A Further Look at Therapeutic Interventions for Suicide Attempts and Self-Harm in Adolescents

An Updated Systematic Review of Randomized Controlled Trials

Bibliographic Data

ID15520581
AuthorsUdita Iyengar (0000-0001-7928-2167, King's College London, corresponding author), Natasha Snowden (King's College London), Joan Rosenbaum Asarnow (0000-0002-1610-044X, University of California, Los Angeles), Paul Moran (0000-0002-9257-8699, National Institute for Health and Care Research), Troy Tranah (Institute of Physics), Dennis Ougrin (0000-0003-1995-5408, National Health Service)
Year2018
Volume9
Pages583-583
Publication date2018-11-23
Open AccessYes
TypeARTICLE
VenueFrontiers in Psychiatry (JOURNAL)
Journal identifiersISSN: 1664-0640 • E-ISSN: 1664-0640
PublisherFrontiers Media (PUBLISHER • CH)
DOI10.3389/fpsyt.2018.00583
PMID30532713
OpenAlexW2901332141
LanguageEN
Citations received16
References cited54

Background: Suicide attempts (SA) and other types of self-harm (SH) are strong predictors of death by suicide in adolescents, emphasizing the need to investigate therapeutic interventions in reduction of these and other symptoms. We conducted an updated systematic review of randomized controlled trials (RCTs) from our previous study reporting therapeutic interventions that were effective in reducing SH including SA, while additionally exploring reduction of suicidal ideation (SI) and depressive symptoms (DS). Method: A systematic literature search was conducted across OVID Medline, psycINFO, PubMed, EMBASE, and Cochrane Library from the first available article to October 22nd, 2017, with a primary focus on RCTs evaluating therapeutic interventions in the reduction of self-harm. Search terms included self-injurious behavior; self-mutilation; suicide, attempted; suicide; drug overdose . Results: Our search identified 1,348 articles, of which 743 eligible for review, yielding a total of 21 studies which met predetermined inclusion criteria. Eighteen unique therapeutic interventions were identified among all studies, stratified by individual-driven, socially driven, and mixed interventions, of which 5 studies found a significant effect for primary outcomes of self-harm and suicide attempts (31.3%), and 5 studies found a significant effect for secondary outcomes of suicidal ideation and depressive symptoms (29.4%) for therapeutic intervention vs. treatment as usual. Collapsing across different variations of Cognitive Behavior Therapy (CBT), and classifying Dialectical Behavior Therapy for Adolescents (DBT-A) as a type of CBT, CBT is the only intervention with replicated positive impact on reducing self-harm in adolescents. Conclusion: While the majority of studies were not able to determine efficacy of therapeutic interventions for both primary and secondary outcomes, our systematic review suggests that individual self-driven and socially-driven processes appeared to show the greatest promise for reducing suicide attempts, with benefits of combined self-driven and systems-driven approaches for reducing overall self-harm. Further RCTs of all intervention categories are needed to address the clinical and etiological heterogeneity of suicidal behavior in adolescents, specifically suicidal ideation and depressive symptoms

Borderline personality disorder · Cochrane Library · Dialectical Behavior Therapy · Medical emergency · MEDLINE · Meta-analysis · Poison control · Psychiatry · Psychological intervention · PsycINFO · Randomized controlled trial · Suicidal ideation · Suicide prevention · Systematic review · Attention Deficit Hyperactivity Disorder · Child and Adolescent Psychosocial and Emotional Development · Clinical Psychology · Medicine · Psychology · Suicide and Self-Harm Studies · Internal Medicine

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