Tuesday, February 23, 2016

DBT Better Than Usual Care in Reducing Self-Harm, Suicidal Thinking in Teens, Study Shows

A form of dialectical behavior therapy (DBT) adapted for use with adolescents appears to be superior to usual care in reducing self-harm and suicidal thinking in teenagers with repetitive self-harming behavior, according to a report online in the Journal of the American Academy of Child and Adolescent Psychiatry.

Norwegian researchers randomly assigned 77 adolescents with a history of self-harming behavior to either DBT adapted for adolescents (DBT-A) or “enhanced” usual care (EUC) for 19 weeks. (Patients in the EUC group received at least 1 session of psychodynamically oriented therapy or cognitive-behavioral therapy per week throughout the trial.)

There were no suicides during the follow-up period. EUC patients reported a mean of 22.5 episodes of self-harm in the 19 weeks of treatment and 14.8 during the subsequent follow-up year, while DBT-A patients reported an average of just 9.0 and 5.5 episodes of self-harm in the corresponding time intervals—a between-group difference that was statistically significant at both time intervals.

Additionally, DBT-A participants at 19 weeks had a significantly lower level of suicidal ideation than participants who received EUC, though the difference was no longer statistically significant at one year.

“Based on these findings, it seems reasonable to conclude that DBT-A both in the short term and in a 1-year post-treatment follow-up perspective leads to a significantly more favorable outcome with respect to reduction in the frequency of self-harm behavior,” the authors wrote. “This is clinically important since repetitive self-harm is a strong predictor of suicide and linked to a range of psychosocial problems.”

For related information, see the Psychiatric News article “Various DBT Interventions Reduce Suicide Risk.”

(iStock/Steve Debenport)


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