Cognitive-behavioral suicide prevention for psychosis in community mental health: A pilot randomized clinical trial.
Lindsay A Bornheimer, Jordan DeVylder, Matthew J Smith et al.
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In 30 seconds
This pilot randomized clinical trial evaluated Cognitive-Behavioral Suicide Prevention for psychosis (CBSPp) plus services as usual (SAU) versus SAU alone among adults with schizophrenia spectrum disorders receiving community mental health care who had recent suicidal ideation or an attempt. Fifty-one participants were randomized, and 41 (80.4%) completed final follow-up. Significant group-by-time interactions indicated greater reductions with CBSPp in suicidal ideation severity (F(3,125.25) = 3.48; P = .018; η 2 ≈ 0.10), depressive symptoms, negative psychosis symptoms, and general psychosis symptoms. The authors describe these findings as preliminary and call for larger trials.
Key findings
- Suicidal ideation severity showed a significant group-by-time interaction favoring CBSPp (F(3,125.25) = 3.48; P = .018; η 2 ≈ 0.10).
- Group-by-time interactions indicated greater reductions with CBSPp in depressive symptoms (η 2 ≈ 0.07), negative psychosis symptoms (η 2 ≈ 0.12), and general psychosis symptoms (η 2 ≈ 0.17).
- Of 51 randomized participants, 41 (80.4%) completed the final follow-up assessment.
Why it matters
Adults with schizophrenia spectrum disorders face elevated suicide risk, while few prevention interventions have been tested for this population. These pilot results suggest that a targeted cognitive-behavioral intervention may improve suicidal ideation and several symptom outcomes when added to community mental health services. Further evaluation is needed before its effectiveness or impact on suicide-related outcomes can be established.
What to keep in mind
This was a pilot trial with 51 participants, and 41 (80.4%) completed final follow-up; the authors call for larger, adequately powered trials across diverse clinical settings.