Treatment with dialectical behavior therapy (DBT) may help lower suicide risk and self-harm in high-risk teenagers, a randomized trial showed.
Compared with individual and group supportive therapy (IGST), 47% of participants -- 95% of whom were girls -- receiving DBT were self-harm free after 6 months of treatment as compared with 28% of those who participated in IGST, wrote Elizabeth McCauley, PhD, of Seattle Children's Hospital, and colleagues in JAMA Psychiatry.
As the authors explained, DBT is a multicomponent cognitive-behavioral treatment that targets treatment engagement and the reduction of self-harm and suicide attempts and focuses on teaching skills for enhancing emotion regulation, distress tolerance, and "building a life worth living."
Significant advantages were found for DBT in all three primary outcomes over the 6-month treatment period when comparing those who received DBT with those who received IGST:
- No suicide attempts: 90.3% (DBT), versus 78.9% (IGST) (OR 0.30, 95% CI 0.10-0.91)
- Non-suicidal self-injury: 56.9% versus 40.0% (OR 0.32, 95% CI 0.13-0.70)
- No incidence of self-harm: 54.2% versus 36.9% (OR 0.33, 95% CI 0.14-0.78)
For DBT, treatment completion rates were higher (at 75.6%) than for IGST (55.2%), but this difference, assessed by pattern-mixture models, did not affect outcomes, the team stated. Over the follow-up period to 1-year, DBT continued to be superior to the control treatment, but this was not statistically significant (OR 0.65, 95% CI 0.12-3.36, P=0.061), with both groups reporting better outcomes over time.