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
Affiliations
- Ainoa García-Fernández
- ORCiD
- Department of Psychiatry, Universidad de Oviedo, Oviedo, Spain Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain Instituto Universitario de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Manuel Couce-Sánchez
- ORCiD
- Department of Psychiatry, Universidad de Oviedo, Oviedo, Spain Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain Instituto Universitario de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain Servicio de Salud del Principado de Asturias (SESPA) Oviedo, Spain Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Jorge Andreo-Jover
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
- Wala Ayad-Ahmed
- ORCiD
- Department of Legal Medicine, Psychiatry and Pathology, School of Medicine, Universidad Complutense de Madrid, Madrid, Spain Hospital Clínico San Carlos, Madrid, Spain
- María Teresa Bobes Bascarán
- ORCiD
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain Instituto Universitario de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain Servicio de Salud del Principado de Asturias (SESPA) Oviedo, Spain
- Maria Angeles Boti
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Barcelona, Spain Bipolar and Depressive Disorders Unit, Hospital Clinic de Barcelona, Barcelona, Spain Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain Institute of Neurosciences (UBNeuro), Barcelona, Spain
- Manuel Canal Rivero
- ORCiD
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain Hospital Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBIS), Sevilla, Spain Department of Psychiatry, Universidad de Sevilla, Sevilla, Spain
- Ana Isabel Cebriá
- ORCiD
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain Mental Health Service, Hospital Universitari Parc Taulí, Unitat Mixta de Neurociència Traslacional I3PT-INc-UAB, Sabadell, Barcelona, Spain Department of Clinical and Health Psychology, Faculty of Psychology, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain
- Benedicto Crespo-Facorro
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain Hospital Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBIS), Sevilla, Spain Department of Psychiatry, Universidad de Sevilla, Sevilla, Spain
- Marina Díaz-Marsá
- ORCiD
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain Department of Legal Medicine, Psychiatry and Pathology, School of Medicine, Universidad Complutense de Madrid, Madrid, Spain
- Verónica Fernández-Rodrigues
- ORCiD
- Hospital Clínico San Carlos, Madrid, Spain
- Sandra Gómez-Vallejo
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain Bipolar and Depressive Disorders Unit, Hospital Clinic de Barcelona, Barcelona, Spain Department of Child and Adolescent Psychiatry and Psychology, Hospital Clinic of Barcelona, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Ana González-Pinto
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain Department of Psychiatry, Araba University Hospital, Universidad de País Vasco UPV/EHU, Vitoria-Gasteiz, Spain Bioaraba Health Research Institute, BIOARABA, Vitoria-Gasteiz, Spain
- Iria Grande
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Barcelona, Spain Bipolar and Depressive Disorders Unit, Hospital Clinic de Barcelona, Barcelona, Spain Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain Institute of Neurosciences (UBNeuro), Barcelona, Spain
- Noelia Iglesias Gutiérrez
- Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, Spain
- Luis Jiménez-Treviño
- ORCiD
- Department of Psychiatry, Universidad de Oviedo, Oviedo, Spain Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain Instituto Universitario de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain Servicio de Salud del Principado de Asturias (SESPA) Oviedo, Spain Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Purificación López-Pena
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain Department of Psychiatry, Araba University Hospital, Universidad de País Vasco UPV/EHU, Vitoria-Gasteiz, Spain Bioaraba Health Research Institute, BIOARABA, Vitoria-Gasteiz, Spain
- Diego J. Palao
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain Mental Health Service, Hospital Universitari Parc Taulí, Unitat Mixta de Neurociència Traslacional I3PT-INc-UAB, Sabadell, Barcelona, Spain Department of Psychiatry and Forensic Medicine, Faculty of Medicine, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain
- Ángela Palao-Tarrero
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, Spain Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain
- Anna Pedrola-Pons
- Department of Legal Medicine, Psychiatry and Pathology, School of Medicine, Universidad Complutense de Madrid, Madrid, Spain
- Miguel Ruiz-Veguilla
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain Hospital Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBIS), Sevilla, Spain Department of Psychiatry, Universidad de Sevilla, Sevilla, Spain
- Elizabeth Suarez-Soto
- Department of Legal Medicine, Psychiatry and Pathology, School of Medicine, Universidad Complutense de Madrid, Madrid, Spain Faculty of Social Sciences, International University of Valencia, Valencia, Spain
- Alejandro de la Torre-Luque
- ORCiD
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain Department of Legal Medicine, Psychiatry and Pathology, School of Medicine, Universidad Complutense de Madrid, Madrid, Spain
- Iñaki Zorrilla
- ORCiD
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain Department of Psychiatry, Araba University Hospital, Universidad de País Vasco UPV/EHU, Vitoria-Gasteiz, Spain Bioaraba Health Research Institute, BIOARABA, Vitoria-Gasteiz, Spain
- Víctor Pérez
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain Mental Health Institute, Hospital del Mar, Barcelona, Spain Hospital del Mar Research Institute (IMIM), Hospital del Mar, Barcelona, Spain Universitat Pomepeu Fabra, Barcelona, Spain Institute of Neuropsychiatry and Addictions, Hospital del Mar, Barcelona, Spain
- SURVIVE Group
- Pilar A. Sáiz
- ORCiD
- Department of Psychiatry, Universidad de Oviedo, Oviedo, Spain Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain Instituto Universitario de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain Servicio de Salud del Principado de Asturias (SESPA) Oviedo, Spain Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- DOI
- https://doi.org/10.1192/j.eurpsy.2025.10065
- Journal volume & issue
-
Vol. 68
Abstract
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.
Keywords