Application of an Exploratory DBT–Based Psychotherapy Program for Suicide-Related Symptoms in Chinese Outpatients With Affective Disorders

Abstract

Objective

This exploratory pilot study aimed to examine the potential effects of a shortened, individually delivered dialectical behavior therapy (DBT)-based intervention added to pharmacotherapy on suicide-related outcomes among Chinese outpatients with affective disorders.

Methods

Twenty-one participants recruited from the psychiatric outpatient clinics of the First Affiliated Hospital, School of Medicine, Zhejiang University, were randomly assigned to two groups. Participants in the research group received pharmacotherapy plus a shortened, individually delivered DBT-based intervention, whereas those in the control group received pharmacotherapy alone. Participants completed baseline assessments, 12 weeks of treatment, and 12 weeks of follow-up, with assessments performed every 4 weeks. Outcomes included suicide risk or severity, depression, anxiety, and hopelessness assessed using self-report scales.

Results

After adjustment for baseline values using repeated-measures analysis of covariance (RM-ANCOVA), the between-group effect on suicide risk showed a marginal trend favoring the DBT-based psychotherapy group, but did not reach conventional statistical significance (F = 4.26, p = 0.054). The time effect (F = 0.234, p = 0.965) and time-by-group interaction (F = 1.306, p = 0.261) for suicide risk were not statistically significant. Depressive symptoms showed a significant time effect across the follow-up period, whereas most suicide-related and hopelessness outcomes were not statistically significant. These findings should be interpreted as preliminary because of the small sample size and baseline imbalance.

Conclusion

The results provided preliminary pilot evidence that a shortened DBT-based intervention may be feasible and potentially beneficial as an adjunct to pharmacotherapy in this clinical population. However, the primary suicide-risk outcome did not show a statistically significant between-group effect. Larger adequately powered trials with baseline-adjusted analyses and more comprehensive outcome assessment are needed before firm conclusions can be drawn.