Efficacy of a brief psychological intervention for adolescents with recent suicide attempt: A randomized clinical trial
Abstract Background Adolescents are at a heightened risk of suicide reattempts following hospital discharge, but few evidence-based interventions exist. This study evaluated the efficacy of the self-awareness of mental health (SAM) program combined with treatment as usual (TAU) versus TAU alone in r...
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Cambridge University Press
2025-01-01
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| Series: | European Psychiatry |
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| author | Ainoa García-Fernández Manuel Couce-Sánchez Jorge Andreo-Jover Wala Ayad-Ahmed María Teresa Bobes Bascarán Maria Angeles Boti Manuel Canal Rivero Ana Isabel Cebriá Benedicto Crespo-Facorro Marina Díaz-Marsá Verónica Fernández-Rodrigues Sandra Gómez-Vallejo Ana González-Pinto Iria Grande Noelia Iglesias Gutiérrez Luis Jiménez-Treviño Purificación López-Pena Diego J. Palao Ángela Palao-Tarrero Anna Pedrola-Pons Miguel Ruiz-Veguilla Elizabeth Suarez-Soto Alejandro de la Torre-Luque Iñaki Zorrilla Víctor Pérez SURVIVE Group Pilar A. Sáiz |
| author_facet | Ainoa García-Fernández Manuel Couce-Sánchez Jorge Andreo-Jover Wala Ayad-Ahmed María Teresa Bobes Bascarán Maria Angeles Boti Manuel Canal Rivero Ana Isabel Cebriá Benedicto Crespo-Facorro Marina Díaz-Marsá Verónica Fernández-Rodrigues Sandra Gómez-Vallejo Ana González-Pinto Iria Grande Noelia Iglesias Gutiérrez Luis Jiménez-Treviño Purificación López-Pena Diego J. Palao Ángela Palao-Tarrero Anna Pedrola-Pons Miguel Ruiz-Veguilla Elizabeth Suarez-Soto Alejandro de la Torre-Luque Iñaki Zorrilla Víctor Pérez SURVIVE Group Pilar A. Sáiz |
| author_sort | Ainoa García-Fernández |
| collection | DOAJ |
| description | Abstract
Background
Adolescents are at a heightened risk of suicide reattempts following hospital discharge, but few evidence-based interventions exist. This study evaluated the efficacy of the self-awareness of mental health (SAM) program combined with treatment as usual (TAU) versus TAU alone in reducing reattempts among high-risk adolescents.
Methods
A randomized clinical trial was conducted across nine Spanish hospitals (January 2021–March 2024) with 261 adolescents (12–17 years) who had attempted suicide within the last 15 days. Participants were assigned to SAM + TAU (n=128) or TAU (n=133), with 12-month follow-up. The primary outcome was suicide reattempts within 12 months; secondary analyses examined time to reattempt and associated risk factors.
Results
After 12-months, no significant differences were found in reattempt rates [22.6% (SAM) versus 27.8% (TAU); OR=0.610, 95%CI (0.321–1.151), p=0.127] or time to reattempt [HR=0.606, 95%CI (0.390–1.021), p=0.060]. In SAM, attentional impulsivity emerged as a significant risk factor [HR=1.126, 95% CI (1.004–1.263), p=0.043], while nonplanning impulsivity was protective [HR=0.878, 95%CI (0.814–0.948), p<0.001]. In TAU, increased suicide risk was linked to suicidal intentionality [HR=1.341, 95%CI (1.009–1.782), p=0.044] and more prior attempts [HR=1.230, 95%CI (1.039–1.457), p=0.016]. Conversely, fewer psychiatric diagnoses emerged as a protective factor [HR=0.821, 95%CI (0.677–0.996), p=0.045].
Conclusions
While no significant differences were found between groups, SAM identified important psychological factors influencing suicide risk. These findings provide a foundation for targeted interventions to prevent reattempts in adolescents.
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| format | Article |
| id | doaj-art-8bb02cc0c2cb4cd38f31453cdfe7ac5c |
| institution | Kabale University |
| issn | 0924-9338 1778-3585 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | European Psychiatry |
| spelling | doaj-art-8bb02cc0c2cb4cd38f31453cdfe7ac5c2025-08-22T08:41:02ZengCambridge University PressEuropean Psychiatry0924-93381778-35852025-01-016810.1192/j.eurpsy.2025.10065Efficacy of a brief psychological intervention for adolescents with recent suicide attempt: A randomized clinical trialAinoa García-Fernández0https://orcid.org/0000-0002-4874-0353Manuel Couce-Sánchez1https://orcid.org/0000-0002-2183-3824Jorge Andreo-Jover2Wala Ayad-Ahmed3https://orcid.org/0000-0002-0786-0076María Teresa Bobes Bascarán4https://orcid.org/0000-0002-5279-504XMaria Angeles Boti5Manuel Canal Rivero6https://orcid.org/0000-0002-5818-5103Ana Isabel Cebriá7https://orcid.org/0000-0002-2632-8130Benedicto Crespo-Facorro8Marina Díaz-Marsá9https://orcid.org/0000-0003-1364-3163Verónica Fernández-Rodrigues10https://orcid.org/0000-0003-0397-513XSandra Gómez-Vallejo11Ana González-Pinto12Iria Grande13Noelia Iglesias Gutiérrez14Luis Jiménez-Treviño15https://orcid.org/0000-0002-9551-8587Purificación López-Pena16Diego J. Palao17Ángela Palao-Tarrero18Anna Pedrola-Pons19Miguel Ruiz-Veguilla20Elizabeth Suarez-Soto21Alejandro de la Torre-Luque22https://orcid.org/0000-0003-0595-6127Iñaki Zorrilla23https://orcid.org/0000-0001-6444-8208Víctor Pérez24SURVIVE GroupPilar A. Sáiz25https://orcid.org/0000-0002-5705-4523Department of Psychiatry, Universidad de Oviedo, Oviedo, Spain Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain Instituto Universitario de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, SpainDepartment of Psychiatry, Universidad de Oviedo, Oviedo, Spain Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain Instituto Universitario de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain Servicio de Salud del Principado de Asturias (SESPA) Oviedo, Spain Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, SpainHospital La Paz Institute for Health Research (IdiPAZ), Madrid, SpainDepartment of Legal Medicine, Psychiatry and Pathology, School of Medicine, Universidad Complutense de Madrid, Madrid, Spain Hospital Clínico San Carlos, Madrid, SpainInstituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain Instituto Universitario de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain Servicio de Salud del Principado de Asturias (SESPA) Oviedo, SpainCentro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Barcelona, Spain Bipolar and Depressive Disorders Unit, Hospital Clinic de Barcelona, Barcelona, Spain Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain Institute of Neurosciences (UBNeuro), Barcelona, SpainCentro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain Hospital Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBIS), Sevilla, Spain Department of Psychiatry, Universidad de Sevilla, Sevilla, SpainCentro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain Mental Health Service, Hospital Universitari Parc Taulí, Unitat Mixta de Neurociència Traslacional I3PT-INc-UAB, Sabadell, Barcelona, Spain Department of Clinical and Health Psychology, Faculty of Psychology, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, SpainCentro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain Hospital Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBIS), Sevilla, Spain Department of Psychiatry, Universidad de Sevilla, Sevilla, SpainCentro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain Department of Legal Medicine, Psychiatry and Pathology, School of Medicine, Universidad Complutense de Madrid, Madrid, SpainHospital Clínico San Carlos, Madrid, SpainCentro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain Bipolar and Depressive Disorders Unit, Hospital Clinic de Barcelona, Barcelona, Spain Department of Child and Adolescent Psychiatry and Psychology, Hospital Clinic of Barcelona, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, SpainCentro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain Department of Psychiatry, Araba University Hospital, Universidad de País Vasco UPV/EHU, Vitoria-Gasteiz, Spain Bioaraba Health Research Institute, BIOARABA, Vitoria-Gasteiz, SpainCentro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Barcelona, Spain Bipolar and Depressive Disorders Unit, Hospital Clinic de Barcelona, Barcelona, Spain Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain Institute of Neurosciences (UBNeuro), Barcelona, SpainDepartment of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, SpainDepartment of Psychiatry, Universidad de Oviedo, Oviedo, Spain Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain Instituto Universitario de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain Servicio de Salud del Principado de Asturias (SESPA) Oviedo, Spain Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, SpainCentro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain Department of Psychiatry, Araba University Hospital, Universidad de País Vasco UPV/EHU, Vitoria-Gasteiz, Spain Bioaraba Health Research Institute, BIOARABA, Vitoria-Gasteiz, SpainCentro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain Mental Health Service, Hospital Universitari Parc Taulí, Unitat Mixta de Neurociència Traslacional I3PT-INc-UAB, Sabadell, Barcelona, Spain Department of Psychiatry and Forensic Medicine, Faculty of Medicine, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, SpainCentro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, Spain Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, SpainDepartment of Legal Medicine, Psychiatry and Pathology, School of Medicine, Universidad Complutense de Madrid, Madrid, SpainCentro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain Hospital Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBIS), Sevilla, Spain Department of Psychiatry, Universidad de Sevilla, Sevilla, SpainDepartment of Legal Medicine, Psychiatry and Pathology, School of Medicine, Universidad Complutense de Madrid, Madrid, Spain Faculty of Social Sciences, International University of Valencia, Valencia, SpainCentro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain Department of Legal Medicine, Psychiatry and Pathology, School of Medicine, Universidad Complutense de Madrid, Madrid, SpainCentro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain Department of Psychiatry, Araba University Hospital, Universidad de País Vasco UPV/EHU, Vitoria-Gasteiz, Spain Bioaraba Health Research Institute, BIOARABA, Vitoria-Gasteiz, SpainCentro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain Mental Health Institute, Hospital del Mar, Barcelona, Spain Hospital del Mar Research Institute (IMIM), Hospital del Mar, Barcelona, Spain Universitat Pomepeu Fabra, Barcelona, Spain Institute of Neuropsychiatry and Addictions, Hospital del Mar, Barcelona, SpainDepartment of Psychiatry, Universidad de Oviedo, Oviedo, Spain Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain Instituto Universitario de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain Servicio de Salud del Principado de Asturias (SESPA) Oviedo, Spain Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, SpainAbstract Background Adolescents are at a heightened risk of suicide reattempts following hospital discharge, but few evidence-based interventions exist. This study evaluated the efficacy of the self-awareness of mental health (SAM) program combined with treatment as usual (TAU) versus TAU alone in reducing reattempts among high-risk adolescents. Methods A randomized clinical trial was conducted across nine Spanish hospitals (January 2021–March 2024) with 261 adolescents (12–17 years) who had attempted suicide within the last 15 days. Participants were assigned to SAM + TAU (n=128) or TAU (n=133), with 12-month follow-up. The primary outcome was suicide reattempts within 12 months; secondary analyses examined time to reattempt and associated risk factors. Results After 12-months, no significant differences were found in reattempt rates [22.6% (SAM) versus 27.8% (TAU); OR=0.610, 95%CI (0.321–1.151), p=0.127] or time to reattempt [HR=0.606, 95%CI (0.390–1.021), p=0.060]. In SAM, attentional impulsivity emerged as a significant risk factor [HR=1.126, 95% CI (1.004–1.263), p=0.043], while nonplanning impulsivity was protective [HR=0.878, 95%CI (0.814–0.948), p<0.001]. In TAU, increased suicide risk was linked to suicidal intentionality [HR=1.341, 95%CI (1.009–1.782), p=0.044] and more prior attempts [HR=1.230, 95%CI (1.039–1.457), p=0.016]. Conversely, fewer psychiatric diagnoses emerged as a protective factor [HR=0.821, 95%CI (0.677–0.996), p=0.045]. Conclusions While no significant differences were found between groups, SAM identified important psychological factors influencing suicide risk. These findings provide a foundation for targeted interventions to prevent reattempts in adolescents. https://www.cambridge.org/core/product/identifier/S0924933825100655/type/journal_articleadolescentpsychological interventionrandomized controlled trialsuicide attempttreatment |
| spellingShingle | Ainoa García-Fernández Manuel Couce-Sánchez Jorge Andreo-Jover Wala Ayad-Ahmed María Teresa Bobes Bascarán Maria Angeles Boti Manuel Canal Rivero Ana Isabel Cebriá Benedicto Crespo-Facorro Marina Díaz-Marsá Verónica Fernández-Rodrigues Sandra Gómez-Vallejo Ana González-Pinto Iria Grande Noelia Iglesias Gutiérrez Luis Jiménez-Treviño Purificación López-Pena Diego J. Palao Ángela Palao-Tarrero Anna Pedrola-Pons Miguel Ruiz-Veguilla Elizabeth Suarez-Soto Alejandro de la Torre-Luque Iñaki Zorrilla Víctor Pérez SURVIVE Group Pilar A. Sáiz Efficacy of a brief psychological intervention for adolescents with recent suicide attempt: A randomized clinical trial European Psychiatry adolescent psychological intervention randomized controlled trial suicide attempt treatment |
| title | Efficacy of a brief psychological intervention for adolescents with recent suicide attempt: A randomized clinical trial |
| title_full | Efficacy of a brief psychological intervention for adolescents with recent suicide attempt: A randomized clinical trial |
| title_fullStr | Efficacy of a brief psychological intervention for adolescents with recent suicide attempt: A randomized clinical trial |
| title_full_unstemmed | Efficacy of a brief psychological intervention for adolescents with recent suicide attempt: A randomized clinical trial |
| title_short | Efficacy of a brief psychological intervention for adolescents with recent suicide attempt: A randomized clinical trial |
| title_sort | efficacy of a brief psychological intervention for adolescents with recent suicide attempt a randomized clinical trial |
| topic | adolescent psychological intervention randomized controlled trial suicide attempt treatment |
| url | https://www.cambridge.org/core/product/identifier/S0924933825100655/type/journal_article |
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