An adolescent with major depression is being treated with fluoxetine. Which additional treatment best protects against suicide risk?

An adolescent with major depression is being treated with fluoxetine. Which additional treatment best protects against suicide risk?

• A. Addition of risperidone therapy
• B. Cognitive-behavioral therapy
• C. Family therapy
• D. Hospitalization

Answer: (B)

The main idea is that combining pharmacotherapy with psychotherapy provides the strongest protection against ongoing suicide risk in adolescents with major depression. Cognitive-behavioral therapy helps by teaching practical skills to challenge and change the negative thoughts that fuel hopelessness and impulsive self-harm ideas, as well as by improving problem-solving, coping strategies, and mood monitoring. It also includes safety planning and behavioral activation to reduce withdrawal and isolation, which are often linked to suicidality. When added to fluoxetine, CBT addresses both the emotional symptoms and the cognitive-behavioral patterns that can lead to suicidal thoughts or attempts, making it more protective than the other options listed. Risperidone may be used for specific symptoms but doesn’t primarily reduce suicide risk; family therapy improves support but isn’t as directly targeted to suicidality; hospitalization is reserved for imminent danger rather than a preventive measure in stable patients.

The main idea is that combining pharmacotherapy with psychotherapy provides the strongest protection against ongoing suicide risk in adolescents with major depression. Cognitive-behavioral therapy helps by teaching practical skills to challenge and change the negative thoughts that fuel hopelessness and impulsive self-harm ideas, as well as by improving problem-solving, coping strategies, and mood monitoring. It also includes safety planning and behavioral activation to reduce withdrawal and isolation, which are often linked to suicidality. When added to fluoxetine, CBT addresses both the emotional symptoms and the cognitive-behavioral patterns that can lead to suicidal thoughts or attempts, making it more protective than the other options listed. Risperidone may be used for specific symptoms but doesn’t primarily reduce suicide risk; family therapy improves support but isn’t as directly targeted to suicidality; hospitalization is reserved for imminent danger rather than a preventive measure in stable patients.