The Effect of Changes in Depression and Anxiety on Changes in Suicide Ideation: A Randomised Control

来源 :国际预防自杀协会(IASP)第26届世界大会 | 被引量 : 0次 | 上传用户:white2008
下载到本地 , 更方便阅读
声明 : 本文档内容版权归属内容提供方 , 如果您对本文有版权争议 , 可与客服联系进行内容授权或下架
论文部分内容阅读
  Background: Despite the known associations between anxiety, depression and suicide ideation, we know little of the course of these constructs over time.There is some evidence that declines in depressive symptoms predict declines in suicide ideation in adults with major depression, but the evidence is less clear in adolescence.Anxiety is increasingly recognised as a risk factor for suicide ideation and suicide attempt, but the temporal relationship among the measures has rarely been examined.One method to determine the short term relationship, and, indeed, gain some knowledge of the causal links among these constructs, is to examine the effects of treatment on these symptoms over time.Very few studies have mapped the time course of suicide ideation through the course of an antidepressant RCT (Mann, 2005) or in response to psychological therapy.In an earlier trial of callers to a telephone counselling service (Farrer et al., submitted) an Internet based CBT program reduced depression symptoms relative to a control condition, but that both the Internet program and the control condition were equally effective in reducing suicide ideation over 6-weeks.The present study investigated the effects of an Internet CBT program on anxiety and suicide ideation in a new RCT trial which aimed to prevent the development of Generalised Anxiety Disorder.We hypothesized that the CBT program would lower anxiety, but that both the control and the CBT intervention arms would lower suicide ideation.Methods: The study consisted of 5 arms: GAD-Internet prevention alone, GAD-Internet with human interaction (telephone), GAD Internet with automated email messages, a placebo Internet intervention plus human interaction (telephone), and the placebo Internet (alone).Participants were recruited from a community sample of 18-30 year-olds with subclinical GAD symptoms.Results: Preliminary data indicated that the GAD internet intervention substantially reduced levels of anxiety compared to the placebo internet conditions.However, the intervention did not significantly decrease suicide ideation.A preliminary analysis of completers using logistic regression (n=82 of 127) examined suicide ideation at post-test as a function of changes in depression and anxiety.Accounting for pre-test GAD-7 scores, group assignment and pre-test suicidality, increases (or smaller decreases) in GAD-7 scores from pre-to post-test was significantly associated with higher odds of suicidality at post-test.Initial depression, depression change scores, age and gender did not predict suicidality after accounting for anxiety.Discussion: An internet based GAD program significantly reduced levels of anxiety.Although the program did not significantly reduce levels of suicide ideation, participants with larger reductions in anxiety were less likely to experience ideation at post-test.Changes in depression did not predict changes in suicide ideation.These results may be specific to individuals at risk of GAD.Methodological limitations include low numbers, short time frame (pre to post), completer analysis, and low levels of suicide ideation at pre-test.Anxiety and ideation may be more strongly linked than depression and suicide ideation.Findings for the larger sample of 300 participants will be presented in September.
其他文献
Background: Most suicide attempts in China are treated for the physical consequences of the attempt in the emergency room departments (ERs) of large general hospitals, few of which have affiliated men
会议
Introduction: Kerala is a state in South India, where suicide rate is remaining at a very high rate.Suicide rate of Kerala is 25.3/1Lakh while the National Suicide Rate in India is 10.9/1Lakh populati
Background: With the rapid development of social economy and culture, university students in China face many challenges together with pressure of competition, leading to increased stress that many stu
Background: Truancy is a serious problem that affects adolescents from all around the world: in the USA, it has been reported that up to 35% of high school students skipper one or more days of school
Background: With the rapid change of social-economics in contemporary China, mental health of youth students has become a major public concern.Although living in a similar environment in university ca
Background: Female suicide rate is slightly higher than male in China, especially in rural areas.Understanding the characteristics of female suicide completers is important for suicide prevention amon
Background: Impulsiveness is a psychological trait which is known to be linked to some axis Ⅰ and Ⅱ DSM-Ⅳ disorders.A recent review of the literature shows that the link between impulsiveness and suic
Introduction: When Brazilian numbers are compared to worldwide suicide rates, Brazil is found to have one of the lowest suicide rates (3.0 to 4.0/100,000/year inhabitants), especially in comparison to
Background: Until the late 1960s the national suicide rate in Scotland was lower than in many other western European countries, including England.Since then the rate in Scotland has become the highest