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Citation
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Kumpula MJ, Wagner HR, Dedert EA, Crowe CM, Day KT, Powell K, Batdorf WH, Shabana H, Kim E, Kimbrel NA. Womens Health Issues 2019; 29(Suppl 1): S103-S111. |
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Affiliation
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Department of Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, North Carolina; Mental Health Service Line, Durham Veterans Affairs Medical Center, Durham, North Carolina; Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina; Department of Veterans Affairs, Durham Center for Health Services Research in Primary Care, Durham, North Carolina. |
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Abstract
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BACKGROUND: Although most suicide-related deaths occur among male veterans, women veterans are dying by suicide in increasing numbers. Identifying and increasing access to effective treatments is imperative for Department of Veterans Affairs suicide prevention efforts. We examined the impact of evidence-based psychotherapies for depression on suicidal ideation and the role of gender and treatment type in patients' responses to treatment.
METHODS: Clinicians receiving case consultation in interpersonal psychotherapy, cognitive-behavioral therapy for depression, and acceptance and commitment therapy for depression submitted data on depressive symptoms and suicidal ideation while treating veterans with depression.
RESULTS: Suicidal ideation was reduced across time in all three treatments. A main effect for wave was associated with statistically significant decreases in severity of suicidal ideation, χ2 (2) = 224.01, p = .0001, and a subsequent test of the Gender × Wave interaction was associated with differentially larger decreases in ideation among women veterans, χ2 (2) = 9.26, p = .001. Within gender-stratified subsamples, a statistically significant Treatment × Time interaction was found for male veterans, χ2 (4) = 16.82, p = .002, with levels of ideation significantly decreased at waves 2 and 3 in interpersonal psychotherapy and cognitive-behavioral therapy for depression relative to acceptance and commitment therapy for depression; the Treatment × Wave interaction within the female subsample was not statistically significant, χ2 (4) = 3.41, p = .492.
CONCLUSIONS: This analysis demonstrates the efficacy of each of the three tested evidence-based psychotherapies for depression as a means of decreasing suicidal ideation, especially in women veterans. For male veterans, decreases in suicidal ideation were significantly greater in interpersonal psychotherapy and cognitive-behavioral therapy for depression relative to acceptance and commitment therapy for depression.
Published by Elsevier Inc.
Language: en |