Reducing short term suicide risk after hospitalization: A randomized controlled trial of the Collaborative Assessment and Management of Suicidality.

Autor: Comtois KA; Department of Psychiatry and Behavioral Sciences, University of Washington, United States of America. Electronic address: uwcspar@uw.edu., Hendricks KE; Department of Psychiatry and Behavioral Sciences, University of Washington, United States of America., DeCou CR; Department of Psychiatry and Behavioral Sciences, University of Washington, United States of America., Chalker SA; Department of Psychology, Catholic University of America, United States of America., Kerbrat AH; Department of Psychiatry and Behavioral Sciences, University of Washington, United States of America., Crumlish J; Department of Psychology, Catholic University of America, United States of America., Huppert TK; Department of Psychiatry and Behavioral Sciences, University of Washington, United States of America., Jobes D; Department of Psychology, Catholic University of America, United States of America.
Jazyk: angličtina
Zdroj: Journal of affective disorders [J Affect Disord] 2023 Jan 01; Vol. 320, pp. 656-666. Date of Electronic Publication: 2022 Sep 23.
DOI: 10.1016/j.jad.2022.09.042
Abstrakt: Background: This study compared the "next day appointment" (NDA) use of the Collaborative Assessment and Management of Suicidality (CAMS) to treatment as usual (TAU) for individuals discharged from the hospital following a suicide-related crisis. We hypothesized that CAMS would significantly reduce suicidal thoughts and behaviors as well as improve psychological distress, quality of life/overall functioning, treatment retention and patient satisfaction.
Methods: Participants were 150 individuals who had at least one lifetime actual, aborted, or interrupted attempt and were admitted following a suicide-related crisis. There were 75 participants in the experimental condition who received adherent CAMS and 75 participants who received TAU. Suicidal thoughts and behaviors, psychological distress, and quality of life/overall functioning were assessed at baseline and at 1, 3, 6, and 12 months post-baseline. Treatment retention and patient satisfaction were assessed at post-treatment.
Results: Participants in both conditions improved from baseline to 12 months but CAMS was not superior to TAU for the primary outcomes. A small but significant improvement was found in probability of suicidal ideation at 3 months favoring TAU and amount of suicidal ideation at 12 months favoring CAMS. CAMS participants experienced less psychological distress at 12 months compared to baseline.
Limitations: The study was limited by only one research clinic, lower than expected recruitment, and imbalance of suicidal ideation at baseline.
Conclusions: All participants improved but CAMS was not more effective than TAU. The NDA clinic was feasible and acceptable to clients and staff in both conditions and future research should investigate its potential benefit.
Competing Interests: Conflict of Interest Katherine Anne Comtois, Karin Hendricks, Chris DeCou, Samantha Chalker, Amanda Kerbrat, and Tierney Huppert declare that they have no conflict of interests. Potential conflicts of interest for David Jobes include research funding from the National Institute of Mental Health (NIMH), book royalties from American Psychological Association (APA) Press and Guilford Press, and as the founder and co-owner of CAMS-care, LLC (a professional and consultation company). Jennifer Crumlish reports personal fees from CAMS-care LLC, outside the submitted work. For this study, all recruitment, consent, enrollment, baseline, and follow-up data were collected at the University of Washington (UW) by Dr. Comtois' team. The Collaborative Assessment and Management of Suicidality (CAMS) study treatment was trained and monitored by Dr. Jobes and his team at Catholic University of America (CUA) with no direct contact with the participants and no role in the consent process nor outcome data collection, except as it specifically related to the CAMS Suicide Status Form and the CAMS Rating Scale (for adherence and fidelity purposes with both arms of the trial). Outcome data were analyzed at UW independently from Dr. Jobes and the CUA team who only reviewed results of analyses in summary (they neither handled raw data nor performed any statistical analyses).
(Copyright © 2022. Published by Elsevier B.V.)
Databáze: MEDLINE
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