A Policy Relevant US Trauma Care System Pragmatic Trial for PTSD and Comorbidity Pilot
Posttraumatic Stress DisorderDepression5 moreThe goal of this pilot study is to develop and implement a larger scale, multi-site stepped collaborative care trial that targets injured patients with presentations of posttraumatic stress disorder (PTSD) and related comorbidities.
Natural History of Hopelessness, Suicidality, and Optimism in Psychiatric Inpatients Following Discharge...
SuicideAttempted1 moreSpecific aim #1: To assess the study team's ability to recruit subjects in this cohort and to successfully complete follow-up assessments by phone or mail. Hypothesis: Over 50% of eligible subjects will enroll in the observational study, and 70% of follow-up assessments will be successfully completed. Specific aim #2: To determine the natural history of hopelessness, ongoing suicidal thoughts, and optimism in subjects at 2, 4 and 8 weeks after discharge. Hypothesis: Subjects will continue to have moderate levels of hopelessness, suicidal thoughts, and optimism at follow-up assessments.
Unique Effects of Perimenstrual Estradiol or Progesterone Supplementation on Perimenstrual Suicidality...
Suicidal IdeationThis within-person, crossover, 3-condition, placebo-controlled study compares the impact of three perimenstrual conditions on severity of suicidal symptoms in females with past-month suicidality but minimal risk of imminent suicide attempt. The three conditions are (1) perimenstrual withdrawal from estradiol only (during progesterone stabilization), (2) perimenstrual withdrawal from progesterone only (during estradiol stabilization), and (3) perimenstrual withdrawal from both estradiol and progesterone during placebo.
Posttraumatic Stress Symptoms Among Rescuers at Risk
TraumaPTSD3 moreThis cross-sectional, anonymous online survey aims to examine how salient variables influence PTSS, well-being, and suicidal ideation across the following professions of rescue workers: firefighters, ambulance personnel, police officers, and emergency and psychiatric nurses. PTSS, coping strategies, well-being, suicidal ideation, previously experienced and work-related trauma, and self-efficacy were measured and analyzed using multiple regression and structural equation modeling.
Effect of Perimenstrual Ovarian Steroid Supplementation on Perimenstrual Suicidality
Suicidal IdeationThis within-person, crossover, 2-condition, placebo-controlled study compares the impact of two perimenstrual conditions on severity of suicidal symptoms in females with past-month suicidality but minimal risk of imminent suicide attempt. The two conditions are (1) natural perimenstrual withdrawal from estradiol and progesterone (during placebo), (2) perimenstrual stabilization of estradiol and progesterone using transdermal estradiol and oral micronized progesterone.
Intensive Outpatient Treatment for Suicidal Veterans
SuicidalityThis investigation is a feasibility study conducted in a VA outpatient treatment setting. The study is designed to test the feasibility of implementing a novel way of working with suicidal patients, the Collaborative Assessment and Management of Suicidality (CAMS). The primary purpose of the proposed project is to determine if it is possible to train clinicians working in the Mental Health Clinic at the Denver VA Medical Center (VAMC) to utilize this therapeutic framework. This project is extremely timely in relation to expectations of future increased clinical demands among potentially high-risk Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) veterans who may become suicidal in the years to come.
Assessing Treatment Emergent Suicidal Ideation in Patients With Major Depression
DepressionThis study will develop a new methodology to evaluate any treatment-emergent suicidal ideation that might occur when an antidepressant treatment has been started and/or during times when doses are increased in patients with major depressive disorder.
Text2Connect, Component 2 of iCHART (Integrated Care to Help At-Risk Teens)
DepressionSuicidal IdeationThis study proposes to develop and examine a personalized, text-based intervention designed to improve engagement with mental health (MH) treatment.
The "AIM Study": Investigating Whether Actigraphy and Ideation Measures Can Promote Patient Safety...
Suicidal IdeationSuicidal Behavior2 moreThis is a research project looking at whether measuring movements or responses to certain questions can help predict suicidal thoughts or actions. This project has two parts: The first part will occur while the participant is receiving hospitalized at the Bedford VA Hospital. It involves wearing a watch-like device on his/her wrist and answering questions or doing tasks to measure mood and other mental health symptoms, and suicidal thoughts. In the second phase, the investigators will call the participant around 12 months after s/he has left the hospital. The investigators will discuss how s/he is doing and if s/he has had suicidal thoughts or made suicidal acts.
Virtual Training Role-Plays to Improve Patient Suicide Outcomes in Primary Care Settings
Suicidal IdeationSIMmersion, in collaboration with the Institute for Family Health (IFH) and the Educational Development Center (EDC) propose to develop a web-based training product, Suicide Prevention Role-plays for Interactive Training (SPiRIT), a series of 4 modules to train providers to more effectively manage patients who screen positive for risk of suicide in this Phase I/Phase II fast-track application. If funded, the team will develop the Risk Assessment module in Phase I and utilize a within group pre-post design to evaluate its feasibility. Twenty practicing clinicians will be recruited to utilize the module and complete a pre-post knowledge test. In Phase II, the team will develop Safety Planning, Access to Lethal Means, and Willingness to Accept a Referral modules. The efficacy of the product to positively influence patient outcomes will be tested with a Historically Controlled Trial (HCT) enlisting 65 practicing clinicians across five IFH sites. All providers will be trained and patient outcomes will be tracked for 6 months post training. This data set will be compared to 6 months of historical data for the same provider group. Primary outcomes of this study will measure the participants' ability in obtain improved patient outcomes related to: 1) rate of same-day C-SSRS Screening; 2) rate of suicide being added to the problem list; 3) rate of same-day safety planning; 4) rate of same day C-SSRS Lifeline/Recent Completion; 5) rate of same-day Risk Assessment; 6) rate of acceptance and attendance to within-Institute referrals for post intervention patients who are offered the referral at the first visit; 7) and lower rates of documented suicide attempts. Ultimately, the development and successful testing of this product would provide the US health care system a novel technology to scale up a clinician's confidence and skill to better manage patients who identify as at-risk for suicide. Additionally, if effective, this product will have a direct impact on patient outcomes, a vital component to any training product that attempts to train health care professionals. The utility and scalability of the proposed product will move health care systems toward the goal of zero deaths from suicide consistent with the Zero suicide approach.