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Randomized Controlled Trial
. 2020 Jun;50(3):652-667.
doi: 10.1111/sltb.12612. Epub 2020 Jan 16.

Adapted Dialectical Behavior Therapy for Adolescents with a High Risk of Suicide in a Community Clinic: A Pragmatic Randomized Controlled Trial

Pilar Santamarina-Perez  1 , Iria Mendez  1 , Manpreet K Singh  2 , Michele Berk  2 , Marisol Picado  1 , Elena Font  1 , Elena Moreno  1 , Esteve Martínez  1 , Astrid Morer  1   3   4 , Roger Borràs  4 , Alexandra Cosi  5 , Soledad Romero  1   3   4
Affiliations
Randomized Controlled Trial

Adapted Dialectical Behavior Therapy for Adolescents with a High Risk of Suicide in a Community Clinic: A Pragmatic Randomized Controlled Trial

Pilar Santamarina-Perez et al. Suicide Life Threat Behav. 2020 Jun.

Abstract

Objective: This study is a pragmatic randomized controlled trial, which compares the effectiveness of an adapted form of Dialectical Behavior Therapy for Adolescents (DBT-A) and treatment as usual plus group sessions (TAU + GS) to reduce suicidal risk for adolescents in a community health mental clinic.

Method: Thirty-five adolescents from a community outpatient clinic, with repetitive NSSI alone or with SA over the last 12 months and with current high suicide risk as assessed by the Columbia-Suicide Severity Rating Scale (C-SSRS), were enrolled. Participants were randomly assigned to undergo either DBT-A (n = 18) or TAU + GT (n = 17) treatments over a 16-week period. Primary outcomes were the difference between NSSI and SA recorded during the first 4 weeks and the final 4 weeks of treatment. Secondary outcomes included changes in Children's Global Assessment Scale (C-GAS), Suicidal Ideation Questionnaire (SIQ-JR), and Beck Depression Inventory-II (BDI-II).

Results: Dialectical Behavior Therapy for Adolescents was more effective than TAU + GS at reducing NSSI, use of antipsychotics, and improving C-GAS. No SAs were reported in the two groups at the end of the treatment. Both treatments were equally effective in decreasing SIQ-JR and BDI-II scores.

Conclusions: These findings support the feasibility and effectiveness of DBT-A for adolescents at high risk of suicide in community settings.

Trial registration: ClinicalTrials.gov NCT02406625.

Keywords: community settings; dialectical behavior therapy; nonsuicidal self-injury; pragmatic randomized controlled trial; suicide attempts.

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References

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