RESUMEN
OBJECTIVE: We evaluated the effect of brief cognitive behavioral therapy (bCBT) on suicidal ideation among medically ill veterans receiving mental health treatment in primary care. METHODS: Secondary analysis was conducted on data collected during a multisite, patient-randomized trial investigating the impact of bCBT (nâ¯=â¯180) on depression and anxiety symptoms, relative to enhanced usual care (EUC; nâ¯=â¯122), in patients with congestive heart failure and/or chronic obstructive pulmonary disease. BCBT was delivered by primary care mental health providers over 4â¯months, with follow-up posttreatment assessments of suicidal ideation, measured by the Patient Health Questionnaire-9 (item 9) at 4, 8, and 12â¯months. Suicidal ideation was the primary outcome examined in the current analysis. Generalized estimating equations modeling suicidal ideation were used to compare the study arms. RESULTS: Participants receiving bCBT were less likely to have high suicidal ideation than participants receiving EUC posttreatment and at 8-month follow-up after accounting for baseline suicidal ideation. Within-group comparisons suggest participants receiving bCBT were less likely to have high suicidal ideation at 4, 8, and 12â¯months when compared with baseline. High suicidal ideation for EUC participants did not differ at 4, or 8â¯months, but they were less likely to have high suicidal ideation at 12â¯months. CONCLUSION: bCBT in primary care reduces suicidal ideation and may help prevent future suicidal ideation.