Family‐focused cognitive behavioral treatment for depressed adolescents in suicidal crisis with co‐occurring risk factors: a randomized trial

Autor: Elisabeth A. Frazier, Kerri L. Kim, Anthony Spirito, Richard T. Liu, Daniel P. Dickstein, Leah M. Adams, Jeffrey Hunt, Jennifer C. Wolff, Shirley Yen, Christianne Esposito-Smythers
Rok vydání: 2019
Předmět:
Male
medicine.medical_specialty
Adolescent
medicine.medical_treatment
Poison control
Suicide
Attempted
Suicide prevention
Article
Suicidal Ideation
law.invention
03 medical and health sciences
0302 clinical medicine
Randomized controlled trial
Risk Factors
law
Outcome Assessment
Health Care
Developmental and Educational Psychology
medicine
Humans
0501 psychology and cognitive sciences
Psychiatry
Suicidal ideation
Depression (differential diagnoses)
Depressive Disorder
Major
Cognitive Behavioral Therapy
Suicide attempt
05 social sciences
medicine.disease
Cognitive behavioral therapy
Psychiatry and Mental health
Pediatrics
Perinatology and Child Health
Major depressive disorder
Female
medicine.symptom
Psychology
Self-Injurious Behavior
030217 neurology & neurosurgery
Follow-Up Studies
050104 developmental & child psychology
Zdroj: J Child Psychol Psychiatry
ISSN: 1469-7610
0021-9630
DOI: 10.1111/jcpp.13095
Popis: Background Suicide is the second leading cause of death among adolescents. The purpose of this study was to test a family-focused outpatient cognitive behavioral treatment (F-CBT) protocol for depressed adolescents following psychiatric hospitalization for a suicide attempt or suicidal ideation, and who had a co-occurring risk factor (suicidal behavior prior to the index admission, nonsuicidal self-injury, and/or a substance use disorder), in a randomized Phase 2 efficacy trial. Method One hundred forty-seven adolescents (mean age = 14.91 years; 76.2% female, 85.5% White) and their families, recruited primarily from an inpatient psychiatric hospitalization program, were randomly assigned to F-CBT or enhanced treatment-as-usual (E-TAU). A suicide attempt was the primary outcome variable. Depression, suicidal ideation, and nonsuicidal self-injury are also reported here. Assessments were completed at pretreatment as well as 6, 12, and 18-months postrandomization (Trial Registration ClinicalTrials.gov Identifier: NCT01732601). Results In the sample as a whole, rates of attempts decreased from 20% at 6 months to 9% at 12 months to 7% at 18 months. There was no evidence of a significant difference between treatment arms in rates of suicide attempts, major depressive disorder, suicidal ideation, or nonsuicidal self-injury at any of the postrandomization assessment points. Conclusions Though F-CBT was associated with reductions in suicidality, depression, and nonsuicidal self-injury, E-TAU showed an equally strong effect. Greater frequency of F-CBT treatment sessions, particularly at the start of care, and alternative approaches to transitioning to care at 12 months, may be necessary when using F-CBT with this population.
Databáze: OpenAIRE
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