Adding cognitive therapy to antidepressant medications decreases suicidal ideation

Khazanov, Gabriela Kattan; Xu, Colin; Hollon, Steven D.; DeRubeis, Robert J.; Thase, Michael E.

doi:10.1016/j.jad.2020.12.032

Cited by 15 publications

(27 citation statements)

References 44 publications

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“…Suicidality variables were extracted from item 3 of the HAM‐D (HAM‐D‐3) and item 9 of the BDI (BDI‐9) from the 76 randomized patients at any of the three time points. An additional measure was produced by adding the scores of the two items: (HAM‐D‐3 plus BDI‐9) 23 Item 3 of the Hamilton Rating Scale for Depression (HAM‐D‐3): The HAM‐D 30 has 17 items, with scores above 15 showing moderate symptoms and, above 26, severe depression, and was applied with the GRID‐HAM‐D 55 .…”

Section: Methodsmentioning

confidence: 99%

“…It was applied to the randomized patients at the three time points. Item 3 of the HAM‐D combined with Item 9 of the BDI (HAM‐D‐3 plus BDI‐9): It is a composite measure that combines the HAM‐D‐3 and BDI‐9 items, yielding scores from 0 to 7. The same combination was used in the study by Khazanov et al, 23 similar to a previous study that also summed suicidality items from two other scales 59 . The items offer different answers and scores to assess suicidality: HAM‐D‐3 presents criteria ranging from no suicidal ideation to suicide attempt 55 .…”

Section: Methodsmentioning

confidence: 99%

“…Indeed, the two items have unique descriptions. Additionally, while an evaluator applies HAM‐D, the BDI is a self‐report measure 23 . In addition, the HAM‐D‐3 plus BDI‐9 assesses suicidality in patients with at least a score of 1, enlarging the sample size 23 …”

Section: Methodsmentioning

confidence: 99%

“…The principal statistical analysis included the scores of the outcome measures from all included patients (HAM‐D‐3, BDI‐9 and HAM‐D‐3 plus BDI‐9), regarding the score, in the three‐time point evaluations. Khazanov et al 23 and Hopko et al 35 performed this procedure. All randomized patients were analysed with ITT, regardless of the time of dropout 65 …”

Section: Methodsmentioning

confidence: 99%

“…For MDD, the recommended treatment is a combination of selective serotonin reuptake inhibitors and cognitive‐behavioural therapy (CBT), behavioural activation therapy (BA) or interpersonal therapy 20‐22 . Likewise, adding CBT to the treatment with AD also appears to decrease suicidal ideation in patients with MDD 23 . There is a lack of evidence that CBT and BA have different efficacy in the treatment of MDD 24‐28 .…”

Section: What Is New and Objectivementioning

confidence: 99%

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Behavioural activation and trial‐based cognitive therapy may be beneficial to reduce suicidal ideation in major depressive disorder: A post hoc study from a clinical trial

Hemanny

Sena

Oliveira

2021

Clinical Pharmacy Therapeu

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What is known and objective The suicidality spectrum is a clinical challenge because of the difficulty of its management and its association with mortality. Few studies have investigated psychotherapies for reducing the components of suicidality. In this study, we compared the effect of behavioural activation (BA), trial‐based cognitive therapy (TBCT) – both added to antidepressant (AD) treatment – and treatment as usual (TAU) in mitigating suicidal ideation in patients with major depressive disorder (MDD). Methods A post hoc study was conducted with data from a randomized clinical trial. Secondary analyses compared the treatments using scores from the items that evaluated suicidal ideation with the HAM‐D (HAM‐D‐3) and BDI (BDI‐9). A composite measurement was constructed by summing the scores from the two items (HAM‐D‐3 plus BDI‐9). Results and discussion Seventy‐six patients were analysed (BA + AD = 24; TBCT + AD = 26 and TAU = 26). In HAM‐D‐3, the BA + AD group showed a statistically greater reduction than the TAU group. In BDI‐9, the three groups did not show significant differences. In the HAM‐D‐3 plus BDI‐9, TBCT + AD reduced ideations more than the TAU group. There were no differences among the psychotherapies in any of the measures. Sensitivity analyses showed improvement in suicidal ideation in both psychotherapies compared to TAU. What is new and conclusion This is one of the few studies that evaluated the effect of BA and TBCT in lowering suicidal ideation. Adding these therapies to ADs seems to decrease suicidal ideation. We suggest the possible beneficial effects of BA and TBCT in the management of suicidal ideation in patients with recurrent MDD. Our findings need further studies to confirm these results.

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Section: Methodsmentioning

confidence: 99%