基于问题解决的简短心理干预预防自杀应用于不同形式的 50 岁以上人群：一项随机对照试验方案。
Brief psychological intervention for suicide prevention based on problem-solving applied in different formats to people over 50 years old: protocol for a randomized controlled trial.
机构信息
Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, Santiago de Compostela, Spain.
Department of Psychiatry, Radiology, Public Health, Nursing and Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain.
出版信息
BMC Psychiatry. 2024 Sep 27;24(1):628. doi: 10.1186/s12888-024-06076-5.
BACKGROUND
Suicide is a major public health problem, especially among individuals over 50 years old. Despite the suitability of this life stage for prevention, research on the efficacy of psychological interventions is scarce and methodologically limited, affecting their clinical utility and efficacy. Brief, flexible interventions that can be applied both in-person and remotely are needed. This study aims to evaluate the efficacy of a brief problem-solving-based suicide prevention program applied through various modalities to individuals over 50 years old.
METHODS
A randomized controlled trial will be conducted. A sample of 212 adults aged 50 or older with suicidal ideation will be randomly assigned to a problem-solving-based psychological intervention administered face-to-face (PSPI-P; n = 53), by telephone multiconference (PSPI-M; n = 53), via a smartphone app (PSPI-A; n = 53), or to a usual care control group (UCCG; n = 53). The intervention will be delivered in 7 sessions or modules of 90 min each. Blind trained evaluators will conduct assessments at pre-intervention, post-intervention, and follow-ups at 3, 6, and 12 months. The primary outcome will be suicidal ideation evaluated using the Suicidal Ideation Scale (SSI) and the Columbia Suicide Severity Rating Scale (C-SSRS). Secondary outcomes will include hopelessness, anxiety and depression symptoms, reasons for living, impulsivity, problem-solving skills, social support, anger syndrome, gratitude, personality, dropouts, treatment adherence, and satisfaction with the intervention.
DISCUSSION
This study will provide evidence of the efficacy of a brief problem-solving-based intervention for suicide prevention in individuals over 50 years old, administered face-to-face, by telephone multiconference, and via a smartphone app. If results are favorable, it will indicate that an effective, accessible, clinically and socially useful suicide prevention intervention has been developed for affected individuals, families, and communities.
TRIAL REGISTRATION
ClinicalTrials.gov NCT06338904. Registered April 1, 2024.
背景
自杀是一个主要的公共卫生问题，尤其是在 50 岁以上的人群中。尽管这个生命阶段适合进行预防，但针对心理干预措施的效果的研究却很少，且方法上存在局限性，这影响了它们的临床实用性和效果。因此，我们需要一种简短、灵活的干预措施，可以面对面和远程应用。本研究旨在评估一种基于问题解决的简短自杀预防方案的效果，该方案通过多种方式应用于 50 岁以上的个体。
方法
将进行一项随机对照试验。我们将招募 212 名有自杀意念的 50 岁及以上成年人，将他们随机分配到面对面的问题解决心理干预组（PSPI-P；n=53）、电话多会议组（PSPI-M；n=53）、智能手机应用组（PSPI-A；n=53）或常规护理对照组（UCCG；n=53）。干预将通过 7 次会议或每次 90 分钟的模块进行。受过训练的盲评估员将在干预前、干预后以及 3、6 和 12 个月时进行评估。主要结局将使用自杀意念量表（SSI）和哥伦比亚自杀严重程度评定量表（C-SSRS）评估自杀意念。次要结局包括绝望感、焦虑和抑郁症状、生存理由、冲动性、解决问题的能力、社会支持、愤怒综合征、感恩、人格、辍学、治疗依从性和对干预的满意度。
讨论
本研究将为 50 岁以上人群的基于问题解决的简短干预预防自杀提供疗效证据，该干预通过面对面、电话多会议和智能手机应用进行。如果结果是有利的，这将表明为受影响的个人、家庭和社区开发了一种有效、可及、临床和社会有用的自杀预防干预措施。
试验注册
ClinicalTrials.gov NCT06338904。2024 年 4 月 1 日注册。
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