A controlled comparison trial of the Collaborative Assessment and Management of Suicidality (CAMS) in an inpatient setting: Outcomes at discharge and six-month follow-up

被引:39
作者
Ellis, Thomas E. [1 ,2 ]
Rufino, Katrina A. [3 ]
Allen, Jon G. [1 ,2 ]
机构
[1] Menninger Clin, 12301 Main St, Houston, TX 77035 USA
[2] Baylor Coll Med, Menninger Dept Psychiat, 1 Baylor Plaza, Houston, TX 77030 USA
[3] Univ Houston, Downtown Dept Social Sci, 1 Main St, Houston, TX 77002 USA
关键词
Suicide; Psychiatric inpatients; Suicide-specific therapies; Propensity score matching; Tertiary prevention; COGNITIVE-BEHAVIORAL THERAPY; RANDOMIZED CONTROLLED-TRIAL; PROPENSITY SCORE METHODS; IDEATION; VALIDITY; DEPRESSION; SEVERITY; DISORDER; SCALE; RISK;
D O I
10.1016/j.psychres.2017.01.032
中图分类号
R749 [精神病学];
学科分类号
100205 ;
摘要
This controlled comparison trial evaluated a suicide-specific intervention, the Collaborative Assessment and Management of Suicidality (CAMS), in an extended-stay psychiatric inpatient setting. Multiple outcomes were examined for 104 patients, half of whom received individual therapy from therapists trained in CAMS. The comparison group was selected from a larger pool through Propensity Score Matching to ensure comparability on age, sex, treatment program, number of prior suicide attempts, and severity of suicidal ideation. Results showed that a) all patients improved significantly across a wide range of measures, including depression, suicidal ideation, functional disability, and well-being; b) these gains were durable over a 6-month post discharge period; and c) patients treated by a CAMS-trained individual therapist improved significantly more from admission to discharge across all measures. Differences between CAMS and non-CAMS patients were no longer statistically significant at 6-month follow-up, although statistical power was compromised due to attrition. Although replication studies are needed, these findings suggest that interventions specifically tailored for suicidal patients may have advantages compared to usual, intensive inpatient treatment, perhaps by addressing psychological vulnerabilities specific to the population. The lack of significant differences at follow-up suggest that post-treatment contact may be needed to maintain advantages associated with this and similar interventions.
引用
收藏
页码:252 / 260
页数:9
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