Adaptation of Dialectical Behavior Therapy Skills-Groups for Individuals With Suicidal Ideation and Depression

Maurizio Fava, MD

Status: Completed

Conditions: Major Depressive Disorder; Suicidal Ideation

Treatments: Behavioral: Wait List-Treatment as Usual; Behavioral: No intervention-treatment as usual; Behavioral: Dialectical Behavior Therapy Skills (DBT-S) Groups

Study type: Interventional

Funder types: Other

Identifiers

NCT01441258

2011P001088

Details and patient eligibility

About

Harley and colleagues demonstrated that adding Dialectical Behavior Therapy (DBT) skills-groups and therapist consultation to treatment as usual successfully reduced symptoms of depression. The present study will expand upon these findings. Second, DBT is not known for reducing suicidal ideation (SI), a major risk factor for suicide . The present study will tailor the aforementioned skills-groups to specifically target suicidal thoughts and behaviors through Cognitive Behavior Therapy (CBT) strategies aimed at increasing problem-solving deficits, hopelessness, and negativistic thinking. Third, the present study will extend this DBT-based approach to a novel population. Fourth, the present study is the first DBT intervention to employ state-of-the-art multi-method measurement (including objective assessment) of suicidal thoughts and behaviors.

The investigators hypothesize that participants in the DBT skills (DBT-S) group will show improvements in level of suicidality as measured by decreased scores on the Beck Scale for Suicide Ideation as compared with participants in the Wait List-Treatment as Usual (WL-TAU) group.

Enrollment: 26 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

1. Participants will be at least 18 years of age.
2. Participants will meet criteria for Major Depressive Disorder (MDD) on the Structured Clinical Interviews for Axis I DSM-IV Disorders
3. Participants must report current suicidal ideation on the Self-Injurious Thoughts and Behaviors Interview
4. Participants must have an outpatient psychiatric provider who they see "regularly" (i.e., at least every other week for therapy, case management, or medication management).
5. English language proficiency.

Exclusion criteria

1. DSM-IV diagnosis of bipolar disorder, schizophrenia, psychotic disorder NOS, or personality disorders.
2. Active current substance dependence.
3. Severe or unstable medical conditions that would prohibit regular group attendance or participation.
4. Other group therapy.
5. Significant dementia or cognitive impairment that would interfere with the learning of DBT skills.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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26 participants in 2 patient groups, including a placebo group

Dialectical Behavior Therapy Skills (DBT-S) Groups

Experimental group

Description:

Patients in the Dialectical Behavior Therapy Skills (DBT-S) group will receive the newly adapted 18-week group-skills training protocol, one-and-a-half hours in length, with weekly homework assignments to facilitate skill generalization.

Treatment:

Behavioral: Dialectical Behavior Therapy Skills (DBT-S) Groups

Wait List-Treatment as Usual

Placebo Comparator group

Description:

Participants assigned to the wait-list condition will be given the opportunity to participate in a DBT skills group after their 18-week wait period has ended.

Treatment:

Behavioral: Wait List-Treatment as Usual

Behavioral: No intervention-treatment as usual