Brief inpatient CBT promising for suicide prevention

Brief cognitive behavioural therapy (CBT) delivered in inpatient settings appears to lower the rate of repeat suicide attempts and readmissions among individuals admitted to psychiatric hospitals, according to a study.

A total of 200 adults (mean age 32.8 years, 58.5 percent female, 61.5 percent White) were recruited from inpatient units of a private psychiatric hospital. Inclusion criteria were a suicide attempt within 1 week of admission or ideation with plan on admission, as well as suicide attempt within 2 years.

The participants were randomly assigned to receive up to four individual sessions of an inpatient version of brief CBT for suicide prevention in addition to treatment as usual (n=94) or treatment as usual alone (n=106).

Follow-up assessments were performed monthly for 6 months after discharge. Suicide attempts and readmissions, the main study outcomes, were evaluated via blind interviews and medical record review. Suicidal ideation was self-reported. More than half of participants (57.0 percent) completed 6-month follow-up assessments.

Compared with treatment as usual, add-on brief CBT was associated with a 60-percent lower odds of suicide attempts over 6 months postdischarge (odds ratio, 0.40, 95 percent CI, 0.20–0.80; number needed to treat, 7).

Moreover, add-on brief CBT correlated with a 71-percent reduction in the rate of psychiatric readmissions but only among participants without a substance use disorder (rate ratio, 0.29, 95 percent CI, 0.09–0.90).

The evidence on the effect of brief CBT on suicidal ideation was less clear. However, post hoc analyses showed less severe suicidal ideation following brief CBT vs treatment as usual at 1 and 2 months postdischarge.