Evaluation of the "Coping Long Term with Active Suicide Program"

， 项目摘要/摘要 自杀和自杀未遂是美国的主要公共卫生问题，其中自杀 造成2009年超过3.6万人死亡，每年有超过50万人自杀未遂。 尽管近年来我们对许多疾病的有效治疗方法的认识取得了重大进展 在精神障碍方面，这个国家的自杀率并没有大幅下降。尽管公众热情高涨 自杀的健康意义以及我们目前的精神治疗显然无法影响 自杀率，相对较少的研究致力于开发或测试直接 打击自杀行为。开发和评估减少自杀行为的新干预措施 NIMH、CDC和最近发布的2012年国家自杀战略将其视为优先领域 预防。 在以前的治疗开发赠款的支持下，我们开发了一种新的干预措施，作为一种 专为减少高危人群自杀行为而设计的社区治疗的辅助工具 这项名为“长期积极应对自杀计划”(CLAP)的干预是一项创新的、以电话为基础的计划 干预，结合了个体心理治疗、病例管理和有意义的因素 其他/家庭治疗。有关CLAP干预的试点数据一直很有希望。入院治疗的病人 精神病院因有自杀风险而接受扣环的人自杀企图比那些 在出院后六个月的随访中接受控制情况。 本申请建议进行一项更大规模的临床试验，以评估该附加剂的效果。 扣环干预，以减少自杀行为。更具体地说，我们建议随机分配232名患者 因自杀未遂或自杀风险而住进精神病院的CLAP干预或 安全评估和后续评估(SAFE)比较，两者都作为社区的附件提供 照常治疗。我们建议在积极干预结束时对两者进行后续评估 阶段(出院后6个月)，出院后9个月和12个月。

, Project Summary/Abstract Suicide and attempted suicide are major public health issues in the United States, with suicide accounting for more than 36,000 deaths in the year 2009, and over 500,000 attempt suicide each year. Although recent years have seen significant advances in our knowledge of efficacious treatments for many psychiatric disorders, the suicide rates in this country have not decreased substantially. Despite the high public health significance of suicide and the apparent inability of our current psychiatric treatments to influence suicide rates, there has been relatively little research devoted to developing or testing interventions that directly target suicidal behavior. Developing and evaluating new interventions to reduce suicidal behavior has been recognized as a priority area by NIMH, CDC and the recently released 2012 National Strategy for Suicide Prevention. Supported by previous treatment development grants, we have developed a new intervention as an adjunct to community treatment specifically designed to reduce suicidal behavior among high-risk populations This intervention, “Coping Long Term with Active Suicide Program” (CLASP) is an innovative, telephone based intervention, which combines elements of individual psychotherapy, case management and significant other/family therapy. Pilot data on the CLASP intervention have been quite promising. Patients admitted to a psychiatric hospital due to suicide risk who received CLASP had two-thirds fewer suicide attempts than those receiving a control condition during a six month follow-up following hospital discharge. This application proposes to conduct a larger scale clinical trial evaluating the effects of the adjunctive CLASP intervention to reduce suicidal behavior. More specifically, we propose to randomly assign 232 patients admitted to a psychiatric hospital due to a suicide attempt or suicide risk to either the CLASP intervention or an Safety Assessment and Follow-up Evaluation (SAFE) comparison, both delivered as adjuncts to community treatment as usual. We propose to conduct follow-up assessments at both at the end of the active intervention phase (6 months post-discharge from hospital) and again at 9 and 12 months post discharge.