Department of Mental Health and Specialist Services Gold Coast University Hospital, 1 Hospital Boulevard, Southport, Queensland, 4215, Australia.
Faculty Health Sciences and Medicine, Bond University, 14 University Drive, Robina, Queensland, 4226, Australia.
Trials. 2021 Oct 21;22(1):723. doi: 10.1186/s13063-021-05658-y.
Despite being preventable, suicide is a leading cause of death and a major global public health problem. For every death by suicide, many more suicide attempts are undertaken, and this presents as a critical risk factor for suicide. Currently, there are limited treatment options with limited underpinning research for those who present to emergency departments with suicidal behaviour. The aim of this study is to assess if adding one of two structured suicide-specific psychological interventions (Attempted Suicide Short Intervention Program [ASSIP] or Brief Cognitive Behavioural Therapy [CBT] for Suicide Prevention) to a standardised clinical care approach (Suicide Prevention Pathway [SPP]) improves the outcomes for consumers presenting to a Mental Health Service with a suicide attempt.
This is a randomised controlled trial with blinding of those assessing the outcomes. People who attempt suicide or experience suicidality after a suicide attempt, present to the Gold Coast Mental Health and Specialist Services, are placed on the Suicide Prevention Pathway (SPP), and meet the eligibility criteria, are offered the opportunity to participate. A total of 411 participants will be recruited for the study, with 137 allocated to each cohort (participants are randomised to SPP, ASSIP + SPP, or CBT + SPP). The primary outcomes of this study are re-presentation to hospitals with suicide attempts. Presentations with suicidal ideation will also be examined (in a descriptive analysis) to ascertain whether a rise in suicidal ideation is commensurate with a fall in suicide attempts (which might indicate an increase in help-seeking behaviours). Death by suicide rates will also be examined to ensure that representations with a suicide attempt are not due to participants dying, but due to a potential improvement in mental health. For participants without a subsequent suicide attempt, the total number of days from enrolment to the last assessment (24 months) will be calculated. Self-reported levels of suicidality, depression, anxiety, stress, resilience, problem-solving skills, and self- and therapist-reported level of therapeutic engagement are also being examined. Psychometric data are collected at baseline, end of interventions, and 6,12, and 24 months.
This project will move both ASSIP and Brief CBT from efficacy to effectiveness research, with clear aims of assessing the addition of two structured psychological interventions to treatment as usual, providing a cost-benefit analysis of the interventions, thus delivering outcomes providing a clear pathway for rapid translation of successful interventions.
ClinicalTrials.gov NCT04072666 . Registered on 28 August 2019.
尽管可以预防，但自杀仍是导致死亡的主要原因之一，也是一个重大的全球公共卫生问题。每有一起自杀身亡事件，就有更多的自杀未遂事件发生，这构成了自杀的关键风险因素。目前，对于那些因自杀行为到急诊科就诊的患者，治疗选择有限，且相关研究也很有限。本研究旨在评估在标准化临床护理方法（自杀预防途径 [SPP]）中添加两种结构化的专门针对自杀的心理干预措施（尝试性自杀短期干预计划 [ASSIP] 或简短认知行为治疗 [CBT] 预防自杀）是否能改善因自杀行为就诊的患者的结局。
这是一项随机对照试验，对评估结果的人员进行了盲法处理。有自杀企图或在自杀企图后出现自杀意念的人会到黄金海岸心理健康和专科服务机构就诊，他们被纳入自杀预防途径（SPP），并符合入选标准，他们将有机会参与该研究。共有 411 名参与者将被招募到这项研究中，其中每个队列 137 人（参与者被随机分配到 SPP、ASSIP+SPP 或 CBT+SPP）。该研究的主要结局是因自杀行为再次到医院就诊。还将对出现自杀意念的情况进行检查（描述性分析），以确定自杀意念的增加是否与自杀企图的减少相一致（这可能表明寻求帮助的行为有所增加）。自杀死亡率也将进行检查，以确保因自杀企图就诊的患者不是因为死亡，而是因为心理健康状况的改善。对于没有随后自杀企图的参与者，将计算从入组到最后评估的总天数（24 个月）。还检查了自我报告的自杀意念水平、抑郁、焦虑、压力、适应力、解决问题的能力，以及自我和治疗师报告的治疗参与水平。在基线、干预结束时以及 6、12 和 24 个月时收集心理测量数据。
本项目将 ASSIP 和简短 CBT 从疗效研究推进到有效性研究，明确目的是评估在常规治疗中添加两种结构化心理干预措施的效果，对干预措施进行成本效益分析，从而提供明确的快速转化成功干预措施的途径的结果。
ClinicalTrials.gov NCT04072666。注册于 2019 年 8 月 28 日。
