A controlled comparison trial of the Collaborative Assessment and Management of Suicidality (CAMS) in an inpatient setting: Outcomes at discharge and six-month follow-up
A controlled comparison trial of the Collaborative Assessment and Management of Suicidality (CAMS) in an inpatient setting: Outcomes at discharge and six-month follow-up
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DOI：
10.1016/j.psychres.2017.01.032
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发表时间：
2017-03-01
影响因子：
11.3
通讯作者：
Allen, Jon G.
中科院分区：
文献类型：
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作者：
Ellis, Thomas E.;Rufino, Katrina A.;Allen, Jon G.
这项对照对照试验评估了一种针对自杀的干预措施，即长期住院精神病患者的自杀行为协作性评估和管理(CAMS)。对104名患者进行了多项结果检查，其中一半接受了接受过CAMS培训的治疗师的个别治疗。对照组是通过倾向评分匹配从更大的池中挑选出来的，以确保在年龄、性别、治疗方案、既往自杀未遂次数和自杀意念的严重性方面具有可比性。结果表明，a)所有患者在包括抑郁、自杀意念、功能残疾和幸福感在内的广泛指标上都有显著改善；b)这些改善在出院后6个月内是持久的；c)接受CAMS培训的个人治疗师治疗的患者从入院到出院在所有指标上的改善都显著更大。在6个月的随访中，CAMS患者和非CAMS患者之间的差异不再具有统计学意义，尽管统计能力因磨损而受到影响。尽管需要重复研究，但这些发现表明，与通常的强化住院治疗相比，专门为自杀患者量身定做的干预措施可能具有优势，可能是通过解决特定人群的心理脆弱性。在随访中缺乏显著差异表明，可能需要治疗后接触以保持与这项干预和类似干预相关的优势。
This controlled comparison trial evaluated a suicide-specific intervention, the Collaborative Assessment and Management of Suicidality (CAMS), in an extended-stay psychiatric inpatient setting. Multiple outcomes were examined for 104 patients, half of whom received individual therapy from therapists trained in CAMS. The comparison group was selected from a larger pool through Propensity Score Matching to ensure comparability on age, sex, treatment program, number of prior suicide attempts, and severity of suicidal ideation. Results showed that a) all patients improved significantly across a wide range of measures, including depression, suicidal ideation, functional disability, and well-being; b) these gains were durable over a 6-month post discharge period; and c) patients treated by a CAMS-trained individual therapist improved significantly more from admission to discharge across all measures. Differences between CAMS and non-CAMS patients were no longer statistically significant at 6-month follow-up, although statistical power was compromised due to attrition. Although replication studies are needed, these findings suggest that interventions specifically tailored for suicidal patients may have advantages compared to usual, intensive inpatient treatment, perhaps by addressing psychological vulnerabilities specific to the population. The lack of significant differences at follow-up suggest that post-treatment contact may be needed to maintain advantages associated with this and similar interventions.