The cognitive behavioural prevention of suicide in psychosis: a clinical trial.
BACKGROUND
Suicide behaviour in psychosis is a significant clinical and social problem. There is a dearth of evidence for psychological interventions designed to reduce suicide risk in this population.


OBJECTIVE
To evaluate a novel, manualised, cognitive behavioural treatment protocol (CBSPp) based upon an empirically validated theoretical model.


METHODS
A randomly controlled trial with independent and masked allocated and assessment of CBSPp with TAU (n=25, 24 sessions) compared to TAU alone (n=24) using standardised assessments. Measures of suicide probability, and suicidal ideation were the primary outcomes and measures of hopelessness, depression, psychotic symptoms, functioning, and self-esteem were the secondary outcomes, assessed at 4 and 6 months follow-up.


RESULTS
The CBSPp group improved differentially to the TAU group on two out of three primary outcome measures of suicidal ideation and suicide probability, and on secondary outcomes of hopelessness related to suicide probability, depression, some psychotic symptoms and self-esteem.


CONCLUSIONS
CBSPp is a feasible intervention which has the potential to reduce proxy measures of suicide in psychotic patients.
Department of Psychology, Institute of Psychiatry, London, UK.
Nicholas
N
Tarrier
Greater Manchester West Mental Health NHS Foundation Trust, UK.
James
J
Kelly
Greater Manchester West Mental Health NHS Foundation Trust, UK.
Sehar
S
Maqsood
Greater Manchester West Mental Health NHS Foundation Trust, UK.
Natasha
N
Snelson
Faculty of Human and Medical Sciences, University of Manchester, UK.
Janet
J
Maxwell
Greater Manchester West Mental Health NHS Foundation Trust, UK.
Heather
H
Law
Faculty of Human and Medical Sciences, University of Manchester, UK.
Graham
G
Dunn
Faculty of Human and Medical Sciences, University of Manchester, UK.
Patricia
P
Gooding
D000328:Adult; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003863:Depression; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D010865:Pilot Projects; D011336:Probability; D011618:Psychotic Disorders / Q000523:psychology / Q000628:therapy*; D012649:Self Concept; D057566:Self Report; D059020:Suicidal Ideation; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D000092864:Suicide Prevention
CBT; Psychological intervention; Psychosis; Schizophrenia; Suicide