A comparision of CBT and antidepressants in the management of adults with suicidal behaviour

Abstract

Psychotherapy for depression and antidepressant medication have both been used as treatments with decreasing suicidal behaviour. These modalities can either be used individually or by combining both therapies. The main purpose in managing suicidal behaviour is to mitigate the behaviour itself, regaining stabilization and prevent any future relapse. Are cognitive behavioural approaches, when compared to antidepressants, more effective in decreasing suicidal behaviour in adult mental health patients exhibiting suicidal behaviour? Adults with suicidal behaviour were the population, whilst the intervention consisted of cognitive behavioural therapies. Antidepressants were the other intervention to be compared with, and the outcome is decreasing suicidal behaviour. Literature search was carried out using reliable databases available such as databases through the University of Malta’s portal. This included HyDi, Google Scholar, CINAHL Complete (EBSCO) and APA PsycNet. Various keywords associated with the research question were used to identify the appropriate studies. Studies were selected against an inclusion and exclusion criteria. Inclusion criteria consisted of Psychiatric settings, Peer reviewed studies, English language only, SSRIs and SNRIs , studies focusing on CBT and studies having a population aged 18 or over. Exclusion criteria included studies published later than eleven years, non-psychiatric settings, grey literature, articles including partial text, articles not written in English language, psychiatric medication: TCA, TeCAs, Antipsychotics, Mood stabilisers, Anti-epileptics. Anxiolytics, and other psychological therapies. Similar results were observed when comparing the selected articles with regards to the effects of CBT and antidepressants, as the majority did answer the PICO question. Interesting observations were noted as the majority of the articles used BDI and HDRS to measure outcomes to their investigations. This was beneficial to increase knowledge in preventing suicide. The main objective in carrying out research for publication is for practice development. It was remarked that policy or education changes may be influenced according to these new findings associated with the effect of both therapies. A recommendation for local formulation of guidelines had been highlighted. This is also congruent to the lack of local insight since the current local situation is deeply lacking