title: Dialectical Behavior Therapy Compared With Enhanced Usual Care for Adolescents With Repeated Suicidal and Self-Harming Behavior: Outcomes Over a One-Year Follow-Up.
abstract: OBJECTIVE
  We conducted a 1-year prospective follow-up study of posttreatment clinical outcomes in adolescents with recent and repetitive self-harm who had been randomly allocated to receive 19 weeks of either dialectical behavior therapy adapted for adolescents (DBT-A) or enhanced usual care (EUC) at community child and adolescent psychiatric outpatient clinics.
  
  
  METHODS
  Assessments of self-harm, suicidal ideation, depression, hopelessness, borderline symptoms, and global level of functioning were made at the end of the 19-week treatment period and at follow-up 1 year later. Altogether 75 of the 77 (97%) adolescents participated at both time points. Frequencies of hospitalizations, emergency department visits and other use of mental health care during the 1-year follow-up period were recorded. Change analyses were performed using mixed effects linear spline regression and mixed effect Poisson regression with robust variance.
  
  
  RESULTS
  Over the 52-week follow-up period, DBT-A remained superior to EUC in reducing the frequency of self-harm. For other outcomes such as suicidal ideation, hopelessness, and depressive or borderline symptoms and for the global level of functioning, inter-group differences apparent at the 19-week assessment were no longer observed, mainly due to participants in the EUC group having significantly improved on these dimensions over the follow-up year, whereas DBT-A participants remained unchanged.
  
  
  CONCLUSIONS
  A stronger long-term reduction in self-harm and a more rapid recovery in suicidal ideation, depression, and borderline symptoms suggest that DBT-A may be a favorable treatment alternative for adolescents with repetitive self-harming behavior.
  
  
  BACKGROUND
  Treatment for Adolescents With Deliberate Self Harm; http://clinicaltrials.gov/; NCT00675129.
authors.affiliation: National Centre for Suicide Research and Prevention, Institute of Clinical Medicine, University of Oslo, Oslo, Norway. Electronic address: lars.mehlum@medisin.uio.no.
authors.forename: Lars
authors.initials: L
authors.lastname: Mehlum
authors.affiliation: National Centre for Suicide Research and Prevention, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
authors.forename: Maria
authors.initials: M
authors.lastname: Ramberg
authors.affiliation: National Centre for Suicide Research and Prevention, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
authors.forename: Anita J
authors.initials: AJ
authors.lastname: Tørmoen
authors.affiliation: National Centre for Suicide Research and Prevention, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
authors.forename: Egil
authors.initials: E
authors.lastname: Haga
authors.affiliation: National Centre for Suicide Research and Prevention, Institute of Clinical Medicine, University of Oslo and Oslo University Hospital.
authors.forename: Lien M
authors.initials: LM
authors.lastname: Diep
authors.affiliation: Columbia University, New York, USA, and the University of Oslo.
authors.forename: Barbara H
authors.initials: BH
authors.lastname: Stanley
authors.affiliation: Montefiore Medical Center and Albert Einstein College of Medicine, New York, USA.
authors.forename: Alec L
authors.initials: AL
authors.lastname: Miller
authors.affiliation: Norwegian University of Science and Technology and St. Olav's University Hospital, Trondheim, Norway.
authors.forename: Anne M
authors.initials: AM
authors.lastname: Sund
authors.affiliation: National Centre for Suicide Research and Prevention, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
authors.forename: Berit
authors.initials: B
authors.lastname: Grøholt
mesh_terms: D000293:Adolescent; D001521:Behavior Therapy / Q000379:methods*; D001883:Borderline Personality Disorder / Q000523:psychology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011446:Prospective Studies; D016728:Self-Injurious Behavior / Q000523:psychology / Q000628:therapy*; D059020:Suicidal Ideation; D013405:Suicide / Q000523:psychology*; D013406:Suicide, Attempted / Q000523:psychology; D016896:Treatment Outcome
keywords: attempted suicide; longitudinal; psychotherapy; randomized trial; self-harm