TY - JOUR
T1 - Effectiveness of an Internet-Based Self-help Therapy Program for Suicidal Ideation With Follow-up at 6 Months
T2 - Results of a Randomized Controlled Trial
AU - Mühlmann, Charlotte
AU - Madsen, Trine
AU - Hjorthøj, Carsten
AU - Forman, Julie L
AU - Kerkhof, Ad J F M
AU - Nordentoft, Merete
AU - Erlangsen, Annette
N1 - © Copyright 2021 Physicians Postgraduate Press, Inc.
PY - 2021/9
Y1 - 2021/9
N2 - Objective: The majority of individuals with suicidal ideation do not receive help, and every year close to 800,000 people die by suicide. This study aimed to investigate the effectiveness of a guided internet-based self-help program compared to a waiting list control group in reducing suicidal ideation. Methods: In a randomized controlled trial, 402 individuals with suicidal ideation were assigned to a guided internet-based self-help program or a waiting list control group from September 13, 2016, to September 2, 2018. The primary outcome was suicidal ideation measured with the Beck Scale for Suicide Ideation at postintervention (6 weeks after baseline). Results: Participants assigned to the internet-based self-help program experienced at postintervention a significant reduction on the primary outcome of suicidal ideation (mean difference: 2.91; 95% CI, 1.28 to 4.54; P = .0005, Cohen's d = 0.25) compared to the waiting list control group and on the secondary outcomes of hopelessness (mean difference: 1.98; 95% CI, 0.97 to 3.99) and worrying (mean difference: 5.19; 95% CI, 2.36 to 8.10). Six months later (follow-up), the difference between the groups remained significant for suicidal ideation, hopelessness, and worrying. A total of 28 (16.8%) of the participants in the intervention group reported negative effects from the internet-based self-help program. Conclusions: Internet-based self-help therapy was associated with a reduction in suicidal ideation at postintervention and 6-month follow-up. Some participants found it challenging to work with the therapeutic exercises, and we recommend that internet-based self-help therapy be implemented in mental health clinics or crisis lines, where support or online counseling is available.
AB - Objective: The majority of individuals with suicidal ideation do not receive help, and every year close to 800,000 people die by suicide. This study aimed to investigate the effectiveness of a guided internet-based self-help program compared to a waiting list control group in reducing suicidal ideation. Methods: In a randomized controlled trial, 402 individuals with suicidal ideation were assigned to a guided internet-based self-help program or a waiting list control group from September 13, 2016, to September 2, 2018. The primary outcome was suicidal ideation measured with the Beck Scale for Suicide Ideation at postintervention (6 weeks after baseline). Results: Participants assigned to the internet-based self-help program experienced at postintervention a significant reduction on the primary outcome of suicidal ideation (mean difference: 2.91; 95% CI, 1.28 to 4.54; P = .0005, Cohen's d = 0.25) compared to the waiting list control group and on the secondary outcomes of hopelessness (mean difference: 1.98; 95% CI, 0.97 to 3.99) and worrying (mean difference: 5.19; 95% CI, 2.36 to 8.10). Six months later (follow-up), the difference between the groups remained significant for suicidal ideation, hopelessness, and worrying. A total of 28 (16.8%) of the participants in the intervention group reported negative effects from the internet-based self-help program. Conclusions: Internet-based self-help therapy was associated with a reduction in suicidal ideation at postintervention and 6-month follow-up. Some participants found it challenging to work with the therapeutic exercises, and we recommend that internet-based self-help therapy be implemented in mental health clinics or crisis lines, where support or online counseling is available.
KW - Adult
KW - Cognitive Behavioral Therapy/methods
KW - Female
KW - Follow-Up Studies
KW - Humans
KW - Internet
KW - Male
KW - Psychiatric Status Rating Scales
KW - Self Care/methods
KW - Suicidal Ideation
KW - Suicide/prevention & control
UR - http://www.scopus.com/inward/record.url?scp=85126563427&partnerID=8YFLogxK
U2 - 10.4088/JCP.20m13803
DO - 10.4088/JCP.20m13803
M3 - Journal article
C2 - 34464522
SN - 0160-6689
VL - 82
JO - The Journal of Clinical Psychiatry
JF - The Journal of Clinical Psychiatry
IS - 5
M1 - 20M13803
ER -