At-risk military members who received a 12-session program of brief cognitive behavioral therapy (BCBT) were significantly less likely to attempt suicide over 24 months, compared with those who received another evidence-based therapy, according to a study issued today by JAMA Psychiatry.Since 2001, suicide rates among the military have increased by nearly 50%, according to Craig J. Bryan, Psy.D., of Ohio State University, and colleagues, who wrote: “Half of military suicide decedents access mental health care in the months preceding their deaths. Mental health settings, therefore, present a critical opportunity to deliver suicide-focused interventions.”
Bryan and colleagues enrolled 108 military personnel or veterans (73% male) who reported suicidal ideation with intent to die within the past week and/or a past-month suicide attempt. Fifty-three participants received 12 weeks of BCBT, which teaches self-regulation strategies to help patients manage emotional distress and change negative thoughts and beliefs. The other 55 participants received 12 weeks of present-centered therapy (PCT), which educates patients about the symptoms and features of suicidal crises and provides emotional support and feedback about life problems and stress.
All participants received a safety planning intervention and continued their usual mental health care in addition to the therapy.
Suicidal ideation significantly decreased in both groups across the 24-month follow-up with no inter-group differences. However, fewer patients receiving BCBT attempted suicide compared with those receiving PCT (6% versus 28%, respectively), and the average time to first suicide attempt was also longer among the BCBT group (756 days versus 639 days). After the researchers adjusted for demographic differences, they found that BCBT was associated with a 78% lower risk of suicide attempts compared with PCT.
The researchers noted that their conclusions may apply only to military personnel and veterans. Furthermore, only about half of participants completed therapy; however, the completion rate was similar between groups, so dropout likely had negligible impact on results.
“Results replicate an earlier randomized control trial (RCT) supporting the efficacy of BCBT for the prevention of suicide attempts among military personnel and converge with RCTs reporting reductions in suicide attempts among nonmilitary patients receiving BCBT,” the researchers wrote. “As such, BCBT should be a recommended treatment for preventing suicide attempts and disseminated throughout the military health system.”
For related information, see the Psychiatric News article “How Psychotherapeutic Techniques Can Be Integrated Into Routine Pharmacotherapy.”
(Image: Getty Images/iStock/Drazen Zigic)
