Danish Research Institute for Suicide Prevention, Mental Health Centre Copenhagen, Copenhagen, Denmark.
Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Copenhagen, Denmark.
J Clin Psychiatry. 2021 Aug 31;82(5):20m13803. doi: 10.4088/JCP.20m13803.
The majority of individuals with suicidal ideation do not receive help, and every year close to 800,000 people die by suicide. This study aimed to investigate the effectiveness of a guided internet-based self-help program compared to a waiting list control group in reducing suicidal ideation. In a randomized controlled trial, 402 individuals with suicidal ideation were assigned to a guided internet-based self-help program or a waiting list control group from September 13, 2016, to September 2, 2018. The primary outcome was suicidal ideation measured with the Beck Scale for Suicide Ideation at postintervention (6 weeks after baseline). Participants assigned to the internet-based self-help program experienced at postintervention a significant reduction on the primary outcome of suicidal ideation (mean difference: 2.91; 95% CI, 1.28 to 4.54; = .0005, Cohen's = 0.25) compared to the waiting list control group and on the secondary outcomes of hopelessness (mean difference: 1.98; 95% CI, 0.97 to 3.99) and worrying (mean difference: 5.19; 95% CI, 2.36 to 8.10). Six months later (follow-up), the difference between the groups remained significant for suicidal ideation, hopelessness, and worrying. A total of 28 (16.8%) of the participants in the intervention group reported negative effects from the internet-based self-help program. Internet-based self-help therapy was associated with a reduction in suicidal ideation at postintervention and 6-month follow-up. Some participants found it challenging to work with the therapeutic exercises, and we recommend that internet-based self-help therapy be implemented in mental health clinics or crisis lines, where support or online counseling is available. ClinicalTrials.gov identifier: NCT02872610.
大多数有自杀意念的人都没有得到帮助，每年有近 80 万人自杀。本研究旨在调查与等待名单对照组相比，一种基于互联网的引导自助计划在减少自杀意念方面的有效性。在一项随机对照试验中，2016 年 9 月 13 日至 2018 年 9 月 2 日，将 402 名有自杀意念的个体随机分配到基于互联网的引导自助计划或等待名单对照组。主要结局是在干预后（基线后 6 周）用贝克自杀意念量表测量的自杀意念。与等待名单对照组相比，分配到基于互联网的自助计划的参与者在干预后的主要结局（自杀意念的平均差异：2.91；95%置信区间，1.28 至 4.54； = .0005，Cohen's = 0.25）和次要结局（绝望的平均差异：1.98；95%置信区间，0.97 至 3.99）和担忧（平均差异：5.19；95%置信区间，2.36 至 8.10）显著降低。6 个月后（随访），两组之间的差异在自杀意念、绝望和担忧方面仍然显著。干预组中有 28 人（16.8%）报告了互联网自助计划的负面效应。基于互联网的自助治疗与干预后和 6 个月随访时自杀意念的减少有关。一些参与者发现很难使用治疗练习，我们建议在心理健康诊所或危机热线中实施基于互联网的自助治疗，在这些地方可以提供支持或在线咨询。临床试验.gov 标识符：NCT02872610。
