Dataset Information

Effectiveness of online self-help for suicidal thoughts: results of a randomised controlled trial.

ABSTRACT:

Background

Many people with suicidal thoughts do not receive treatment. The Internet can be used to reach more people in need of support.

Objective

To test the effectiveness of unguided online self-help to reduce suicidal thoughts.

Method

236 adults with mild to moderate suicidal thoughts were randomised to the intervention (n=116) or a waitlist control group (n=120). Assessments took place at baseline, and 2, 4 and 6 weeks later. Primary outcome was suicidal thoughts. Secondary outcomes were depressive symptoms, anxiety, hopelessness, worry, and health status.

Results

The intervention group showed a small significant effect in reducing suicidal thoughts (d=0.28). Effects were more pronounced for those with a history of repeated suicide attempts. There was also a significant reduction in worry (d=0.33). All other secondary outcomes showed small but non-significant improvements.

Conclusions

Although effect sizes were small, the reach of the internet could enable this intervention to help many people reduce their suicidal thoughts.

Trial registration

Netherlands Trial Register NTR1689.

SUBMITTER: van Spijker BA

PROVIDER: S-EPMC3937447 | biostudies-literature | 2014

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Effectiveness of online self-help for suicidal thoughts: results of a randomised controlled trial.

van Spijker Bregje A J BA van Straten Annemieke A Kerkhof Ad J F M AJ

PloS one 20140227 2

<h4>Background</h4>Many people with suicidal thoughts do not receive treatment. The Internet can be used to reach more people in need of support.<h4>Objective</h4>To test the effectiveness of unguided online self-help to reduce suicidal thoughts.<h4>Method</h4>236 adults with mild to moderate suicidal thoughts were randomised to the intervention (n=116) or a waitlist control group (n=120). Assessments took place at baseline, and 2, 4 and 6 weeks later. Primary outcome was suicidal thoughts. Seco ...[more]

PMID: 24587233

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Project description:BackgroundSuicidal thoughts are common, causing distress for millions of people all over the world. However, people with suicidal thoughts might not access support due to financial restraints, stigma or a lack of available treatment offers. Self-help programs provided online could overcome these barriers, and previous efforts show promising results in terms of reducing suicidal thoughts. This study aims to examine the effectiveness of an online self-help intervention in reducing suicidal thoughts among people at risk of suicide. The Danish Self-help Online against Suicidal thoughts (SOS) trial is a partial replication of a previously conducted Dutch trial.Methods and designA randomized, waiting-list controlled trial with 1:1 allocation ratio will be carried out. A total of 438 people with suicidal thoughts will be recruited from the Danish suicide hotline, The Lifeline's, website and allocated to the intervention condition (N = 219) or the control condition (N = 219). The intervention condition consists of a 6-week, Internet-based self-help therapy intervention. The format of the intervention is self-help, but the participants can be guided by the trial manager. The control condition consists of a waiting-list assignment for 32 weeks. The primary outcomes are frequency and intensity of suicidal thoughts. Secondary outcome measures include depressive symptoms, hopelessness, worrying, quality of life, costs related to health care utilization and production loss. Number of deliberate self-harm episodes, suicides and deaths will, as well as the participant's evaluation of the intervention and the experience of negative effects, be investigated. Assessments will be conducted over the intervention website through self-report questionnaires at baseline, 2 weeks, 4 weeks, 6 weeks and 32 weeks (6 months post intervention).DiscussionIf we find the intervention to be linked to reductions in suicidal thoughts, this will strengthen the evidence that online self-help interventions are relevant tools for people with suicidal thoughts.Trial registrationClinicalTrials.gov, NCT02872610 . Registered on 9 August 2016.

Project description:OBJECTIVES:To ascertain whether an ultrabrief intervention (UBI) improves mental health outcomes for patients in general practice with mild-to-moderate mental health concerns. TRIAL DESIGN:Two-arm cluster randomised controlled trial. METHODS:Participants: general practitioners (GPs) were invited based on working in a participating general practice. Patients were eligible to participate if aged 18-65 years, scored ?35 on the Kessler-10 (K10) and if meeting local mental health access criteria (based on age, low income or ethnic group). INTERVENTIONS:intervention arm GPs were trained on the UBI approach, with participating patients receiving three structured appointments over 5 weeks. GPs randomised to practice as usual (PAU) did not receive training, and delivered support following their existing practice approaches. OUTCOME MEASURES:primary outcome was patient-level K10 score at 6 months postrecruitment.Randomisation: GP practices were randomised to UBI training or PAU at the start of the study.Blinding: GPs were not blinded to group assignment. RESULTS:Numbers randomised: 62 GPs (recruiting 85 patients) were randomised to UBI, and 50 to PAU (recruiting 75 patients).Numbers analysed: 31 GPs recruited at least one patient in the UBI arm (70 patients analysed), and 21 GPs recruited at least one patient in the PAU arm (69 patients analysed). OUTCOME:K10 scores from an intention-to-treat analysis were similar in UBI and PAU arms, with a wide CI (mean adjusted K10 difference=1.68 points higher in UBI arm, 95% CI -1.18 to 4.55; p=0.255). Secondary outcomes were also similar in the two groups. CONCLUSIONS:the UBI intervention did not lead to better outcomes than practice as usual, although the study had lower than planned power due to poor recruitment. The study results can still contribute to the continuing debate about brief psychological therapy options for primary care and their development. TRIAL REGISTRATION NUMBER:ACTRN12613000041752; Pre-results.

Dataset Information

Effectiveness of online self-help for suicidal thoughts: results of a randomised controlled trial.

Background

Objective

Method

Results

Conclusions

Trial registration

Publications

Effectiveness of online self-help for suicidal thoughts: results of a randomised controlled trial.

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