Dialectical behavior therapy tied to fewer suicide attempts

Dialectical behavior therapy (DBT) is effective for decreasing suicide attempts among adolescents with bipolar spectrum disorder, according to a study published online Sept. 13 in JAMA Psychiatry.

Tina R. Goldstein, Ph.D., from University of Pittsburgh, and colleagues randomly assigned adolescents (aged 12 to 18 years) diagnosed with bipolar spectrum disorder to one year of DBT (36 sessions; 47 patients) or standard-of-care (SOC) psychotherapy (schedule clinically determined; 53 patients).

During a mean follow-up of 47 weeks, both groups showed significant and similar improvement in mood symptoms and episodes. During follow-up, DBT participants reported significantly fewer suicide attempts versus SOC participants using the Adolescent Longitudinal Follow-Up Evaluation (mean attempts per follow-up period, 0.2 versus 1.1, when controlling for baseline attempts) and using the Columbia-Suicide Severity Rating Scale Pediatric Version (mean attempts per follow-up period, 0.04 versus 0.10, when controlling for baseline attempts). However, the decreased rate of suicide attempts in the DBT group was moderated by presence of lifetime history of suicide attempt and time (incident rate ratio, 0.23) and mediated by improvement in emotion dysregulation (incident rate ratio, 0.61), particularly for those with high baseline emotion dysregulation.

"These findings support DBT as the first psychosocial intervention with demonstrated effects on suicidal behavior for adolescents with bipolar spectrum disorder," the authors write.

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