BCBT for Suicide Prevention
Trial question
What is the role of brief CBT for psychiatric inpatient suicide prevention?
Study design
Single center
Open label
RCT
Population
Characteristics of study participants
58.4% female
41.6% male
N = 200
200 patients (117 female, 83 male).
Inclusion criteria: adult psychiatric inpatients with a suicide attempt within 1 week of admission or ideation with plan on admission as well as suicide attempt within 2 years.
Key exclusion criteria: current mania; lifetime schizophrenia, schizoaffective disorder, intellectual disability, or organic brain disease; electroconvulsive therapy included in the inpatient treatment plan; expected length of stay < 4 business days; unwilling or unable to follow study procedures.
Interventions
N=94 brief CBT (up to 4 individual therapy sessions plus usual care).
N=106 usual care (24-hour multidisciplinary inpatient care based on short-term stabilization model).
Primary outcome
Mean rate of suicide attempts
0.26
0.66
0.7
0.5
0.3
0.2
0.0
Brief cognitive behavioral
therapy
Usual
care
Significant
decrease ▼
Significant decrease in mean rate of suicide attempts (0.26 vs. 0.66; RR 0.39, 95% CI 0 to 0.75).
Secondary outcomes
Significant decrease in mean rate of psychiatric readmissions (0.13 vs. 0.45; RR 0.29, 95% CI 0.09 to 0.9).
Significant increase in mean rate of suicide attempts in patients with substance use disorder (0.6 vs. 0.28; RR 2.15, 95% CI 1.1 to 4.24).
No significant difference in mean rate of psychiatric readmissions in patients with substance use disorder (0.57 vs. 0.54; RR 1.06, 95% CI 0.55 to 2.06).
Conclusion
In adult psychiatric inpatients with a suicide attempt within 1 week of admission or ideation with plan on admission as well as suicide attempt within 2 years, brief CBT was superior to usual care with respect to mean rate of suicide attempts.
Reference
Gretchen J Diefenbach, Kayla A Lord, Jessica Stubbing et al. Brief Cognitive Behavioral Therapy for Suicidal Inpatients: A Randomized Clinical Trial. JAMA Psychiatry. 2024 Dec 1;81(12):1177-1186.
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