Abstract：
BACKGROUND: Many autistic people in mental health are suicidal. This study evaluated the effectiveness of dialectical behavior therapy (DBT) v. treatment as usual (TAU) in reducing suicidal ideation and suicide attempts.
METHODS: At six Dutch mental health centers, 123 outpatients (18-65 years) with DSM-5 diagnosed autism spectrum disorder (ASD) and suicidal behavior were randomly assigned to the DBT intervention group (n = 63) or TAU control group (n = 60). Assessments were conducted at baseline, post-treatment at 6 months and 12-month follow-up. The primary outcomes were severity of suicidal ideation and frequency of suicide attempts. The severity of depression and social anxiety were secondary outcomes.
RESULTS: At end-of-treatment, DBT significantly reduced both suicidal ideation (z = -2.24; p = 0.025; b = -4.41; s.e. = 197.0) and suicide attempts (z = -3.15; p = 0.002; IRR = 0.046; s.e. = 0.045) compared to TAU, but lost statistical significance at the 12-month follow-up. Depression severity significantly decreased with DBT (z = -1.99; p = 0.046: b = -2.74; s.e. = 1.37) remaining so at 12 months (z = -2.46; p = 0.014; b = -3.37; s.e. = 1.37). No effects were observed on social anxiety. Severe adverse events included two suicides in the TAU condition.
CONCLUSIONS: DBT is an acceptable, safe, and short-term effective intervention to reduce suicidal ideation and suicide attempts in autistic adults with suicidal behavior.
METHODS: At six Dutch mental health centers, 123 outpatients (18-65 years) with DSM-5 diagnosed autism spectrum disorder (ASD) and suicidal behavior were randomly assigned to the DBT intervention group (n = 63) or TAU control group (n = 60). Assessments were conducted at baseline, post-treatment at 6 months and 12-month follow-up. The primary outcomes were severity of suicidal ideation and frequency of suicide attempts. The severity of depression and social anxiety were secondary outcomes.
RESULTS: At end-of-treatment, DBT significantly reduced both suicidal ideation (z = -2.24; p = 0.025; b = -4.41; s.e. = 197.0) and suicide attempts (z = -3.15; p = 0.002; IRR = 0.046; s.e. = 0.045) compared to TAU, but lost statistical significance at the 12-month follow-up. Depression severity significantly decreased with DBT (z = -1.99; p = 0.046: b = -2.74; s.e. = 1.37) remaining so at 12 months (z = -2.46; p = 0.014; b = -3.37; s.e. = 1.37). No effects were observed on social anxiety. Severe adverse events included two suicides in the TAU condition.
CONCLUSIONS: DBT is an acceptable, safe, and short-term effective intervention to reduce suicidal ideation and suicide attempts in autistic adults with suicidal behavior.
摘要：
背景：许多心理健康的自闭症患者都有自杀倾向。这项研究评估了辩证行为疗法（DBT）与常规疗法（TAU）在减少自杀意念和自杀企图方面的有效性。
方法：在六个荷兰心理健康中心，将123名DSM-5诊断为自闭症谱系障碍（ASD）和自杀行为的门诊患者（18-65岁）随机分配到DBT干预组（n=63）或TAU对照组（n=60）。在基线时进行评估，治疗后6个月和12个月随访。主要结果是自杀意念的严重程度和自杀未遂的频率。抑郁和社交焦虑的严重程度是次要结果。
结果：治疗结束时，与TAU相比，DBT显着降低了自杀意念（z=-2.24;p=0.025;b=-4.41;s.e.=197.0）和自杀企图（z=-3.15;p=0.002;IRR=0.046;s.e.=0.045），但在12个月的随访中失去统计学意义。随着DBT（z=-1.99；p=0.046：b=-2.74；s.e.=1.37）在12个月时仍然如此（z=-2.46；p=0.014；b=-3.37；s.e.=1.37），抑郁严重程度显着降低。没有观察到对社交焦虑的影响。严重不良事件包括TAU条件下的两次自杀。
结论：DBT是可以接受的，安全,以及短期有效的干预措施，以减少有自杀行为的自闭症成年人的自杀意念和自杀企图。
方法：在六个荷兰心理健康中心，将123名DSM-5诊断为自闭症谱系障碍（ASD）和自杀行为的门诊患者（18-65岁）随机分配到DBT干预组（n=63）或TAU对照组（n=60）。在基线时进行评估，治疗后6个月和12个月随访。主要结果是自杀意念的严重程度和自杀未遂的频率。抑郁和社交焦虑的严重程度是次要结果。
结果：治疗结束时，与TAU相比，DBT显着降低了自杀意念（z=-2.24;p=0.025;b=-4.41;s.e.=197.0）和自杀企图（z=-3.15;p=0.002;IRR=0.046;s.e.=0.045），但在12个月的随访中失去统计学意义。随着DBT（z=-1.99；p=0.046：b=-2.74；s.e.=1.37）在12个月时仍然如此（z=-2.46；p=0.014；b=-3.37；s.e.=1.37），抑郁严重程度显着降低。没有观察到对社交焦虑的影响。严重不良事件包括TAU条件下的两次自杀。
结论：DBT是可以接受的，安全,以及短期有效的干预措施，以减少有自杀行为的自闭症成年人的自杀意念和自杀企图。
