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Cognitive Therapy Halves Risk of Second Suicide Attempt

It pinpoints problems, provides solutions, researcher says

TUESDAY, Aug. 2, 2005 (HealthDay News) -- A psychiatric technique of straight talk about tough problems reduces the chance that people who have survived one suicide attempt will try again, a new study finds.

The method is called cognitive therapy, and the risk of a second suicide try was cut almost in half for the 60 persons who received it, compared to those getting conventional treatment, according to a report by psychiatrists at the University of Pennsylvania.

The report appears in the Aug. 3 edition of the Journal of the American Medical Association, which is a themed issue on human rights and violence.

"Cognitive therapy, developed in the 1970s, targets the thoughts and beliefs that patients have related to a particular disorder or problem area, aiming to change those thoughts or beliefs," said Gregory K. Brown, a research associate professor of clinical psychology and psychiatry and a member of the research team.

Another member was Dr. Aaron Beck, a psychiatrist who is regarded as the father of cognitive therapy.

Said Brown: "We recruited suicide attempters from the emergency room and asked them to tell us the story, what led them to attempt suicide -- emotional triggers, major events in their lives, reactions to those events. What our treatment does is pinpoint where they are having problems coping with a crisis, and how to cope better."

The study followed the 120 participants for 18 months. Over that time, 13 (24.1 percent) of those who got cognitive therapy made a second suicide attempt, compared to 23 (41.6 percent) of those who got standard treatment. Measurements of depression found significantly lower levels for the cognitive therapy group.

"It is a very good start, but not the end of the story," said Jane Pearson, chairwoman of the National Institute of Mental Health Suicide Research Consortium, which funded the study and is now funding the University of Pennsylvania effort to make cognitive therapy more widely available.

"This is not widely available now, people have to be trained to do it," Brown said. "We are trying to train therapists in community centers."

One impressive part of the study was that it had "very minimal exclusion criteria," meaning that it included people who attempted suicide for a wide variety of problems, Pearson said. Many other studies limit their efforts to a single cause, such as depression, she said.

Another important point is that the researchers followed the participants for 18 months, much longer than many previous studies, said Alan L. Berman, executive director of the American Association of Suicidology. The results confirm that "cognitive therapy is an effective therapy" for reducing the risk of second suicide attempts, he added.

An unsolved problem is detecting people who are likely to make the first suicide attempt, Berman said. The outward signs of trouble that could lead to such an attempt are often not obvious to family members and friends, and "suicidal people are not the greatest of help-seekers," he said. But a first suicide try is "a calling card" that intervention is needed, he noted.

More information

Suicide, its causes and treatment, are explained by the American Association of Suicidology.

SOURCES: Gregory K. Brown, Ph.D., research associate professor, clinical psychology and psychiatry, University of Pennsylvania, Philadelphia; Jane Pearson, Ph.D., chairwoman, National Institute of Mental Health Suicide Research Consortium, Bethesda, Md.; Alan L. Berman, Ph.D, executive director, American Association of Suicidology, Washington, D.C.; Aug. 3, 2005, Journal of the American Medical Association
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