Adults who had attempted suicide reduced their risk of a repeat attempt by participating in a cognitive therapy program, compared to adults who received the usual care, according to a study in the August 3 issue of JAMA: The Journal of the American Medical Association, a theme issue on violence and human rights.
In 2002, suicide was the fourth leading cause of death for adults between the ages of 18 and 65 years with approximately 25,000 suicides for this age group in the United States, according to background information in the article. Attempted suicide is one of the strongest risk factors for completed suicide in adults. Previous studies have indicated that individuals who attempted suicide were about 40 times more likely to commit suicide than those who had not attempted suicide. Evidence for treatments that effectively prevent repetition of suicide attempts has been limited.
Gregory K. Brown, Ph.D., of the University of Pennsylvania, Philadelphia, and colleagues conducted a randomized controlled trial to determine whether a brief psychosocial intervention could reduce the rate of repeat suicide attempts over an 18-month interval. The study included 120 adults who attempted suicide and were evaluated at a hospital emergency department within 48 hours of the attempt. Sixty participants were randomized to receive 10 sessions of cognitive therapy and 60 to receive enhanced usual care with tracking and referral services.
The central feature of cognitive therapy was the identification of thoughts, images, and core beliefs that were activated prior to the suicide attempt. Strategies were applied to address the identified thoughts and beliefs and participants were helped to develop adaptive ways of coping with stressors. Usual care included outpatient therapy and medication.
From baseline to the 18-month assessment, 13 participants (24.1 percent) in the cognitive therapy group and 23 participants (41.6 percent) in the usual care group made at least one subsequent suicide attempt.