS - 1 KW - Adult Anxiety/psychology *Cognitive Behavioral Therapy Depression/psychology Female Humans Male Middle Aged Risk Factors Self Efficacy Substance-Related Disorders/psychology/*therapy Suicidal Ideation Suicide/*prevention & control/psychology Suicide, Attempted/*prevention & control/psychology Treatment Outcome LA - eng N1 - 1939-2117 Morley, Kirsten C Sitharthan, Gomathi Haber, Paul S Tucker, Peter Sitharthan, Thiagarajan Journal Article Multicenter Study Randomized Controlled Trial Research Support, Non-U.S. Gov't United States J Consult Clin Psychol. 2014 Feb;82(1):130-40. doi: 10.1037/a0035310. Epub 2013 Dec 23. PY - 2014 SN - 0022-006x SP - 130-40 ST - The efficacy of an opportunistic cognitive behavioral intervention package (OCB) on substance use and comorbid suicide risk: a multisite randomized controlled trial T2 - J Consult Clin Psychol TI - The efficacy of an opportunistic cognitive behavioral intervention package (OCB) on substance use and comorbid suicide risk: a multisite randomized controlled trial VL - 82 ID - 292 ER - TY - JOUR AB - OBJECTIVE: To assess whether an assertive outreach intervention after suicide attempt could reduce the frequency of subsequent suicidal acts, compared with standard treatment. DESIGN: Randomised, parallel group, superiority trial with blinded outcome assessment. SETTING: Outpatient intervention at one location at Copenhagen University Hospital, Denmark. PARTICIPANTS: Patients older than 12 years admitted to regional hospitals in Copenhagen with a suicide attempt within the past 14 days. We excluded patients diagnosed with schizophrenia spectrum disorders and patients living in institutions. INTERVENTION: Case management through assertive outreach that provided crisis intervention and flexible problem solving. This approach incorporated motivational support and actively assisted patients to scheduled appointments to improve adherence with after‐treatment as an add on to standard treatment. MAIN OUTCOME: Repeated suicide attempt and death by suicide, recorded in medical records and death register at 1‐year follow‐up. RESULTS: 243 patients were included. During 12 months of follow‐up, 20/123 (16%) patients in the intervention group had been registered in hospital records with subsequent suicide attempt, compared with 13/120 (11%) in the control group (odds ratio 1.60, 95% confidence interval 0.76 to 3.38; P=0.22). By contrast, self reported data on new events showed 11/95 (12%) in the intervention group versus 13/74 (18%) in the control group (0.61, 0.26 to 1.46; P=0.27). By imputing missing data on the selfreported outcomes, we estimated 15/123 (12%) events in the intervention group and 23/120 (19%) in the control group (0.69, 0.34 to 1.43; P=0.32). CONCLUSION: Assertive outreach showed no significant effect on subsequent suicide attempt. The difference in rates of events between register data and self reported data could indicate detection bias. TRIAL REGISTRATION: ClinicalTrials.gov NCT00700089. AN - CN-00836353 AU - Morthorst, B. AU - Krogh, J. AU - Erlangsen, A. AU - Alberdi, F. AU - Nordentoft, M. DO - 10.1136/bmj.e4972 KW - Adolescent Adult Aged Aged, 80 and over Case Management Child Crisis Intervention [*methods] Denmark Female Follow‐Up Studies Humans Male Middle Aged Patient Compliance Registries Self Report Single‐Blind Method Suicide [prevention & control, statistics & numerical data] Suicide, Attempted [*prevention & control, statistics & numerical data] Treatment Outcome Young Adult M3 - Journal Article; Randomized Controlled Trial; Research Support, Non‐U.S. Gov't PY - 2012 SP - e4972 ST - Effect of assertive outreach after suicide attempt in the AID (assertive intervention for deliberate self harm) trial: randomised controlled trial T2 - BMJ (Clinical research ed.) TI - Effect of assertive outreach after suicide attempt in the AID (assertive intervention for deliberate self harm) trial: randomised controlled trial UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00836353/full VL - 345 ID - 641 ER - TY - JOUR AB - OBJECTIVE: This study tested the hypothesis that professionals' maintenance of long-term contact with persons who are at risk of suicide can exert a suicide-prevention influence. This influence was hypothesized to result from the development of a feeling of connectedness and to be most pertinent to high-risk individuals who refuse to remain in the health care system. METHODS: A total of 3,005 persons hospitalized because of a depressive or suicidal state, populations known to be at risk of subsequent suicide, were contacted 30 days after discharge about follow-up treatment. A total of 843 patients who had refused ongoing care were randomly divided into two groups; persons in one group were contacted by letter at least four times a year for five years. The other group-the control group-received no further contact. A follow-up procedure identified patients who died during the five-year contact period and during the subsequent ten years. Suicide rates in the contact and no-contact groups were compared. RESULTS: Patients in the contact group had a lower suicide rate in all five years of the study. Formal survival analyses revealed a significantly lower rate in the contact group (p=.04) for the first two years; differences in the rates gradually diminished, and by year 14 no differences between groups were observed. CONCLUSIONS: A systematic program of contact with persons who are at risk of suicide and who refuse to remain in the health care system appears to exert a significant preventive influence for at least two years. Diminution of the frequency of contact and discontinuation of contact appear to reduce and eventually eliminate this preventive influence. AD - Department of Psychiatry, University of California, San Francisco, School of Medicine, CA 94143, USA. jerrymotto@aol.com AN - 11376235 AU - Motto, J. A. AU - Bostrom, A. G. DA - Jun DO - 10.1176/appi.ps.52.6.828 DP - NLM ET - 2001/05/29 IS - 6 KW - Adult *Aftercare California Depressive Disorder/complications/*rehabilitation Female Humans Male *Postal Service Statistics, Nonparametric Suicide/*prevention & control/statistics & numerical data Survival Analysis Survival Rate *Treatment Refusal LA - eng N1 - Motto, J A Bostrom, A G MH-16524/MH/NIMH NIH HHS/United States MH-25080/MH/NIMH NIH HHS/United States Clinical Trial Journal Article Randomized Controlled Trial Research Support, U.S. Gov't, P.H.S. United States Psychiatr Serv. 2001 Jun;52(6):828-33. doi: 10.1176/appi.ps.52.6.828. PY - 2001 SN - 1075-2730 (Print) 1075-2730 SP - 828-33 ST - A randomized controlled trial of postcrisis suicide prevention T2 - Psychiatr Serv TI - A randomized controlled trial of postcrisis suicide prevention VL - 52 ID - 242 ER - TY - JOUR AB - Attempted suicide is a strong risk factor for subsequent suicidal behavior. In recent years, a particular interest has been given to follow‐up interventions as a potential effective strategy in preventing recurrent suicidal behavior. We developed a follow‐up intervention program called OSTA (organization of a suitable monitoring for suicide attempters) aimed at addressing this issue and tested its effectiveness in a 1‐year randomized controlled trial. Individuals who attempted suicide and were admitted to the emergency department (ED) of Bicêtre Hospital (n=320) were randomly allocated to receive either the OSTA program or a control treatment. On an intention to treat basis, the proportion of patients who reattempted suicide did not differ significantly between the interventional group (IG) 14.5% (22/152) and the control group (CG) 14% (21/150). There were also no significant differences, between the two arms, in the number of suicide attempts. Although no significant difference has been found between the OSTA program and the control treatment concerning the rate of suicide reattempts, we believe that further studies should be conducted to test the effectiveness of more standardized follow‐up studies in suicide prevention. AN - CN-01141551 AU - Mouaffak, F. AU - Marchand, A. AU - Castaigne, E. AU - Arnoux, A. AU - Hardy, P. DO - 10.1016/j.psychres.2015.11.024 IS - 3 KW - *health care *organization of a suitable monitoring for suicide attempter *suicide/pc [Prevention] Adult Article Behavior Therapy [*methods] Clinical effectiveness Controlled study Emergency Service, Hospital Emergency care Female Follow up Follow‐Up Studies Hospitalization Human Humans Intention to treat analysis Major clinical study Male Middle Aged Outcome assessment Priority journal Prospective study Randomized controlled trial Risk Factors Suicidal Ideation Suicide [*prevention & control] Suicide attempt/pc [Prevention] Suicide, Attempted [*prevention & control] Treatment Outcome M3 - Journal Article; Randomized Controlled Trial PY - 2015 SP - 913‐918 ST - OSTA program: a French follow up intervention program for suicide prevention T2 - Psychiatry research TI - OSTA program: a French follow up intervention program for suicide prevention UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-01141551/full VL - 230 ID - 642 ER - TY - JOUR AB - BACKGROUND: To evaluate the efficacy of different ways of communications on prevention of suicidal reattempt, we compared the efficacy of phone call versus face-to-face follow-up in patients with previous attempt. MATERIALS AND METHODS: In a randomized controlled clinical trial, 55 suicide reattempters who were admitted to the poisoning emergency were divided into phone call (29 patients) and face-to-face (26 patients) groups randomly. They were followed at 8 occasions: 2(nd) and 4(th) weeks, and the 2(nd), 3(rd), 4(th), 5(th), 6(th), and 8(th) months. The suicidal reattempt, suicidal thought, hope, and interest of the patients were assessed on each occasion, and the patients were guided to visit by a therapist, if needed. The findings were analyzed by Mann-Whitney, Chi-square, Cochran, Friedman, and independent t-tests using SPSS 20. RESULTS: The status of "hope" and "interest" improved in both groups, but it showed more significant difference in the face-to-face group. Suicidal thoughts in both groups decreased over time, and this was more significant in the face-to-face group. However, we did not found any significant difference in the frequency of the suicidal reattempts between two groups. CONCLUSION: Face-to-face versus phone call follow-up of suicide attempters can significantly alleviate suicidal thoughts and improve hopes and interests. AD - Department of Psychiatry, Behavioral Sciences Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran. Department of Epidemiology, Behavioral Sciences Research Center, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran. AN - 28028524 AU - Mousavi, S. G. AU - Amini, M. AU - Mahaki, B. AU - Bagherian-Sararoudi, R. C2 - PMC5156977 DO - 10.4103/2277-9175.190990 DP - NLM ET - 2016/12/29 KW - Face to face follow-up phone call recurrent suicide attempt LA - eng N1 - 2277-9175 Mousavi, Seyed Ghafur Amini, Mohsen Mahaki, Behzad Bagherian-Sararoudi, Reza Journal Article Adv Biomed Res. 2016 Nov 28;5:184. doi: 10.4103/2277-9175.190990. eCollection 2016. PY - 2016 SN - 2277-9175 (Print) 2277-9175 SP - 184 ST - Effect of phone call versus face-to-face follow-up on recurrent suicide attempts prevention in individuals with a history of multiple suicide attempts T2 - Adv Biomed Res TI - Effect of phone call versus face-to-face follow-up on recurrent suicide attempts prevention in individuals with a history of multiple suicide attempts VL - 5 ID - 2647 ER - TY - JOUR AB - BACKGROUND: Suicide is a major problem, and its prevention is a global priority. In many cases, suicide attempter attempts to do it again after the rescue. In current study we aimed to compare active visit and treatment of patients in a periodic manner with treatment as usual, in the prevention of recurrent suicidal attempts. MATERIALS AND METHODS: This study was a randomized controlled clinical trial which was conducted in Isfahan Noor Hospital's Emergency Center on 60 patients in 2013-2014. The samples were selected using simple random sampling and they were assigned into two groups: The conventional treatment group (treatment as usual) (30 patients), and visit and active treatment (30 patients). In the intervention group, there were ten follow-ups by a face-to-face visit over 12 months, and six follow-ups by phone call in control group. Through the completion of the initial and follow-up questionnaire evaluation was performed. The data were analyzed using Cochran test, and repeated measure (ANOVA). RESULTS: During the 12-month follow-up visit and active treatment, significant difference in reducing suicidal thoughts (P = 0.003) was observed and an increase in the life expectancy (P = 0.001), interest and motivation in life (P = 0.001) was found in the intervention group, and also nonsignificant reduction was found in the rate of suicidal attempts. CONCLUSION: Visit and active treatment is useful in suicide attempters and it can helps in preventing recurrent suicide attempt as a preventive program by increasing hope and reducing suicidal thoughts. AD - Department of Psychiatry, School of Medicine, Behavioral Sciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran. Department of Epidemiology and Statistics, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran. AN - 28503493 AU - Mousavi, S. G. AU - Tehrani, M. N. AU - Maracy, M. C2 - PMC5414404 DO - 10.4103/2277-9175.204586 DP - NLM ET - 2017/05/16 KW - Follow-up prevention suicide treatment LA - eng N1 - 2277-9175 Mousavi, Seyed Ghafur Tehrani, Marayam Nader Maracy, Mohammadreza Journal Article Adv Biomed Res. 2017 Apr 17;6:38. doi: 10.4103/2277-9175.204586. eCollection 2017. PY - 2017 SN - 2277-9175 (Print) 2277-9175 SP - 38 ST - The Effect of Active Treatment and Visit Compared to Conventional Treatment, on Preventing Recurrent Suicidal Attempts: A Randomized Controlled Clinical Trial T2 - Adv Biomed Res TI - The Effect of Active Treatment and Visit Compared to Conventional Treatment, on Preventing Recurrent Suicidal Attempts: A Randomized Controlled Clinical Trial VL - 6 ID - 2648 ER - TY - JOUR AB - BACKGROUND: prevention of suicide is one of priority world health. Suicide is one of the preventable causes of death. The aim of this study is evaluation of telephone follow up on suicide reattempt. MATERIALS AND METHODS: This randomized controlled clinical trial is a prospective study which has been done in Noor Hospital of Isfahan-Iran, at 2010. 139 patients who have suicide attempt history divided in one of two groups, randomly, 70 patients in" treatment as usual (TAU)" and 69 patients in "brief interventional control (BIC). Seven telephone contact with BIC group patients have been done "during six months" and two questionnaires have been filled in each session. The data has been analyzed by descriptive and Chi-square test, under SPSS. RESULTS: No significant differences of suicide reattempt has been found between two groups (P = 0.18), but significant reduction in frequency of suicidal thoughts (P = 0.007) and increase in hope at life (P = 0.001) was shown in intervention group. CONCLUSION: Telephones follow up in patients with suicide history decrease suicidal thought frequency" and increase hope in life, significantly. AD - Department of Psychiatry, Behavioral Sciences Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran. Department of Epidemiology and Statistics, School of Health, Isfahan University of Medical Sciences, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran. AN - 25337528 AU - Mousavi, S. G. AU - Zohreh, R. AU - Maracy, M. R. AU - Ebrahimi, A. AU - Sharbafchi, M. R. C2 - PMC4202499 DO - 10.4103/2277-9175.142043 DP - NLM ET - 2014/10/23 KW - Prevention suicide suicides reattempt telephone follow up LA - eng N1 - 2277-9175 Mousavi, Seyed Ghafur Zohreh, Rabiei Maracy, Mohammad Reza Ebrahimi, Amrollah Sharbafchi, Mohammad Reza Journal Article Adv Biomed Res. 2014 Sep 30;3:198. doi: 10.4103/2277-9175.142043. eCollection 2014. PY - 2014 SN - 2277-9175 (Print) 2277-9175 SP - 198 ST - The efficacy of telephonic follow up in prevention of suicidal reattempt in patients with suicide attempt history T2 - Adv Biomed Res TI - The efficacy of telephonic follow up in prevention of suicidal reattempt in patients with suicide attempt history VL - 3 ID - 506 ER - TY - JOUR AB - Background: Suicidal behaviour is a major contributor to the health burden globally. Non‐fatal suicidal behaviour may be 10‐40 times more frequent than fatal suicidal behaviour. National responses to this crisis have been variable. This study was designed to evaluate and compare the effectiveness of a brief Buddy intervention support programme with the World Health Organization Multisite Intervention Study on Suicidal Behaviours (SUPRE‐MISS) programme with regard to a cohort of suicide attempters. Method: Six hundred and eighty‐eight suicide attempters were recruited into this randomised control study following admission and stabilisation in two community‐based hospitals. They were randomised into either the SUPRE‐MISS intervention group (control) or the Buddy intervention support group (experimental), and followed‐up over 18 months. Data were analysed using SPSSR 19. Results: Three suicides occurred in the control group and one in the Buddy group. Collectively, 171 further suicide attempts were recorded during the 18 months, with 103 in the control group and 68 in the Buddy group. Differences between the two groups were statistically significant. Conclusion: The Buddy intervention was found to be effective and relevant in reducing suicidal behaviour in the local community. These findings have practical implications for implementation at primary care level in all communities. Copyright © 2014 The Author(s). AN - CN-01331898 AU - Naidoo, S. S. AU - Gathiram, P. AU - Schlebusch, L. DO - 10.1080/20786190.2014.980159 IS - 5 KW - *intervention study *primary medical care *program effectiveness *suicidal behavior *suicide attempt Adult Aged Article Clinical outcome Comparative effectiveness Control group Controlled clinical trial Controlled study Coping behavior Counseling Female Hospital Human Incidence Intervention study Major clinical study Male Normal human Psychological well being Psychotherapy Randomized controlled trial Sex difference Suicide attempt Support group World health organization M3 - Journal: Article PY - 2014 SP - 263‐270 ST - Effectiveness of a buddy intervention support programme for suicidal behaviour in a primary care setting T2 - South african family practice TI - Effectiveness of a buddy intervention support programme for suicidal behaviour in a primary care setting UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-01331898/full VL - 56 ID - 643 ER - TY - JOUR AB - Background: 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. Methods: 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. Results: 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). Conclusions: 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. AN - CN-02182515 AU - Norimoto, K. AU - Ikeshita, K. AU - Kishimoto, T. AU - Okuchi, K. AU - Yonemoto, N. AU - Sugimoto, T. AU - Chida, F. AU - Shimoda, S. AU - Hirayasu, Y. AU - Kawanishi, C. DO - 10.1186/s12888-020-02723-9 IS - 1 KW - *assertive training *axis I disorder /diagnosis *axis II disorder /diagnosis *comorbidity *mental disease /diagnosis *suicide attempt /therapy Adult Article Case Management Comorbidity DSM‐IV Female Human Humans Incidence Major clinical study Male Personality Disorders [epidemiology] Randomized controlled trial (topic) Recurrent disease Secondary analysis Suicide, Attempted Survival Treatment outcome M3 - Journal Article; Randomized Controlled Trial; Research Support, Non‐U.S. Gov't PY - 2020 SP - 311 ST - Effect of assertive case management intervention on suicide attempters with comorbid Axis I and II psychiatric diagnoses: secondary analysis of a randomised controlled trial T2 - BMC psychiatry TI - Effect of assertive case management intervention on suicide attempters with comorbid Axis I and II psychiatric diagnoses: secondary analysis of a randomised controlled trial UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-02182515/full VL - 20 ID - 645 ER - TY - JOUR AB - OBJECTIVES: We investigated the treatment effects reported from a high-quality randomized controlled trial of cognitive behavioural therapy (CBT) for 106 people with borderline personality disorder attending community-based clinics in the UK National Health Service - the BOSCOT trial. Specifically, we examined whether the amount of therapy and therapist competence had an impact on our primary outcome, the number of suicidal acts, using instrumental variables regression modelling. DESIGN: Randomized controlled trial. Participants from across three sites (London, Glasgow, and Ayrshire/Arran) were randomized equally to CBT for personality disorders (CBTpd) plus Treatment as Usual or to Treatment as Usual. Treatment as Usual varied between sites and individuals, but was consistent with routine treatment in the UK National Health Service at the time. CBTpd comprised an average 16 sessions (range 0-35) over 12 months. METHOD: We used instrumental variable regression modelling to estimate the impact of quantity and quality of therapy received (recording activities and behaviours that took place after randomization) on number of suicidal acts and inpatient psychiatric hospitalization. RESULTS: A total of 101 participants provided full outcome data at 2 years post randomization. The previously reported intention-to-treat (ITT) results showed on average a reduction of 0.91 (95% confidence interval 0.15-1.67) suicidal acts over 2 years for those randomized to CBT. By incorporating the influence of quantity of therapy and therapist competence, we show that this estimate of the effect of CBTpd could be approximately two to three times greater for those receiving the right amount of therapy from a competent therapist. CONCLUSIONS: Trials should routinely control for and collect data on both quantity of therapy and therapist competence, which can be used, via instrumental variable regression modelling, to estimate treatment effects for optimal delivery of therapy. Such estimates complement rather than replace the ITT results, which are properly the principal analysis results from such trials. AD - Centre for Healthcare Randomised Trials, Health Services Research Unit, Aberdeen University, UK. AN - 23420622 AU - Norrie, J. AU - Davidson, K. AU - Tata, P. AU - Gumley, A. C2 - PMC4491320 DA - Sep DO - 10.1111/papt.12004 DP - NLM ET - 2013/02/20 IS - 3 KW - Age of Onset Borderline Personality Disorder/psychology/*therapy Clinical Competence/*standards Cognitive Behavioral Therapy/standards/*statistics & numerical data Female Follow-Up Studies Hospitalization/*statistics & numerical data Humans Intention to Treat Analysis Kaplan-Meier Estimate Outcome Assessment, Health Care/*statistics & numerical data Regression Analysis State Medicine Statistics, Nonparametric Suicide, Attempted/psychology/*statistics & numerical data Time Factors United Kingdom LA - eng N1 - 2044-8341 Norrie, John Davidson, Kate Tata, Philip Gumley, Andrew CZH/4/435/Chief Scientist Office/United Kingdom 064027/Z/01/Z/Wellcome Trust/United Kingdom Journal Article Randomized Controlled Trial Research Support, Non-U.S. Gov't Psychol Psychother. 2013 Sep;86(3):280-93. doi: 10.1111/papt.12004. Epub 2013 Feb 19. PY - 2013 SN - 1476-0835 (Print) 1476-0835 SP - 280-93 ST - Influence of therapist competence and quantity of cognitive behavioural therapy on suicidal behaviour and inpatient hospitalisation in a randomised controlled trial in borderline personality disorder: further analyses of treatment effects in the BOSCOT study T2 - Psychol Psychother TI - Influence of therapist competence and quantity of cognitive behavioural therapy on suicidal behaviour and inpatient hospitalisation in a randomised controlled trial in borderline personality disorder: further analyses of treatment effects in the BOSCOT study VL - 86 ID - 279 ER - TY - JOUR AB - BACKGROUND: We investigated whether a volitional helpsheet (VHS), a brief psychological intervention, could reduce repeat self‐harm in the 6 months following a suicide attempt. METHODS: We did a prospective, single‐site, randomised controlled trial. Patients admitted to a hospital in Edinburgh, UK, after a suicide attempt were deemed eligible for the study if they were over the age of 16 years, had a self‐reported history of self‐harm, were fluent in English, were medically fit to interview, and were not participating in other research studies within the hospital. Eligible patients were randomly assigned (1:1), via web‐based randomisation, to receive either VHS plus usual treatment (intervention group) or only treatment as usual (control group). Randomisation was stratified by sex and self‐reported past self‐harm history. The Information Services Division of the National Health Service (NHS‐ISD) staff and those extracting data from medical notes were masked to the study group the participant was allocated to. Clinical staff working within the hospital were also masked to participants' randomisation status. There were three primary outcomes: the proportion of paticipants who re‐presented to hospital with self‐harm during the 6‐month follow‐up period; the number of times a participant re‐presented to hospital with self‐harm during the 6‐month follow‐up period; and cost‐effectiveness of the VHS as measured by estimated incremental cost per self‐harm event averted. Primary outcomes were analysed in all randomised patients. Follow‐up data collection was extracted from the Information Services Division of the NHS and from patient medical records. The trial is registered with International Standard Randomised Controlled Trial Number Registry, number ISRCTN99488269. FINDINGS: Between May 9, 2012, and Feb 24, 2014, we assessed 1308 people for eligibility. Of these, 259 patients were randomly assigned to the intervention group and 259 to the control group. We obtained complete follow‐up data on 512 (99%) of 518 patients (five participants were lost to follow‐up in the intervention group and one in the control group). 11 patients assigned to the intervention group did not complete the VHS in hospital. Overall, the intervention did not affect the number of people who re‐presented with self‐harm (67 [26%] of 254 patients in the intervention group vs 71 [28%] of 258 patients in the control group, odds ratio [OR] 0·90, 95% CI 0·58‐1·39, p=0·63). The intervention had no effect on the number of re‐presentations per patient (mean 0·67 [SD 2·55] re‐presentations for the intervention group vs 0·85 [2·79] for the control group, incident rate ratio [IRR] 1·65, 95% CI 0·74‐3·67, p=0·21). Mean total costs per person for NHS hospital services in the VHS intervention group over the 6 months were £513 versus £561 in the control group but this difference was not significant (95% CI‐£353 to £257, p=0·76). Three patients died by suicide in the 6 months following their index suicide attempt (one in the intervention group and two in the control group). There were no reported unintended effects or adverse events in either group. INTERPRETATION: For the primary outcomes, there were no significant differences between groups. Although the VHS had no overall effect, post‐hoc analyses suggest VHS might be effective in reducing the number of self‐harm repetitions following a suicide attempt in people who complete the helpsheet and who have been previously admitted to hospital with self‐harm. This is the first study to investigate the usefulness of the VHS to reduce self‐harm among those who have attempted suicide. These subgroup findings require replication. The potential use of the VHS in those who self‐harm for different motives requires further exploration. FUNDING: Chief Scientist Office (CZH/4/704). AN - CN-01952514 AU - O'Connor, R. C. AU - Ferguson, E. AU - Scott, F. AU - Smyth, R. AU - McDaid, D. AU - Park, A. L. AU - Beautrais, A. AU - Armitage, C. J. DO - 10.1016/S2215-0366(17)30129-3 IS - 6 KW - Adult Cost‐Benefit Analysis Female Hospitalization [statistics & numerical data] Humans Incidence Male Middle Aged Outcome Assessment, Health Care Prospective Studies Psychotherapy, Brief [*methods] Self‐Injurious Behavior [epidemiology, *prevention & control, psychology, *therapy] Suicide, Attempted [*prevention & control, statistics & numerical data] United Kingdom [epidemiology] Volition [physiology] M3 - Journal Article; Randomized Controlled Trial; Research Support, Non‐U.S. Gov't PY - 2017 SP - 451‐460 ST - A brief psychological intervention to reduce repetition of self-harm in patients admitted to hospital following a suicide attempt: a randomised controlled trial T2 - The lancet. Psychiatry TI - A brief psychological intervention to reduce repetition of self-harm in patients admitted to hospital following a suicide attempt: a randomised controlled trial UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-01952514/full VL - 4 ID - 646 ER - TY - JOUR AB - OBJECTIVE: The aim of this study was to further evaluate the acceptability and feasibility of the Teachable Moment Brief Intervention (TMBI). METHOD: A single blind, pilot randomized controlled trial of the TMBI + care as usual (CAU) compared to CAU was conducted for patients who survived a recent suicide attempt that required medical inpatient hospitalization. The intervention was delivered on medical/surgical and inpatient psychiatry units in the medical center. Interviews were completed at baseline, 1, 3, and 12 months. RESULTS: Patients reported high ratings of satisfaction with the TMBI. Interventionists representing fields of Psychiatry, Social Work, and Counseling were able to deliver the intervention with fidelity to the treatment manual with equal adherence ratings. The TMBI patients were more likely to maintain a positive recovery trajectory on motivation and engagement in mental health services at 3 months. CONCLUSION: The TMBI provides an option for targeted intervention to health care providers as they engage patients admitted to an acute medical setting after a serious suicide attempt. This is the second pilot study demonstrating enhanced motivation in the post‐hospitalization period. AN - CN-02209030 AU - O'Connor, S. S. AU - McClay, M. M. AU - Choudhry, S. AU - Shields, A. D. AU - Carlson, R. AU - Alonso, Y. AU - Lavin, K. AU - Venanzi, L. AU - Comtois, K. A. AU - Wilson, J. E. AU - et al. DO - 10.1016/j.genhosppsych.2018.08.001 KW - Adult Feasibility Studies Female Hospitalization Humans Inpatients [psychology] Male Middle Aged Outcome and Process Assessment, Health Care Patient Acceptance of Health Care [psychology] Pilot Projects Psychotherapy, Brief Single‐Blind Method Suicide, Attempted [psychology] Survivors [psychology] M3 - Journal Article; Randomized Controlled Trial; Research Support, Non‐U.S. Gov't PY - 2020 SP - 111‐118 ST - Pilot randomized clinical trial of the Teachable Moment Brief Intervention for hospitalized suicide attempt survivors T2 - General hospital psychiatry TI - Pilot randomized clinical trial of the Teachable Moment Brief Intervention for hospitalized suicide attempt survivors UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-02209030/full VL - 63 ID - 648 ER - TY - JOUR AB - OBJECTIVE: Bipolar disorder is associated with high risk for suicidal acts. Observational studies suggest a protective effect of lithium against suicidal behavior. However, testing this effect in randomized clinical trials is logistically and ethically challenging. The authors tested the hypothesis that lithium offers bipolar patients with a history of suicide attempt greater protection against suicidal behavior compared to valproate. METHOD: Patients with bipolar disorder and past suicide attempts (N=98) were randomly assigned to treatment with lithium or valproate, plus adjunctive medications as indicated, in a double-blind 2.5-year trial. An intent-to-treat analysis was performed using the log-rank test for survival data. Two models were fitted: time to suicide attempt and time to suicide event (attempt or hospitalization or change in medication in response to suicide plans). RESULTS: There were 45 suicide events in 35 participants, including 18 suicide attempts made by 14 participants, six from the lithium group and eight from the valproate group. There were no suicides. Intent-to-treat analysis using the log-rank test showed no differences between treatment groups in time to suicide attempt or to suicide event. Post hoc power calculations revealed that the modest sample size, reflective of challenges in recruitment, only permits detection of a relative risk of 5 or greater. CONCLUSIONS: Despite the high frequency of suicide events during the study, this randomized controlled trial detected no difference between lithium and valproate in time to suicide attempt or suicide event in a sample of suicide attempters with bipolar disorder. However, smaller clinically significant differences between the two drugs were not ruled out. AD - Columbia University, New York State Psychiatric Institute, New York, USA. mao4@columbia.edu AN - 21768611 AU - Oquendo, M. A. AU - Galfalvy, H. C. AU - Currier, D. AU - Grunebaum, M. F. AU - Sher, L. AU - Sullivan, G. M. AU - Burke, A. K. AU - Harkavy-Friedman, J. AU - Sublette, M. E. AU - Parsey, R. V. AU - Mann, J. J. C2 - PMC3767999 C6 - NIHMS511136 DA - Oct DO - 10.1176/appi.ajp.2011.11010163 DP - NLM ET - 2011/07/20 IS - 10 KW - Adult Antimanic Agents/*therapeutic use Bipolar Disorder/*drug therapy Double-Blind Method Female Humans Lithium/*therapeutic use Male Middle Aged Suicide/*prevention & control Suicide, Attempted/*prevention & control Treatment Outcome Valproic Acid/*therapeutic use LA - eng N1 - 1535-7228 Oquendo, Maria A Galfalvy, Hanga C Currier, Dianne Grunebaum, Michael F Sher, Leo Sullivan, Gregory M Burke, Ainsley K Harkavy-Friedman, Jill Sublette, M Elizabeth Parsey, Ramin V Mann, J John P20 AA015630/AA/NIAAA NIH HHS/United States R01 MH059710/MH/NIMH NIH HHS/United States MH 59710/MH/NIMH NIH HHS/United States MH AA15630/AA/NIAAA NIH HHS/United States Comparative Study Journal Article Randomized Controlled Trial Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't Am J Psychiatry. 2011 Oct;168(10):1050-6. doi: 10.1176/appi.ajp.2011.11010163. Epub 2011 Jul 18. PY - 2011 SN - 0002-953X (Print) 0002-953x SP - 1050-6 ST - Treatment of suicide attempters with bipolar disorder: a randomized clinical trial comparing lithium and valproate in the prevention of suicidal behavior T2 - Am J Psychiatry TI - Treatment of suicide attempters with bipolar disorder: a randomized clinical trial comparing lithium and valproate in the prevention of suicidal behavior VL - 168 ID - 268 ER - TY - JOUR AB - During the last decade, the problem of suicide has become more serious in individuals with depression. Repetitive transcranial magnetic stimulation (rTMS) is an effective treatment for major depressive disorder (MDD). This study aims to investigate the efficacy of magnetic resonance imaging (MRI)-based neuronavigation-guided daily high-dose rTMS for rapidly improving suicidal ideation in treatment-naive patients with MDD. In the present 1-week double-blind study, 42 treatment-naive patients with MDD with suicidal ideation were randomly assigned to the treatment of escitalopram oxalate tablets (10 mg/d) in combination with either active (n = 21) or sham (n = 21) rTMS. The TMS coil was positioned over a specified target location (-44, 40, and 29) in left dorsolateral prefrontal cortex based on MRI data. The severity of suicidal ideation was measured by the Beck Scale for Suicide Ideation (BSI). The 24-item Hamilton Depression Rating Scale (HAMD-24) and Montgomery-Åsberg Depression Rating Scale (MADRS) were utilized to assess the severity of depression. The Wisconsin Card Sorting Test, Continuous Performance Test, and Stroop Color-Word Test were adopted to assess executive function. In contrast to the sham group, the active rTMS group showed a significantly greater BSI score reduction at the third day and the seventh day (P < 0.001). Moreover, the active rTMS group showed a significantly greater HAMD (P < 0.001) and MADRS (P < 0.001) score reduction at the seventh day in comparison to the sham group. The present findings suggested that the neuronavigation-guided high-dose rTMS may be a novel method to rapidly reduce suicidal ideation and mitigate depressive symptoms. AU - Pan, Fen AU - Shen, Zhe AU - Jiao, JianPing AU - Chen, Jinkai AU - Li, Shangda AU - Lu, Jing AU - Duan, Jinfeng AU - Wei, Ning AU - Shang, Desheng AU - Hu, Shaohua AU - Xu, Yi AU - Huang, Manli DA - 2020/10//undefined DO - 10.1002/cpt.1858 IS - 4 J2 - Clin Pharmacol Ther KW - *Suicidal Ideation China Adolescent Adult Female Humans Male Young Adult Treatment Outcome Combined Modality Therapy Predictive Value of Tests *Magnetic Resonance Imaging Double-Blind Method Neuropsychological Tests Depressive Disorder, Major/diagnosis/psychology/*therapy *Neuronavigation/adverse effects *Transcranial Direct Current Stimulation/adverse effects Antidepressive Agents, Second-Generation/therapeutic use Citalopram/therapeutic use Feasibility Studies Prefrontal Cortex/diagnostic imaging/*physiopathology LA - eng PY - 2020 SN - 1532-6535 0009-9236 SP - 826-832 ST - Neuronavigation-Guided rTMS for the Treatment of Depressive Patients With Suicidal Ideation: A Double-Blind, Randomized, Sham-Controlled Trial T2 - Clinical pharmacology and therapeutics TI - Neuronavigation-Guided rTMS for the Treatment of Depressive Patients With Suicidal Ideation: A Double-Blind, Randomized, Sham-Controlled Trial VL - 108 ID - 1888 ER - TY - JOUR AB - OBJECTIVE: College counseling centers (CCCs) are increasingly being called upon to treat highly distressed students with complex clinical presentations. This study compared the effectiveness of Dialectical Behavior Therapy (DBT) for suicidal college students with an optimized control condition and analyzed baseline global functioning as a moderator. METHOD: The intent-to-treat (ITT) sample included 63 college students between the ages of 18 and 25 years who were suicidal at baseline, reported at least 1 lifetime nonsuicidal self-injurious (NSSI) act or suicide attempt, and met 3 or more borderline personality disorder (BPD) diagnostic criteria. Participants were randomly assigned to DBT (n = 31) or an optimized treatment-as-usual (O-TAU) control condition (n = 32). Treatment was provided by trainees, supervised by experts in both treatments. Both treatments lasted 7-12 months and included both individual and group components. Assessments were conducted at pretreatment, 3 months, 6 months, 9 months, 12 months, and 18 months (follow-up). RESULTS: Mixed effects analyses (ITT sample) revealed that DBT, compared with the control condition, showed significantly greater decreases in suicidality, depression, number of NSSI events (if participant had self-injured), BPD criteria, and psychotropic medication use and significantly greater improvements in social adjustment. Most of these treatment effects were observed at follow-up. No treatment differences were found for treatment dropout. Moderation analyses showed that DBT was particularly effective for suicidal students who were lower functioning at pretreatment. CONCLUSIONS: DBT is an effective treatment for suicidal, multiproblem college students. Future research should examine the implementation of DBT in CCCs in a stepped care approach. AD - University of Nevada, Reno, NV, USA. pistorel@unr.edu AN - 22730955 AU - Pistorello, J. AU - Fruzzetti, A. E. AU - Maclane, C. AU - Gallop, R. AU - Iverson, K. M. C2 - PMC3514574 C6 - NIHMS396505 DA - Dec DO - 10.1037/a0029096 DP - NLM ET - 2012/06/27 IS - 6 KW - Adolescent Adult Behavior Therapy/*methods Borderline Personality Disorder/psychology/*therapy Female Humans Male Self-Injurious Behavior/psychology/*therapy Social Adjustment Students/*psychology Suicidal Ideation Suicide, Attempted/*psychology Treatment Outcome Universities LA - eng N1 - 1939-2117 Pistorello, Jacqueline Fruzzetti, Alan E Maclane, Chelsea Gallop, Robert Iverson, Katherine M R34 MH071904/MH/NIMH NIH HHS/United States R34MH071904/MH/NIMH NIH HHS/United States Journal Article Randomized Controlled Trial Research Support, N.I.H., Extramural J Consult Clin Psychol. 2012 Dec;80(6):982-94. doi: 10.1037/a0029096. Epub 2012 Jun 25. PY - 2012 SN - 0022-006X (Print) 0022-006x SP - 982-94 ST - Dialectical behavior therapy (DBT) applied to college students: a randomized clinical trial T2 - J Consult Clin Psychol TI - Dialectical behavior therapy (DBT) applied to college students: a randomized clinical trial VL - 80 ID - 2672 ER - TY - JOUR AU - Pistorello, Jacqueline AU - Jobes, David A. AU - Gallop, Robert AU - Compton, Scott N. AU - Locey, Nadia Samad AU - Au, Josephine S. AU - Noose, Samantha K. AU - Walloch, Joseph C. AU - Johnson, Jacquelyn AU - Young, Maria AU - Dickens, Yani AU - Chatham, Patricia AU - Jeffcoat, Tami DA - 2020/04/10/ DO - 10.1080/13811118.2020.1749742 J2 - null PY - 2020 SN - 1381-1118 SP - 1-25 ST - A Randomized Controlled Trial of the Collaborative Assessment and Management of Suicidality (CAMS) Versus Treatment as Usual (TAU) for Suicidal College Students T2 - Archives of Suicide Research TI - A Randomized Controlled Trial of the Collaborative Assessment and Management of Suicidality (CAMS) Versus Treatment as Usual (TAU) for Suicidal College Students UR - https://doi.org/10.1080/13811118.2020.1749742 ID - 1922 ER - TY - JOUR AB - BACKGROUND: Young people with early psychosis are at particularly high risk of suicide. However, there is evidence that early intervention can reduce this risk. Despite these advances, first episode psychosis patients attending these new services still remain at risk. To address this concern, a program called LifeSPAN was established within the Early Psychosis Prevention and Intervention Centre (EPPIC). The program developed and evaluated a number of suicide prevention strategies within EPPIC and included a cognitively oriented therapy (LifeSPAN therapy) for acutely suicidal patients with psychosis. We describe the development of these interventions in this paper. METHOD: Clinical audit and surveys provided an indication of the prevalence of suicidality among first episode psychosis patients attending EPPIC. Second, staff focus groups and surveys identified gaps in service provision for suicidal young people attending the service. Third, a suicide risk monitoring system was introduced to identify those at highest risk. Finally, patients so identified were referred to and offered LifeSPAN therapy whose effectiveness was evaluated in a randomised controlled trial. RESULTS: Fifty-six suicidal patients with first episode psychosis were randomly assigned to standard clinical care or standard care plus LifeSPAN therapy. Forty-two patients completed the intervention. Clinical ratings and measures of suicidality and risk were assessed before, immediately after the intervention, and 6 months later. Benefits were noted in the treatment group on indirect measures of suicidality, e.g., hopelessness. The treatment group showed a greater average improvement (though not significant) on a measure of suicide ideation. CONCLUSIONS: Early intervention in psychosis for young people reduces the risk of suicide. Augmenting early intervention with a suicide preventative therapy may further reduce this risk. AD - Department of Psychiatry, Lambeth Early Onset service, South London & Maudsley NHS Trust, 108 Landor Road, London SW9 9NT, UK. Paddy.Power@slam.nhs.uk AN - 12873325 AU - Power, P. J. AU - Bell, R. J. AU - Mills, R. AU - Herrman-Doig, T. AU - Davern, M. AU - Henry, L. AU - Yuen, H. P. AU - Khademy-Deljo, A. AU - McGorry, P. D. DA - Aug DO - 10.1046/j.1440-1614.2003.01209.x DP - NLM ET - 2003/07/23 IS - 4 KW - Acute Disease Adolescent Adult Australia Cognitive Behavioral Therapy/*methods Follow-Up Studies Humans *Program Development Psychiatric Status Rating Scales Psychotic Disorders/complications/*psychology/*therapy Suicide/*prevention & control Time Factors Treatment Outcome LA - eng N1 - Power, P J R Bell, R J Mills, R Herrman-Doig, T Davern, M Henry, L Yuen, H P Khademy-Deljo, A McGorry, P D Clinical Trial Journal Article Randomized Controlled Trial Research Support, Non-U.S. Gov't England Aust N Z J Psychiatry. 2003 Aug;37(4):414-20. doi: 10.1046/j.1440-1614.2003.01209.x. PY - 2003 SN - 0004-8674 (Print) 0004-8674 SP - 414-20 ST - Suicide prevention in first episode psychosis: the development of a randomised controlled trial of cognitive therapy for acutely suicidal patients with early psychosis T2 - Aust N Z J Psychiatry TI - Suicide prevention in first episode psychosis: the development of a randomised controlled trial of cognitive therapy for acutely suicidal patients with early psychosis VL - 37 ID - 2673 ER - TY - JOUR AB - BACKGROUND: Prisoners have an exceptional risk of suicide. Cognitive-behavioural therapy for suicidal behaviour has been shown to offer considerable potential, but has yet to be formally evaluated within prisons. This study investigated the feasibility of delivering and evaluating a novel, manualized cognitive-behavioural suicide prevention (CBSP) therapy for suicidal male prisoners. METHOD: A pilot randomized controlled trial of CBSP in addition to treatment as usual (CBSP; n = 31) compared with treatment as usual (TAU; n = 31) alone was conducted in a male prison in England. The primary outcome was self-injurious behaviour occurring within the past 6 months. Secondary outcomes were dimensions of suicidal ideation, psychiatric symptomatology, personality dysfunction and psychological determinants of suicide, including depression and hopelessness. The trial was prospectively registered (number ISRCTN59909209). RESULTS: Relative to TAU, participants receiving CBSP therapy achieved a significantly greater reduction in suicidal behaviours with a moderate treatment effect [Cohen's d = -0.72, 95% confidence interval -1.71 to 0.09; baseline mean TAU: 1.39 (S.D. = 3.28) v. CBSP: 1.06 (S.D. = 2.10), 6 months mean TAU: 1.48 (S.D. = 3.23) v. CBSP: 0.58 (S.D. = 1.52)]. Significant improvements were achieved on measures of psychiatric symptomatology and personality dysfunction. Improvements on psychological determinants of suicide were non-significant. More than half of the participants in the CBSP group achieved a clinically significant recovery by the end of therapy, compared with a quarter of the TAU group. CONCLUSIONS: The delivery and evaluation of CBSP therapy within a prison is feasible. CBSP therapy offers significant promise in the prevention of prison suicide and an adequately powered randomized controlled trial is warranted. AD - School of Psychological Sciences,University of Manchester,Manchester,UK. Department of Psychology,Institute of Psychiatry,King's College London,London,UK. Institute of Population Health,University of Manchester,Manchester,UK. Institute of Brain,Behaviour and Mental Health,University of Manchester,Manchester,UK. AN - 26165919 AU - Pratt, D. AU - Tarrier, N. AU - Dunn, G. AU - Awenat, Y. AU - Shaw, J. AU - Ulph, F. AU - Gooding, P. C2 - PMC4682193 C6 - EMS66273 DA - Dec DO - 10.1017/s0033291715001348 DP - NLM ET - 2015/07/15 IS - 16 KW - Adult Affect Attention Cognition Cognitive Behavioral Therapy/*methods Depression/*therapy England Humans Male Middle Aged *Patient Compliance Pilot Projects Prisoners/*psychology Problem Solving Psychiatric Status Rating Scales Self Concept Self Report Suicide/*prevention & control Treatment Outcome Young Adult Cognitive therapy prison randomized controlled trials suicide prevention LA - eng N1 - 1469-8978 Pratt, D Tarrier, N Dunn, G Awenat, Y Shaw, J Ulph, F Gooding, P PB-PG-0609-19126/Department of Health/United Kingdom Journal Article Randomized Controlled Trial Research Support, Non-U.S. Gov't Psychol Med. 2015 Dec;45(16):3441-51. doi: 10.1017/S0033291715001348. Epub 2015 Jul 13. PY - 2015 SN - 0033-2917 (Print) 0033-2917 SP - 3441-51 ST - Cognitive-behavioural suicide prevention for male prisoners: a pilot randomized controlled trial T2 - Psychol Med TI - Cognitive-behavioural suicide prevention for male prisoners: a pilot randomized controlled trial VL - 45 ID - 2674 ER - TY - JOUR AB - BACKGROUND: A primary goal of dialectical behaviour therapy (DBT) is to reduce self‐harm, but findings from empirical studies are inconclusive. The aim of this study was to assess the effectiveness and cost‐effectiveness of DBT in reducing self‐harm in patients with personality disorder. METHODS: Participants with a personality disorder and at least 5 days of self‐harm in the previous year were randomised to receive 12 months of either DBT or treatment as usual (TAU). The primary outcome was the frequency of days with self‐harm; secondary outcomes included borderline personality disorder symptoms, general psychiatric symptoms, subjective quality of life, and costs of care. RESULTS: Forty patients each were randomised to DBT and TAU. In an intention‐to‐treat analysis, there was a statistically significant treatment by time interaction for self‐harm (incidence rate ratio 0.91, 95% CI 0.89‐0.92, p < 0.001). For every 2 months spent in DBT, the risk of self‐harm decreased by 9% relative to TAU. There was no evidence of differences on any secondary outcomes. The economic analysis revealed a total cost of a mean of 5,685 GBP (6,786 EUR) in DBT compared to a mean of 3,754 GBP (4,481 EUR) in TAU, but the difference was not significant (95% CI ‐603 to 4,599 GBP). Forty‐eight per cent of patients completed DBT. They had a greater reduction in self‐harm compared to dropouts (incidence rate ratio 0.78, 95% CI 0.76‐0.80, p < 0.001). CONCLUSIONS: DBT can be effective in reducing self‐harm in patients with personality disorder, possibly incurring higher total treatment costs. The effect is stronger in those who complete treatment. Future research should explore how to improve treatment adherence. AN - CN-00852756 AU - Priebe, S. AU - Bhatti, N. AU - Barnicot, K. AU - Bremner, S. AU - Gaglia, A. AU - Katsakou, C. AU - Molosankwe, I. AU - McCrone, P. AU - Zinkler, M. DO - 10.1159/000338897 IS - 6 KW - Adult Behavior Therapy [economics, methods] Borderline Personality Disorder [complications, therapy] Costs and Cost Analysis Cost‐Benefit Analysis Female Humans Male Personality Disorders [complications, *therapy] Self‐Injurious Behavior [complications, *therapy] Treatment Outcome M3 - Journal Article; Randomized Controlled Trial; Research Support, Non‐U.S. Gov't PY - 2012 SP - 356‐365 ST - Effectiveness and cost-effectiveness of dialectical behaviour therapy for self-harming patients with personality disorder: a pragmatic randomised controlled trial T2 - Psychotherapy and psychosomatics TI - Effectiveness and cost-effectiveness of dialectical behaviour therapy for self-harming patients with personality disorder: a pragmatic randomised controlled trial UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00852756/full VL - 81 ID - 650 ER - TY - JOUR AB - Despite evidence for its efficacy, diagnosis-specific psychoeducation is not routinely applied. This exploratory randomized controlled trial analyses the efficacy of an easily implementable bifocal diagnosis-mixed group psychoeducation in the treatment of severe psychiatric disorders regarding readmission, compliance and clinical variables, for example global functioning. Inpatients of the Psychiatric Hospital of the University of Basel (N = 82) were randomly assigned to a diagnosis-mixed psychoeducational (PE) or a non-specific intervention control group. Relatives were invited to join corresponding family groups. Results at baseline, 3- and 12-month follow-ups are presented. Better compliance after 3 months and a lower suicide rate were significant in favour of PE. For most other outcome variables, no significant differences, however advantages, in PE were found. In summary, it can be concluded that diagnosis-mixed group psychoeducation is effective in the treatment of severe psychiatric disorders. The effects can be classified as induced by distinctive psychoeducational elements. Findings similar to those on psychosis-specific programmes justify clinical application and further investigation. AD - Psychiatric Hospital of the University of Basel, Switzerland. kristin.rabovsky@upkbs.ch AN - 22290638 AU - Rabovsky, K. AU - Trombini, M. AU - Allemann, D. AU - Stoppe, G. DA - Aug DO - 10.1007/s00406-012-0291-1 DP - NLM ET - 2012/02/01 IS - 5 KW - Adult Analysis of Variance Double-Blind Method Female Follow-Up Studies Hospitalization/statistics & numerical data Humans Male Mental Disorders/diagnosis/*psychology/*rehabilitation Middle Aged Patient Compliance Psychiatric Status Rating Scales Psychotherapy, Group/*methods Quality of Life Retrospective Studies Treatment Outcome LA - eng N1 - 1433-8491 Rabovsky, K Trombini, M Allemann, D Stoppe, G Journal Article Randomized Controlled Trial Research Support, Non-U.S. Gov't Germany Eur Arch Psychiatry Clin Neurosci. 2012 Aug;262(5):431-40. doi: 10.1007/s00406-012-0291-1. PY - 2012 SN - 0940-1334 SP - 431-40 ST - Efficacy of bifocal diagnosis-independent group psychoeducation in severe psychiatric disorders: results from a randomized controlled trial T2 - Eur Arch Psychiatry Clin Neurosci TI - Efficacy of bifocal diagnosis-independent group psychoeducation in severe psychiatric disorders: results from a randomized controlled trial VL - 262 ID - 305 ER - TY - JOUR AB - OBJECTIVE: The objective of the study was to find the efficacy of cognitive behaviour therapy (CBT) in the management of deliberate self-harm (DSH) patients. METHOD: The experimental group (n=20) was given 10 sessions of CBT. CBT included cognitive methods, behavioural methods, problem-solving skills training and behavioural counselling to significant others. The control group (n=20) was given routine medical treatment. Post-assessment was done for both groups at the end of 3 months. RESULTS: The analysis of pre-post-assessment revealed that only the experimental group showed significant improvement on all the variables, except on impulsivity. CONCLUSION: CBT was effective in the management of DSH patients. AD - Clinical Psychologist, Department of Clinical Psychology, Nimhans, Bangalore, India 560 029. antonyraj@hotmail.com AN - 11722314 AU - Raj, M. Aj AU - Kumaraiah, V. AU - Bhide, A. V. DA - Nov DO - 10.1034/j.1600-0447.2001.00075.x DP - NLM ET - 2001/11/28 IS - 5 KW - Adolescent Adult Anxiety Disorders/diagnosis/psychology/*therapy *Cognitive Behavioral Therapy Depressive Disorder/diagnosis/psychology/*therapy Female Humans India Male Middle Aged Suicide, Attempted/prevention & control/*psychology LA - eng N1 - Raj M, A J Kumaraiah, V Bhide, A V Clinical Trial Journal Article Randomized Controlled Trial United States Acta Psychiatr Scand. 2001 Nov;104(5):340-5. doi: 10.1034/j.1600-0447.2001.00075.x. PY - 2001 SN - 0001-690X (Print) 0001-690x SP - 340-5 ST - Cognitive-behavioural intervention in deliberate self-harm T2 - Acta Psychiatr Scand TI - Cognitive-behavioural intervention in deliberate self-harm VL - 104 ID - 513 ER - TY - JOUR AB - AIM: Suicide attempt, ideation and deliberate self-harm are common among adolescents. Limited evidence exists regarding interventions that can reduce risk; however, research indicates that maintaining contact with at-risk adults following discharge from services via letter or postcard can reduce risk. The aim of the study was to test a postcard intervention among people aged 15-24 who presented to mental health services but were not accepted, yet were at risk of suicide. METHODS: A randomized controlled trial of 3 years in duration was used. The intervention consisted of 12 postcards sent once a month for 12 months following presentation to the service. Key outcomes of interest were reduced rates of suicide attempt, suicidal ideation and deliberate self-harm, assessed at 12 and 18 months. RESULTS: Participants reported that they liked receiving the postcard and that they used the strategies recommended. However, no significant effect of the postcard intervention was found on suicide risk, although participants in both groups improved on measures of mental health over the course of the study. CONCLUSIONS: There remains a need for further research into youth-friendly interventions for young people at risk of suicide. AD - Orygen Youth Health Research Centre, Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia. jr@unimelb.edu.au.au AN - 22260366 AU - Robinson, J. AU - Yuen, H. P. AU - Gook, S. AU - Hughes, A. AU - Cosgrave, E. AU - Killackey, E. AU - Baker, K. AU - Jorm, A. AU - McGorry, P. AU - Yung, A. DA - May DO - 10.1111/j.1751-7893.2011.00334.x DP - NLM ET - 2012/01/21 IS - 2 KW - Adolescent Female Humans Male Patient Education as Topic/*methods/statistics & numerical data Patient Satisfaction/statistics & numerical data Self-Injurious Behavior/*prevention & control *Suicidal Ideation Suicide, Attempted/*prevention & control Young Adult LA - eng N1 - 1751-7893 Robinson, Jo Yuen, Hok Pan Gook, Sara Hughes, Alison Cosgrave, Elizabeth Killackey, Eoin Baker, Kathryn Jorm, Anthony McGorry, Patrick Yung, Alison Journal Article Randomized Controlled Trial Australia Early Interv Psychiatry. 2012 May;6(2):145-52. doi: 10.1111/j.1751-7893.2011.00334.x. Epub 2012 Jan 19. PY - 2012 SN - 1751-7885 SP - 145-52 ST - Can receipt of a regular postcard reduce suicide-related behaviour in young help seekers? A randomized controlled trial T2 - Early Interv Psychiatry TI - Can receipt of a regular postcard reduce suicide-related behaviour in young help seekers? A randomized controlled trial VL - 6 ID - 313 ER - TY - JOUR AB - OBJECTIVE: The authors evaluated the effectiveness of brief cognitive-behavioral therapy (CBT) for the prevention of suicide attempts in military personnel. METHOD: In a randomized controlled trial, active-duty Army soldiers at Fort Carson, Colo., who either attempted suicide or experienced suicidal ideation with intent, were randomly assigned to treatment as usual (N=76) or treatment as usual plus brief CBT (N=76). Assessment of incidence of suicide attempts during the follow-up period was conducted with the Suicide Attempt Self-Injury Interview. Inclusion criteria were the presence of suicidal ideation with intent to die during the past week and/or a suicide attempt within the past month. Soldiers were excluded if they had a medical or psychiatric condition that would prevent informed consent or participation in outpatient treatment, such as active psychosis or mania. To determine treatment efficacy with regard to incidence and time to suicide attempt, survival curve analyses were conducted. Differences in psychiatric symptoms were evaluated using longitudinal random-effects models. RESULTS: From baseline to the 24-month follow-up assessment, eight participants in brief CBT (13.8%) and 18 participants in treatment as usual (40.2%) made at least one suicide attempt (hazard ratio=0.38, 95% CI=0.16-0.87, number needed to treat=3.88), suggesting that soldiers in brief CBT were approximately 60% less likely to make a suicide attempt during follow-up than soldiers in treatment as usual. There were no between-group differences in severity of psychiatric symptoms. CONCLUSIONS: Brief CBT was effective in preventing follow-up suicide attempts among active-duty military service members with current suicidal ideation and/or a recent suicide attempt. AD - From the National Center for Veterans Studies, University of Memphis, Memphis; the National Center for Veterans Studies, University of Utah, Salt Lake City; Fort Carson, Colo.; and the University of Texas Health Science Center at San Antonio. AN - 25677353 AU - Rudd, M. D. AU - Bryan, C. J. AU - Wertenberger, E. G. AU - Peterson, A. L. AU - Young-McCaughan, S. AU - Mintz, J. AU - Williams, S. R. AU - Arne, K. A. AU - Breitbach, J. AU - Delano, K. AU - Wilkinson, E. AU - Bruce, T. O. DA - May DO - 10.1176/appi.ajp.2014.14070843 DP - NLM ET - 2015/02/14 IS - 5 KW - Adult Cognitive Behavioral Therapy/*methods Female Follow-Up Studies Humans Male Military Personnel/psychology Psychotherapy, Brief/*methods Suicidal Ideation Suicide, Attempted/*prevention & control/psychology Treatment Outcome LA - eng N1 - 1535-7228 Rudd, M David Bryan, Craig J Wertenberger, Evelyn G Peterson, Alan L Young-McCaughan, Stacey Mintz, Jim Williams, Sean R Arne, Kimberly A Breitbach, Jill Delano, Kenneth Wilkinson, Erin Bruce, Travis O Journal Article Randomized Controlled Trial Research Support, U.S. Gov't, Non-P.H.S. United States Am J Psychiatry. 2015 May;172(5):441-9. doi: 10.1176/appi.ajp.2014.14070843. Epub 2015 Feb 13. PY - 2015 SN - 0002-953x SP - 441-9 ST - Brief cognitive-behavioral therapy effects on post-treatment suicide attempts in a military sample: results of a randomized clinical trial with 2-year follow-up T2 - Am J Psychiatry TI - Brief cognitive-behavioral therapy effects on post-treatment suicide attempts in a military sample: results of a randomized clinical trial with 2-year follow-up VL - 172 ID - 87 ER - TY - JOUR AB - This study evaluated the effectiveness of a time-limited, outpatient intervention targeting suicidal young adults. Participants (N = 264) were randomly assigned to either the experimental treatment or the control condition (i.e., treatment as usual). In addition to intake assessments, participants completed follow-ups at 1, 6, 12, 18, and 24 months. Both treatment and control participants evidenced significant improvement across all outcome measures throughout the follow-up period. Reductions were reported in suicidal ideation and behavior, associated symptomatology, and experienced stress, along with marked improvement in self-appraised problem-solving ability. Results also indicated that the experimental treatment was more effective than treatment as usual at retaining the highest risk participants. Available data demonstrate the efficacy of a time-limited, outpatient intervention for suicidal young adults. Implications of current findings for intervention with and treatment of this population are discussed. AD - Texas A&M University Health Science Center College of Medicine, Temple 76508, USA. AN - 8907098 AU - Rudd, M. D. AU - Rajab, M. H. AU - Orman, D. T. AU - Joiner, T. AU - Stulman, D. A. AU - Dixon, W. DA - Feb DO - 10.1037//0022-006x.64.1.179 DP - NLM ET - 1996/02/01 IS - 1 KW - Adolescent Adult *Ambulatory Care Female Follow-Up Studies Humans Male Patient Admission Problem Solving Suicide/*prevention & control/psychology Treatment Outcome LA - eng N1 - Rudd, M D Rajab, M H Orman, D T Joiner, T Stulman, D A Dixon, W MH-48097/MH/NIMH NIH HHS/United States Clinical Trial Comparative Study Journal Article Randomized Controlled Trial Research Support, U.S. Gov't, P.H.S. United States J Consult Clin Psychol. 1996 Feb;64(1):179-90. doi: 10.1037//0022-006x.64.1.179. PY - 1996 SN - 0022-006X (Print) 0022-006x SP - 179-90 ST - Effectiveness of an outpatient intervention targeting suicidal young adults: preliminary results T2 - J Consult Clin Psychol TI - Effectiveness of an outpatient intervention targeting suicidal young adults: preliminary results VL - 64 ID - 219 ER - TY - JOUR AB - The aim of the present study was to assess the effect of initial level of psychiatric severity on treatment outcome in psychodynamic therapy and dialectical behavior therapy (DBT) for borderline personality disorder (BPD). It was hypothesized that DBT would lead to better outcome for patients with high psychiatric severity, whereas dynamic treatment would lead to better outcome for patients with lower psychiatric severity. Data from the 5th‐year follow‐up of the Stockholm City Council's and the Karolinska Institute's Psychotherapy Project were used in the present study. A total of 106 female patients diagnosed with BPD with at least 2 past suicide attempts were randomized into object‐relational psychotherapy (ORP; based on transference‐focused psychotherapy), DBT, and treatment as usual. Patients' baseline global severity index was used as a moderator. Global Assessment of Functioning (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition [American Psychiatric Association, 1994]) was used to examine outcome. There was a significant 3‐way interaction of Time x Treatment x Severity. Post hoc analyses suggested that patients with lower levels of severity had significantly better outcomes in object‐relational psychotherapy. For patients with higher severity, the 3 treatments resulted in similar outcomes in terms of level of functioning. Outcome of treatment for BPD might differ significantly for patients depending on their initial levels of overall psychiatric severity. If our findings are replicated for patients with low severity and supported for a high‐severity sample, psychiatric severity can be used as a low‐cost and effective tool to match patients with BPD to optimal treatments. (PsycINFO Database Record Copyright (c) 2018 APA, all rights reserved). AN - CN-01667430 AU - Sahin, Z. AU - Vinnars, B. AU - Gorman, B. S. AU - Wilczek, A. AU - Asberg, M. AU - Barber, J. P. DO - 10.1037/per0000276 IS - 5 KW - *behavior therapy *borderline state Adult Article Controlled study DSM‐IV Diagnosis Female Follow up Global Assessment of Functioning Human Major clinical study Post hoc analysis PsycINFO Randomized controlled trial Suicide attempt Transference M3 - Article PY - 2018 SP - 437‐446 ST - Clinical severity as a moderator of outcome in psychodynamic and dialectical behavior therapies for borderline personality disorder T2 - Personality disorders TI - Clinical severity as a moderator of outcome in psychodynamic and dialectical behavior therapies for borderline personality disorder UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-01667430/full VL - 9 ID - 651 ER - TY - JOUR AB - In a controlled trial, 20 patients at high risk of repeated suicide attempts were randomly allocated to either cognitive-behavioural problem solving or a 'treatment-as-usual' control condition. The group practising problem solving improved significantly more than controls on ratings of depression, hopelessness, suicidal ideation and target problems at the end of treatment and at follow-up of up to one year, and there was evidence of an effect on the rates of repetition over the six months after treatment. AD - University of Oxford Department of Psychiatry, Warneford Hospital. AN - 2289097 AU - Salkovskis, P. M. AU - Atha, C. AU - Storer, D. DA - Dec DO - 10.1192/bjp.157.6.871 DP - NLM ET - 1990/12/01 KW - Adolescent Adult Aged Antidepressive Agents/poisoning Cognitive Behavioral Therapy/*methods Drug Overdose/prevention & control/psychology Female Follow-Up Studies Humans Male Middle Aged Personality Inventory *Problem Solving Recurrence Suicide, Attempted/prevention & control/*psychology LA - eng N1 - Salkovskis, P M Atha, C Storer, D Clinical Trial Journal Article Randomized Controlled Trial Research Support, Non-U.S. Gov't England Br J Psychiatry. 1990 Dec;157:871-6. doi: 10.1192/bjp.157.6.871. PY - 1990 SN - 0007-1250 (Print) 0007-1250 SP - 871-6 ST - Cognitive-behavioural problem solving in the treatment of patients who repeatedly attempt suicide. A controlled trial T2 - Br J Psychiatry TI - Cognitive-behavioural problem solving in the treatment of patients who repeatedly attempt suicide. A controlled trial VL - 157 ID - 530 ER - TY - JOUR AB - BACKGROUND: Gatekeeper training aims to train people to recognize and identify those who are at risk for suicide and assist them in getting care. Applied Suicide Intervention Skills Training (ASIST), a form of gatekeeper training, has been implemented around the world without a controlled evaluation. We hypothesized that participants in 2 days of ASIST gatekeeper training would have increased knowledge and preparedness to help people with suicidal ideation in comparison to participants who received a 2-day Resilience Retreat that did not focus on suicide awareness and intervention skills (control condition). METHODS: First Nations on reserve people in Northwestern Manitoba, aged 16 years and older, were recruited and randomized to two arms of the study. Self-reported measures were collected at three time points-immediately pre-, immediately post-, and 6 months post intervention. The primary outcome was the Suicide Intervention Response Inventory, a validated scale that assesses the capacity for individuals to intervene with suicidal behavior. Secondary outcomes included self-reported preparedness measures and gatekeeper behaviors. RESULTS: In comparison with the Resilience Retreat (n = 24), ASIST training (n = 31) was not associated with a significant impact on all outcomes of the study based on intention-to-treat analysis. There was a trend toward an increase in suicidal ideation among those who participated in the ASIST in comparison to those who were in the Resilience Retreat. CONCLUSIONS: The lack of efficacy of ASIST in a First Nations on-reserve sample is concerning in the context of widespread policies in Canada on the use of gatekeeper training in suicide prevention. AD - Department of Psychiatry, University of Manitoba, Winnipeg, Canada; Department of Psychology, University of Manitoba, Winnipeg, Canada; Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada. AN - 23761133 AU - Sareen, J. AU - Isaak, C. AU - Bolton, S. L. AU - Enns, M. W. AU - Elias, B. AU - Deane, F. AU - Munro, G. AU - Stein, M. B. AU - Chateau, D. AU - Gould, M. AU - Katz, L. Y. DA - Oct DO - 10.1002/da.22141 DP - NLM ET - 2013/06/14 IS - 10 KW - Adolescent Adult Aged *American Native Continental Ancestry Group Analysis of Variance Female Health Education/*methods Health Knowledge, Attitudes, Practice Humans Male Manitoba Middle Aged Program Evaluation Regression Analysis Resilience, Psychological *Suicidal Ideation Suicide/*prevention & control/psychology Surveys and Questionnaires clinical trials depression ethnicity/race life events/stress suicide/self harm L1 - internal-pdf://3223884015/Sareen-2013-Gatekeeper training for suicide pr.pdf LA - eng N1 - 1520-6394 Sareen, Jitender Isaak, Corinne Bolton, Shay-Lee Enns, Murray W Elias, Brenda Deane, Frank Munro, Garry Stein, Murray B Chateau, Dan Gould, Madelyn Katz, Laurence Y 273657/Canadian Institutes of Health Research/Canada Comparative Study Journal Article Randomized Controlled Trial Research Support, Non-U.S. Gov't United States Depress Anxiety. 2013 Oct;30(10):1021-9. doi: 10.1002/da.22141. Epub 2013 Jun 12. PY - 2013 SN - 1091-4269 SP - 1021-9 ST - Gatekeeper training for suicide prevention in First Nations community members: a randomized controlled trial T2 - Depress Anxiety TI - Gatekeeper training for suicide prevention in First Nations community members: a randomized controlled trial UR - https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/da.22141?download=true VL - 30 ID - 55 ER - TY - JOUR AB - BACKGROUND: Up to 15% of patients with major depressive disorder (MDD) attempt suicide and up to 2% complete suicide. This was a post-hoc analysis aimed to evaluate the risk of suicide ideation and behavior associated with adjunctive pimavanserin treatment in adults with MDD. METHODS: CLARITY was a randomized, double-blind, placebo-controlled study in patients with MDD and an inadequate response to a selective serotonin reuptake inhibitor (SSRI) or serotonin-norepinephrine reuptake inhibitor (SNRI). For this post-hoc analysis, the primary endpoint was mean change from baseline for HAMD item 3 (suicide). The incidence of suicidal ideation or behavior was also assessed from the Columbia-Suicide Severity Rating Scale (C-SSRS) and reports of adverse events. RESULTS: During Stage 1, LS mean change for HAMD Item 3 was reduced from baseline at each week with pimavanserin with a significant difference between pimavanserin and placebo at Week 3 (p=0.012, effect size: 0.431). At any post-baseline assessment, suicidal ideation on the C-SSRS was reported in 28 (18.1%) of patients with placebo and 9 (17.3%) with pimavanserin during Stage 1 and in 7 (20.7%) with placebo and 4 (13.8%) with pimavanserin during Stage 2. No events of suicidal behavior were observed with either placebo or pimavanserin. LIMITATIONS: The post hoc nature, exclusion of patients with any history of suicide from the primary study, and the small number of patients who demonstrated evidence of suicidal ideation. CONCLUSIONS: Adjunctive pimavanserin was not associated with an increase in suicidal ideation in patients with MDD. Further study is needed to verify these results. AU - Shelton, Richard C. AU - Fava, Maurizio AU - Freeman, Marlene P. AU - Thase, Michael E. AU - Papakostas, George I. AU - Jha, Manish K. AU - Trivedi, Madhukar H. AU - Dirks, Bryan AU - Liu, Keith AU - Stankovic, Srdjan DA - 2020/12/01/ DO - 10.1016/j.jad.2020.08.051 J2 - J Affect Disord KW - *Suicidality Suicidal Ideation Depression Adult Humans *Depressive Disorder, Major/drug therapy *Major depressive disorder Double-Blind Method *Pimavanserin Piperidines/adverse effects Urea/analogs & derivatives LA - eng PY - 2020 SN - 1573-2517 0165-0327 SP - 478-485 ST - Effect of adjunctive pimavanserin on suicidal ideation in patients with major depression: Analysis of the CLARITY study T2 - Journal of affective disorders TI - Effect of adjunctive pimavanserin on suicidal ideation in patients with major depression: Analysis of the CLARITY study VL - 277 ID - 2064 ER - TY - JOUR AB - The aim of this study was to investigate the effectiveness of Individual Cognitive Behavior Therapy (ICBT) in treating patients with mood disorders with suicidal ideation. A total of 69 patients (48 females, 21 males) with the diagnoses above were randomly allocated to either the group of Treatment As Usual (TAU)+ICBT (n=33) or the TAU group (n=36). All participants completed the Beck Depression Inventory (BDI), Beck Scale for Suicide Ideation (BSS), Positive and Negative Suicide Ideation Inventory (PANSI), Beck Hopelessness Scale (BHS), and Depression Anxiety Stress Scale-21 (DASS-21). These questionnaires were administered at pre-treatment, midway through treatment (week 4), post-treatment (week 8), and at follow-ups after three months (week 20) and six months (week 32). Factorial ANOVA results showed that the TAU+ICBT patients improved significantly and at faster rate as compared to the TAU group, which showed improvement only from pre to mid treatment on DASS-D and BHS-T measures. The effect size (Cohen's d), for the TAU+ICBT group showed large effect (1.47) for depressive symptoms and suicidal ideation (1.00). These findings suggest that ICBT used in addition to the TAU, was effective in enhancing treatment outcome of patients with unipolar mood disorders as well as, reducing risk for suicide behavior. AD - Universiti Kebangsaan Malaysia Medical Centre, Malaysia; University of Queensland, Australia. University of Queensland, Australia; James Cook University, Singapore; Nanjing University, PR China. Universiti Kebangsaan Malaysia Medical Centre, Malaysia. Universiti Kebangsaan Malaysia, Malaysia. Electronic address: ponnusaami@ukm.edu.my. AN - 28463716 AU - Sinniah, A. AU - Oei, T. P. S. AU - Maniam, T. AU - Subramaniam, P. DA - Aug DO - 10.1016/j.psychres.2017.04.026 DP - NLM ET - 2017/05/04 KW - Adult Aged Cognitive Behavioral Therapy/*methods Depressive Disorder/epidemiology/*psychology/*therapy Female Follow-Up Studies Humans Malaysia/epidemiology Middle Aged Mood Disorders/epidemiology/*psychology/*therapy Psychiatric Status Rating Scales *Suicidal Ideation Treatment Outcome *icbt *Intervention *Mood disorders LA - eng N1 - 1872-7123 Sinniah, Aishvarya Oei, T P S Maniam, T Subramaniam, Ponnusamy Journal Article Randomized Controlled Trial Ireland Psychiatry Res. 2017 Aug;254:179-189. doi: 10.1016/j.psychres.2017.04.026. Epub 2017 Apr 18. PY - 2017 SN - 0165-1781 SP - 179-189 ST - Positive effects of Individual Cognitive Behavior Therapy for patients with unipolar mood disorders with suicidal ideation in Malaysia: A randomised controlled trial T2 - Psychiatry Res TI - Positive effects of Individual Cognitive Behavior Therapy for patients with unipolar mood disorders with suicidal ideation in Malaysia: A randomised controlled trial VL - 254 ID - 299 ER - TY - JOUR AB - Background Self-harm (SH) is among the strongest risk factors for eventual suicide death yet there are limited data on which interventions are most effective for treating SH in youth. Methods This single-blind, pilot randomized controlled trial examined brief cognitive behavioral therapy (BCBT) for suicide prevention vs. minimally-directive supportive psychotherapy in youth (aged 16–26) hospitalized following SH. Both therapies included 10 acute sessions over 15 weeks with three booster sessions occurring at three month intervals thereafter. The primary feasibility outcome was ≥70% retention at study endpoint. Efficacy measures, including repeat SH, were secondary outcomes. Results Twenty-four subjects were enrolled (12 per group) with one BCBT subject and two controls dropping out prior to the first therapy session. Five (45%) of the remaining BCBT subjects and seven (70%) control subjects completed all 10 acute therapy sessions. All subjects who completed five sessions went on to complete 10. There were significantly fewer instances of repeat SH in BCBT subjects (7 of 62 weeks of acute follow-up; 11%) compared to control subjects (24 of 79 weeks; 30%)(OR 0.34, 95%CI:0.13–0.92). Three subjects, all in the control condition, made a total of five suicide attempts during the study. Limitations This study had a modest sample size and retention rate. Conclusions This study failed to achieve its primary feasibility retention goal for BCBT. However, it did demonstrate that initial adherence to follow-up predicted study completion. Despite small numbers, it also found a significant reduction in repeat SH in the BCBT group, a finding which requires replication. AU - Sinyor, Mark AU - Williams, Marissa AU - Mitchell, Rachel AU - Zaheer, Rabia AU - Bryan, Craig J. AU - Schaffer, Ayal AU - Westreich, Neal AU - Ellis, Janet AU - Goldstein, Benjamin I. AU - Cheung, Amy H. AU - Selchen, Steven AU - Kiss, Alex AU - Tien, Homer DA - 2020/04/01/ DO - 10.1016/j.jad.2020.01.178 DP - ScienceDirect J2 - Journal of Affective Disorders KW - Suicide Cognitive behavioural therapy Non-suicidal self- injury Self-harm Suicide attempt Youth LA - en PY - 2020 SN - 0165-0327 SP - 686-694 ST - Cognitive behavioral therapy for suicide prevention in youth admitted to hospital following an episode of self-harm T2 - Journal of Affective Disorders TI - Cognitive behavioral therapy for suicide prevention in youth admitted to hospital following an episode of self-harm: A pilot randomized controlled trial UR - https://www.sciencedirect.com/science/article/pii/S0165032719327351 VL - 266 Y2 - 2021/09/28/18:35:47 ID - 2083 ER - TY - JOUR AB - BACKGROUND: Self‐harm by young people is occurring with increasing frequency. Conventional in‐patient and out‐patient treatment has yet to be proved efficacious. AIMS: To investigate the efficacy of a short cognitive‐behavioural therapy intervention with 90 adolescents and adults who had recently engaged in self‐harm. METHOD: Participants (aged 15‐35 years) were randomly assigned to treatment as usual plus the intervention, or treatment as usual only. Assessments were completed at baseline and at 3 months, 6 months and 9 months follow‐up. RESULTS: Patients who received cognitive‐behavioural therapy in addition to treatment as usual were found to have significantly greater reductions in self‐harm, suicidal cognitions and symptoms of depression and anxiety, and significantly greater improvements in self‐esteem and problem‐solving ability, compared with the control group. CONCLUSIONS: These findings extend the evidence that a time‐limited cognitive‐behavioural intervention is effective for patients with recurrent and chronic self‐harm. AN - CN-00638088 AU - Slee, N. AU - Garnefski, N. AU - van der Leeden, R. AU - Arensman, E. AU - Spinhoven, P. DO - 10.1192/bjp.bp.107.037564 IS - 3 KW - Adolescent Adult Anxiety [therapy] Cognitive Behavioral Therapy [*methods] Depression [therapy] Female Follow‐Up Studies Health Services [statistics & numerical data] Humans Male Patient Acceptance of Health Care [statistics & numerical data] Problem Solving Psychiatric Status Rating Scales Psychometrics Self Concept Self‐Injurious Behavior [psychology, *therapy] Treatment Outcome M3 - Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non‐U.S. Gov't PY - 2008 SP - 202‐211 ST - Cognitive-behavioural intervention for self-harm: randomised controlled trial T2 - British journal of psychiatry TI - Cognitive-behavioural intervention for self-harm: randomised controlled trial UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00638088/full VL - 192 ID - 652 ER - TY - JOUR AB - Cognitive behavior therapy (CBT), problem-solving therapy (PST), or treatment as usual (TAU) were compared in the management of suicide attempters. Participants completed the Beck Hopelessness Scale, Beck Scale for Suicidal Ideation, Social Problem-Solving Inventory, and Client Satisfaction Questionnaire at pre- and posttreatment. Both CBT and PST indicated significant improvements over time within the majority of measured variables; when compared to TAU, both groups showed significant differences on satisfaction. When PST was compared to TAU, results indicated significant differences on suicidal ideation, indicating overall efficacy of brief therapies with suicide attempters. AD - University of Southern Queensland, Mental Health Service, Acute Care Team, Adult Mental Health, 100 Sixth Avenue, Maroochydore, QLD 4558, Australia. carmiedee@hotmail.com AN - 19929153 AU - Stewart, C. D. AU - Quinn, A. AU - Plever, S. AU - Emmerson, B. DA - Oct DO - 10.1521/suli.2009.39.5.538 DP - NLM ET - 2009/11/26 IS - 5 KW - Adult Australia *Cognitive Behavioral Therapy Female Follow-Up Studies Humans Male Middle Aged Problem Solving Psychiatric Status Rating Scales Psychotherapy/*methods Risk Risk Factors Self-Injurious Behavior/psychology/*therapy *Suicide, Attempted/psychology Surveys and Questionnaires Time Factors Young Adult LA - eng N1 - 1943-278x Stewart, Carment D Quinn, Andrea Plever, Sally Emmerson, Brett Comparative Study Journal Article England Suicide Life Threat Behav. 2009 Oct;39(5):538-47. doi: 10.1521/suli.2009.39.5.538. PY - 2009 SN - 0363-0234 SP - 538-47 ST - Comparing cognitive behavior therapy, problem solving therapy, and treatment as usual in a high risk population T2 - Suicide Life Threat Behav TI - Comparing cognitive behavior therapy, problem solving therapy, and treatment as usual in a high risk population VL - 39 ID - 170 ER - TY - JOUR AB - The results of a trial of cognitive behaviour therapy, supportive counselling and treatment as usual in recent onset schizophrenia on suicide behaviour are reported. Treatment was delivered over a five week period during hospitalisation for an acute episode. Participants were assessed at baseline, 6 weeks, 3 and 18 months. Over the 18 months there were 3 definite suicides and 2 deaths by accidental causes. The rates of moderate to severe suicidal behaviour were 13% at admission, 4% at six weeks, 1.5% at three months and 6% at 18 months. There were no beneficial or adverse effects of psychological treatment on suicide behaviour that reduced significantly with clinical recovery. There is a general picture of those who suffer persistently higher levels of psychotic symptoms, poorer functioning, depression and low self-esteem have higher severity of suicide behaviour, although the numbers with clinically significant suicide behaviour are low. CBT may need to be modified to directly target suicide behaviour and its antecedents to significantly reduce risk; recommendations on this are made. AD - Division of Clinical Psychology, School of Psychological Sciences, University of Manchester, UK. nicholas.tarrier@manchester.ac.uk AN - 16460916 AU - Tarrier, N. AU - Haddock, G. AU - Lewis, S. AU - Drake, R. AU - Gregg, L. DA - Mar DO - 10.1016/j.schres.2005.12.846 DP - NLM ET - 2006/02/08 IS - 1 KW - Acute Disease Adolescent Adult Analysis of Variance *Cognitive Behavioral Therapy Female Follow-Up Studies Humans Male Middle Aged Randomized Controlled Trials as Topic Schizophrenia/*therapy Schizophrenic Psychology Self-Injurious Behavior/prevention & control/psychology Social Support Suicide/*prevention & control/statistics & numerical data LA - eng N1 - Tarrier, Nicholas Haddock, Gillian Lewis, Shon Drake, Richard Gregg, Lynsey SoCRATES Trial Group Comparative Study Journal Article Research Support, Non-U.S. Gov't Netherlands Schizophr Res. 2006 Mar;83(1):15-27. doi: 10.1016/j.schres.2005.12.846. Epub 2006 Feb 7. PY - 2006 SN - 0920-9964 (Print) 0920-9964 SP - 15-27 ST - Suicide behaviour over 18 months in recent onset schizophrenic patients: the effects of CBT T2 - Schizophr Res TI - Suicide behaviour over 18 months in recent onset schizophrenic patients: the effects of CBT VL - 83 ID - 171 ER - TY - JOUR AB - Recent findings have indicated that lithium treatment markedly reduces suicide risk in major affective disorders. To compare the effect of lithium with carbamazepine and amitriptyline, suicidal behavior was analyzed during the randomized prospective long-term MAP study (N = 378; duration 2.5 years). Of the nine suicides and five attempted suicides, none took place during lithium treatment. The findings support the view that lithium has a specific antisuicidal effect over and above its prophylactic benefit. AD - Department of Psychiatry, Freie Universität Berlin, Germany. AN - 8738314 AU - Thies-Flechtner, K. AU - Müller-Oerlinghausen, B. AU - Seibert, W. AU - Walther, A. AU - Greil, W. DA - May DO - 10.1055/s-2007-979553 DP - NLM ET - 1996/05/01 IS - 3 KW - Adolescent Adult Affective Disorders, Psychotic/*psychology Aged Amitriptyline/therapeutic use Antidepressive Agents, Tricyclic/therapeutic use Antimanic Agents/therapeutic use Carbamazepine/therapeutic use Central Nervous System Agents/therapeutic use Follow-Up Studies Humans Lithium/therapeutic use Middle Aged Prospective Studies Risk Suicide/*prevention & control LA - eng N1 - Thies-Flechtner, K Müller-Oerlinghausen, B Seibert, W Walther, A Greil, W Clinical Trial Comparative Study Journal Article Multicenter Study Randomized Controlled Trial Germany Pharmacopsychiatry. 1996 May;29(3):103-7. doi: 10.1055/s-2007-979553. PY - 1996 SN - 0176-3679 (Print) 0176-3679 SP - 103-7 ST - Effect of prophylactic treatment on suicide risk in patients with major affective disorders. Data from a randomized prospective trial T2 - Pharmacopsychiatry TI - Effect of prophylactic treatment on suicide risk in patients with major affective disorders. Data from a randomized prospective trial VL - 29 ID - 809 ER - TY - JOUR AB - No Abstract AN - CN-00213106 AU - Torhorst, A. AU - Moller, H. J. AU - Burk, F. AU - Kurz, A. AU - Wachtler, C. AU - Lauter, H. IS - 1 PY - 1987 SP - 53‐61 ST - The psychiatric management of parasuicide patients: a controlled clinical study comparing different strategies of outpatient treatment T2 - Crisis TI - The psychiatric management of parasuicide patients: a controlled clinical study comparing different strategies of outpatient treatment UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00213106/full VL - 8 ID - 655 ER - TY - JOUR AB - BACKGROUND: We carried out a large randomized trial of a brief form of cognitive therapy, manual‐assisted cognitive behaviour therapy (MACT) versus treatment as usual (TAU) for deliberate self‐harm. METHOD: Patients presenting with recurrent deliberate self‐harm in five centres were randomized to either MACT or (TAU) and followed up over 1 year. MACT patients received a booklet based on cognitive behaviour therapy (CBT) principles and were offered up to five plus two booster sessions of CBT from a therapist in the first 3 months of the study. Ratings of parasuicide risk, anxiety, depression, social functioning and global function, positive and negative thinking, and quality of life were measured at baseline and after 6 and 12 months. RESULTS: Four hundred and eighty patients were randomized. Sixty per cent of the MACT group had both the booklet and CBT sessions. There were seven suicides, five in the TAU group. The main outcome measure, the proportion of those repeating deliberate self‐harm in the 12 months of the study, showed no significant difference between those treated with MACT (39%) and treatment as usual (46%) (OR 0.78, 95% CI 0.53 to 1.14, P=0.20). CONCLUSION: Brief cognitive behaviour therapy is of limited efficacy in reducing self‐harm repetition, but the findings taken in conjunctin with the economic evaluation (Byford et al. 2003) indicate superiority of MACT over TAU in terms of cost and effectiveness combined. AN - CN-00457588 AU - Tyrer, P. AU - Thompson, S. AU - Schmidt, U. AU - Jones, V. AU - Knapp, M. AU - Davidson, K. AU - Catalan, J. AU - Airlie, J. AU - Baxter, S. AU - Byford, S. AU - et al. DO - 10.1017/s0033291703008171 IS - 6 KW - *automutilation/th [Therapy] *behavior therapy *cognitive therapy Adult Anxiety Article Clinical trial Cognitive Behavioral Therapy [*methods] Controlled clinical trial Controlled study Cost effectiveness analysis Depression Economic evaluation Female Follow up Follow‐Up Studies Human Humans Major clinical study Male Multicenter study Outcomes research Psychotherapist Quality of life Randomized controlled trial Recurrence Recurrent disease Self‐Injurious Behavior [psychology, *therapy] Social interaction Suicide Suicide attempt Suicide, Attempted [statistics & numerical data] Thinking M3 - Clinical Trial; Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non‐U.S. Gov't PY - 2003 SP - 969‐976 ST - Randomized controlled trial of brief cognitive behaviour therapy versus treatment as usual in recurrent deliberate self-harm: the POPMACT study T2 - Psychological medicine TI - Randomized controlled trial of brief cognitive behaviour therapy versus treatment as usual in recurrent deliberate self-harm: the POPMACT study UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00457588/full VL - 33 ID - 657 ER - TY - JOUR AB - A total of 480 patients were treated in a large, multicenter randomized trial of a brief form of cognitive therapy, manual-assisted cognitive behavior therapy (MACT) versus treatment as usual (TAU) for recurrent deliberate self-harm. Each patient was randomized after a self-harm episode assessed at an accident and emergency center and followed up over 1 year. The main hypothesis tested was that those allocated to MACT would have a lower proportion of self-harm episodes in the succeeding year. A total of 60% of those allocated to MACT had face-to-face treatment and 430 (90%) of all patients had self-harm data recorded after 1 year. Although the results showed no significant difference between those repeating self-harm in the MACT group (39%) compared with the TAU group (46%) (P = 0.20), the treatment was cost effective (10% cheaper than TAU) and the frequency of self-harm episodes was fewer (50%) in the MACT group. A total of nine of 10 patients had some personality disturbance (42% of these with disorder), and for those where information on parasuicide events was collected, the proportion having a repeat episode ranged from 33% to 63% for different personality disorders. Those with BPD were most likely to repeat episodes quickly (mean 89 days for 25% to repeat) with dissocial personality disorder (equivalent mean 384 days) the slowest to repeat. Total costs were significantly greater in those with personality disorder and were reduced in those allocated to MACT; this saving was reversed in those with borderline disorder. On average, MACT appeared to increase the cost of those patients with BPD (BPD) and reduce the cost of those with other personality disorders. It is concluded that MACT has value in preventing self-harm cost effectively but this appears to be confined mainly to those who do not have BPD. AD - Department of Psychological Medicine, Imperial College (Charing Cross Campus), Claybrook Center, London, UK. p.tyrer@imperial.ac.uk AN - 15061347 AU - Tyrer, P. AU - Tom, B. AU - Byford, S. AU - Schmidt, U. AU - Jones, V. AU - Davidson, K. AU - Knapp, M. AU - MacLeod, A. AU - Catalan, J. DA - Feb DO - 10.1521/pedi.18.1.102.32770 DP - NLM ET - 2004/04/06 IS - 1 KW - Adult *Bibliotherapy/methods *Cognitive Behavioral Therapy/methods England Female Humans Male Personality Disorders/prevention & control/*therapy Professional-Patient Relations Recurrence Self-Injurious Behavior/prevention & control/*therapy Suicide, Attempted/prevention & control Time Factors Treatment Outcome LA - eng N1 - Tyrer, Peter Tom, Brian Byford, Sarah Schmidt, Ulrike Jones, Vanessa Davidson, Kate Knapp, Martin MacLeod, Andrew Catalan, Jose POPMACT Group Clinical Trial Journal Article Multicenter Study Randomized Controlled Trial Research Support, Non-U.S. Gov't United States J Pers Disord. 2004 Feb;18(1):102-16. doi: 10.1521/pedi.18.1.102.32770. PY - 2004 SN - 0885-579X (Print) 0885-579x SP - 102-16 ST - Differential effects of manual assisted cognitive behavior therapy in the treatment of recurrent deliberate self-harm and personality disturbance: the POPMACT study T2 - J Pers Disord TI - Differential effects of manual assisted cognitive behavior therapy in the treatment of recurrent deliberate self-harm and personality disturbance: the POPMACT study VL - 18 ID - 545 ER - TY - JOUR AB - OBJECTIVES: To determine the effect of a primary care-based collaborative care program for depression on suicidal ideation in older adults. DESIGN: Randomized, controlled trial. SETTING: Eighteen diverse primary care clinics. PARTICIPANTS: One thousand eight hundred one adults aged 60 and older with major depression or dysthymia. INTERVENTION: Participants randomized to collaborative care had access to a depression care manager who supported antidepressant medication management prescribed by their primary care physician and offered a course of Problem Solving Treatment in Primary Care for 12 months. Participants in the control arm received care as usual. MEASUREMENTS: Participants had independent assessments of depression and suicidal ideation at baseline and 3, 6, 12, 18, and 24 months. Depression was assessed using the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (SCID). Suicidal ideation was determined using the SCID and the Hopkins Symptoms Checklist. RESULTS: At baseline, 139 (15.3%) intervention subjects and 119 (13.3%) controls reported thoughts of suicide. Intervention subjects had significantly lower rates of suicidal ideation than controls at 6 months (7.5% vs 12.1%) and 12 months (9.8% vs 15.5%) and even after intervention resources were no longer available at 18 months (8.0% vs 13.3%) and 24 months (10.1% vs 13.9%). There were no completed suicides in either group. Information on suicide attempts or hospitalization for suicidal ideation was not available. CONCLUSION: Primary care-based collaborative care programs for depression represent one strategy to reduce suicidal ideation and potentially the risk of suicide in older primary care patients. AD - Department of Psychiatry, School of Medicine, University of Washington, Seattle, Washington 98195, USA. unutzer@u.washington.edu AN - 17038073 AU - Unützer, J. AU - Tang, L. AU - Oishi, S. AU - Katon, W. AU - Williams, J. W., Jr. AU - Hunkeler, E. AU - Hendrie, H. AU - Lin, E. H. AU - Levine, S. AU - Grypma, L. AU - Steffens, D. C. AU - Fields, J. AU - Langston, C. DA - Oct DO - 10.1111/j.1532-5415.2006.00882.x DP - NLM ET - 2006/10/14 IS - 10 KW - Aged *Attitude to Death Cooperative Behavior Depressive Disorder/psychology/*therapy Female Follow-Up Studies Humans Male Primary Health Care/*methods *Psychological Techniques Suicide/*prevention & control/psychology Time Factors United States LA - eng N1 - Unützer, Jürgen Tang, Lingqi Oishi, Sabine Katon, Wayne Williams, John W Jr Hunkeler, Enid Hendrie, Hugh Lin, Elizabeth H B Levine, Stuart Grypma, Lydia Steffens, David C Fields, Julie Langston, Christopher IMPACT Investigators Journal Article Multicenter Study Randomized Controlled Trial Research Support, Non-U.S. Gov't United States J Am Geriatr Soc. 2006 Oct;54(10):1550-6. doi: 10.1111/j.1532-5415.2006.00882.x. PY - 2006 SN - 0002-8614 (Print) 0002-8614 SP - 1550-6 ST - Reducing suicidal ideation in depressed older primary care patients T2 - J Am Geriatr Soc TI - Reducing suicidal ideation in depressed older primary care patients VL - 54 ID - 172 ER - TY - JOUR AB - OBJECTIVE: To determine the effects over one year of contacting patients by telephone one month or three months after being discharged from an emergency department for deliberate self poisoning compared with usual treatment. DESIGN: Multicentre, randomised controlled trial. SETTING: 13 emergency departments in the north of France. PARTICIPANTS: 605 people discharged from an emergency department after attempted suicide by deliberate self poisoning. INTERVENTION: The intervention consisted of contacting patients by telephone at one month or three months after discharge from an emergency department for attempted suicide to evaluate the success of recommended treatment or to adjust treatment. Control patients received treatment as usual, in most cases referral back to their general practitioner. MAIN OUTCOME MEASURES: The primary outcome measures were proportion of participants who reattempted suicide, number of deaths by suicide, and losses to follow-up at 13 months' follow-up. Secondary outcome measures were types and number of contacts with health care. RESULTS: On an intention to treat basis, the three groups did not differ significantly for further suicide attempts, deaths by suicide, or losses to follow-up: contact at one month (intervention 23% (34/147) v controls 30% (93/312), difference 7%, 95% confidence interval - 2% to 15%), three months (25% (36/146) v 30%, difference 5%, - 4% to 14%). Participants contacted at one month were less likely at follow-up to report having reattempted suicide (12% v 22% in control group, difference 10%, 2% to 18%). CONCLUSION: Contacting people by telephone one month after being discharged from an emergency department for deliberate self poisoning may help reduce the number of reattempted suicides over one year. AD - University Hospital of Lille, School of Medicine, France. gvaiva@chru-lille.fr AN - 16735333 AU - Vaiva, G. AU - Vaiva, G. AU - Ducrocq, F. AU - Meyer, P. AU - Mathieu, D. AU - Philippe, A. AU - Libersa, C. AU - Goudemand, M. C2 - PMC1471935 DA - May 27 DO - 10.1136/bmj.332.7552.1241 DP - NLM ET - 2006/06/01 IS - 7552 KW - Adolescent Adult Aged Drug Overdose/prevention & control Emergency Service, Hospital/statistics & numerical data Humans Middle Aged Patient Acceptance of Health Care/statistics & numerical data Self-Injurious Behavior/prevention & control Suicide, Attempted/*prevention & control/statistics & numerical data *Telephone L1 - internal-pdf://3800858979/Vaiva-2006-Effect of telephone contact on furt.pdf LA - eng N1 - 1756-1833 Vaiva, Guillaume Ducrocq, François Meyer, Philippe Mathieu, Daniel Philippe, Alain Libersa, Christian Goudemand, Michel Comparative Study Journal Article Multicenter Study Randomized Controlled Trial Research Support, Non-U.S. Gov't BMJ. 2006 May 27;332(7552):1241-5. doi: 10.1136/bmj.332.7552.1241. PY - 2006 SN - 0959-8138 (Print) 0959-8138 SP - 1241-5 ST - Effect of telephone contact on further suicide attempts in patients discharged from an emergency department: randomised controlled study T2 - Bmj TI - Effect of telephone contact on further suicide attempts in patients discharged from an emergency department: randomised controlled study UR - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1471935/pdf/bmj33201241.pdf VL - 332 ID - 236 ER - TY - JOUR AB - Dialectical Behaviour Therapy (DBT) is considered one of the most promising treatments for borderline personality disorder (BPD). Recently, we reported significantly positive effects of 12 months DBT on parasuicidal behaviour and impulsivity in a mixed group of female BPD patients with and without substance abuse. Fifty-eight women with BPD were randomly assigned to either 52 weeks of DBT or treatment as usual (TAU). Follow-up assessment took place at 78 weeks, i.e., 6 months after discontinuation of DBT. Participants were clinical referrals from addiction treatment and psychiatric services. Outcome measures included parasuicidal behaviour, impulsivity and substance abuse. Six months after treatment discontinuation, the benefits of DBT over TAU in terms of lower levels of parasuicidal and impulsive behaviours, and in alcohol use, sustained. No differences between the treatment conditions were found for drug abuse. In conclusion, DBT seems to have a sustained effect on some of the core symptoms of BPD and on alcohol problems in a mixed population of female borderline patients with and without substance abuse problems. AD - Forensic Psychiatric Institute Oldenkotte, Kievenneweg 18, Rekken 7157 CC, The Netherlands. wiesvdbosch@planet.nl AN - 16005708 AU - van den Bosch, L. M. AU - Koeter, M. W. AU - Stijnen, T. AU - Verheul, R. AU - van den Brink, W. DA - Sep DO - 10.1016/j.brat.2004.09.008 DP - NLM ET - 2005/07/12 IS - 9 KW - Adolescent Adult Aged Alcohol Drinking/psychology Behavior Therapy/*methods Borderline Personality Disorder/psychology/*therapy Female Humans Impulsive Behavior/psychology Middle Aged Self Mutilation/psychology Substance-Related Disorders/psychology Suicide, Attempted/psychology Treatment Outcome LA - eng N1 - van den Bosch, Louisa M C Koeter, Maarten W J Stijnen, Theo Verheul, Roel van den Brink, Wim Journal Article Randomized Controlled Trial Research Support, Non-U.S. Gov't England Behav Res Ther. 2005 Sep;43(9):1231-41. doi: 10.1016/j.brat.2004.09.008. PY - 2005 SN - 0005-7967 (Print) 0005-7967 SP - 1231-41 ST - Sustained efficacy of dialectical behaviour therapy for borderline personality disorder T2 - Behav Res Ther TI - Sustained efficacy of dialectical behaviour therapy for borderline personality disorder VL - 43 ID - 222 ER - TY - JOUR AB - BACKGROUND: A randomised clinical trial was carried out in suicide attempters to assess clinical efficacy of an intensive psychosocial intervention compared with treatment as usual. METHOD: Two hundred and seventy‐four suicide attempters presenting for medical treatment were randomly assigned to either intensive psychosocial treatment or 'care as usual'. Intensive psychosocial treatment consisted of brief admission to a special crisis‐intervention unit and problem‐solving aftercare. 'Care as usual' included any form of treatment the assessing clinicians thought appropriate. Psychological well‐being was evaluated by the SCL‐90 and the Hopelessness Scale at 3, 6 and 12 months following entry in the study. RESULTS: No differences in outcome were found. The probability of repeat suicide attempts in the 12‐month follow‐up was 0.17 for patients in the experimental group and 0.15 for the control group. There were no differences in ratings on the SCL‐90 and the Hopelessness Scale. Patients in the experimental group attended significantly more out‐patient treatment sessions. CONCLUSIONS: General implementation of an intensive in‐patient and community intervention programme for suicide attempters does not seem justified. AN - CN-00144205 AU - van der Sande, R. AU - van Rooijen, L. AU - Buskens, E. AU - Allart, E. AU - Hawton, K. AU - van der Graaf, Y. AU - van Engeland, H. DO - 10.1192/bjp.171.1.35 KW - Adult Community Mental Health Services [statistics & numerical data] Female Follow‐Up Studies Hospitalization Humans Male Patient Acceptance of Health Care Psychotherapy [*methods] Recurrence Risk Factors Social Support Suicide, Attempted [*prevention & control] Treatment Outcome M3 - Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non‐U.S. Gov't PY - 1997 SP - 35‐41 ST - Intensive in-patient and community intervention versus routine care after attempted suicide. A randomised controlled intervention study T2 - British journal of psychiatry TI - Intensive in-patient and community intervention versus routine care after attempted suicide. A randomised controlled intervention study UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00144205/full VL - 171 ID - 660 ER - TY - JOUR AB - The failure to comply with referral for out-patient after-care is a well-documented problem among attempted suicide patients. The present study aimed at the investigation of an experimental referral procedure by means of a randomized controlled study. Non-compliant patients in the experimental group were visited in their homes by a community nurse in order to assess reasons for non-compliance and to motivate patients to comply with referral. One year after their suicide attempt patients were visited in their homes in order to assess repetition of suicidal behaviour. Uni- and multi-variate analyses showed a significant beneficial effect of the experimental procedure on compliance with referral. A near-significant effect of the experimental procedure on the rate of repetition of suicidal behaviour was found. AD - Department of Psychiatry, University Hospital Gent, Belgium. AN - 8588015 AU - Van Heeringen, C. AU - Jannes, S. AU - Buylaert, W. AU - Henderick, H. AU - De Bacquer, D. AU - Van Remoortel, J. DA - Sep DO - 10.1017/s0033291700037454 DP - NLM ET - 1995/09/01 IS - 5 KW - Adolescent Adult *Ambulatory Care Female Humans Male *Patient Compliance Recurrence *Referral and Consultation *Suicide, Attempted L1 - internal-pdf://2165845362/Van Heeringen-1995-The management of non-compl.pdf LA - eng N1 - Van Heeringen, C Jannes, S Buylaert, W Henderick, H De Bacquer, D Van Remoortel, J Clinical Trial Journal Article Randomized Controlled Trial England Psychol Med. 1995 Sep;25(5):963-70. doi: 10.1017/s0033291700037454. PY - 1995 SN - 0033-2917 (Print) 0033-2917 SP - 963-70 ST - The management of non-compliance with referral to out-patient after-care among attempted suicide patients: a controlled intervention study T2 - Psychol Med TI - The management of non-compliance with referral to out-patient after-care among attempted suicide patients: a controlled intervention study UR - https://www.cambridge.org/core/services/aop-cambridge-core/content/view/9547D4EA42C58AD63DA249CB988B864F/S0033291700037454a.pdf/div-class-title-the-management-of-non-compliance-with-referral-to-out-patient-after-care-among-attempted-suicide-patients-a-controlled-intervention-study-div.pdf VL - 25 ID - 237 ER - TY - JOUR AB - BACKGROUND: Suicidal ideation is highly prevalent, but often remains untreated. The Internet can be used to provide accessible interventions. OBJECTIVE: To evaluate the cost-effectiveness of an online, unguided, self-help intervention for reducing suicidal ideation. METHODS: A total of 236 adults with mild to moderate suicidal thoughts, defined as scores between 1-26 on the Beck Scale for Suicide Ideation (BSS), were recruited in the general population and randomized to the intervention (n = 116) or to a waitlist, information-only, control group (n = 120). The intervention aimed to decrease the frequency and intensity of suicidal ideation and consisted of 6 modules based on cognitive behavioral techniques. Participants in both groups had unrestricted access to care as usual. Assessments took place at baseline and 6 weeks later (post-test). All questionnaires were self-report and administered via the Internet. Treatment response was defined as a clinically significant decrease in suicidal ideation on the BSS. Total per-participant costs encompassed costs of health service uptake, participants' out-of-pocket expenses, costs stemming from production losses, and intervention costs. These were expressed in Euros (€) for the reference year 2009. RESULTS: At post-test, treatment response was 35.3% and 20.8% in the experimental and control conditions, respectively. The incremental effectiveness was 0.35 - 0.21 = 0.15 (SE 0.06, P = .01). The annualized incremental costs were -€5039 per participant. Therefore, the mean incremental cost-effectiveness ratio (ICER) was estimated to be -€5039/0.15 = -€34,727 after rounding (US -$41,325) for an additional treatment response, indicating annual cost savings per treatment responder. CONCLUSIONS: This is the first trial to indicate that online self-help to reduce suicidal ideation is feasible, effective, and cost saving. Limitations included reliance on self-report and a short timeframe (6 weeks). Therefore, replication with a longer follow-up period is recommended. AD - Department of Clinical Psychology and the EMGO+ Institute for Health and Care Research, Faculty of Psychology and Education, VU University Amsterdam, Amsterdam, Netherlands. baj.van.spijker@gmail.com AN - 23103835 AU - van Spijker, B. A. AU - Majo, M. C. AU - Smit, F. AU - van Straten, A. AU - Kerkhof, A. J. C2 - PMC3517339 DA - Oct 26 DO - 10.2196/jmir.1966 DP - NLM ET - 2012/10/30 IS - 5 KW - Adult *Cost-Benefit Analysis Female Humans *Internet Male Netherlands *Suicidal Ideation Surveys and Questionnaires LA - eng N1 - 1438-8871 van Spijker, Bregje A J Majo, M Cristina Smit, Filip van Straten, Annemieke Kerkhof, Ad J F M Journal Article Randomized Controlled Trial Research Support, Non-U.S. Gov't J Med Internet Res. 2012 Oct 26;14(5):e141. doi: 10.2196/jmir.1966. PY - 2012 SN - 1439-4456 (Print) 1438-8871 SP - e141 ST - Reducing suicidal ideation: cost-effectiveness analysis of a randomized controlled trial of unguided web-based self-help T2 - J Med Internet Res TI - Reducing suicidal ideation: cost-effectiveness analysis of a randomized controlled trial of unguided web-based self-help VL - 14 ID - 317 ER - TY - JOUR AB - BACKGROUND: Treatment for suicidality can be delivered online, but evidence for its effectiveness is needed. OBJECTIVE: The goal of our study was to examine the effectiveness of an online self-help intervention for suicidal thinking compared to an attention-matched control program. METHODS: A 2-arm randomized controlled trial was conducted with assessment at postintervention, 6, and, 12 months. Through media and community advertizing, 418 suicidal adults were recruited to an online portal and were delivered the intervention program (Living with Deadly Thoughts) or a control program (Living Well). The primary outcome was severity of suicidal thinking, assessed using the Columbia Suicide Severity Rating Scale. RESULTS: Intention-to-treat analyses showed significant reductions in the severity of suicidal thinking at postintervention, 6, and 12 months. However, no overall group differences were found. CONCLUSIONS: Living with Deadly Thoughts was of no greater effectiveness than the control group. Further investigation into the conditions under which this program may be beneficial is now needed. Limitations of this trial include it being underpowered given the effect size ultimately observed, a high attrition rate, and the inability of determining suicide deaths or of verifying self-reported suicide attempts. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12613000410752; https://www.anzctr.org.au/ Trial/Registration/TrialReview.aspx?id=364016 (Archived by WebCite at http://www.webcitation.org/6vK5FvQXy); Universal Trial Number U1111-1141-6595. AD - Centre for Mental Health Research, Australian National University, Canberra, Australia. Black Dog Institute, Department of Medicine, University of New South Wales, Randwick, Australia. EMGO Institute for Health Care Research, VU University Amsterdam, Amsterdam, Netherlands. Department of Clinical Neuro and Developmental Psychology, VU University Amsterdam, Amsterdam, Netherlands. AN - 29444769 AU - van Spijker, B. A. AU - Werner-Seidler, A. AU - Batterham, P. J. AU - Mackinnon, A. AU - Calear, A. L. AU - Gosling, J. A. AU - Reynolds, J. AU - Kerkhof, A. J. AU - Solomon, D. AU - Shand, F. AU - Christensen, H. C2 - PMC5830610 DA - Feb 14 DO - 10.2196/jmir.8595 DP - NLM ET - 2018/02/16 IS - 2 KW - Adolescent Adult Aged Australia Female Humans Internet/*standards Male Middle Aged Self-Help Groups/*standards *Suicidal Ideation Young Adult *psychosocial interventions *randomized controlled trial *suicide described in this manuscript. BAJvS and AJFMK are also authors of and receive royalties from an adapted paper version of the self-help program published under the title Piekeren Over Zelfdoding [38]. BAJvS, AJFMK, and HC are authors of the English translation of the Web-based program described in this manuscript. LA - eng N1 - 1438-8871 van Spijker, Bregje Aj Orcid: 0000-0002-8124-2559 Werner-Seidler, Aliza Orcid: 0000-0002-9046-6159 Batterham, Philip J Orcid: 0000-0002-4547-6876 Mackinnon, Andrew Orcid: 0000-0003-0831-9801 Calear, Alison L Orcid: 0000-0002-7028-725x Gosling, John A Orcid: 0000-0003-4831-0190 Reynolds, Julia Orcid: 0000-0001-9910-0455 Kerkhof, Ad Jfm Orcid: 0000-0003-1701-5332 Solomon, Daniela Orcid: 0000-0003-2360-1645 Shand, Fiona Orcid: 0000-0001-6765-228x Christensen, Helen Orcid: 0000-0003-0435-2065 Journal Article Randomized Controlled Trial Research Support, Non-U.S. Gov't J Med Internet Res. 2018 Feb 14;20(2):e15. doi: 10.2196/jmir.8595. PY - 2018 SN - 1439-4456 (Print) 1438-8871 SP - e15 ST - Effectiveness of a Web-Based Self-Help Program for Suicidal Thinking in an Australian Community Sample: Randomized Controlled Trial T2 - J Med Internet Res TI - Effectiveness of a Web-Based Self-Help Program for Suicidal Thinking in an Australian Community Sample: Randomized Controlled Trial VL - 20 ID - 319 ER - TY - JOUR AB - Background Many people with suicidal thoughts do not receive treatment. The Internet can be used to reach more people in need of support. Objective To test the effectiveness of unguided online self-help to reduce suicidal thoughts. Method 236 adults with mild to moderate suicidal thoughts were randomised to the intervention (n = 116) or a waitlist control group (n = 120). Assessments took place at baseline, and 2, 4 and 6 weeks later. Primary outcome was suicidal thoughts. Secondary outcomes were depressive symptoms, anxiety, hopelessness, worry, and health status. Results The intervention group showed a small significant effect in reducing suicidal thoughts (d = 0.28). Effects were more pronounced for those with a history of repeated suicide attempts. There was also a significant reduction in worry (d = 0.33). All other secondary outcomes showed small but non-significant improvements. Conclusions Although effect sizes were small, the reach of the internet could enable this intervention to help many people reduce their suicidal thoughts. Trial Registration Netherlands Trial Register NTR1689 AU - van Spijker, Bregje A. J. AU - van Straten, Annemieke AU - Kerkhof, Ad J. F. M. DO - 10.1371/journal.pone.0090118 IS - 2 PY - 2014 SP - e90118 ST - Effectiveness of Online Self-Help for Suicidal Thoughts: Results of a Randomised Controlled Trial T2 - PLOS ONE TI - Effectiveness of Online Self-Help for Suicidal Thoughts: Results of a Randomised Controlled Trial UR - https://doi.org/10.1371/journal.pone.0090118 VL - 9 ID - 490 ER - TY - JOUR AB - BACKGROUND: Dialectical behaviour therapy (DBT) is widely considered to be a promising treatment for borderline personality disorder (BPD). However, the evidence for its efficacy published thus far should be regarded as preliminary. AIMS: To compare the effectiveness of DBT with treatment as usual for patients with BPD and to examine the impact of baseline severity on effectiveness. METHOD: Fifty-eight women with BPD were randomly assigned to either 12 months of DBT or usual treatment in a randomised controlled study. Participants were recruited through clinical referrals from both addiction treatment and psychiatric services. Outcome measures included treatment retention and the course of suicidal, self-mutilating and self-damaging impulsive behaviours. RESULTS: Dialectical behaviour therapy resulted in better retention rates and greater reductions of self-mutilating and self-damaging impulsive behaviours compared with usual treatment, especially among those with a history of frequent self-mutilation. CONCLUSIONS: Dialectical behaviour therapy is superior to usual treatment in reducing high-risk behaviours in patients with BPD. AD - DeViersprong Center of Psychotherapy, University of Amsterdam, Halsteren, The Netherlands. roel.verheul@deviersprong.net AN - 12562741 AU - Verheul, R. AU - Van Den Bosch, L. M. AU - Koeter, M. W. AU - De Ridder, M. A. AU - Stijnen, T. AU - Van Den Brink, W. DA - Feb DO - 10.1192/bjp.182.2.135 DP - NLM ET - 2003/02/04 KW - Adult Aged Antipsychotic Agents/therapeutic use Behavior Therapy/*methods Borderline Personality Disorder/drug therapy/psychology/*therapy Combined Modality Therapy Female Humans Middle Aged Patient Compliance Psychiatric Status Rating Scales Self-Injurious Behavior/prevention & control Suicide, Attempted/prevention & control Treatment Outcome LA - eng N1 - Verheul, Roel Van Den Bosch, Louise M C Koeter, Maarten W J De Ridder, Maria A J Stijnen, Theo Van Den Brink, Wim Clinical Trial Journal Article Randomized Controlled Trial England Br J Psychiatry. 2003 Feb;182:135-40. doi: 10.1192/bjp.182.2.135. PY - 2003 SN - 0007-1250 (Print) 0007-1250 SP - 135-40 ST - Dialectical behaviour therapy for women with borderline personality disorder: 12-month, randomised clinical trial in The Netherlands T2 - Br J Psychiatry TI - Dialectical behaviour therapy for women with borderline personality disorder: 12-month, randomised clinical trial in The Netherlands VL - 182 ID - 524 ER - TY - JOUR AB - Aim: To determine whether brief intervention and contact (BIC) is effective in reducing subsequent suicidal behavior among suicide attempters. Materials and Methods: Suicide attempters (n=680) admitted in a general hospital in Chennai were randomly allocated to treatment as usual and BIC whose components include brief intervention at the time of discharge and contact for 18 months. Results: Completed suicide was significantly lower in the BIC group, OR 35.4 (CI 18.4‐78.2) as also attempted suicide, OR 17.3 (CI 10.8‐29.7). Conclusions: This low‐cost intervention which can be readily implemented may be an important suicide prevention strategy in healthcare settings in India. AN - CN-01761943 AU - Vijayakumar, L. AU - Umamaheswari, C. AU - Shujaath Ali, Z. S. AU - Devaraj, P. AU - Kesavan, K. DO - 10.4103/0019-5545.86817 IS - 3 KW - *behavior therapy *brief intervention and contact *suicidal behavior /epidemiology /prevention /therapy *suicide attempt /epidemiology /prevention /therapy Adult Article Assisted suicide Completed suicide Female General hospital Hospital admission Hospital discharge Human India Intervention study Major clinical study Male Randomized controlled trial Suicide M3 - Journal: Article PY - 2011 SP - 244‐248 ST - Intervention for suicide attempters: a randomized controlled study T2 - Indian journal of psychiatry TI - Intervention for suicide attempters: a randomized controlled study UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-01761943/full VL - 53 ID - 661 ER - TY - JOUR AB - This randomized controlled trial was designed to evaluate the effectiveness of using crisis coping cards (n = 32) in the case management of suicide prevention compared with case management without the use of coping cards (n = 32) over a 3‐month intervention period. The generalized estimating equation was used to examine the interaction effect between treatments and time on suicide risk, depression, anxiety, and hopelessness. Results indicated that subsequent suicidal behaviors, severity of suicide risk, depression, anxiety, and hopelessness were reduced more in the coping card intervention group compared to the case management only group. Moreover, for the survival curves of time to suicide reattempt, the coping card group showed a significantly longer time to reattempt than the case management only group at 2‐month and 3‐month intervention periods. AN - CN-01258927 AU - Wang, Y. C. AU - Hsieh, L. Y. AU - Wang, M. Y. AU - Chou, C. H. AU - Huang, M. W. AU - Ko, H. C. DO - 10.1111/sltb.12177 IS - 1 KW - Adaptation, Psychological Adult Case Management Female Follow‐Up Studies Humans Male Middle Aged Suicide [*prevention & control, psychology] Suicide, Attempted [*statistics & numerical data] Treatment Outcome M3 - Journal Article; Randomized Controlled Trial PY - 2016 SP - 106‐120 ST - Coping Card Usage can Further Reduce Suicide Reattempt in Suicide Attempter Case Management Within 3-Month Intervention T2 - Suicide & life-threatening behavior TI - Coping Card Usage can Further Reduce Suicide Reattempt in Suicide Attempter Case Management Within 3-Month Intervention UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-01258927/full VL - 46 ID - 662 ER - TY - JOUR AB - BACKGROUND: Non-treatment-engaged individuals experiencing suicidal thoughts have been largely overlooked in the intervention literature, despite reviews suggesting most individuals who die by suicide were not in treatment immediately prior to their death. Most intervention studies recruit individuals from treatment providers, potentially neglecting those individuals who are not already engaged in services. These individuals clearly represent a group in need of additional empirical attention. METHODS: A randomized clinical trial was conducted to compare a single-session dialectical behavior therapy skills-based intervention to a relaxation training control condition. Ninety-three non-treatment-engaged subjects participated in a single in-person assessment, received one of the intervention protocols, and completed follow-up phone interviews for three months including measures of suicidal ideation, emotion dysregulation, and coping skills, as well as other relevant assessments. RESULTS: Both conditions reported significantly reduced levels of suicidal ideation, depression, and anxiety; however, analyses revealed no significant differences between conditions on the main outcome measures of suicidal ideation, emotion dysregulation, skills use, depression, or anxiety. LIMITATIONS: The two interventions may have been too similar to permit detection of differential effects with this sample size. Specifically, the control condition may have been too active and there may have been stylistic overlap by providers who delivered both interventions. CONCLUSIONS: Encouragingly, half of subjects contacted other mental health services during the follow-up period. Although the two interventions under investigation did not yield differential results, the significant changes in important domains across interventions suggest that brief interventions may hold promise for this difficult-to-reach population. AD - University of Washington, 3935 University Way NE, Seattle, WA 98195, United States; Hofstra University, 135 Hofstra University, Hempstead, NY 11549, United States. Electronic address: erin.f.wardciesielski@hofstra.edu. University of Washington, 3935 University Way NE, Seattle, WA 98195, United States. AN - 28709022 AU - Ward-Ciesielski, E. F. AU - Tidik, J. A. AU - Edwards, A. J. AU - Linehan, M. M. C2 - PMC5558839 C6 - NIHMS891879 DA - Nov DO - 10.1016/j.jad.2017.07.011 DP - NLM ET - 2017/07/15 KW - Adaptation, Psychological Adult Anxiety/psychology/*therapy Behavior Therapy/*methods Depression/psychology/*therapy Female Humans Male Mental Health Services Relaxation Therapy/methods *Suicidal Ideation Suicide/*psychology Treatment Outcome *Brief interventions *Suicide *Treatment engagement she has written on Dialectical Behavior Therapy. Drs. Linehan and Ward-Ciesielski receive fees for Dialectical Behavior Therapy trainings. All other authors declare that they have no conflicts of interest. LA - eng N1 - 1573-2517 Ward-Ciesielski, Erin F Tidik, Julia A Edwards, Amanda J Linehan, Marsha M F31 MH095257/MH/NIMH NIH HHS/United States Journal Article Randomized Controlled Trial J Affect Disord. 2017 Nov;222:153-161. doi: 10.1016/j.jad.2017.07.011. Epub 2017 Jul 6. PY - 2017 SN - 0165-0327 (Print) 0165-0327 SP - 153-161 ST - Comparing brief interventions for suicidal individuals not engaged in treatment: A randomized clinical trial T2 - J Affect Disord TI - Comparing brief interventions for suicidal individuals not engaged in treatment: A randomized clinical trial VL - 222 ID - 300 ER - TY - JOUR AB - BACKGROUND: Studies on the effects of interventions in patients who have attempted suicide in China have not reported so far. AIMS: To describe the basic situation surrounding the interventions and follow‐up of patients who have attempted suicide and to determine whether the interventions would be effective in reducing repeat suicide attempts. METHOD: 239 patients who had attempted suicide were evaluated in the emergency departments of four general hospitals. They were randomized into three groups: cognitive therapy group, telephone intervention group, and control group. Postintervention the participants were evaluated at 3, 6, and 12 months separately by the following measurements: a detailed structured questionnaire, Beck Suicide Ideation Scale (SIS), Hamilton Rating Scale for Depression (HAMD), and a quality‐of‐life scale. RESULTS: After 12 months, the cumulative dropout rate was 69.5% (n = 57) for the cognitive therapy group, 55.0% (n = 44) for the telephone intervention group, and 64.9% (n = 50) for the control group. One patient (1.2%) in the cognitive therapy group, one patient (1.3%) in the telephone intervention group, and five patients (6.5%) in the control group made at least one subsequent suicide attempt. The rates of repeated attempted suicide among the three groups were not significantly different (χ² = 5.077, p = .08). Five patients (6.1%) received cognitive therapy, and 60 patients (75.0%) received telephone intervention. There were no differences regarding the score of HAMD, a quality‐of‐life scale, and the rates of subsequent suicide attempt and suicide ideation among the three groups at follow‐up. CONCLUSIONS: The dropout rates were higher than those reported in developed countries. Most participants in the cognitive therapy group refused to receive cognitive therapy so that the effect of cognitive therapy for these patients cannot be evaluated. The participants in the telephone intervention group had good compliance, but the effect of telephone intervention could not be confirmed, so that more studies are needed in the future. Consequently, interventions cannot be evaluated accurately in their preventing suicide attempts for patients who have attempted suicide in China at present. AN - CN-00853218 AU - Wei, S. AU - Liu, L. AU - Bi, B. AU - Li, H. AU - Hou, J. AU - Tan, S. AU - Chen, X. AU - Chen, W. AU - Jia, X. AU - Dong, G. AU - et al. DO - 10.1027/0227-5910/a000181 IS - 2 KW - Adolescent Adult China Cognitive Behavioral Therapy Crisis Intervention Emergency Service, Hospital Female Follow‐Up Studies Hospitals, General Hotlines Humans Male Middle Aged Patient Dropouts Personality Inventory [statistics & numerical data] Psychometrics Quality of Life Secondary Prevention Suicidal Ideation Suicide, Attempted [*prevention & control, psychology] Young Adult M3 - Journal Article; Multicenter Study; Randomized Controlled Trial PY - 2013 SP - 107‐115 ST - An intervention and follow-up study following a suicide attempt in the emergency departments of four general hospitals in Shenyang, China T2 - Crisis TI - An intervention and follow-up study following a suicide attempt in the emergency departments of four general hospitals in Shenyang, China UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00853218/full VL - 34 ID - 663 ER - TY - JOUR AB - BACKGROUND: Dialectical behavior therapy (DBT) is a first-line treatment for the prevention of suicide. Zhong-Yong thinking could be viewed as a Chinese way of dialectical thinking, has long been a culturally dictating thinking style in China. To enhance cultural adaptability, we integrated Zhong-Yong thinking into DBT group skills training and examined its efficacy in suicidal prevention compared with a supportive group therapy and a wait-list group in high-risk suicidal Chinese college students. METHODS: A total of 97 suicidal participants were randomized to either Zhong-Yong thinking based DBT group skills training (DBT(ZYT) , n = 33), or supportive group therapy (SGT; n = 32), or wait-list group (WL; n = 32). DBT(ZYT) was a 12-week program based on Zhong-Yong thinking instead of dialectical thinking, coaching participants mindfulness, emotion regulation, distress tolerance, and interpersonal effectiveness. Supportive group therapy was a 12-week program aiming at improving interpersonal effectiveness and emotion regulation skills. Outcome measures were assessed at pre- and post-treatment and 6-month follow-up. RESULTS: At post-treatment measures, the levels of suicidal ideation, hopelessness, psychache symptoms, and general psychopathology had significantly decreased in both intervention groups; at the 6-month follow-up measures, the intervention effects were better maintained in the DBT(ZYT) group rather than in the SGT group. Specifically, DBT(ZYT) was more effective in relieving participants' long-term obsessive-compulsive, anxiety, hostility, phobic, psychotic, and additional symptoms. CONCLUSIONS: Zhong-Yong thinking not only could integrate with DBT skills training in Chinese young adult population, but also has special strength in enhancing DBT's efficacy. AU - Yang, Xueling AU - Liu, Ding AU - Wang, You AU - Chen, Yu AU - Chen, Weichen AU - Yang, Caiyan AU - Zhang, Peining AU - Ding, Siyuan AU - Zhang, Xiaoyuan DA - 2020/06//undefined DO - 10.1002/brb3.1621 IS - 6 J2 - Brain Behav KW - Suicidal Ideation China Humans Young Adult *dialectical behavior therapy Treatment Outcome *Psychotherapy, Group *suicide prevention Follow-Up Studies *randomized controlled trial *Zhong-Yong thinking LA - eng PY - 2020 SN - 2162-3279 SP - e01621 ST - Effectiveness of Zhong-Yong thinking based dialectical behavior therapy group skills training versus supportive group therapy for lowering suicidal risks in Chinese young adults: A randomized controlled trial with a 6-month follow-up T2 - Brain and behavior TI - Effectiveness of Zhong-Yong thinking based dialectical behavior therapy group skills training versus supportive group therapy for lowering suicidal risks in Chinese young adults: A randomized controlled trial with a 6-month follow-up VL - 10 ID - 2311 ER - TY - JOUR AB - BACKGROUND: Currently, no pharmacological treatments for bipolar depression exist that exert rapid (within hours) antidepressant or antisuicidal effects. We previously reported that intravenous administration of the N-methyl-D-aspartate antagonist ketamine produced rapid antidepressant effects in patients with treatment-resistant bipolar depression. The present study sought to replicate this finding in an independent sample. METHODS: In this double-blind, randomized, crossover, placebo-controlled study, 15 subjects with DSM-IV bipolar I or II depression maintained on therapeutic levels of lithium or valproate received a single intravenous infusion of either ketamine hydrochloride (.5 mg/kg) or placebo on 2 test days 2 weeks apart. The primary outcome measure was the Montgomery-Asberg Depression Rating Scale, which was used to rate overall depressive symptoms at baseline; at 40, 80, 110, and 230 minutes postinfusion; and on days 1, 2, 3, 7, 10, and 14 postinfusion. RESULTS: Within 40 minutes, depressive symptoms, as well as suicidal ideation, significantly improved in subjects receiving ketamine compared with placebo (d = .89, 95% confidence interval = .61-1.16, and .98, 95% confidence interval = .64-1.33, respectively); this improvement remained significant through day 3. Seventy-nine percent of subjects responded to ketamine and 0% responded to placebo at some point during the trial. The most common side effect was dissociative symptoms, which occurred only at the 40-minute time point. CONCLUSIONS: This study replicated our previous finding that patients with bipolar depression who received a single ketamine infusion experienced a rapid and robust antidepressant response. In addition, we found that ketamine rapidly improved suicidal ideation in these patients. AD - Experimental Therapeutics & Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, and Department of Health and Human Services, Bethesda, Maryland, USA. zaratec@mail.nih.gov AN - 22297150 AU - Zarate, C. A., Jr. AU - Brutsche, N. E. AU - Ibrahim, L. AU - Franco-Chaves, J. AU - Diazgranados, N. AU - Cravchik, A. AU - Selter, J. AU - Marquardt, C. A. AU - Liberty, V. AU - Luckenbaugh, D. A. C2 - PMC3343177 C6 - NIHMS346797 interest. DA - Jun 1 DO - 10.1016/j.biopsych.2011.12.010 DP - NLM ET - 2012/02/03 IS - 11 KW - Adult Bipolar Disorder/*drug therapy Cross-Over Studies Depression/*drug therapy Double-Blind Method Excitatory Amino Acid Antagonists/*therapeutic use Female Humans Infusions, Intravenous Ketamine/*therapeutic use Male Middle Aged *Suicidal Ideation Treatment Outcome LA - eng N1 - 1873-2402 Zarate, Carlos A Jr Brutsche, Nancy E Ibrahim, Lobna Franco-Chaves, Jose Diazgranados, Nancy Cravchik, Anibal Selter, Jessica Marquardt, Craig A Liberty, Victoria Luckenbaugh, David A ZIA MH002857-07/Intramural NIH HHS/United States Journal Article Randomized Controlled Trial Research Support, N.I.H., Intramural Research Support, Non-U.S. Gov't Biol Psychiatry. 2012 Jun 1;71(11):939-46. doi: 10.1016/j.biopsych.2011.12.010. Epub 2012 Jan 31. PY - 2012 SN - 0006-3223 (Print) 0006-3223 SP - 939-46 ST - Replication of ketamine's antidepressant efficacy in bipolar depression: a randomized controlled add-on trial T2 - Biol Psychiatry TI - Replication of ketamine's antidepressant efficacy in bipolar depression: a randomized controlled add-on trial VL - 71 ID - 744 ER - TY - JOUR AB - OBJECTIVE: To explore relationships between baseline sociodemographic and clinical features and baseline suicidal ideation, and treatment effects on suicidal ideation and behavior, in depressed outpatients. METHOD: From March 2008 to September 2009, the Combining Medications to Enhance Depression Outcomes study, a single-blind, 7-month randomized trial, enrolled outpatients with nonpsychotic chronic and/or recurrent major depressive disorder (DSM-IV-TR criteria) in primary and psychiatric care (N = 665). Participants received escitalopram plus placebo, bupropion sustained release (SR) plus escitalopram, or venlafaxine extended release (XR) plus mirtazapine. The primary outcome measure for this report is presence of suicidal ideation assessed by the Concise Health Risk Tracking Self-Report, which measures suicidal ideation and behaviors over the last 24 hours. Sociodemographic and clinical features were compared in those with versus without baseline ideation. At 4, 12, and 28 weeks, treatment effects on suicidality were assessed, and unadjusted and adjusted outcomes were compared among those with and without baseline ideation using linear, logistic, ordinal logistic, and negative binomial regression models. RESULTS: Baseline suicidal ideation was associated with greater depressive severity, childhood neglect, childhood abuse, early major depressive disorder onset, greater psychiatric comorbidity, and worse functioning and quality of life. After adjustment for treatment, gender, age at first depressive episode, obsessive-compulsive symptoms, and depressive severity, depressive symptom outcomes did not differ between ideation groups at 12 or 28 weeks or between treatments. Overall, 79% of participants with baseline suicidal ideation had none at week 4, 83% had none at week 12, and 86% had none at week 28. All treatments reduced ideation, with bupropion-SR plus escitalopram the most effective at week 12 (P < .01). In participants without baseline ideation, emergent ideation did not differ between treatments: 2.5% had ideation at 4 weeks, 1.3% had ideation at 12 weeks, and only 1.7% had ideation at 28 weeks. Four patients (all receiving venlafaxine-XR plus mirtazapine) attempted suicide (P = .0162). CONCLUSION: Baseline ideation did not affect depressive symptom outcome. Bupropion-SR plus escitalopram most effectively reduced ideation. Ideation emergence was uncommon. Venlafaxine-XR plus mirtazapine may pose a higher risk of suicide attempts. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00590863. AD - VA Healthcare System, San Diego, CA 92161, USA. szisook@ucsd.edu AN - 22075098 AU - Zisook, S. AU - Lesser, I. M. AU - Lebowitz, B. AU - Rush, A. J. AU - Kallenberg, G. AU - Wisniewski, S. R. AU - Nierenberg, A. A. AU - Fava, M. AU - Luther, J. F. AU - Morris, D. W. AU - Trivedi, M. H. DA - Oct DO - 10.4088/JCP.10m06724 DP - NLM ET - 2011/11/15 IS - 10 KW - Adolescent Adult Aged Antidepressive Agents/economics/*therapeutic use Bupropion/therapeutic use Citalopram/therapeutic use Cyclohexanols/therapeutic use Delayed-Action Preparations/therapeutic use Depressive Disorder, Major/complications/drug therapy/economics Drug Therapy, Combination Female Humans Male Mianserin/analogs & derivatives/therapeutic use Middle Aged Mirtazapine Regression Analysis Risk Factors Self Report Single-Blind Method *Suicidal Ideation Surveys and Questionnaires Time Factors Treatment Outcome Venlafaxine Hydrochloride Young Adult LA - eng N1 - 1555-2101 Zisook, Sidney Lesser, Ira M Lebowitz, Barry Rush, A John Kallenberg, Gene Wisniewski, Stephen R Nierenberg, Andrew A Fava, Maurizio Luther, James F Morris, David W Trivedi, Madhukar H N01MH90003/MH/NIMH NIH HHS/United States Comparative Study Journal Article Randomized Controlled Trial Research Support, N.I.H., Extramural United States J Clin Psychiatry. 2011 Oct;72(10):1322-32. doi: 10.4088/JCP.10m06724. PY - 2011 SN - 0160-6689 SP - 1322-32 ST - Effect of antidepressant medication treatment on suicidal ideation and behavior in a randomized trial: an exploratory report from the Combining Medications to Enhance Depression Outcomes Study T2 - J Clin Psychiatry TI - Effect of antidepressant medication treatment on suicidal ideation and behavior in a randomized trial: an exploratory report from the Combining Medications to Enhance Depression Outcomes Study VL - 72 ID - 270 ER -