***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: AIM The aim of the present study was to examine the intervention effects of intensive interpersonal psychotherapy for depressed adolescents with suicidal risk ( IPT-A-IN ) by comparison with treatment as usual ( TAU ) at schools . METHODS A total of 347 students from one-fifth of the classes of a high school in southern Taiwan completed the Beck Depression Inventory-II , the Beck Scale for Suicide Ideation , the Beck Anxiety Inventory and the Beck Hopelessness Scale for screening for suicidal risk . Of them , 73 depressed students who had suicidal risk on screening were r and omly assigned to the IPT-A-IN or TAU group . Analysis of covariance ( ANCOVA ) was performed to examine the effect of IPT-A-IN on reducing the severity of depression , suicidal ideation , anxiety and hopelessness . RESULTS Using the pre-intervention scores as covariates , the IPT-A-IN group had lower post-intervention severity of depression , suicidal ideation , anxiety and hopelessness than the TAU group . CONCLUSION Intensive school-based IPT-A-IN is effective in reducing the severity of depression , suicidal ideation , anxiety and hopelessness in depressed adolescents with suicidal risk IMPORTANCE In the United States , approximately 1 physician dies by suicide every day . Training physicians are at particularly high risk , with suicidal ideation increasing more than 4-fold during the first 3 months of internship year . Despite this increase , to our knowledge , very few efforts have been made to prevent the escalation of suicidal thoughts among training physicians . OBJECTIVE To assess the effectiveness of a web-based cognitive behavioral therapy ( wCBT ) program delivered prior to the start of internship year in the prevention of suicidal ideation in medical interns . DESIGN , SETTING , AND PARTICIPANTS A r and omized clinical trial conducted at 2 university hospitals with 199 interns from multiple specialties during academic years 2009 - 2010 or 2011 - 2012 . The current study was conducted from May 2009 to June 2010 and May 2011 to June 2012 , and data were analyzed using intent-to-treat principles , including last observation carried forward . INTERVENTIONS Interns were r and omly assigned to 2 study groups ( wCBT and attention-control group [ ACG ] ) , and completed study activities lasting 30 minutes each week for 4 weeks prior to starting internship year . Participants assigned to wCBT completed online CBT modules and those assigned to ACG received emails with general information about depression , suicidal thinking , and local mental health professionals . MAIN OUTCOMES AND MEASURES The Patient Health Question naire-9 was used to assess suicidal ideation ( ie , " thoughts that you would be better off dead or hurting yourself in some way " ) prior to the start of intern year and at 3-month intervals throughout the year . RESULTS A total of 62.2 % of interns ( 199 of 320 ) agreed to take part in the study ; 100 were assigned to the wCBT group and 99 to the ACG . During at least 1 point over the course of internship year , 12 % of interns ( 12 of 100 ) assigned to wCBT endorsed suicidal ideation compared with 21.2 % of interns ( 21 of 99 ) assigned to ACG . After adjusting for covariates identified a priori that have previously shown to increase the risk for suicidal ideation , interns assigned to wCBT were less likely to endorse suicidal ideation during internship year ( relative risk , 0.40 ; 95 % CI , 0.17- 0.91 ; P = .03 ) compared with those assigned to ACG . CONCLUSIONS AND RELEVANCE This study demonstrates that a free , easily accessible , brief wCBT program is associated with reduced likelihood of suicidal ideation among medical interns . Prevention programs with these characteristics could be easily disseminated to medical training programs across the country . TRIAL REGISTRATION anzctr.org.au Identifier : ACTRN12610000628044 Background Suicide-related behaviours are common in young people and associated with a range of negative outcomes . There are few evidence -based interventions ; however , cognitive behavioural therapy ( CBT ) shows promise . Internet delivery of CBT is popular , with potential to increase reach and accessibility . Objective To test the effectiveness of an internet-based CBT program ( Reframe-IT ) in reducing suicide-related behaviours , depression , anxiety , hopelessness and improving problem solving and cognitive and behavioural skills in school students with suicide-related behaviours . Methods A parallel r and omised controlled trial testing the effectiveness of Reframe-IT plus treatment as usual ( TAU ) compared with TAU alone in reducing suicidal ideation , suicide attempts , depression , hopelessness , symptoms of anxiety , negative problem orientation and cognitive and behavioural skill acquisition was undertaken . We recruited students experiencing suicidal ideation from 18 schools in Melbourne , Australia , between August 2013 and December 2016 . The intervention comprised eight modules of CBT delivered online over 10 weeks with assessment s conducted at baseline , 10 weeks and 22 weeks . Findings Only 50 of the planned 169 participants were recruited . There were larger improvements in the Reframe-IT group compared with the TAU group for the primary outcome of suicidal ideation ( intervention −61.6 , SD 41.6 ; control −47.1 , SD 42.3 , from baseline to 22-week follow-up intervention ) ; however , differences were non-significant ( p=0.593 ) . There were no increases in distress in the majority of participants ( 91.1 % ) after completion of each module . Changes in depression and hopelessness partly mediated the effect of acquisition of CBT skills on suicidal ideation . Conclusions The trial was underpowered due to difficulties recruiting participants as a result of the complex recruitment procedures that were used to ensure safety of participants . Although there were no significant differences between groups , young people were safely and generally well engaged in Reframe-IT and experienced decreases in suicidal ideation and other symptoms as well as improvements in CBT skills . The study is the first online intervention trial internationally to include young people demonstrating all levels of suicide risk . Clinical implication s Integration of internet-delivered interventions for young people with suicide-related behaviour may result in reductions in these behaviours . Further research is needed , but research ers should feel more confident about being able to safely undertake research with young people who experience these behaviours . Trial registration number ACTRN12613000864729 The objective of this paper is to adapt attachment-based family therapy ( ABFT ) for use with suicidal lesbian , gay , and bisexual ( LGB ) adolescents and to obtain preliminary data on the feasibility and efficacy of the treatment with this population . In Phase I , a treatment development team modified ABFT to meet the unique needs of LGB suicidal youth . In Phase II , 10 suicidal LGB youth were offered 12 weeks of LGB sensitive ABFT . Adolescents ' report of suicidal ideation , depressive symptoms , and maternal attachment-related anxiety and avoidance were gathered at pretreatment , 6 weeks , and 12 weeks ( posttreatment ) . In Phase I , the treatment was adapted to : ( a ) include more individual time working with parents in order to process their disappointments , pain , anger , and fears related to their adolescent 's minority sexual orientation ; ( b ) address the meaning , implication s , and process of acceptance ; and ( c ) heighten parents ' awareness of subtle yet potent invalidating responses to their adolescents ' sexual orientation . Results of Phase II suggest this population can be recruited and successfully treated with a family based therapy , evidence d by high levels of treatment retention and significant decreases in suicidal ideation , depressive symptoms , and maternal attachment-related anxiety and avoidance . This is the first family-based treatment adapted and tested specifically for suicidal LGB adolescents . Though promising , the results are preliminary and more research on larger sample s is warranted Summary Background Self-harm in adolescents is common and repetition occurs in a high proportion of these cases . Scarce evidence exists for effectiveness of interventions to reduce self-harm . Methods This pragmatic , multicentre , r and omised , controlled trial of family therapy versus treatment as usual was done at 40 UK Child and Adolescent Mental Health Services ( CAMHS ) centres . We recruited young people aged 11–17 years who had self-harmed at least twice and presented to CAMHS after self-harm . Participants were r and omly assigned ( 1:1 ) to receive manualised family therapy delivered by trained and supervised family therapists or treatment as usual by local CAMHS . Participants and therapists were aware of treatment allocation ; research ers were masked . The primary outcome was hospital attendance for repetition of self-harm in the 18 months after group assignment . Primary and safety analyses were done in the intention-to-treat population . The trial is registered at the IS RCT N registry , number IS RCT N59793150 . Findings Between Nov 23 , 2009 , and Dec 31 , 2013 , 3554 young people were screened and 832 eligible young people consented to participation and were r and omly assigned to receive family therapy ( n=415 ) or treatment as usual ( n=417 ) . Primary outcome data were available for 795 ( 96 % ) participants . Numbers of hospital attendances for repeat self-harm events were not significantly different between the groups ( 118 [ 28 % ] in the family therapy group vs 103 [ 25 % ] in the treatment as usual group ; hazard ratio 1·14 [ 95 % CI 0·87–1·49 ] p=0·33 ) . Similar numbers of adverse events occurred in both groups ( 787 in the family therapy group vs 847 in the treatment as usual group ) . Interpretation For adolescents referred to CAMHS after self-harm , having self-harmed at least once before , our family therapy intervention conferred no benefits over treatment as usual in reducing subsequent hospital attendance for self-harm . Clinicians are therefore still unable to recommend a clear , evidence -based intervention to reduce repeated self-harm in adolescents . Funding National Institute for Health Research Health Technology Assessment programme OBJECTIVE Suicide is the third leading cause of death among adolescents . Many suicidal youths treated in emergency departments do not receive follow-up treatment as advocated by the National Strategy for Suicide Prevention . Two strategies for improving rates of follow-up treatment were compared . METHODS In a r and omized controlled trial , suicidal youths at two emergency departments ( N=181 ; ages ten to 18 ) were individually assigned between April 2003 and August 2005 to one of two conditions : an enhanced mental health intervention involving a family-based cognitive-behavioral therapy session design ed to increase motivation for follow-up treatment and safety , supplemented by care linkage telephone contacts after emergency department discharge , or usual emergency department care enhanced by provider education . Assessment s were conducted at baseline and approximately two months after discharge from the emergency department or hospital . The primary outcome measure was rates of outpatient mental health treatment after discharge . RESULTS Intervention patients were significantly more likely than usual care patients to attend outpatient treatment ( 92 % versus 76 % ; p=.004 ) . The intervention group also had significantly higher rates of  psychotherapy  ( 76 % versus 49 % ; p=.001 ) , combined psychotherapy and medication  ( 58 % versus 37 % ; p=.003 ) , and  psychotherapy visits ( mean 5.3 versus 3.1 ; p=.003 ) . Neither the emergency department intervention nor community outpatient treatment ( in exploratory analyses ) was significantly associated with improved clinical or functioning outcomes . CONCLUSIONS Results support efficacy of the enhanced emergency department intervention for improving linkage to outpatient mental health treatment but underscore the need for improved community outpatient treatment to prevent suicide , suicide attempts , and poor clinical and functioning outcomes for suicidal youths treated in emergency departments OBJECTIVE To determine whether brief intervention and contact is effective in reducing subsequent suicide mortality among suicide attempters in low and middle-income countries . METHODS Suicide attempters ( n = 1867 ) identified by medical staff in the emergency units of eight collaborating hospitals in five culturally different sites ( Campinas , Brazil ; Chennai , India ; Colombo , Sri Lanka ; Karaj , Islamic Republic of Iran ; and Yuncheng , China ) participated , from January 2002 to October 2005 , in a r and omized controlled trial to receive either treatment as usual , or treatment as usual plus brief intervention and contact ( BIC ) , which included patient education and follow-up . Overall , 91 % completed the study . The primary study outcome measurement was death from suicide at 18-month follow-up . FINDINGS Significantly fewer deaths from suicide occurred in the BIC than in the treatment-as-usual group ( 0.2 % versus 2.2 % , respectively ; chi2 = 13.83 , P < 0.001 ) . CONCLUSION This low-cost brief intervention may be an important part of suicide prevention programmes for underre source d low- and middle-income countries Background Suicide prevention organisations frequently use websites to educate the public , but evaluations of these websites are lacking . Aims To examine the effects of educative websites and the moderating effect of participant vulnerability . Method A total of 161 adults were r and omised to either view an educative website on suicide prevention or an unrelated website in a single-blinded r and omised controlled trial ( trial registration with the American Economic Association 's registry : RCT -ID : 000924 ) . The primary outcome was suicidal ideation ; secondary 
    Output:
    
Large scale interventions delivered in both clinical and educational setting s appear to reduce self-harm and suicidal ideation post-intervention , and to a lesser extent at follow-up .
In community setting s , multi-faceted , place-based approaches seem to have an impact .