@article{ref1,
title="Temporal relationships between changes in depression and suicidal ideation: a mediation analysis in a randomized double-blinded clinical trial",
journal="Psychology and psychotherapy",
year="2022",
author="Shaygan, Maryam and Hosseini, Fahimeh Alsadat and Negad, Soheila Sheybani",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="OBJECTIVES: There is a considerable debate regarding the possible dependence between depression and suicidal ideation treatments. The present study used a novel mediation approach in a randomized comparison of pharmacotherapy and combined therapy to explore whether depressive symptoms mediate the association between treatment and suicidal ideation and whether it depends on the treatment condition. <br><br>DESIGN: This study is a randomized, controlled, parallel group (1:1), clinical trial using a novel mediation approach for longitudinal data. Latent difference score modelling was utilized to investigate whether changes in depressive symptoms drive subsequent changes in suicide ideation. <br><br>METHOD: Participants were 94 depressive suicidal outpatients who were assessed regarding depressive symptoms and suicidal ideation over the course of an experiment (0-2-7 months). Direct and indirect associations between (change in) depressive symptoms and (change in) suicidal ideation were explored using Pearson's correlations and latent difference score model. <br><br>RESULTS: The results showed that depression treatment affects not only suicidal ideation directly but also its influence on suicidal ideation occurs via improvement in depressive symptoms. It was found a more significant effect of combining pharmacotherapy and PPT (in comparison with the pharmacotherapy alone) on the early and late improvements of suicidal ideation (Δ 0-2 and Δ 2-7) via the early improvement of depressive symptoms (Δ 0-2). <br><br>CONCLUSIONS: The findings indicate that changes in depressive symptoms preceded changes in suicidal ideation. Our results highlighted that improving depressive symptoms could be a primary target in treating patients with depression experiencing suicidal thoughts.<p /> <p>Language: en</p>",
language="en",
issn="1476-0835",
doi="10.1111/papt.12444",
url="http://dx.doi.org/10.1111/papt.12444"
}