Cognitive therapy shown to reduce suicide risk in landmark study
RESEARCH UPDATE—Sept. 12, 2005—Attempted suicide is one of the strongest risk factors for suicide deaths in adults. Alarmingly, even one previous attempt multiplies suicide risk by 38–40 times. Yet few interventions specifically designed to prevent suicide attempts have been evaluated. This landmark study does just that, demonstrating that cognitive therapy reduced almost by half the risk of repeat suicide attempts in patients who recently attempted suicide.
This is one of the most rigorous tests ever of a psychotherapy technique in people whose attempts to die by their own hand have been serious enough for hospitalization. Research trials typically exclude such patients, in part because they are more prone to die by suicide when compared with individuals who are not as suicidal. By including these high-risk individuals in the trial, researchers learned what worked for them—and it was cognitive therapy.
This trial recruited 120 adults from the emergency department of a university hospital after trying to kill themselves. Averaging in their mid-thirties, patients had multiple problems, including substance-use disorders, depression and homelessness, and many of them were already taking drugs for depression. Participants were randomly assigned to cognitive therapy or usual care, i.e., services available within the community. Those in the cognitive group were scheduled to receive 10 outpatient weekly or biweekly cognitive therapy sessions specifically developed to prevent suicide attempts. Sessions helped patients find more effective ways of viewing and coping with problems, and how to better handle negative thoughts and feelings of hopelessness.
Because suicide is the fourth leading cause of death for adults under age 65, this groundbreaking study has important public health implications given its effectiveness for preventing repeat attempts.
Cognitive Therapy for the Prevention of Suicide Attempts: A Randomized Controlled Trial. G. K. Brown, T. Ten Have, G. R. Henriques, S. X. Xie, J. E. Hollander, A. T. Beck. JAMA. 2005 Aug 3; 294(55):563-570.