RCT of Cognitive Behaviour Therapy in active suicidal ideation-as feasibility study in Sri Lanka

Background and Objectives: With one of the highest rates of suicide in the world and high rates of suicidal ideation in the population, we set out to pilot a study to ascertain whether it is possible to conduct a randomised controlled trial. Secondly we aimed to study whether Cognitive Behavioural Therapy (CBT) for suicidal ideation is better than treatment as usual (TAU). Method: Those with suicidal ideation (identified by a population survey using GHQ-30 and Beck’s suicidal ideation scale) were randomly allocated to 3-6 sessions of structured Cognitive Behavioural Therapy. The CBT was provided using a manual in primary care settings. Results: Of the two groups (CBT = 5, TAU = 4) the group which had received CBT showed a greater reduction in Beck’s Suicidal Intent Score (from mean 11.2 to 0.2) and in GHQ-30 (from 22.0 to 10.8) in three months. Conclusions: The pilot study indicates that it is possible to conduct CBT and RCT in developing countries. The implications of this are discussed. Received 1 November 2005 Revised 21 March 2007 Accepted 8 May 2007