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A Digital Therapeutic Intervention for Inpatients With Elevated Suicide Risk: A Randomized Clinical Trial.

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A smartphone app delivering cognitive behavior therapy (CBT) did not reduce the time to first suicide attempt in hospitalized patients. However, it sustained reduced suicidal ideation and lowered repeat attempts in those with prior suicide attempts.

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Area of Science:

  • Digital therapeutics
  • Psychiatry
  • Suicidology

Background:

  • Suicide is a significant public health concern in the US, necessitating effective interventions.
  • Suicide-specific cognitive behavior therapy (CBT) is effective but faces implementation challenges.
  • Digital therapeutic interventions offer a scalable solution for delivering CBT for suicide prevention.

Purpose of the Study:

  • To evaluate the efficacy of a smartphone-based digital therapeutic delivering suicide-focused CBT.
  • To assess the intervention's impact on reducing suicidal behavior in hospitalized patients.
  • To compare the digital therapeutic against a control application in a randomized clinical trial.

Main Methods:

  • Multisite, double-blind, randomized clinical trial involving 339 adult inpatients with elevated suicide risk.
  • Participants received either a digital therapeutic intervention or a control application, alongside treatment as usual.
  • Primary endpoint: time to first actual suicide attempt; secondary endpoints: suicidal ideation, clinical improvement.

Main Results:

  • The digital therapeutic did not significantly alter the time to the first suicide attempt.
  • Among patients with prior suicide attempts, the digital therapeutic group showed a 58.3% lower rate of follow-up suicide attempts.
  • The digital therapeutic group experienced sustained reductions in suicidal ideation and higher rates of clinical improvement.

Conclusions:

  • The smartphone-based digital therapeutic intervention did not meet its primary endpoint for reducing time to first suicide attempt.
  • The intervention demonstrated potential in sustaining reductions in suicidal ideation and reducing recurrent suicide attempts in specific patient subgroups.
  • Findings suggest the digital therapeutic may be beneficial for patients with a history of suicide attempts, warranting further investigation.