Suicidal thoughts? Therapy-oriented website can help

by University of Washington

Mental health researchers behind the website nowmattersnow.org have demonstrated that the site could be beneficial in decreasing suicidal thoughts.Researchers asked more than 3,000 website visitors how they felt before they got to the site compared to a few minutes on the website. Nearly one-third were significantly less suicidal, and the intensity of their negative emotions had also decreased. Results were published in the Journal of Medical Internet Research, an open-access publication.

04 may 2019--Lead author Ursula Whiteside, a clinical psychologist at the University of Washington School of Medicine, said the results offer hope for people struggling to cope. The site exposes visitors to dialectical behavioral therapy (DBT), a form of psychotherapy that combines behavioral science and Buddhist principles on mindfulness and acceptance. It was developed by UW psychology professor Marsha Linehan.

"We set out to build a free resource based not only in science but also with the voices and stories of people who had experienced suicidal thoughts," Whiteside said. "We wanted clinicians to feel empowered to help those who are struggling."

The home page presents a panel of video-linked images of individuals with relatable experiences on suicide and negative emotions and resources to explore DBT skills.

The site was launched in 2014 on Sept. 10, World Suicide Prevention Day, and had more than 250,000 unique visitors as of December 2018. Site funding came from the National Institute of Mental Health and the American Foundation of Suicide Prevention.

Whiteside said she wanted any research she and her colleagues were doing to be accessible right away since the public has little access to DBT therapy.

The survey of users was conducted from March 5, 2015, and Dec. 3, 2017. Of the 3,670 unique survey responses, 514 (14% of survey sample) identified as men ages 36 to 64; 460 (13%) identified as mental health professionals and 308 (8%) as other healthcare professionals, with 40 (1%) identifying as both.

Users were asked to rate their suicidal thoughts or negative feelings on a scale of 1-5 (5 being the most suicidal or negative). More than 70% of survey respondents recalled having some suicidal thoughts when they arrived at the website. Of those who reported suicidal thoughts (2,644) at baseline, 29% reported a reduction of one point or more in suicidal thoughts during the site visit. The vast majority, 63%, experienced no change, and 8% rated suicidal thoughts 1 or more points worse. Of those who reported worse scores after the visit, 2% were more than one point worse 1% (N = 21) were 3 or 4 points worse.

Researchers found that significant reductions in suicidal thoughts and negative emotions were consistent across subgroups, including middle-aged men, who represent 38% of all suicides. However, reductions for middle- age men were not as large as that of the rest of the sample; therefore the website could be more tailored toward men, researchers wrote.

Co-author Julie Richards, with Kaiser Permanente Washington Health Research Institute, said the website gives healthcare providers a resource for their patients.

"The vast majority of people who die by suicide never receive specialized mental health care," she said.

Researchers noted that nearly half of all people who die by suicide in the United States see some type of healthcare provider in the month before their death. They said newly released screening and care guidelines have the potential to increase the number of suicidal patients detected in healthcare settings. Unfortunately, they said, most providers—particularly those in primary-care settings, where the majority of patients are seen before death by suicide—have no relevant training and lack immediate resources to support patients.

---

More information: www.nowmattersnow.org

Journal information: Journal of Medical Intern

Sanofi obesity drug faces tough EU safety review

By Ben Hirschler, European Pharmaceuticals CorrespondentMon Jul 16, 9:41 AM ET
Sanofi-Aventis SA's obesity pill Acomplia faces a tough review from European drug safety experts this week, with data suggesting officials see issues over the drug's link with suicidal thoughts.
The European Medicines Agency (EMEA) safety assessment comes a month after a U.S. advisory panel recommended the drug should not be approved in the world's biggest market because it may increase depression and suicidal thinking.
That decision prompted France's Sanofi to withdraw its pending application to sell the medicine in the United States, dealing a major blow to what had been its biggest new drug hope.
In Europe, by contrast, Acomplia -- which is also known by the brand name Zimulti and generically as rimonabant -- has been on sale since last year.
Most industry analysts expect European officials to allow it to stay on the market but with stricter warnings that will limit its commercial potential. Acomplia use is already limited to patients with no history of major depression.
The EMEA's Committee for Medicinal Products for Human Use (CHMP) convened in London on Monday and is due to announce its decision on Thursday. It has a range of options available.
"They will recommend whatever they think is appropriate. It ranges from nothing to new warnings or other restrictions or contra-indications to suspension or withdrawal," an agency spokeswoman said.
Doing nothing seems unlikely.
Data compiled by the EMEA and presented to the U.S. Food and Drug Administration advisory panel last month underscores suspicions about Acomplia's link to psychiatric side effects.
After just one year on the market, the EMEA's post-marketing data showed there were 208 psychiatric adverse events reported with Acomplia, including 27 cases of suicidal thinking.
That compares with 14 cases of suicidal ideation with Roche Holding AG's obesity drug Xenical in the nine years since its 1998 launch and 15 cases with Abbott Laboratories Inc.'s Reductil/Meridia, which went on sale in 1999.
The figures are not directly comparable, however, since the Acomplia reports are a result of patient monitoring while those for Xenical and Reductil were unprompted.
Acomplia is the first in a new class of drugs that switch off the same brain circuits that make people hungry when they smoke cannabis.
Its unique mode of action and ability to reduce several risk factors for cardiovascular disease led to predictions it would become a multibillion-dollar-a-year blockbuster. In practice, however, sales to date have been modest.
Worldwide sales of Acomplia in the first quarter of 2007 totaled just 15 million euros ($20.7 million), down from 20 million in the fourth quarter of 2006.