Brief Cognitive Behavioral Therapy for Suicide Prevention in a Brazilian Sample: a Study Protocol of a Randomized Clinical Trial
试验速览
- 阶段
- 3 期
- 状态
- 尚未招募
- 入组人数
- 150
研究概览
简要总结
The vast majority of suicides occur in low-and middle-income countries (LMICs), and evidence on effective psychotherapeutic interventions to prevent suicide that are culturally adapted to these contexts is limited. This scenario implies an urgent need for evidence-based suicide prevention strategies in Brazil. This research aims to evaluate the effectiveness of brief cognitive-behavioral therapy in preventing suicide in an outpatient setting of a Brazilian university. A randomized, controlled clinical trial with two arms, whose participants are adults who have attempted suicide or have had suicidal ideation with intent to die, will be designed. Inclusion criteria will be suicidal ideation with intent to die in the last week and/or suicide attempt in the last month. Patients will be randomly assigned to receive either a weekly 12-session supportive therapy or brief cognitive-behavioral therapy. The duration of treatment will be approximately 3 months. Both groups will have weekly individual therapy. Follow-up contact will be made 1 month and 6 months after treatment. If necessary, patients are entitled to two booster sessions during the follow-up period. The outcomes to be assessed, a priori, are suicide attempts, self-harm without suicidal intent and suicidal ideation, assessed by the Beck Scale for Suicide Ideation (BSI). Linear mixed models will be used to assess the outcomes of continuous variables, logistic regression models for categorical outcomes and survival analysis for the analysis of suicide attempts.
详细描述
Brief cognitive behavioral therapy for suicide prevention in a Brazilian sample: a study protocol of a randomized clinical trial
Background
Suicide figures as a major public health-related outcome and as one of the main causes of premature mortality (O'Connor et al., 2023). According to World Health Organization (WHO) data, more than 720,000 deaths by suicide are registered worldwide each year (World Health Organization, n.d.). Considering the alarming numbers, WHO has set the reduction of suicide mortality as a priority in the United Nations Sustainable Development Goals (SDGs), as well as in WHO's 13th General Programme of Work 2019-2023 and in the WHO Mental Health Action Plan 2013-2022 which has been extended to 2030 (World Health Organization, 2021). WHO (2021) states that an articulated response to suicide prevention is urged as this outcome costs millions of lives and burdens suicide-exposed people, affected by those who have attempted or died by suicide (World Health Organization, 2021). Each death by suicide affects in average more than 130 people, that may further need clinician support after being exposed to suicide grief (Cerel et al., 2016).
In 2019, the global age-standardized suicide rate was 9.0 per 100,000 population and in Brazil the suicide rate was 6.7 per 100,000 inhabitants (World Health Organization, 2021). In 2021, a significant majority of suicides - 73% - occurred in low-and-middle-income countries (LMICs) (World Health Organization, n.d). This data explains the urgent need for effective suicide prevention strategies in LMICs, including Brazil, where suicide is a growing public health concern. Despite the Brazilian rate being inferior to the global age-standardized rate in 2019, other alarming data highlights the urgency of addressing this public health issue in Brazil. Regardless of the 36% global reduction in the numbers of suicides from 2000 to 2019 (Damiano et al., 2024) some countries, such as Brazil, still face the challenge to address rising numbers. The Americas region has demonstrated a 17% increase in the same period and Brazil figures as one of the countries with the most significant rise (43%) (World Health Organization, 2021). According to the most recent epidemiological bulletin released by the Brazilian government, from 2000 to 2021, there was a 42% increase in the suicide mortality rate, from 5.2 to 7.5 per 100,000 inhabitants (Brasil, Ministério da Saúde, Secretaria de Vigilância em Saúde e Ambiente, 2024).
Brief Cognitive Behavioral Therapy CBT for suicide prevention protocols are designed to help high-risk individuals to identify patient-specific factors that trigger and intensify suicidal thoughts and behaviors, as well as to develop effective coping strategies when dealing with stressors and problems that activate the suicidal mode (Mann et al., 2021; Bryan & Rudd, 2018).
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Single (Participant)
入排标准
- 年龄范围
- 18 Years 至 60 Years（Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •if they are (1) Between the ages of 18-65; (2) Treatment-seeking status in outpatient mental health and/ or inpatient psychiatry discharge; (3) Report current (within the past week) suicide ideation (e.g., score greater than 2 on the Scale for Suicide Ideation) and/or a suicide attempt within the past month (e.g., as assessed by the Beck Scale for Suicide Ideation (BSI); (4) Able to understand and speak Portuguese; (5) Able to complete the informed consent process.
排除标准
- 未提供
研究者
Loren Beiram
PhD student at the Institute of Psychiatr
University of Sao Paulo