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通过单次虚拟心理治疗减轻自杀风险:“安全生活简短技能”的开放标签试验

Mitigating suicide risk with a single session of virtually-delivered psychotherapy: An open-label trial of Brief Skills for Safer Living.

作者信息

Lalovic Aleksandra, Hyde Molly, Bergmans Yvonne, Morton Michael, Razac Aliana, Nicoll Gina, Syms Dwight, Kennedy Sidney H, Rizvi Sakina J

机构信息

ASR Suicide and Depression Studies Program, Department of Psychiatry, St. Michael's Hospital, 193 Yonge St., 6th Floor, Toronto M5B 1M4, Ontario, Canada.

ASR Suicide and Depression Studies Program, Department of Psychiatry, St. Michael's Hospital, 193 Yonge St., 6th Floor, Toronto M5B 1M4, Ontario, Canada; Institute of Medical Science, University of Toronto, Ontario, Canada.

出版信息

J Affect Disord. 2025 May 27;388:119512. doi: 10.1016/j.jad.2025.119512.

Abstract

BACKGROUND

Suicide is a global challenge and suicide rates have not significantly decreased. The COVID-19 pandemic also increased suicide risk and intensified pre-existing lack of access to mental health services. To address this issue, "Brief Skills for Safer Living" (Brief-SfSL) was developed, a single-session individual psychotherapy intervention with the potential to make it easier to access care and shorten the time to access intervention. Derived from the original success of the SfSL 20-week group therapy, Brief-SfSL helps individuals understand their suicidal thoughts, build skills to manage these thoughts, and stay safer during crises. This national study tested the effectiveness of remote Brief-SfSL on suicidal ideation over 12 weeks, as well as feasibility and acceptability.

METHODS

This was a single-arm trial of virtually-delivered Brief-SfSL in 77 adults with suicidal ideation across Canada with follow-up at 1, 4 and 12 weeks. The primary outcome was the Beck Scale for Suicide Ideation, and secondary measures assessed depression, anxiety, social connectedness, and life functioning.

RESULTS

The results demonstrated that Brief-SfSL is an effective, feasible, acceptable, and safe intervention for suicide risk.

CONCLUSIONS

These data support the utility of Brief-SfSL as a single-session targeted suicide intervention that can increase accessibility due to the flexibility in delivery format and minimal resources required. They also underscore that remote suicide intervention can be conducted with a suicide safety protocol in place. Future studies will investigate Brief-SfSL in a randomized controlled trial and the long-term impact of Brief-SfSL on suicide risk, healthcare system utilization, and health economics.

摘要

背景

自杀是一项全球性挑战,自杀率并未显著下降。新冠疫情也增加了自杀风险,并加剧了此前心理健康服务获取途径不足的问题。为解决这一问题,研发了“安全生活简要技能”(Brief-SfSL),这是一种单次个体心理治疗干预措施,有可能使获得护理更加容易,并缩短获得干预的时间。Brief-SfSL源自为期20周的SfSL团体治疗的最初成功经验,帮助个体理解其自杀念头,培养管理这些念头的技能,并在危机期间保持安全。这项全国性研究测试了远程Brief-SfSL在12周内对自杀意念的有效性,以及可行性和可接受性。

方法

这是一项对加拿大77名有自杀意念的成年人进行的虚拟交付Brief-SfSL单臂试验,在第1、4和12周进行随访。主要结局是贝克自杀意念量表(Beck Scale for Suicide Ideation),次要指标评估抑郁、焦虑、社会联系和生活功能。

结果

结果表明,Brief-SfSL是一种针对自杀风险的有效、可行、可接受且安全的干预措施。

结论

这些数据支持Brief-SfSL作为一种单次针对性自杀干预措施的效用,由于其交付形式的灵活性和所需资源最少,它可以提高可及性。它们还强调,远程自杀干预可以在有自杀安全协议的情况下进行。未来的研究将在随机对照试验中调查Brief-SfSL,以及Brief-SfSL对自杀风险、医疗系统利用和健康经济学的长期影响。

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