The Effects of Cognitive Behavioral Therapy on Suicide Risk among Elderly Patients with Diabetes in Erawan District, Loei Province, Thailand: a Randomized Controlled Trial

Abstract

Objective: To determine the effects of cognitive behavioral therapy on suicide risk in elderly patients with diabetes mellitus. Methods: A randomized controlled trial was conducted among 102 elderly diabetic patients at risk of suicide in Erawan District, Loei Province. They were assigned into either (a) an experimental group receiving CBT program combined with usual care or (b) a control group receiving usual care only (each with 51 participants). Follow-up was conducted for 6 months. Outcomes were measured using the Suicidal Behaviors Questionnaire-Revised (SBQ-R), 9Q Depression Assessment Scale, Beck Hopelessness Scale (BHS), and Interpersonal Needs Questionnaire-Perceived Burdensomeness (INQ-PB). Results: Most participants were female (62.7%) with a mean age of 67.8 ± 5.2 years. The experimental group showed statistically significant reduction in suicide risk scores compared to the control group (9.8 ± 2.1 to 6.5 ± 1.7 versus 9.6 ± 2.3 to 8.9 ± 2.0, p < 0.001). The effect size (Cohen's d) was large (1.35). The experimental group showed statistically significant improvements in depression, hopelessness, and perceived burdensomeness compared to the control group (p < 0.001). The treatment response rate in the experimental group was as high as 83.3% at 6 months post-intervention. Conclusion: The cognitive behavioral therapy program was effective in significantly reducing suicide risk and improving mental health outcomes in elderly diabetic patients, both statistically and clinically. Treatment effects were sustained up to 6 months post-intervention.