The cognitive behavioural prevention of suicide in psychosis: a clinical trial.

BACKGROUND Suicide behaviour in psychosis is a significant clinical and social problem. There is a dearth of evidence for psychological interventions designed to reduce suicide risk in this population. AIMS To evaluate a novel, manualised, cognitive behavioural treatment protocol (CBSPp) based upon an empirically validated theoretical model. METHODS A randomly controlled trial with independent and masked allocated and assessment of CBSPp with TAU (n=25, 24 sessions) compared to TAU alone (n=24) using standardised assessments. Measures of suicide probability, and suicidal ideation were the primary outcomes and measures of hopelessness, depression, psychotic symptoms, functioning, and self-esteem were the secondary outcomes, assessed at 4 and 6 months follow-up. RESULTS The CBSPp group improved differentially to the TAU group on two out of three primary outcome measures of suicidal ideation and suicide probability, and on secondary outcomes of hopelessness related to suicide probability, depression, some psychotic symptoms and self-esteem. CONCLUSIONS CBSPp is a feasible intervention which has the potential to reduce proxy measures of suicide in psychotic patients.