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Clinical Trial
. 2019 Oct;60(10):1133-1141.
doi: 10.1111/jcpp.13095. Epub 2019 Jul 21.

Family-focused cognitive behavioral treatment for depressed adolescents in suicidal crisis with co-occurring risk factors: a randomized trial

Christianne Esposito-Smythers  1 , Jennifer C Wolff  2 , Richard T Liu  2 , Jeffrey I Hunt  2 , Leah Adams  1 , Kerri Kim  2 , Elisabeth A Frazier  2 , Shirley Yen  2 , Daniel P Dickstein  2 , Anthony Spirito  2
Affiliations
Clinical Trial

Family-focused cognitive behavioral treatment for depressed adolescents in suicidal crisis with co-occurring risk factors: a randomized trial

Christianne Esposito-Smythers et al. J Child Psychol Psychiatry. 2019 Oct.

Abstract

Background: Suicide is the second leading cause of death among adolescents. The purpose of this study was to test a family-focused outpatient cognitive behavioral treatment (F-CBT) protocol for depressed adolescents following psychiatric hospitalization for a suicide attempt or suicidal ideation, and who had a co-occurring risk factor (suicidal behavior prior to the index admission, nonsuicidal self-injury, and/or a substance use disorder), in a randomized Phase 2 efficacy trial.

Method: One hundred forty-seven adolescents (mean age = 14.91 years; 76.2% female, 85.5% White) and their families, recruited primarily from an inpatient psychiatric hospitalization program, were randomly assigned to F-CBT or enhanced treatment-as-usual (E-TAU). A suicide attempt was the primary outcome variable. Depression, suicidal ideation, and nonsuicidal self-injury are also reported here. Assessments were completed at pretreatment as well as 6, 12, and 18-months postrandomization (Trial Registration ClinicalTrials.gov Identifier: NCT01732601).

Results: In the sample as a whole, rates of attempts decreased from 20% at 6 months to 9% at 12 months to 7% at 18 months. There was no evidence of a significant difference between treatment arms in rates of suicide attempts, major depressive disorder, suicidal ideation, or nonsuicidal self-injury at any of the postrandomization assessment points.

Conclusions: Though F-CBT was associated with reductions in suicidality, depression, and nonsuicidal self-injury, E-TAU showed an equally strong effect. Greater frequency of F-CBT treatment sessions, particularly at the start of care, and alternative approaches to transitioning to care at 12 months, may be necessary when using F-CBT with this population.

Keywords: Suicide; adolescent; clinical trial; cognitive behavioral therapy.

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Conflict of interest statement

Conflict of interest statement: No conflicts declared.

The authors have declared that they have no competing or potential conflicts of interest.

Figures

Figure 1.
Figure 1.
Participant flow through the study. Note. aNumber analyzed in intent-to-treat analyses.
See this image and copyright information in PMC

References

    1. Asarnow JR, Berk M, Hughes JL, & Anderson NL (2017). The SAFETY Program: A treatment-development trial of a cognitive-behavioral family treatment for adolescent suicide attempters. Journal of Clinical Child and Adolescent Psychology, 44, 194–203. - PMC - PubMed
    1. Burns B, Angold A, Magruder-Habib K, Costello E, Patrick M (1997). Child and Adolescent Services Assessment (version 4.2). Durham, NC: Duke University.
    1. Centers for Disease Control and Prevention. Web-Based Injury Statistics Query and Reporting System (WISQARS). Atlanta, GA: Centers for Disease Control and Prevention; 2017. http://www.cdc.gov/injury/wisqars/LeadingCauses.html
    1. Cigularov K, Chen PY, Thurber BW, & Stallones L (2008). What prevents adolescents from seeking help after a suicide education program? Suicide and Life-Threatening Behavior, 38, 74–86. - PubMed
    1. Curtin SC, Hedegaard H, Minino AM, Warner M QuickStats: Death rates for motor vehicle traffic injury, suicide, and homicide among children and adolescents aged 10–14 years — United States, 1999–2014. MMWR Morb Mortal Wkly Rep. 2016;65. - PubMed

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