Aktiv kontakt- og oppfølgingstiltak for å forhindre gjentatte selvmordsforsøk i høyrisikoperioder blant pasienter innlagt på akuttavdelinger for selvmordsatferd: Systematisk oversikt og metaanalyse

Active contact and follow-up interventions to prevent repeat suicide attempts during high-risk periods among patients admitted to emergency departments for suicidal behavior: a systematic review and meta-analysis

Forfattere
Inagaki, M. Kawashima, Y. Yonemoto, N. Yamada, M.
Årstall
2019
Tidsskrift
BMC Psychiatry
Volum
19
Sider
11
Background There is evidence that several intervention types, including psychotherapy, reduce repeat suicide attempts. However, these interventions are less applicable to the heterogeneous patients admitted to emergency departments (EDs). The risk of a repeat suicide attempt is especially high in the first 6months after the initial attempt. Therefore, it is particularly important to develop effective ED interventions to prevent repeat suicide attempts during this 6-month period. Methods We systematically reviewed randomized controlled trials of ED-initiated interventions for suicidal patients admitted to EDs using the databases MEDLINE, PsychoINFO, CINAHL, and EMBASE up to January 2015 in accordance with an a priori published protocol (PROSPERO: CRD42013005463). Interventions were categorized into four types, including active contact and follow-up interventions (intensive care plus outreach, brief interventions and contact, letter/postcard, telephone, and composite of letter/postcard and telephone), and a meta-analysis was conducted to determine pooled relative risks (RRs) and 95% confidence intervals (CIs) of a repeat suicide attempt within 6months. Results Of the 28 selected trials, 14 were active contact and follow-up interventions. Two of these trials (n=984) reported results at 6months (pooled RR=0.48; 95% CI: 0.31 to 0.76). There were not enough trials of other interventions to perform meta-analysis. Some trials included in the meta-analysis were judged as showing risk of bias. Conclusion Active contact and follow-up interventions are recommended for suicidal patients admitted to an ED to prevent repeat suicide attempts during the highest-risk period of 6months. Systematic review registration PROSPERO CRD42013005463 (27 August 2013).

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Tiltaksnivå

Behandling og hjelpetiltak

Tema

Psykiske vansker og lidelser

Følelsesmessige problemer

Selvskading/selvmord

Tiltak

Organisering av tiltak

Døgnbehandling

Aldersgruppe

Ungdom (13-18 år)

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