Cognitive Behavioral Therapy May Alter Suicidal Ideation in Anxiety Disorders

Patients with post-traumatic stress disorder (PTSD) are at a high risk for suicidal ideation, and suicidal ideation can be reduced significantly with cognitive behavioral therapy, according to research published in the Journal of Anxiety Disorders.

Researchers evaluated 355 treatment-seeking patients who were diagnosed with an anxiety-related disorder at intake, mid-treatment (about 14 weeks), and post-treatment (about 24 weeks). Diagnoses were confirmed through psychometric evaluations, suicidal ideation was measured through the Beck Depression Inventory, treatment progress was assessed through self-report questionnaires, and all participants received cognitive behavioral therapy as treatment.

At intake, suicidal ideation was highest in those with PTSD (48.9%) and lowest in individuals with panic disorder (26.9%). Time played a significant role in reducing suicidal ideation (odds ratio [OR] 0.930; 95% CI, 0.899-0.962, P <.001). From intake to mid-treatment there was a 6.7% increase in new cases of suicidal ideation, and then a 4.4% increase in new cases at post-treatment. At mid-point, 46% of participants noted improvement in suicidal ideation, while 50% noted no change. At post-treatment, 55.6% of individuals noted improvement of suicidal ideation, and 44.4% reported no change. Participants with PTSD and unspecified anxiety disorder noted significant improvements using cognitive behavioral therapy from intake to post-treatment and the rates of new onset of suicidal ideation were very low during the treatment period.

Future studies need to address suicidal ideation over an extended period of time, include a more diverse study population, and incorporate a control component to evaluate the effects of time. 

The researchers conclude that “[cognitive behavioral therapy] for anxiety-related disorders is associated with improvements rather than exacerbation in [suicide ideation] risk over treatment.”

Reference

Brown LA, Gallagher T, Petersen J, Benhamou K, Foe EB, Asnaani A. Does CBT for anxiety-related disorders alter suicidal ideation? Findings from a naturalistic sample. J Anxiety Disord. 2018; 59:10-16. doi: 10.1016/j.janxdis.2018.08.001.