BACKGROUND Southeast Asia has the highest suicide mortality worldwide. To improve our knowledge on the effectiveness of interventions for suicidal ideation (SI) in individuals with depression in Indonesia, we conducted a secondary analysis of a randomised controlled trial. OBJECTIVE We explored whether an internet-based behavioural activation (BA) intervention ('Guided Act and Feel Indonesia' (GAF-ID)) was superior in targeting SI compared with online-delivered psychoeducation (PE). METHODS In total, 313 participants were randomised between treatment allocation. The SI item of the Patient Health Questionnaire-9 was the primary outcome measure. Mediation analyses were conducted to identify if BA at week 10 mediated the relationship between intervention and SI at week 24. FINDINGS The GAF-ID intervention was not superior in reducing SI compared with online minimal PE at week 10 (OR 0.61, 95% CI (0.37 to 1.01)), nor at week 24 (OR 0.84, 95% CI (0.47 to 1.52)). SI at week 24 was not mediated by BA at week 10 (b=-0.03, 95% CI (-0.05 to 0.00), p=0.07). CONCLUSIONS In individuals with depression in Indonesia, the GAF-ID intervention was not superior in reducing self-reported SI compared with PE. Also, the association between treatment condition and SI at week 24 was not mediated via BA at week 10. CLINICAL IMPLICATIONS This study supports the need for further research on the efficacy of psychological treatments targeting SI in the Southeast Asia context.

中文翻译：

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基于互联网的行为激活疗法与在线心理教育对印度尼西亚抑郁症患者自我报告的自杀意念的比较：随机对照试验的二次分析。


背景 东南亚是全球自杀死亡率最高的地区。为了提高我们对印度尼西亚抑郁症患者自杀意念 (SI) 干预措施有效性的了解，我们对一项随机对照试验进行了二次分析。目的 我们探讨基于互联网的行为激活 (BA) 干预措施（“印尼指导行动和感受”(GAF-ID)）与在线心理教育 (PE) 相比，在针对 SI 方面是否更胜一筹。方法 总共 313 名参与者被随机分配接受治疗。患者健康问卷 9 的 SI 项目是主要结果指标。进行中介分析以确定第 10 周的 BA 是否介导干预与第 24 周的 SI 之间的关系。 结果 与第 10 周的在线最小 PE 相比，GAF-ID 干预在降低 SI 方面并不优越（OR 0.61，95% CI（ 0.37 至 1.01))，第 24 周也没有变化（OR 0.84，95% CI（0.47 至 1.52））。第 24 周的 SI 不是由第 10 周的 BA 介导的（b=-0.03，95% CI（-0.05 至 0.00），p=0.07）。结论 在印度尼西亚抑郁症患者中，与 PE 相比，GAF-ID 干预在减少自我报告的 SI 方面并不优越。此外，第 24 周时治疗条件与 SI 之间的关联并非通过第 10 周时的 BA 介导。 临床意义 这项研究支持需要进一步研究东南亚背景下针对 SI 的心理治疗的功效。