Is combined antidepressant medication (ADM) and psychotherapy better than either monotherapy at preventing suicide attempts and other psychiatric serious adverse events for depressed patients? A rare events meta-analysis

Antidepressant medication (ADM)-only, psychotherapy-only, and their combination are the first-line treatment options for major depressive disorder (MDD). Previous meta-analyses of randomized controlled trials (RCTs) established that psychotherapy and combined treatment were superior to ADM-only for MDD treatment remission or response. The current meta-analysis extended previous ones by determining the comparative efficacy of ADM-only, psychotherapy-only, and […]

Trajectories and predictors of change in emotion dysregulation and deliberate self-harm amongst adolescents with borderline features

Background Deliberate self-harm (DSH) and emotion dysregulation (ED) peaks in adolescence, and is associated with an increased risk of psychopathology, suicide and lower functioning in adulthood. DBT-A has been established as an effective treatment for reducing DSH, however less is known about changes in emotion dysregulation. This study aimed to identify baseline predictors of treatment […]

A profound absence of counseling interventions for suicide prevention among youth in Africa: A call to action based on an empty scoping review

Objective One-third of all global suicide deaths occur among adolescents and young adults, making suicide the second leading cause of death among young people. Nearly 80% of suicide deaths occur in low- and middle-income countries, and many African nations have higher rates of suicide than global averages. However, interventions are scarce. We conducted a scoping […]

Expanding access to evidence-based psychotherapy in VA settings: Implementation of the brief cognitive behavioral therapy for depression program

Introduction: Evidence-based psychotherapies (EBPs) are effective for mental health conditions, but access to these services remains limited and rural Veterans are particularly underserved. Specialized implementation and dissemination programs are needed to improve access to known EBPs. Methods: The current project sought to improve access to a known EBP—brief Cognitive Behavioral Therapy for depression (Brief CBT). Diverse Veterans […]

No benefit of antidepressants in inpatient treatment of depression: A longitudinal, quasi‑experimental field study

Objectives The benefit of the additional use of AD in the inpatient treatment of depression with intensive cognitive-behavioral therapy (CBT) has been investigated in a naturalistic design. Methods Depressiveness was assessed using the Beck Depression Inventory (BDI-II) during a preliminary interview (T0), at admission (T1), at discharge (T2), and at a 6-month follow-up (T3). Two […]

Unifying psychotherapy in suicide prevention

Youth and young adults are facing an unprecedented mental health crisis, where part of the solution is providing flexible and effective psychotherapy. In this case study commentary, we review the case of Maggie, a young adult in the United States dealing with suicidal ideation, symptoms from a traumatic sexual assault, and internalized shame. Using his […]

Nightmares in borderline personality disorder: Narrative review

BACKGROUND: Borderline personality disorder (BPD) patients commonly suffer from nightmares. Still, the prevalence of this issue does not match the little clinical attention it usually receives. Nightmares impact sleep and daily functioning and may play a role in BPD symptomatology, including suicidality. Since BPD has been linked with high rates of suicide, the potential connection […]

Teaching gender competency with Men in Mind: Foundations of an online training program for mental health practitioners

Recognition of the importance of mental health practitioners’ enactment of ‘gender competency’ when working with men is growing. This article describes the development and theoretical background to a novel online training program for practitioners, called Men in Mind. The training focuses on men’s gender socialization, engaging male clients in therapy, and responding effectively to men’s depression and […]

Session-specific effects on suicidality in group therapy: No evidence for contagion

Objective Explicitly addressing suicidality in group therapy is often avoided due to the fear of contagion effects. However, there is some evidence that this fear is not valid. Therefore, the present study aims at contributing to this question by investigating the session-specific effects of two modules on suicidality that are part of the Metacognitive Training […]

A suicide prevention strategy for youth presenting to the emergency department with suicide related behaviour: Protocol for a randomized controlled trial

Background Suicide is a leading cause of death among adolescents in North America. Youth who present to the Emergency Department (ED) with acute suicidality are at increased risk for eventual death by suicide, thereby presenting an opportunity for secondary prevention of suicide. The current study evaluates the effectiveness of a standardized individual and family-based suicidal […]

Effectiveness of psychotherapy on prevention of suicidal re-attempts in psychiatric emergencies: A systematic review and network meta-analysis of randomized controlled trials

Objectives: We conducted a systematic review and network meta-analysis to evaluate the relative effects of psychological interventions for preventing suicide re-attempts in psychiatric emergencies. Methods: We searched PubMed, Embase, Cochrane, and PsycINFO from inception to December 1, 2022. Selection and data extraction were conducted independently by two reviewers based on prespecified criteria. We evaluated the efficacy of […]

How to save a life: From neurobiological underpinnings to psychopharmacotherapies in the prevention of suicide

The impact of suicide on our societies, mental healthcare, and public health is beyond questionable. Every year approximately 700 000 lives are lost due to suicide around the world (WHO, 2021); more people die by suicide than by homicide and war. Although suicide is a key issue and reducing suicide mortality is a global imperative, […]

Relationship between clinicians’ inclination toward patients at risk for suicide and self-reported countertransference

Objectives We investigate the relationship between clinicians’ inclination toward treating patients at risk for suicide (PRS), and self-reported countertransference (CT). We consider these observed group differences to explore two competing interpretations for observed CT patterns from a primary study; whether CT patterns are more consistent with defensive attitudes or an adaptative CT montage. Method We used one-way ANOVA, […]

The clinical utility of spirituality and religion in meaning-making theory for suicide loss survivors: A scoping review

In the case of violent/traumatic loss due to a completed suicide, there can be an overwhelming and complicated grief reaction followed by a spiritual need for the process of sense making and finding meaning. Some emerging literature on suicide loss survivors (SLSs) denotes that suicide loss is more similar to other forms of bereavement but […]

The long-run effects of psychotherapy on depression, beliefs, and economic outcomes

We revisit two clinical trials that randomized depressed adults in India (n=775) to a brief course of psychotherapy or a control condition. Four to five years later, the treatment group was 11 percentage points less likely to be depressed than the control group. The more effective intervention averted 9 months of depression on average over […]

Patients with borderline personality disorder in emergency departments

Borderline personality disorder (BPD) patients, when in crisis, are frequent visitors of emergency departments (EDs). When these patients exhibit symptoms such as aggressiveness, impulsivity, intense anxiety, severe depression, self-harm, and suicidal attempts or gestures, diagnosis, and treatment of the BPD becomes challenging for ED doctors. This review will, therefore, outline advice to physicians and health-care […]

Applying the collaborative assessment and management of suicidality (CAMS) to suicidal adolescents

Suicide continues to be one of the leading causes of death for adolescents, with limited evidence of empirically-supported treatment approaches for reducing risk of suicide, suicide attempts, and suicidal ideation in this population. The purpose of the current article is to present the Collaborative Assessment and Management of Suicidality (CAMS) therapeutic framework as a potentially  […]

Psychotherapists’ knowledge of guideline recommendations for the treatment of depressed suicidal patients

Objective: Clinical practice guidelines present expert consensus on the treatment of mental disorders. Yet, studies have shown that knowledge of and adherence to recommendations are moderate. The aim of the present study was to investigate, whether and to what extent psychotherapists are aware of and follow the German guideline recommendations for the treatment of suicidal depressed […]

The relationship between the therapeutic alliance in psychotherapy and suicidal experiences: A systematic review

Few studies have examined the relationship between the therapeutic alliance in therapy and suicidal experiences. No studies have examined this relationship with people with non-affective psychosis. The present study sought to redress this gap in the literature. Sixty-four participants with non-affective psychosis and suicidal experiences who were receiving a suicide-focused cognitive therapy were recruited. Self-reported […]

A pilot observational study of implementing an equine-assisted services program within a VA medical center residential substance use disorder treatment program

Introduction The aim of this observational pilot study was to assess the safety, feasibility, preliminary outcomes, and predictors of participant response as a result of implementing an equine-assisted intervention within a residential substance abuse treatment program at a large Veterans Administration medical center. A secondary aim was to evaluate psychological instruments for use in future, […]

Addressing co-occurring suicidal thoughts and behaviors and posttraumatic stress disorder in evidence-based psychotherapies for adults: A systematic review

Posttraumatic stress disorder (PTSD) is a well-established risk factor for suicidal thoughts and behaviors. Historically, guidelines for treating PTSD have recommended against the use of trauma-focused therapies for patients who are at high risk for suicide, likely due to concerns about potential suicide-related iatrogenesis, specifically the “triggering” of suicidal behaviors. This systematic review examined evidence […]

No bad parts: Healing trauma & restoring wholeness with the internal family systems model

Is there just one “you”? We’ve been taught to believe we have a single identity, and to feel fear or shame when we can’t control the inner voices that don’t match the ideal of who we think we should be. Yet Dr. Richard Schwartz’s research now challenges this “mono-mind” theory. “All of us are born […]

Managing suicidality within specialized care: A randomized controlled trial

Background: Suicide prevention is a core task in mental health services. Our objective was to determine whether Collaborative Assessment and Management of Suicidality (CAMS) reduced suicidal thoughts and behaviors and mental health distress more effectively than treatment as usual (TAU) in a heterogeneous patient population within specialized mental health care services. Methods: In this observer-blinded pragmatic randomized […]