European Psychiatry (Jan 2025)

Efficacy of a brief psychological intervention for adolescents with recent suicide attempt: A randomized clinical trial

  • Ainoa García-Fernández,
  • Manuel Couce-Sánchez,
  • Jorge Andreo-Jover,
  • Wala Ayad-Ahmed,
  • María Teresa Bobes Bascarán,
  • Maria Angeles Boti,
  • Manuel Canal Rivero,
  • Ana Isabel Cebriá,
  • Benedicto Crespo-Facorro,
  • Marina Díaz-Marsá,
  • Verónica Fernández-Rodrigues,
  • Sandra Gómez-Vallejo,
  • Ana González-Pinto,
  • Iria Grande,
  • Noelia Iglesias Gutiérrez,
  • Luis Jiménez-Treviño,
  • Purificación López-Pena,
  • Diego J. Palao,
  • Ángela Palao-Tarrero,
  • Anna Pedrola-Pons,
  • Miguel Ruiz-Veguilla,
  • Elizabeth Suarez-Soto,
  • Alejandro de la Torre-Luque,
  • Iñaki Zorrilla,
  • Víctor Pérez,
  • SURVIVE Group,
  • Pilar A. Sáiz

DOI
https://doi.org/10.1192/j.eurpsy.2025.10065
Journal volume & issue
Vol. 68

Abstract

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Abstract Background Adolescents are at a heightened risk of suicide reattempts following hospital discharge, but few evidence-based interventions exist. This study evaluated the efficacy of the self-awareness of mental health (SAM) program combined with treatment as usual (TAU) versus TAU alone in reducing reattempts among high-risk adolescents. Methods A randomized clinical trial was conducted across nine Spanish hospitals (January 2021–March 2024) with 261 adolescents (12–17 years) who had attempted suicide within the last 15 days. Participants were assigned to SAM + TAU (n=128) or TAU (n=133), with 12-month follow-up. The primary outcome was suicide reattempts within 12 months; secondary analyses examined time to reattempt and associated risk factors. Results After 12-months, no significant differences were found in reattempt rates [22.6% (SAM) versus 27.8% (TAU); OR=0.610, 95%CI (0.321–1.151), p=0.127] or time to reattempt [HR=0.606, 95%CI (0.390–1.021), p=0.060]. In SAM, attentional impulsivity emerged as a significant risk factor [HR=1.126, 95% CI (1.004–1.263), p=0.043], while nonplanning impulsivity was protective [HR=0.878, 95%CI (0.814–0.948), p<0.001]. In TAU, increased suicide risk was linked to suicidal intentionality [HR=1.341, 95%CI (1.009–1.782), p=0.044] and more prior attempts [HR=1.230, 95%CI (1.039–1.457), p=0.016]. Conversely, fewer psychiatric diagnoses emerged as a protective factor [HR=0.821, 95%CI (0.677–0.996), p=0.045]. Conclusions While no significant differences were found between groups, SAM identified important psychological factors influencing suicide risk. These findings provide a foundation for targeted interventions to prevent reattempts in adolescents.

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