Efficacy of a problem‐solving intervention for the indicated prevention of suicidal risk in young Brazilians: Randomized controlled trial


Alessandra Xavier, Patricia Otero, Vanessa Blanco, Fernando L Vázquez.


textbfObjective The aim of this study was to evaluate the efficacy of a problem‐solving intervention for the prevention of suicidal risk in Brazilian adolescents with elevated suicidal potential and depressive symptoms. textbfMethods A randomized controlled trial was conducted involving 100 participants (mean age 17.2 years, 60% women, 46% mixed race), allocated to the problem‐solving intervention (n = 50) or the usual care control group (n = 50). Blinded interviewers conducted assessments at pretreatment, posttreatment, 1, 3, and 6 months of follow‐up. The main outcome was suicidal orientation; secondary outcomes were suicidal risk, suicidal plans and attempts, depressive symptoms, and problem‐solving skills. textbfResults At posttreatment and up to 6‐month follow‐up, there was lower suicidal orientation and suicidal risk in the problem‐solving group compared to the control group. There were lower suicidal plans and attempts (0.0% participants vs 2.2% with a suicide plan and 2.2% with both suicide plan and attempt); risk difference was 0.04 (95% CI: 0.01–0.09) and the number needed to treat was 25 (95% CI: 11–70). Significant effects of the intervention on depressive symptoms were found at posttreatment and maintained for 6 months. The change in global and functional problem‐solving skills mediated the reduction in suicide orientation. textbfConclusions Thus, suicidal risk can be successfully prevented in adolescents. BRÉSIL AMÉRIQUE-DU-SUD GENRE HOMME FEMME ADOLESCENT IDÉATION INTENTION TENTATIVE INTERVENTION RÉSOLUTION-PROBLÈME DÉPRESSION

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