Cognitive Therapy for Suicidal Older Men in Primary Care Settings

This study has been completed.
National Institute of Mental Health (NIMH)
Information provided by (Responsible Party):
University of Pennsylvania Identifier:
First received: September 6, 2005
Last updated: April 6, 2015
Last verified: June 2006

This study will assess the effectiveness of cognitive therapy in reducing the incidence of suicide ideation and behavior in older men in a primary care setting.

Condition Intervention Phase
Suicide, Attempted
Behavioral: Cognitive Therapy
Phase 1

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Single Blind (Outcomes Assessor)
Primary Purpose: Treatment
Official Title: Cognitive Therapy for Suicidal Older Men in Primary Care Settings

Resource links provided by NLM:

Further study details as provided by University of Pennsylvania:

Primary Outcome Measures:
  • Suicidal Ideation; measured at Months 1, 3, 6, 12, 18, and 24 [ Time Frame: 1, 3, 6, 12, 18, and 24 months ] [ Designated as safety issue: Yes ]

Secondary Outcome Measures:
  • Depression; measured at Months 1, 3, 6, 12, 18, and 24 [ Time Frame: 1, 3, 6, 12, 18, and 24 months ] [ Designated as safety issue: Yes ]
  • Hopelessness; measured at Months 1, 3, 6, 12, 18, and 24 [ Time Frame: 1, 3, 6, 12, 18, and 24 months ] [ Designated as safety issue: No ]
  • Perceived Social Support; measured at Months 1, 3, 6, 12, 18, and 24 [ Time Frame: 1, 3, 6, 12, 18, and 24 months ] [ Designated as safety issue: No ]

Enrollment: 34
Study Start Date: May 2005
Study Completion Date: February 2011
Primary Completion Date: December 2008 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Cognitive Therapy + Enriched Usual Care

The cognitive therapy intervention consists of approximately 12 (1-hour) sessions over the course of a 4-month period. The main therapy components include:

  1. Using problem-solving and cognitive restructuring techniques to target hopelessness, reasons for living and dying, coping with loss, and perceived medical comorbidity that lead to suicidal ideation.
  2. Improving social resources.
  3. Improving adherence to medical regimen.
  4. Targeting Suicidal Cognitions.
Behavioral: Cognitive Therapy
No Intervention: EnrichedUsual Care Condition

The Enriched Care (EC) condition will be used as the treatment comparison for this study. EC consists of usual care patients may obtain in the community as well as the assessment and referral services provided by the study case managers. Participation in the study does not restrict patients in any way in their access to other health care, and all patients in both conditions will be allowed to receive any additional mental health treatment in the community.

The primary role of the study case manager is to establish a strong relationship with patients in order to retain the patients in the study for the duration of the study period.

Detailed Description:

Older adult males have the highest suicide rate of any age group in the U.S. Over 70 percent of older suicide victims have been to their primary care physician within a month of their death, many with a depressive illness that was not detected. However, most research concerning treatments for suicide ideation and behavior has focused on adolescents and young adults. Very few treatments have been developed to reduce suicide ideation and behavior in men aged 60 and above. This study will assess the effectiveness of specialized cognitive therapy versus typical treatment in treating older men with suicide ideation.

Participants in this two-year, single-blind study will be randomly assigned to receive either cognitive therapy combined with enriched care or enriched care alone. Participants will be identified in primary care settings as having experienced suicide ideation in the past month. Cognitive therapy will be provided by Ph.D.-level therapists and will be geared specifically toward older men with suicidal tendencies. The enriched care condition will consist of the usual care that individuals receive for suicide prevention, plus assessment and referral services provided by independent evaluators and study case managers. All participants will be assessed pre-treatment to attain baseline measures of suicide ideation, hopelessness, and depression. Study visits will occur at baseline and Months 1, 3, 6, 12, 18, and 24 to assess suicide ideation. Self-report and clinician-administered measures will be used to assess participants' progress.

For information on a related study, please follow this link:


Ages Eligible for Study:   60 Years and older
Genders Eligible for Study:   Male
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Currently experiencing death ideation or suicidal ideation (total score greater than 0 on the Scale for Suicide Ideation)
  • English-speaking
  • Lives within the area served by the research unit
  • Able to provide at least 2 verifiable contacts (typically family members)

Exclusion Criteria:

  • Requires priority treatment for an acute, unstable, or severe Axis III disorder (e.g., dementia)
  • Requires priority treatment for another debilitating problem (e.g., severe alcohol or drug dependence, mania, severe anorexia)
  • Suffers from a psychotic disorder or psychotic thought processes
  • Exhibits self-mutilating behavior without any intent to commit suicide (e.g., burning oneself with a cigarette)
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its identifier: NCT00149773

United States, Pennsylvania
Psychopathology Research Unit - University of Pennsylvania
Philadelphia, Pennsylvania, United States, 19104
Sponsors and Collaborators
University of Pennsylvania
National Institute of Mental Health (NIMH)
Principal Investigator: Aaron T. Beck, MD University of Pennsylvania
Principal Investigator: Gregory K. Brown, PhD University of Pennsylvania
  More Information

No publications provided

Responsible Party: University of Pennsylvania Identifier: NCT00149773     History of Changes
Other Study ID Numbers: P20 MH071905-01, P20MH071905-01, 802223, DSIR 83-ATP
Study First Received: September 6, 2005
Last Updated: April 6, 2015
Health Authority: United States: Federal Government

Keywords provided by University of Pennsylvania:
Cognitive therapy
Older men
Death ideation
Primary care

Additional relevant MeSH terms:
Suicide, Attempted
Behavioral Symptoms
Self-Injurious Behavior
Suicide processed this record on October 13, 2015