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Cognitive Therapy and Preventing Suicide Attempts
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To the Editor: Dr Brown and colleagues1 studied the effectiveness of cognitive therapy for the prevention of suicide attempts. This randomized controlled trial appears to show a benefit to introducing cognitive therapy in these patients. Randomization will on average create comparable groups at baseline, but it is possible that bias could have occurred at a later point in the intervention because the study was not blinded.2
One area of concern is the number of participants who received no treatment in the usual care group, which is significantly higher than the number who did not receive treatment in the cognitive therapy group throughout the first 6 months. Lack of any treatment could be the underlying explanation for the observed difference between the 2 groups. Most of the divergence in the survival curves occurs in the first 6 months of treatment when the proportional difference in absence of treatment between the groups . . . [Full Text of this Article]
Kristian B. Filion, BSc
Centre for Clinical Epidemiology & Community Studies
Sir Mortimer B. Davis Jewish General Hospital
Montreal, Quebec
J. A. C. Delaney, MA, MSc
chris.delaney@clinepi.mcgill.ca
Division of Clinical Epidemiology
Royal Victoria Hospital
Montreal, Quebec
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