Treatments for Individuals with Suicidal Thoughts: Use, Indications, and Helpfulness.

Background: Although millions of adults seriously consider suicide each year, clinical trials often exclude individuals experiencing suicidal ideation (SI). This analysis sought to describe the use of a range of psychiatric treatment modalities in individuals with mood disorders with and without a history of suicide attempt or SI. Methods: Individuals with mood disorders (n=211; M=93/F=118) who had previously participated in psychiatric research at the National Institutes of Health Clinical Center completed a follow-up clinical assessment (range=1-20 years since study participation). In addition to clinical outcomes, participants were asked about psychiatric treatment use since discharge, treatment indication, and perceived helpfulness of the intervention. Differences between participants who did and did not report SI and/or history of suicide attempt at index visit were analyzed using general linear models. Results: Individuals with SI on index visit had generally similar clinical outcomes as those who did not report SI on index visit, but they were more likely to report use of psychiatric medications or ketamine at follow-up. Few group differences were noted with regard to perceived helpfulness or use of treatments for suicide-related indications. Individuals with a history of suicide attempt on index visit were more likely to report suicide attempts and psychiatric hospitalization at follow-up. Conclusion: Individuals with SI or with a history of suicide attempts frequently use psychiatric services, particularly psychiatric medications and hospitalizations. The results underscore the need for effective, suicide-focused treatments for individuals with suicidal thoughts and behaviors. Clinical Trials Identifier: www.clinicaltrials.gov (NCT02543983).