Trajectories of Suicidal Ideation in People Seeking Web-Based Help for Suicidality: Secondary Analysis of a Dutch Randomized Controlled Trial.

Trine Madsen, Bregje van Spijker, Karen-Inge Karstoft, Merete Nordentoft, Ad J.F.M. Kerkhof

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

Background: Suicidal ideation (SI) is a common mental health problem. Variability in intensity of SI over time has been linked
to suicidal behavior, yet little is known about the temporal course of SI.
Objective: The primary aim was to identify prototypical trajectories of SI in the general population and, secondarily, to examine
whether receiving Web-based self-help for SI, psychiatric symptoms, or sociodemographics predicted membership in the identified
SI trajectories.
Methods: We enrolled 236 people, from the general Dutch population seeking Web-based help for SI, in a randomized controlled
trial comparing a Web-based self-help for SI group with a control group. We assessed participants at inclusion and at 2, 4, and 6
weeks. The Beck Scale for Suicide Ideation was applied at all assessments and was included in latent growth mixture modeling
analysis to empirically identify trajectories.
Results: We identified 4 SI trajectories. The high stable trajectory represented 51.7% (122/236) of participants and was
characterized by constant high level of SI. The high decreasing trajectory (50/236, 21.2%) consisted of people with a high baseline
SI score followed by a gradual decrease to a very low score. The third trajectory, high increasing (12/236, 5.1%), also had high
initial SI score, followed by an increase to the highest level of SI at 6 weeks. The fourth trajectory, low stable (52/236, 22.0%)
had a constant low level of SI. Previous attempted suicide and having received Web-based self-help for SI predicted membership
in the high decreasing trajectory.
Conclusions: Many adults experience high persisting levels of SI, though results encouragingly indicate that receiving Web-based
self-help for SI increased membership in a decreasing trajectory of SI.
Original languageEnglish
Pages (from-to)e178
JournalJournal of Medical Internet Research
Volume18
Issue number6
Publication statusPublished - 2016

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