Status:
TERMINATED
Reducing Suicide Risk in Older Veterans Using Problem Solving Therapy
Lead Sponsor:
VA Office of Research and Development
Conditions:
Suicidal Ideation
Depressive Disorder
Eligibility:
All Genders
55+ years
Phase:
NA
Brief Summary
Suicide is a national crisis, especially among older Veterans for whom evidence-based suicide prevention efforts are lacking. This proposal responds to the national priority to develop and improve int...
Detailed Description
The proposed randomized control trial will examine the efficacy of a brief behavioral treatment for reducing suicidal ideation and for increasing reasons for living in older Veterans at risk for suici...
Eligibility Criteria
Inclusion
- \>= 55 years old
- SI (past month) on the C-SSRS
- No SI or imminent risk (will be excluded)
- Eligibility now includes non-specific active suicidal thoughts to active SI with some planning (on C-SSRS item 3: "Have you been thinking about how you might do this") and/or some intent to act (on C-SSRS item 4: "Have you had these thoughts and had some intention of acting on them?") provided that those endorsing item 4 have an established relationship with a psychiatrist aware of this intent level (who is not also performing psychotherapy)
- Those endorsing C-SSRS item 5: "Do you intend to carry out this plan?" would be considered at imminent risk and excluded
- Presence of DSM-5 depressive disorder or anxiety disorder, specified or unspecified, or PTSD or subthreshold PTSD.
- No diagnosis of dementia; evidence that cognitive impairment is not indicative of possible dementia based on a negative cognitive telephone screen (\<10 errors on the Blessed cognitive screen)
- No diagnosis on MINI or medical record for psychotic symptoms or disorders, bipolar disorder, or severe OCD (mild or moderate OCD will be eligible)
- No history of head injury past 12 months
- No severe or unstable chronic medical illness or other severe or unstable respiratory, cardiovascular, neurologic, hepatic, hematopoietic, gastrointestinal or metabolic dysfunction
- AUDIT Total score \<15 for men or \<13 for women (no current alcohol use disorder)
- No substance use disorder of any type for illicit substances, no moderate or severe substance use disorder for cannabis/marijuana - on the MINI.
- No prominent homicidal ideation
- English language proficiency to engage in treatment
- Sensory abilities sufficiently intact to engage in assessment and treatment
- Not currently enrolled in individual psychotherapy for a mental health issue. Participants who are receiving mental health care are eligible if their current care includes treatment from a psychiatrist, supportive therapy, peer counseling or support, or participating in psychoeducational groups.
- No current prescription for anti-psychotics if prescribed for a psychotic disorder
- Anti-psychotics for depression without psychosis are eligible
- Psychotropic medications (e.g., SSRIs) are also eligible
Exclusion
- \< 55 years old
- No SI (past month) or imminent risk on the C-SSRS will be excluded. Those endorsing C-SSRS item 5: "Do you intend to carry out this plan?" would be considered at imminent risk and excluded
- No DSM-5 depressive disorder or anxiety disorder, or PTSD or subthreshold PTSD
- Diagnosis of dementia; evidence that cognitive impairment is indicative of possible dementia based on a positive cognitive telephone screen (\>=10 errors on the Blessed cognitive screen)
- Diagnosis on MINI or medical record for psychotic symptoms or disorders, bipolar disorder, or severe OCD (mild or moderate OCD will be eligible)
- History of head injury past 12 months
- Severe or unstable chronic medical illness or other severe or unstable respiratory, cardiovascular, neurologic, hepatic, hematopoietic, gastrointestinal or metabolic dysfunction
- AUDIT Total score \>14 for men or \>12 for women (no current alcohol use disorder)
- Substance use disorder of any type for illicit substances, moderate or severe substance use disorder for cannabis/marijuana - on the MINI.
- Prominent homicidal ideation
- Lacking English language proficiency to engage in treatment
- Sensory abilities not sufficiently intact to engage in assessment and treatment
- Currently enrolled in individual psychotherapy for a mental health issue. Participants who are receiving mental health care are eligible if their current care includes treatment from a psychiatrist, supportive therapy, peer counseling or support, or participating in psychoeducational groups.
- Current prescription for anti-psychotics if prescribed for a psychotic disorder, and not prescribed for depression without psychosis
Key Trial Info
Start Date :
January 24 2022
Trial Type :
INTERVENTIONAL
Allocation :
ACTUAL
End Date :
November 5 2025
Estimated Enrollment :
117 Patients enrolled
Trial Details
Trial ID
NCT04763330
Start Date
January 24 2022
End Date
November 5 2025
Last Update
January 9 2026
Active Locations (2)
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1
VA Palo Alto Health Care System, Palo Alto, CA
Palo Alto, California, United States, 94304-1207
2
Syracuse VA Medical Center, Syracuse, NY
Syracuse, New York, United States, 13210