Behavioural, psychological, and temperamental predictors of risk suicide trend after brief psychodynamic psychotherapy

摘要

BACKGROUND: Evidence has shown that psychotherapy is effective for depression, whereas the outcome for suicide risk is unclear. AIM: It was to investigate whether possible pre-treatment predictors of suicide risk (SR) decrease after a brief psychodynamic psychotherapy treatment and at follow-up. PATIENTS AND METHODS: Forty-one patients were assessed at: baseline (T0) for clinical history, clinical family history, physical diseases, type of suffered abuse; after the treatment (T1); and, at six-month follow-up (T2) for mood ratings, temperamental features, and SR levels. RESULTS: The levels of depression and cyclothymia decreased at T1 and T2 compared to T0; however, the distribution of the patients with high SR level was similar between T0 and T1, and at T2 it increased. T1-T0 SR (Δ1SR) was correlated with suicidality in the last month and with depression levels at T0; T2-T0 SR (Δ2SR) was correlated with many historical, clinical, and temperamental variables; T2-T1 SR (Δ3SR) was correlated with the presence of previous psychotherapy, abuse, and anxiety. Linear regression models revealed that Δ1SR was predicted by the suicidality in the last month; Δ2SR was not significantly predicted by any variable; and, Δ3SR was predicted by anxiety. CONCLUSIONS: The treatment was able to decrease the depression but not the SR. Findings confirm the difficulty of affecting SR and the importance of carefully considering the anxiety and the previous experiences of abuse in order to manage the interruption of the psychotherapy.