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Logo of bmjoInstructions for authorsCurrent ToCBMJ Open
BMJ Open. 2012; 2(5): e001558.
Published online Sep 13, 2012. doi:  10.1136/bmjopen-2012-001558
PMCID: PMC3467611
A clinical audit of changes in suicide ideas with internet treatment for depression
Sarah Watts, Jill M Newby, Louise Mewton, and Gavin Andrews
Clinical Research Unit for Anxiety and Depression, School of Psychiatry, University of New South Wales at St Vincent's Hospital, Darlinghurst,  New South Wales, Australia
Correspondence to Dr Louise Mewton; louisem/at/
Received May 28, 2012; Accepted August 15, 2012.
To examine reductions in suicidal ideation among a sample of patients who were prescribed an internet cognitive behavior therapy (iCBT) course for depression.
Effectiveness study within a quality assurance framework.
Primary care.
299 patients who were prescribed an iCBT course for depression by primary care clinicians.
Six lesson, fully automated cognitive behaviour therapy course delivered over the internet. Primary outcome: suicidal ideation as measured by question 9 on the Patient Health Questionnaire (PHQ-9).
Suicidal ideation was common (54%) among primary care patients prescribed iCBT treatment for depression but dropped to 30% post-treatment despite minimal clinician contact and the absence of an intervention focused on suicidal ideation. This reduction in suicidal ideation was evident regardless of sex and age.
The findings do not support the exclusion of patients with significant suicidal ideation.
Keywords: Mental Health, Primary Care, Psychiatry
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