Behavioural activation and trial-based cognitive therapy may be beneficial to reduce suicidal ideation in major depressive disorder: A post hoc study from a clinical trial

Mindfulness and trial-based cognitive therapy for the psychological well-being in the judiciary: A controlled and randomized study protocol

Introduction

The judiciary sector faces high absenteeism due to mental health issues, yet applying effective therapies like mindfulness and trial-based cognitive therapy (TBCT) remains unexplored.

Objectives

Develop and apply Mindfulness-Integrated Trial-Based Cognitive Therapy (M-TBCT) in the judiciary to assess its acceptability, feasibility, and efficacy in enhancing psychological well-being and reducing depression, anxiety, and improving self-care.

Methods

Conduct a controlled, randomized study in two phases: Phase 1 involves a pilot study to structure the M-TBCT protocol and test its acceptability and feasibility in the judiciary (N = 30); Phase 2, an efficacy trial with 90 participants, comparing M-TBCT to a waitlist. M-TBCT consists of 8 online, individual, weekly sessions. Participants recruited via SRQ-20, with WHO-5, PHQ-9, GAD-7, CD-QUEST and ASAS-R as outcomes.

Expected outcomes

M-TBCT is expected to be acceptable, feasible, and effective in improving psychological well-being, reducing anxiety, depression, and enhancing self-care, with sustained benefits at a 6-month follow-up.

Conclusions

This study introduces a novel psychotherapeutic approach to address mental well-being and self-care in the judiciary.

Internet-based behavioural activation therapy versus online psychoeducation for self-reported suicidal ideation in individuals with depression in Indonesia: a secondary analysis of an RCT

BACKGROUND

Southeast Asia has the highest suicide mortality worldwide. To improve our knowledge on the effectiveness of interventions for suicidal ideation (SI) in individuals with depression in Indonesia, we conducted a secondary analysis of a randomised controlled trial.

OBJECTIVE

We explored whether an internet-based behavioural activation (BA) intervention ('Guided Act and Feel Indonesia' (GAF-ID)) was superior in targeting SI compared with online-delivered psychoeducation (PE).

METHODS

In total, 313 participants were randomised between treatment allocation. The SI item of the Patient Health Questionnaire-9 was the primary outcome measure. Mediation analyses were conducted to identify if BA at week 10 mediated the relationship between intervention and SI at week 24.

FINDINGS

The GAF-ID intervention was not superior in reducing SI compared with online minimal PE at week 10 (OR 0.61, 95% CI (0.37 to 1.01)), nor at week 24 (OR 0.84, 95% CI (0.47 to 1.52)). SI at week 24 was not mediated by BA at week 10 (b=-0.03, 95% CI (-0.05 to 0.00), p=0.07).

CONCLUSIONS

In individuals with depression in Indonesia, the GAF-ID intervention was not superior in reducing self-reported SI compared with PE. Also, the association between treatment condition and SI at week 24 was not mediated via BA at week 10.

CLINICAL IMPLICATIONS

This study supports the need for further research on the efficacy of psychological treatments targeting SI in the Southeast Asia context.