Aarhus University.
Aarhus University Hospital.
Behav Ther. 2019 Mar;50(2):421-429. doi: 10.1016/j.beth.2018.07.007. Epub 2018 Jul 30.
Suicide is a global public health problem and effective psychological interventions are needed. The objective of the present study was to evaluate the effect of an app-assisted suicide prevention treatment on suicide risk and depression. One hundred twenty-nine participants were randomized to treatment as usual (TAU), consisting of psychotherapy adhering to the framework of Collaborative Assessment and Management of Suicidality (CAMS), with (TAU+APP, N = 60) or without (TAU, N = 69) access to a mobile application (i.e., LifeApp'tite). Suicide risk and symptoms of depression were assessed pre- and posttherapy, and at 4-month follow-up. The TAU+APP group showed a smaller decrease on self-reported suicide risk at the end of treatment, corresponding to a medium between-group effect size (p = .008, d = 0.46). At the 4-month follow-up this was the case only at the trend level, where the effect size was also of a smaller magnitude (p = .057, d = 0.30). No differences between the treatment groups were observed on self-reported depressive symptoms, either immediately following treatment (p = .732, d = 0.05) or at follow-up (p = .467, d = 0.11). The unexpected negative effect concerning suicide risk points to crucial consideration of issues pertaining to timing, dosing, and content when adding new technology to existing treatments both in this and other populations.
自杀是一个全球性的公共卫生问题，需要有效的心理干预。本研究的目的是评估应用程序辅助的自杀预防治疗对自杀风险和抑郁的影响。129 名参与者被随机分为常规治疗组（TAU），包括遵循协作评估和自杀管理框架（CAMS）的心理治疗，（TAU+APP，N=60）或不（TAU，N=69）使用移动应用程序（即 LifeApp'tite）。在治疗前、治疗后和 4 个月随访时评估自杀风险和抑郁症状。TAU+APP 组在治疗结束时自我报告的自杀风险下降较小，对应于中等组间效应大小（p=0.008，d=0.46）。在 4 个月的随访中，这种情况仅在趋势水平上，此时的效应大小也较小（p=0.057，d=0.30）。在治疗结束时（p=0.732，d=0.05）或随访时（p=0.467，d=0.11），两组在自我报告的抑郁症状上均无差异。关于自杀风险的意外负面结果表明，在为现有治疗添加新技术时，无论在本研究还是其他人群中，都需要对时间、剂量和内容等问题进行重要考虑。
