Disorders - Suicide or self-harm behaviours
Zhao, Y., He, Z., Luo, W., Yu, Y., Chen, J., Cai, X., Gao,
J., Li, L., Gao, Q., Chen, H., Lu, F.
BACKGROUND: Suicidal
ideation is a serious symptom of major depressive disorder (MDD). Intermittent theta burst stimulation (iTBS) is a safe, effective brain stimulation
treatment for alleviating suicidal ideation in adults with MDD. This study aimed to examine the clinical efficacy of iTBS on reducing suicidal
ideation in adolescent MDD with suicide attempt.\rMETHODS: In a randomized, sham-controlled protocol, a total of 10 sessions of iTBS was
administrated to the left dorsolateral prefrontal cortex (DLPFC) in patients once a day for two weeks. The suicidal ideation and depressive symptoms
were assessed using Beck Scale for Suicide Ideation-Chinese Version (BSI-CV), Hamilton Rating Scale for Depression (HAMD-24), and Self-rating
Depression Scale (SDS) at baseline and after 10 treatment sessions.\rRESULTS: Forty-five patients were randomized assigned to either active iTBS (n =
23) or sham group (n = 22). The suicidal ideation and depressive symptoms of the active iTBS group were significantly ameliorated over 2 weeks of
treatment. Further, higher baseline SDS, HAMD-24 and BSI-CV scores in the active iTBS group were associated with greater reductions.\rLIMITATIONS: A
larger sample size and double-blinded clinical trial should be conducted to verify the reliability and reproducibility.\rCONCLUSIONS: The current
study suggested that daily iTBS of the left DLPFC for 2 weeks could effectively and safely alleviate suicidal ideation and mitigate depression in
adolescent MDD, especially for individuals with relatively more severe symptoms. Although caution is warranted, the findings could provide further
evidence for the effectiveness and safety of iTBS in clinical practice.
, 325 : 618-
626
- Year: 2023
- Problem: Depressive Disorders, Suicide or self-harm behaviours (excluding non-suicidal self-harm), Suicide or self-harm with comorbid mental disorder
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder), At risk (indicated or selected prevention)
-
Treatment and intervention: Biological Interventions
(any), Other biological interventions
Xie, M., Wodzinski, M., Gajaria, A., Battaglia, M., Rotem, A.
Background: Young people often face barriers to
psychiatric care and are increasingly seeking crisis services for mental health issues through the emergency department (ED). Urgent psychiatric care
models provide youth in crisis with rapid access to time-limited mental health care on an outpatient basis. This scoping review aims to evaluate the
impact of such urgent psychiatric services for youth aged 13-25 on patient and health system outcomes. Method(s): We conducted a literature search on
PubMed, EMBASE, MEDLINE, PsycINFO, and the Cochrane Database of Systematic Reviews for studies published from inception to November 20, 2020. We
included studies that described outpatient psychiatric services designed for youth aged 13 to 25, took place in a clinical setting, and offered any
combination of assessment, treatment, and referral. We excluded studies describing suicide intervention programmes. Result(s): Our search yielded six
studies, four of which were descriptive studies and two of which were randomized controlled trials. Most studies found that access to urgent
psychiatric care for youth was associated with reduced ED volumes, fewer health system costs, and fewer hospitalizations. None of the studies
presented evidence that urgent psychiatric services are associated with improved patient symptomatology or functioning. Conclusion(s): The results of
this scoping review highlight the scarcity of robust evidence evaluating the effectiveness of urgent care for youth mental health. Further
experimental studies and a set of standardized quality measures for evaluating these services are needed to bridge this critical gap in mental health
care for youth in crisis. Copyright © 2022 Association for Child and Adolescent Mental Health.
Child and Adolescent Mental Health, 28(2) : 287-298
- Year: 2023
- Problem: Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Other service delivery and improvement
interventions
Waraan, L., Siqveland, J., Hanssen-Bauer, K., Czjakowski, N. O., Axelsdottir, B., Mehlum, L., Aalberg, M.
OBJECTIVE: To systematically review and meta-analyze the
effectiveness of family therapy compared to other active treatments for adolescents with depressive disorders or suicidal ideation.\rMETHOD: We
conducted a systematic search of The Cochrane Central Register of Controlled Trials, Medline, Embase, PsycINFO, AMED, CINAHL and Web of Science and
performed two meta-analyses of outcomes for depressive symptoms and suicidal ideation.\rRESULTS: We screened 5,940 records and identified 10
randomized controlled studies of family therapy for depressive disorder or suicidal ideation in adolescents with an active treatment comparison
group. Nine studies reported outcome measures of depressive symptoms and four reported outcome measures of suicidal ideation. The meta-analysis
showed no significant difference between family therapy and active comparison treatments for end-of-treatment levels of depression. For suicidal
ideation our meta-analysis showed a significant effect in favour of family therapy over comparison treatments for suicidal ideation.\rCONCLUSIONS:
Based on the current body of research, we found that family therapy is not superior to other psychotherapies in the treatment of depressive disorder.
However, family therapy leads to significantly improved outcomes for suicidal ideation, compared to other psychotherapies. The evidence for the
treatment of depression is of low quality needs more research.
, 28(2) : 831-849
- Year: 2023
- Problem: Depressive Disorders, Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder), At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Family therapy
Sullivan, S. R., Spears, A. P., Mitchell, E. L., Walsh, S., Love, C., Goodman, M.
Background: This PRISMA scoping review explored worldwide research on family-based treatments for suicide prevention.
Research on this topic highlights the importance of facilitating familial understanding of a suicidal individual. Aim(s): The review sought evidence
of outcomes of trials in which both the patient and family member in the intervention arm attended the same sessions at which suicide was openly
discussed. Method(s): To explore this topic, the authors searched for randomized and nonrandomized controlled trials using Medline (Ovid), PsycINFO
(Ovid), Social Services Abstracts (EBSCO), and Web of Science on July 8, 2020. Result(s): Ten different studies were included that spanned five
treatment modalities. Specifically, of the interventions in these 10 articles, 40% employed some sort of cognitive-behavioral therapy, 20% examined
attachment-based family therapy, 20% used family-based crisis intervention, and the remaining 20% were distinct interventions from one another.
Additionally, several of these articles demonstrated rigorous study methodology and many of the articles reported significant improvements in
suicidal ideation or behaviors. Conclusion(s): Several important research gaps were identified. While this approach has been largely understudied,
and to date has been primarily researched in adolescent populations, family interventions have great potential for treatment and prevention of
suicidality.
Crisis, 44(1) : 49-60
- Year: 2023
- Problem: Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any)
Pan, F., Mou, T., Shao, J., Chen, H., Tao, S., Wang, L., Jiang, C., Zhao, M., Wang, Z., Hu, S., Xu, Y., Huang, M.
Background: Neuronavigation-guided high-dose repetitive
transcranial magnetic stimulation (rTMS) could\rrapidly treat depressive patients with suicidal ideation. But the mechanism of rTMS still needs to be
elucidated.\rThis study aims to investigate if rTMS improves suicidal ideation and depressive symptoms by influencing brainderived neurotrophic
factor (BDNF), tropomysin receptor kinase B (TrkB) and VGF levels.\rMethods: In the present 1-week study, 59 treatment-naive depressive patients with
suicidal ideation were\rrandomly assigned to the active (n = 31) or sham (n = 28) rTMS group. The severity of suicidal ideation and\rdepression were
measured by the Beck Scale for Suicide Ideation, the Hamilton Depression Rating Scale and\rMontgomery - Asberg Depression Rating Scale. Fasting
venous blood samples were collected at baseline and after\rtreatment. Serum protein concentrations of BDNF, TrkB and VGF were measured by enzyme
linked immunosorbent assay.\rResults: We found after treatment the levels of BDNF in the active rTMS group were higher than the sham group\r(p =
0.011), TrkB levels were decreased in the active group (p < 0.001), VGF levels were increased in the active\rgroup (p = 0.005). Post-treatment VGF
levels in the active group were higher than the sham group (p = 0.008).\rHowever, there were no significant correlation between changes in BDNF, TrkB
and VGF levels and the changes\rin clinical variables.\rLimitations: Participants taking medication may affect the results.\rConclusions: Our results
suggest that the BDNF-TrkB pathway and VGF may be implicated in the mechanisms\runderlying neuronavigation-guided rTMS for treating depressive
patients with suicidal ideation.
, 323 : 617-623
- Year: 2023
- Problem: Depressive Disorders, Suicide or self-harm behaviours (excluding non-suicidal self-harm), Suicide or self-harm with comorbid mental disorder
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Selective serotonin reuptake inhibitors (SSRIs), Antidepressants
(any), Transcranial magnetic stimulation
(TMS)
Meza, J. I., Zullo, L., Vargas, S. M., Ougrin, D., Asarnow, J. R.
BACKGROUND: Adopting a common elements approach, this
practitioner review aims to highlight specific treatment elements that are common to interventions with demonstrated benefits in randomized
controlled trials (RCTs) for reducing suicide attempts and self-harm in youth. Identification of common treatment elements among effective
interventions offers a key strategy for clarifying the most robust features of effective interventions and improving our ability to implement
effective treatment and decrease the lag between scientific advances and clinical care.\rMETHODS: A systematic search of RCTs evaluating
interventions targeting suicide/self-harm in youth (ages 12-18) yielded a total of 18 RCTs assessing 16 different manualized interventions. An open
coding process was used to identify common elements present within each intervention trial. Twenty-seven common elements were identified and
classified into format, process, and content categories. All trials were coded for the inclusion of these common elements by two independent raters.
RCTs were also classified into those where trial results supported improvements in suicide/self-harm behavior (n = 11 supported trials) and those
without supported evidence (n = 7 unsupported trials).\rRESULTS: Compared with unsupported trials, the 11 supported trials shared the following
elements: (a) inclusion of therapy for both the youth and family/caregivers; (b) an emphasis on relationship-building and the therapeutic alliance;
(c) utilization of an individualized case conceptualization to guide treatment; (d) provided skills training (e.g. emotion regulation skills) to both
youth and their parents/caregivers; and (e) lethal means restriction counseling as part of self-harm monitoring and safety planning.\rCONCLUSIONS:
This review highlights key treatment elements associated with efficacy that community practitioners can incorporate in their treatments for youth
presenting with suicide/self-harm behaviors.
Journal of Child Psychology & Psychiatry & Allied
Disciplines, 06 : 06
- Year: 2023
- Problem: Non-suicidal self-harm behaviours, Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any)
Liljedahl, S. I., Hellner, C., Pettersson,
A., Ghaderi, A.
Both self-harm and suicidal behaviors have been targeted
through school-based prevention programs, many of which have been developed in the United States. The aims of this systematic review were to assess
effects of school-based prevention programs on suicide and self-harm and to evaluate whether they are fit to the exporting culture. The review
followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Our inclusion criteria, structured according to
population/problem, intervention, control/comparison, outome, were: children and youth up to 19 years of age, school-based programs at universal,
selective or indicated levels compared with teaching as usual or with other programs, and outcomes of suicide or self-harm measured at least 10 weeks
after intervention. Studies without a control group or using non-behavioral outcomes were excluded. A comprehensive and systematic literature search
was conducted from the 1990s to March 2022. Risk for bias was assessed with checklists adapted from the Cochrane Risk of Bias (ROB) tool. A total of
1,801 abstracts were retrieved. Five studies fulfilled our inclusion criteria, but one had high risk for bias. Confidence in the evidence for effect
was assessed with Grading of Recommendations Assessment, Development and Evaluation (GRADE). Studies included in this review were evaluated with
respect to applicability in the context of international export. Only two school-based programs demonstrated efficacy in preventing suicidal
behaviors. Although implementation of evidence-based interventions is a crucial next step, further replication with simultaneous attention to
dissemination and implementation issues are called for. Funding and registration: conducted on assignment by the Swedish government. The protocol is
available at the SBU website in Swedish.
Scandinavian Journal of
Psychology, 27 : 27
- Year: 2023
- Problem: Non-suicidal self-harm behaviours, Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Systematic reviews
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any)
Kodish, T., Lau, A. S., Belin, T. R., Berk, M. S., Asarnow, J. R.
OBJECTIVE: This study evaluated the effects of Safe Alternatives for Teens and
Youths-Acute (SAFETY-A), a brief strengths-based, cognitive-behavioral family intervention, on racial-ethnic minority youths receiving emergency
department (ED) treatment for suicidal episodes.\rMETHODS: Participants were 105 racial-ethnic minority youths enrolled in a randomized controlled
trial evaluating SAFETY-A versus enhanced usual care for youths receiving ED treatment for suicidal episodes. Analyses examined group effects on care
linkage after discharge and adequate treatment dose. A sample of 55 White youths was included for comparison.\rRESULTS: Racial-ethnic minority youths
who received SAFETY-A had higher treatment linkage rates than those receiving usual care. Adequate treatment dose rates did not differ by group.
\rCONCLUSIONS: Racial-ethnic minority youths receiving SAFETY-A had higher treatment linkage rates after discharge than those receiving usual care.
SAFETY-A is a promising approach to enhance care continuity and mental health equity for racial-ethnic minority youths at risk for suicide.
Psychiatric Services, 74(4) : 419-422
- Year: 2023
- Problem: Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Gaynor, K., O'Reilly, M. D., Redmond, D., Nealon, C., Twomey, C., Hennessy, E.
INTRODUCTION: Suicidality among young people is a significant
societal issue. The current study conducted a meta-analysis of community and clinical interventions targeting suicide attempts, self-harm, and
suicidal ideation in adolescents.\rMETHODS: Interventions targeting suicide attempts, self-harm and suicidal ideation were identified by searching
PsychINFO, Medline, CINAHL and Embase in line with the PRISMA statement. Study quality was determined using a risk of bias tool. Meta-analyses
examined the efficacy of the interventions. Effect sizes were calculated for suicidal ideation data (continuous data) using Hedge's g for
standardised mean differences. Suicide attempts and self-harm (dichotomous data) were calculated using odds ratios (ORs).\rRESULTS: Seventeen RCTs
were included in the meta-analysis. No significant differences were found between treatment and control groups on measures of suicide attempts or
self-harm. A small effect-size was observed on measures of suicidal ideation (g = 0.47). A secondary meta-analysis investigated change over time in
treatment as usual conditions, finding significant large effect-sizes for suicide attempts (OR = 18.67), self-harm (OR = 12.77), and suicidal
ideation (g = 0.86).\rLIMITATIONS: The methodological decision to focus on specific outcomes over a broad definition of self-harm excluded some
papers, which have been included in other reviews. It is unlikely to have significantly affected the overall results. The review was not
preregistered.\rCONCLUSIONS: These twin findings highlight the importance overcoming the methodological difficulty of discerning effective
interventions during a period of baseline improvement. We suggest that future trials should move away from broadly addressing \"suicidality/self-
harm\" and encourage a greater targeting of at-risk individuals.
Comprehensive Psychiatry, 122 : 152374
- Year: 2023
- Problem: Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any)
Dobias, Mallory L., Chen, Sharon, Fox, Kathryn R., Schleider, Jessica L.
Rates of self-injurious thoughts and
behaviors (SITBs) increase sharply across adolescence and remain high in young adulthood. Across 50 years of research, existing interventions for
SITBs remain ineffective and inaccessible for many young people in particular need of mental healthcare. Briefer intervention options may increase
access to care. However, many traditional interventions for SITBs take 6 months or more to complete-making it difficult for providers to target SITBs
under real-world time constraints. The present review (1) identifies and (2) summarizes evaluations of brief psychosocial interventions for SITBs in
young people, ages 10-24 years. We conducted searches for randomized and quasi-experimental trials conducted in the past 50 years that evaluated
effects of \"brief interventions\" (i.e., not exceeding 240 min, or four 60-min sessions in total length) on SITBs in young people. Twenty-six
articles were identified for inclusion, yielding a total of 23 brief interventions. Across all trials, results are mixed; only six interventions
reported any positive intervention effect on at least one SITB outcome, and only one intervention was identified as \"probably efficacious\" per
standard criteria for evidence-based status. While brief interventions for SITBs exist, future research must determine if, how, and when these
interventions should be disseminated. (PsycInfo Database Record (c) 2023 APA, all rights reserved)
Clinical child and family psychology review, 26(2) : 482-
568
- Year: 2023
- Problem: Non-suicidal self-harm behaviours, Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Systematic reviews
-
Stage: Universal prevention, At risk (indicated or selected prevention), Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Other service delivery and improvement
interventions
Cai, H., Du, R., Song, J., Wang, Z., Wang, X., Yu, Y., Wang, Y., Shang, L., Zhang, J., Yang, K., Li,
W.
OBJECTIVE: Few studies on electroconvulsive therapy (ECT) investigate efficacy and safety on depressive adolescents with
strong suicidal ideation. Our study examined adolescents (aged 13-18 years) with major depressive disorder to explore ECT effectiveness in improving
suicidal ideation and depressive symptoms, as well as its impact on cognitive function.\rMETHODS: This nonrandomized controlled trial enrolled 183
adolescent patients suffering from major depressive disorder. The ECT group (n = 81) was treated with antidepressants and 8 rounds of ECT for 2
weeks. The control group comprised 79 patients treated with antidepressants only. Depressive symptoms, suicidal ideation, and cognitive functions
were assessed at baseline (pre-ECT) and at 2 and 6 weeks post-ECT.\rRESULTS: The ECT group showed significant improvements over control in suicidal
ideation from the end of treatment to 6 weeks after (P < 0.001). Depressive symptoms also improved (P < 0.001). Patients treated with ECT
demonstrated poorer performance in delayed memory, attention, and language, but these impairments were transient. Thus, ECT was generally safe in
adolescent patients with major depressive disorder.\rCONCLUSIONS: Our findings verified ECT as effective and safe for improving suicidal ideation and
depressive symptoms of adolescent patients with major depressive disorder. In addition, partially impaired cognitive function recovered gradually
after ECT.
Journal of ECT, 30 : 30
- Year: 2023
- Problem: Depressive Disorders, Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Controlled clinical trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Selective serotonin reuptake inhibitors (SSRIs), Antidepressants
(any), Electroconvulsive therapy (ECT)
Allen, J., Charles, B., Fok, C. C. T., Lee, K-S., Grogan-Kaylor, A., Rasmus, S.
We examined the effectiveness of the Qungasvik
(Tools for Life) intervention in enhancing protective factors as a universal suicide and alcohol prevention strategy for young people ages 12-18
living in highly affected rural Alaska Native communities. Four communities were assigned to immediate intervention or to a dynamic wait list.
Outcomes were analyzed for 239 young people at four time points over two years of community intervention. Outcomes assessed two ultimate variable
protective factors buffering suicide and alcohol risk, and three intermediate variable protective factors at the individual, family, and community
level. Dose dependent intervention effects were associated with growth in ultimate but not intermediate variables. This evaluation of the Qungasvik
intervention provides support for the effectiveness of its Indigenous strategies for suicide and alcohol misuse prevention in this rural Alaska
Native setting. Though findings did not provide support for a theory of change where growth in ultimate variables is occasioned through effects on
intermediate variables, research designs focused on young people who enter intervention at lower levels of preexisting protection hold promise for
better understanding of intervention change processes. The Qungasvik intervention is responsive to an acute public health need for effective rural
Alaska Native suicide and alcohol risk prevention strategies. (PsycInfo Database Record (c) 2023 APA, all rights reserved)
American Journal of Community Psychology, 71(1-2) : 184-
197
- Year: 2023
- Problem: Suicide or self-harm behaviours (excluding non-suicidal self-harm), Alcohol
Use
- Type:
-
Stage: Universal prevention
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Other Psychological Interventions, Other service delivery and improvement
interventions