Differential effectiveness of pharmacotherapy and Mindfulness-integrated Cognitive Behavior Therapy (MiCBT) in suicidal adults following hospitalization

Abstract Backgrounds: Suicidality can emerge from psychiatric disorders, illness-related distress, grief, functional impairments, and medication adverse effects, where symptom-reduction treatments tend to take precedence over the cultivation of insight. This pilot trial evaluates the potential benefits of Mindfulness-integrated Cognitive Behavior Therapy (MiCBT) to promote whole-person mental health and reduce relapse in adults who previously attempted suicide.

Method: Thirty medicated adults with a previous suicide attempt were referred to urban health centers for complementary treatment following hospitalization. Participants were randomly assigned to an intervention group (MiCBT + medication) who received MiCBT and pharmacological treatment, or to a control group (Treatment as usual; TAU) who continued receiving pharmacological treatment only until completion of the two-month follow-up. All participants filled in questionnaires measuring depression, anxiety, stress, suicidal intention, and coping strategies at pre- and post-intervention and 2-month follow-up.

Results: While no between-group differences appeared at baseline on all measures, post-intervention and follow-up scores in the intervention group showed significantly greater reduction in depression, anxiety, stress, and suicidal intention than in the TAU group. The intervention group also showed greater increase in coping strategies.

Conclusion: In this study, MiCBT + medication was a more effective approach than medication alone to assist suicidal adults manage distressing symptoms and develop better coping skills. Although the results support the advantage of including MiCBT as adjunct to TAU, the small sample size of this pilot study is a notable limitation, and larger trials are necessary to verify the generalizability of these benefits.