Cognitive Therapy for Suicidal Older Men
| Status: | Completed |
|---|---|
| Conditions: | Psychiatric |
| Therapuetic Areas: | Psychiatry / Psychology |
| Healthy: | No |
| Age Range: | 50 - Any |
| Updated: | 6/9/2017 |
| Start Date: | September 2011 |
| End Date: | April 6, 2017 |
The primary aim of the proposed study is to compare the efficacy of cognitive therapy (CT)
with the efficacy of an enhanced usual care (EUC) intervention for reducing the rate of
suicide ideation (SI) and the severity of depression and hopelessness among older men. The
investigators expect that suicidal older men randomly assigned to the CT intervention
condition will have a lower rate of SI during the follow-up period than participants
assigned to the control condition.
with the efficacy of an enhanced usual care (EUC) intervention for reducing the rate of
suicide ideation (SI) and the severity of depression and hopelessness among older men. The
investigators expect that suicidal older men randomly assigned to the CT intervention
condition will have a lower rate of SI during the follow-up period than participants
assigned to the control condition.
Older adult males have the highest suicide rate of any age group in the U.S. However, most
research concerning treatments for suicide ideation and behavior has focused on adolescents
and young adults. Very few treatments have been developed to reduce suicide ideation and
behavior in men aged 50 and above. This study will assess the effectiveness of specialized
cognitive therapy versus enhanced usual care in treating older men with suicide ideation.
Participants in this five-year study will be randomly assigned to receive either cognitive
therapy or enhanced usual care. Participants will be identified within the VA Medical Center
and the University of Pennsylvania Health System (UPHS) as having experienced suicide
ideation in the past month. Cognitive therapy will be provided by Ph.D.-level therapists and
will be geared specifically toward older men with suicidal tendencies. The enhanced usual
care condition will consist of the usual care that individuals receive for suicide
prevention, plus assessment and referral services provided by independent evaluators and
study case managers. In addition, patients in the enhanced usual care condition will receive
weekly telephone calls from the study therapists. These phone calls will be approximately
15-30 minutes in duration and their purpose will be to ensure patient safety and to provide
some support. All participants will be assessed pre-treatment to attain baseline measures of
suicide ideation, hopelessness, and depression. Study visits will occur at baseline and
Months 1, 3, 6, 9, and 12 to assess suicide ideation. Self-report and clinician-administered
measures will be used to assess participants' progress.
research concerning treatments for suicide ideation and behavior has focused on adolescents
and young adults. Very few treatments have been developed to reduce suicide ideation and
behavior in men aged 50 and above. This study will assess the effectiveness of specialized
cognitive therapy versus enhanced usual care in treating older men with suicide ideation.
Participants in this five-year study will be randomly assigned to receive either cognitive
therapy or enhanced usual care. Participants will be identified within the VA Medical Center
and the University of Pennsylvania Health System (UPHS) as having experienced suicide
ideation in the past month. Cognitive therapy will be provided by Ph.D.-level therapists and
will be geared specifically toward older men with suicidal tendencies. The enhanced usual
care condition will consist of the usual care that individuals receive for suicide
prevention, plus assessment and referral services provided by independent evaluators and
study case managers. In addition, patients in the enhanced usual care condition will receive
weekly telephone calls from the study therapists. These phone calls will be approximately
15-30 minutes in duration and their purpose will be to ensure patient safety and to provide
some support. All participants will be assessed pre-treatment to attain baseline measures of
suicide ideation, hopelessness, and depression. Study visits will occur at baseline and
Months 1, 3, 6, 9, and 12 to assess suicide ideation. Self-report and clinician-administered
measures will be used to assess participants' progress.
Inclusion Criteria:
1. Suicidal intent or desire during the past month prior to the baseline interview as
indicated by a score of 1 or higher on items 4 or 5 of the Scale for Suicide
Ideation.
2. Male
3. 50 years of age or older
4. Able to speak English
5. Able to provide written informed consent
6. Able to attend study assessment and therapy sessions
7. Able to provide at least two verifiable contacts for tracking purposes
8. Able to function at an intellectual level to allow for the reliable completion of
study assessments and participate in psychotherapy as indicated by a Mini-Mental
Status Exam (MMSE) total score of 24 or higher and an Executive Interview (EXIT-25)
total score of 14 or lower.
Exclusion Criteria:
1. Needed priority treatment for a substance use disorder as determined by the referring
clinician.
2. Needed priority treatment for PTSD as determined by the referring clinician.
3. Taking antidepressant medication for less than one month, or if antidepressant
medication has been changed in the last month as indicated by the Alexopolous
"Composite Antidepressant Score" Scale.
We found this trial at
1
site
Philadelphia, Pennsylvania 19104
Principal Investigator: Gregory K. Brown, Ph.D.
Phone: 215-898-4104
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