Cognitive Therapy Reduces Repeat Suicide Attempts by 50 Percent

Treatment of Suicide Attempt

Recent suicide attempters treated with cognitive therapy were 50 percent less likely to try to kill themselves again within 18 months than those who did not receive the therapy, report researchers supported by the National Institutes of Health's (NIH) National Institute of Mental Health (NIMH) and the Center for Disease Control and Prevention (CDC). A targeted form of cognitive therapy designed to prevent suicide proved better at lifting depression and feelings of hopelessness than the usual care available in the community, according to Gregory Brown, Ph.D., Aaron Beck, M.D., University of Pennsylvania, and colleagues, who published their findings in the August 3, 2005 Journal of the American Medical Association (JAMA).

"Since even one previous attempt multiplies suicide risk by 38-40 times and suicide is the fourth leading cause of death for adults under 65, a proven way to prevent repeat attempts has important public health implications," said NIMH Director Thomas Insel, M.D.

To achieve a large enough sample to reliably detect differences in the effectiveness of interventions, the researchers first screened hundreds of potential suicide attempters admitted to the emergency room of the Hospital of the University of Pennsylvania in Philadelphia, ultimately recruiting 120 patients into the study.

Averaging in their mid-thirties, 61 percent of the participants were female, 60 percent black, 35 percent white, and 5 percent Hispanic and other ethnicities. Most had attempted to kill themselves by drug overdosing (58 percent), with 17 percent by stabbing, 7 percent by jumping and 4 percent by hanging, shooting or drowning. Seventy-seven percent had major depression and 68 percent a substance use disorder.

After a clinical evaluation, each participant was randomly assigned to one of two conditions: cognitive therapy or usual care