Twenty-six years of psychosocial interventions to reduce suicide risk in adolescents: Systematic review and meta-analysis

Twenty-six years of psychosocial interventions to reduce suicide risk in adolescents: Systematic review and meta-analysis

Forfattere
Itzhaky, L. Davaasambuu, S. Ellis, S. P. Cisneros-Trujillo, S. Hannett, K. Scolaro, K. Stanley, B. H. Mann, J. J. Wainberg, M. L. Oquendo, M. A. Sublette, M. E.
Årstall
2022
Tidsskrift
Journal of Affective Disorders
Volum
300
Sider
511-531
Background During adolescence, suicide risk increases; effective treatments are needed to reduce risk. Method(s) Databases were searched (1995-2020) for randomized controlled trials (RCTs) concerning psychosocial treatments for suicide prevention in adolescents (10-18 yrs). Data were extracted from the timepoint closest to 6 months. Cohen's ds were estimated for reducing suicidal ideation (SI), self-harming behaviors (SHB) excluding strictly non-suicidal self-injury, and suicide attempts (SA) and analyzed using generalized least square regression. Meta-analytic innovations included within-person correlations to reflect trait suicidality; annualization to control for exposure; estimated lifetime risk based on ages; and modeling inclusion/exclusion criteria. Alternate approaches included relative risk and comparison of intervention and control treatments to baseline. Result(s) Of 30 RCTs, 6 assessing SHB (4 measuring SA), and 7 assessing SI demonstrated treatment effectiveness. Overall, interventions decreased SI (n = 25) with low effect size (d = 0.08, p = 0.01), non-significant after controlling for publication bias (d = 0.05, p = 0.1); interventions were non-significant for SHB (n = 25, d = 0.001, p = 0.97) or SA (n = 18, d = 0.03, p = 0.52). To prevent one SHB, the number needed to treat (NNT) was 45[26,156]; for SA, NNT=42[24,149]. Non-superiority may relate to effectiveness of control treatments. Thus, experimental and control treatments also were compared to baseline: both reduced SI (p < 0.0001), and effectiveness improved for SHB (NNT=12) and SA (NNT=11). Limitation(s): Study heterogeneity and inconsistent statistical reporting limited meta-analysis. Conclusion(s) Psychosocial interventions for suicide risk in adolescents showed little effectiveness compared with control treatments; suicide outcomes improved in both groups compared to baseline. Different approaches may be needed, including precision medicine methodologies and standardized statistical reporting criteria. Copyright © 2021 Elsevier B.V.

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Tiltaksnivå

Behandling og hjelpetiltak

Tema

Psykiske vansker og lidelser

Følelsesmessige problemer

Selvskading/selvmord

Tiltak

Psykologiske behandlingsmetoder

Familieterapi

Kognitiv atferdsterapi, atferdsterapi og kognitiv terapi

Mindfulness

Psykoedukative tiltak (inkl. videobasert modellæring)

Organisering av tiltak

Gruppetiltak

Hjemmebaserte tjenester

Nettverkstiltak (inkl. MST)

Aldersgruppe

Ungdom (13-18 år)

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