Disorders - Suicide or self-harm behaviours
Hurzeler,
T., Giannopoulos, V., Uribe, G., Louie, E., Haber, P., Morley, K. C.
Objective: We aimed to provide a synthesis and evaluation of psychosocial interventions to prevent suicide and reduce self-harm, as well
as alcohol intake, for patients with alcohol problems. Method(s): The systematic review was carried out according to the PRISMA guidelines and
considered articles published in English from all countries. Terms relating to suicidality and alcohol problems were used to search Medline, EMBASE
and PsycINFO databases. Randomized controlled trials of psychosocial interventions targeted for outpatient settings were included. Result(s): Six
studies with a total of 400 participants were included. Two investigated dialectic behavioural therapy (DBT), one internet-delivered DBT, one dynamic
deconstructivist psychotherapy (DDP) and two integrated cognitive behavioural therapy (CBT). Face to face and online DBT was significantly associated
with abstinence and reductions in consumption with only a trend for a reduction in suicide attempts in one study relative to treatment at usual
(TAU). DDP yielded significant reductions in alcohol consumption and suicide attempts versus community care. CBT was significantly effective relative
to TAU in reducing alcohol use and suicide attempts in one trial with adolescents but not in another trial in an adult population. Conclusion(s):
Integrated CBT has promise for adolescents, DBT may be helpful for alcohol patients with borderline personality disorder and iDBT may be useful for
the wider community with heavy alcohol use. However, given the paucity of studies and the exploratory nature of these trials, there is currently no
strong evidence for an effective psychosocial intervention to reduce alcohol consumption and suicidal behaviour in adults with problematic alcohol
use. Copyright © The Author(s) 2020. Medical Council on Alcohol and Oxford University Press. All rights reserved.
Alcohol and Alcoholism, 56(1) : 17-
27
- Year: 2021
- Problem: Suicide or self-harm behaviours (excluding non-suicidal self-harm), Suicide or self-harm with comorbid mental disorder, Alcohol
Use
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder), At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Other Psychological Interventions
Herres, J., James, K. M., Bounoua, N., Ewing,
E. S. K., Kobak, R., Diamond, G. S.
Although
treatments for youth at risk for suicide have been successful, they are not similarly effective for everyone. Anxiety may interfere with
adolescents' ability to engage with therapy and explain why some adolescents do not respond as well as others to treatment. The current study tested
whether an anxiety diagnosis predicted treatment outcome among a sample of adolescents with suicidal ideation and depressive symptoms participating
in either attachment-based family therapy or family-enhanced nondirective supportive therapy (N = 129; Mage = 14.87, SD = 1.68; 81.9%
female). The data set that the current study used had a high representation of Black/African American adolescents (48.8% of sample), which is
valuable, as few studies have included adequate representation of this population. A significant indirect effect (.88; 95% confidence interval [.01,
2.64]) showed that across both treatment conditions, participants who met criteria for an anxiety disorder had greater difficulties engaging in
goal-directed behavior midtreatment, and these difficulties, in turn, predicted more posttreatment suicidal ideation. The effect of anxiety on
treatment outcome via difficulties with goal-directed behavior was nonspecific to the treatment condition. However, attachment-based family therapy
was superior to family-enhanced nondirective supportive therapy in improving this aspect of emotion regulation among adolescents who did not have
anxiety. In addition, difficulties with goal-directed behavior on treatment outcome were worse for adolescents' who reported greater attachment
avoidance to their parents. Future research should test whether targeting goal-directed behavior and attachment avoidance would result in better
treatment outcome for adolescents with suicidal ideation and anxiety. Copyright © 2021. American Psychological Association
Psychotherapy, 58(4) : 523-532
- Year: 2021
- 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: Psychological Interventions
(any), Family therapy, Supportive
therapy
Gruhn, M. A., West, A., Hamlat, E., Weinstein, S.
OBJECTIVE: Suicidal ideation (SI) is significantly higher for youth with pediatric bipolar
disorder (PBD), yet clinical correlates of suicidality remain poorly understood in this population. The current study investigates how change in risk
factors for SI relate to change in SI intensity over a 6-month period of treatment. METHOD(S): Children ages 9 to 13 (N=71; 41% female; 54%
Caucasian; Mean age=9.17) engaged in one of two psychotherapy treatment conditions and completed assessments of SI risk factors and psychopathology
symptoms at baseline (pre-treatment), 4 and 8weeks (during treatment), 12weeks (post-treatment), and 39weeks (follow-up assessment at 6months post-
treatment). Children also completed assessments of SI intensity at baseline, post-treatment (12weeks), and 6months post-treatment. RESULT(S): Mixed-
effects regression models indicate that increases in health-related quality of life in the family, mobilization of the family to acquire/accept help
for PBD, and child self-concept were associated with decreased SI intensity over time. CONCLUSION(S): Findings highlight the importance of family and
child level factors in influencing longitudinal change in SI intensity in youth with PBD. Clinical implications and future directions are
discussed.
Clinical
child psychology and psychiatry, : 1359104521996762
- Year: 2021
- Problem: Bipolar 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: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Family therapy
Grigoroglou, C.
To assess whether CC is more effective at reducing suicidal ideation in people with depression compared with
usual care, and whether study and patient factors moderate treatment effects. Method(s): We searched Medline, Embase, PubMed, PsycINFO, CINAHL,
CENTRAL from inception to March 2020 for Randomised Controlled Trials (RCTs) that compared the effectiveness of CC with usual care in depressed
adults, and reported changes in suicidal ideation at 4 to 6 months post-randomisation. Mixed-effects models accounted for clustering of participants
within trials and heterogeneity across trials. This study is registered with PROSPERO, CRD42020201747. Result(s): We extracted data from 28 RCTs
(11,165 patients) of 83 eligible studies. We observed a small significant clinical improvement of CC on suicidal ideation, compared with usual care
(SMD, -0.11 [95%CI, -0.15 to -0.08]; I2, 0.47% [95%CI 0.04% to 4.90%]). CC interventions with a recognised psychological treatment were
associated with small reductions in suicidal ideation (SMD, -0.15 [95%CI -0.19 to -0.11]). CC was more effective for reducing suicidal ideation among
patients aged over 65 years (SMD, - 0.18 [95%CI -0.25 to -0.11]). Conclusion(s): Primary care based CC with an embedded psychological intervention is
the most effective CC framework for reducing suicidal ideation and older patients may benefit the most. Copyright © 2021
General Hospital Psychiatry, 71 : 27-
35
- Year: 2021
- Problem: Suicide or self-harm behaviours (excluding non-suicidal self-harm), Suicide or self-harm with comorbid mental disorder
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention), Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Other Psychological Interventions, Other service delivery and improvement
interventions
Goldston, D. B.
Depression, suicidal behaviors and substance use problems frequently co-occur, and treatment for youth with these co-occurring problems
is often fragmented and challenging. An integrated cognitive-behavioral treatment approach that builds upon a relapse prevention framework and
applies common core skills, language, and approach for treating these related problems may be clinically beneficial. Following a description of the
integrated approach, we present results of a pilot trial (n = 13) to examine the acceptability and feasibility of the Cognitive-Behavioral Therapy-
Relapse Prevention (CBT-RP) intervention plus enhanced treatment as usual (TAU) compared to enhanced TAU alone. The feasibility of the CBT-RP + TAU
intervention was reflected by high rates of retention (86%). The acceptability was reflected in positive evaluations regarding the helpfulness of the
intervention by adolescents and families. The majority of youth in both CBT-RP + TAU and TAU alone groups evidenced reductions in depression and
suicide ideation from study entry to Week 20. Patterns of reduction were more consistent, however, for youth receiving CBT-RP + TAU, and reductions
were slower to emerge for some youth receiving TAU alone. Reductions in alcohol and marijuana problems were similar, but half of the youth in TAU
alone (and none in the CBT-RP + TAU group) had emergency department visits related to psychiatric crises or substance-related problems. These
findings, although based on a small sample, underscore the feasibility and acceptability of an integrated cognitive-behavioral relapse prevention
approach for youth with depression, suicide attempt histories, and substance use problems. Copyright © 2021 Society of Clinical Child & Adolescent
Psychology.
Evidence-Based Practice in Child and Adolescent Mental Health, 6(2) : 155-
172
- Year: 2021
- Problem: Depressive Disorders, Suicide or self-harm behaviours (excluding non-suicidal self-harm), Suicide or self-harm with comorbid mental disorder, Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT)
Goldbach, J. T., Rhoades, H., Mamey, M. R., Senese, J., Karys, P., Marsiglia, F. F.
BACKGROUND: Minority stress may lead to poorer mental health for sexual and gender minority adolescents, yet no
interventions have been tested through an RCT to address these concerns. METHOD(S): We report on an RCT of an intervention-Proud & Empowered-with
four high schools. Measures assess the intervention's impact on mental health symptoms. RESULT(S): Compared to the control, participants in the
treatment condition reported significant differences in minority stress, anxiety, and depressive symptoms. Moderation analyses showed that the
intervention significantly moderated the relationship between minority stress and PTSD (b = -1.28, p = .032), depression (b = -0.79, p = .023), and
suicidality (b = 0.14, p = .012) symptoms; those in the intervention condition had mitigated relationships between measures of stress and health
outcomes compared to those in the control condition. CONCLUSION(S): Results suggest that Proud & Empowered help reduce mental health symptoms and
exposure to minority stressors and build coping strategies. TRIAL REGISTRATION: The intervention was registered on clinicaltrials.gov on August 1,
2019 under Trial # NCT04041414 . Copyright © 2021. The Author(s).
BMC public health, 21
(1) : 2315
- Year: 2021
- Problem: Anxiety Disorders (any), Depressive Disorders, Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Czyz, E. K., King, C. A., Prouty, D., Micol, V. J., Walton, M., Nahum-Shani, I.
BACKGROUND: The
need for effective interventions for psychiatrically hospitalized adolescents who have varying levels of postdischarge suicide risk calls for
personalized approaches, such as adaptive interventions (AIs). We conducted a nonrestricted pilot Sequential, Multiple Assignment, Randomized Trial
(SMART) to guide the development of an AI targeting suicide risk after hospitalization. METHOD(S): Adolescent inpatients (N = 80; ages 13-17; 67.5%
female) were randomized in Phase 1 to a Motivational Interview-Enhanced Safety Plan (MI-SP), delivered during hospitalization, alone or in
combination with postdischarge text-based support (Texts). Two weeks after discharge, participants were re-randomized in Phase 2 to added telephone
booster calls or to no calls. Mechanisms of change were assessed with daily diaries for four weeks and over a 1- and 3-month follow-up. This trial is
registered with clinicaltrials.gov (identifier: NCT03838198). RESULT(S): Procedures were feasible and acceptable. Mixed effects models indicate that
adolescents randomized to MI-SP + Texts (Phase 1) and those randomized to booster calls (Phase 2) experienced significant improvement in daily-level
mechanisms, including safety plan use, self-efficacy to refrain from suicidal action, and coping by support seeking. Those randomized to MI-SP +
Texts also reported significantly higher coping self-efficacy at 1 and 3 months. Although exploratory, results were in the expected direction for
MI-SP + Texts, versus MI-SP alone, in terms of lower risk of suicide attempts (Hazard ratio = 0.30; 95% CI = 0.06, 1.48) and suicidal behavior
(Hazard ratio = 0.36; 95% CI = 0.10, 1.37) three months after discharge. Moreover, augmentation with booster calls did not have an overall meaningful
impact on suicide attempts (Hazard ratio = 0.65; 95% CI = 0.17, 3.05) or suicidal behavior (Hazard ratio = 0.78; 95% CI = 0.23, 2.67); however,
boosters benefited most those initially assigned to MI-SP + Texts. CONCLUSION(S): The current SMART was feasible and acceptable for the purpose of
informing an AI for suicidal adolescents, warranting additional study. Findings also indicate that postdischarge text-based support offers a
promising augmentation to safety planning delivered during hospitalization. Copyright © 2021 Association for Child and Adolescent Mental Health.
Journal of child
psychology and psychiatry, and allied disciplines., 15 :
- Year: 2021
- 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), Motivational interviewing, includes Motivational Enhancing Therapy, Other Psychological Interventions
Correll, C. U., Cortese, S., Croatto, G., Monaco, F., Krinitski, D., Arrondo, G., Ostinelli, E., Zangani, C., Fornaro, M., Estrade, A., Fusar-Poli, P., Carvalho, A. F., Solmi, M.
Top-tier evidence on the safety/tolerability
of 80 medications in children/adolescents with mental disorders has recently been reviewed in this jour-nal. To guide clinical practice, such data
must be combined with evidence on efficacy and acceptability. Besides medications, psychosocial inter-ventions and brain stimulation techniques are
treatment options for children/adolescents with mental disorders. For this umbrella review, we systematically searched network meta-analyses (NMAs)
and meta-analyses (MAs) of randomized controlled trials (RCTs) evaluating 48 medications, 20 psychosocial interventions, and four brain stimulation
techniques in children/adolescents with 52 different mental disorders or groups of mental disorders, reporting on 20 different efficacy/acceptability
outcomes. Co-primary outcomes were disease-specific symptom reduction and all-cause discontinuation (\"acceptability\"). We included 14 NMAs and 90
MAs, reporting on 15 mental disorders or groups of mental disorders. Overall, 21 medications outperformed placebo regarding the co-primary outcomes,
and three psychosocial interventions did so (while seven outperformed waiting list/no treatment). Based on the meta-analytic evidence, the most
convincing efficacy profile emerged for amphetamines, methylphenidate and, to a smaller extent, behavioral therapy in attention-deficit/hyperactivity
disorder; aripiprazole, risperidone and several psychosocial interventions in autism; risperidone and behavioral interventions in disruptive behavior
disorders; several antipsychotics in schizophrenia spectrum disorders; fluoxetine, the combination of fluoxetine and cognitive behavioral therapy
(CBT), and interpersonal therapy in depression; aripiprazole in mania; fluoxetine and group CBT in anxiety disorders; fluoxetine/selective serotonin
reuptake inhibitors, CBT, and behavioral therapy with exposure and response prevention in obsessive-compulsive disorder; CBT in post-traumatic stress
disorder; imipramine and alarm behavioral intervention in enuresis; behavioral therapy in encopresis; and family therapy in anorexia nervosa. Results
from this umbrella review of interventions for mental disorders in children/adolescents provide evidence-based information for clinical decision
making.Copyright © 2021 World Psychiatric Association
World Psychiatry, 20(2) : 244-
275
- Year: 2021
- Problem: Anxiety Disorders (any), Obsessive Compulsive Disorder, Bipolar Disorders, Depressive Disorders, Anorexia Nervosa, Psychosis Disorders, Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Psychological Interventions
(any)
Breet, E.
BACKGROUND: Youth suicide prevention in high-schools and universities is a public health priority. Our aim was to
propose a research agenda to advance evidence-based suicide prevention in high-schools and universities by synthesizing and critically reviewing the
research focus and methodologies used in existing intervention studies. METHOD(S): Fourteen databases were systematically searched to identify
studies which evaluate suicide prevention interventions delivered on high-school or university campuses, with before and after measures. Data from
included studies (n=43) were extracted to identify what, where, how and for whom interventions have been tested. Narrative synthesis was used to
critically evaluate research focus and methodology. Study quality was assessed. RESULT(S): Research has focused primarily on selective interventions,
with less attention on indicated and universal interventions. Most evidence comes from North America and high-income countries. The target of
interventions has been: non-fatal suicidal behaviour; confidence and ability of staff/students to intervene in a suicidal crisis; suicide-related
knowledge and attitudes; and suicide-related stigma. No studies included suicide deaths as an outcome, evaluated eco-systemic interventions, explored
how context influences implementation, used multisite study designs, or focused explicitly on LGBTQ+ youth. Two studies evaluated digital
interventions. Quality of the majority of studies was compromised by lack of methodological rigour, small samples, and moderate/high risk of bias.
Interventions often assume the existence of an external well-functioning referral pathway, which may not be true in low-resource settings.
CONCLUSION(S): To advance evidence-based suicide prevention in educational settings we need to: conduct more high-quality clinical and pragmatic
trials; promote research in low- and middle-income countries; test targeted interventions for vulnerable populations (like LGBTQ+ youth), evaluate
interventions where death by suicide is the primary outcome; include translational studies and use implementation science to promote intervention
uptake; evaluate the potential use of digital and eco-systemic interventions; and conduct multisite studies in diverse cultural settings.
BMC public
health, 21(1) : 1116
- Year: 2021
- Problem: Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention), Universal prevention
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Other Psychological Interventions, Other service delivery and improvement
interventions
Braun, M., Till,
B., Pirkis, J., Niederkrotenthaler, T.
Suicide prevention videos featuring young people's personal narratives of hope and recovery are increasingly used in suicide prevention,
but research on their effects is scarce. A double-blind randomized controlled trial was conducted to test the effects of a suicide prevention video
featuring an adolescent mastering his suicidal ideation by getting help on 14 to 19-year-olds. N = 299 adolescents were randomly allocated to watch
the intervention video (n = 148) or a control video unrelated to mental health (n = 151). Questionnaire data were collected before (T1)
and immediately after exposure (T2), and 4 weeks later (T3). Data were analyzed with a repeated-measures ANCOVA. The primary
outcome was suicidal ideation, assessed with the Reasons for Living Inventory for Adolescents. Secondary outcomes were help-seeking intentions,
attitudes towards suicide, stigmatization of suicidality, and mood. There was an immediate beneficial effect of the intervention on suicidal ideation
(T2 mean change from baseline within intervention group MChange = - 0.16 [95% CI - 0.20 to - 0.12], mean difference compared to
control group MDiff = - 0.09 [95% CI - 0.15 to - 0.03], etap2 = 0.03), which was not maintained at T3.
Participants reported significantly higher help-seeking intentions, which was maintained at 4-week follow-up. They also reported a sustained
reduction of favorable attitudes to suicide. Effects on suicidal ideation were mediated by identification with the featured protagonist. Adolescents
appear to benefit from suicide prevention narratives featuring personal stories from peers on coping with suicidal ideation and help-seeking.Trial
registration DRKS00017405; 24/09/19; retrospectively registered.
European
Child & Adolescent Psychiatry, 24 : 24
- Year: 2021
- Problem: Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Other Psychological Interventions, Technology, interventions delivered using technology (e.g. online, SMS)
Brann, Kristy L.
Suicide is an increasingly prevalent cause of death among adolescents across all demographics. Schools can be effective settings for
identification and prevention of suicide due to the amount of time that students spend in school. This study presents a meta-analysis of school-based
suicide prevention programs for students and school staff on the following outcomes: suicide awareness, helping skill, suicide behavior,
psychological wellness, and psychological distress outcomes. A total of 27 studies were identified via 5 databases. Results suggest that suicide
prevention programs have the largest impact on suicide awareness (k = 18, g = 0.72) and helping skill (k = 15, g = 0.43) compared to suicide behavior
(k = 8, g = 0.17), psychological wellness (k = 7, g = 0.16), and psychological distress (k = 9, g = 0.16). However, results are limited by the
availability of previous research. We conclude with a discussion of limitations, implications for practice, and directions for future research.
(PsycInfo Database Record (c) 2021 APA, all rights reserved)
Children and Youth Services Review Vol 121 2021, ArtID
105826, 121 :
- Year: 2021
- Problem: Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Systematic reviews
-
Stage: Universal prevention, At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Other Psychological Interventions, Other service delivery and improvement
interventions
Bahji, A.
Importance: Self-harm and suicidal behavior
are associated with substantial morbidity and mortality among children and adolescents. The comparative performance of psychotherapies for
suicidality is unclear because few head-to-head clinical trials have been conducted. Objective(s): To compare the efficacy of psychotherapies for the
treatment of self-harm and suicidality among children and adolescents. Data Sources: Four major bibliographic databases (PubMed, MEDLINE, PsycINFO,
and Embase) were searched for clinical trials comparing psychotherapy with control conditions from inception to September 2020. Study Selection:
Randomized clinical trials comparing psychotherapies for suicidality and/or self-harm with control conditions among children and adolescents were
included after a blinded review by 3 independent reviewers (A.B., M.P., and J.W.). Data Extraction and Synthesis: The Preferred Reporting Items for
Systematic Reviews and Meta-analyses (PRISMA) reporting guideline was followed for data abstraction, and the Cochrane risk of bias tool was used to
evaluate study-level risk of bias. Data abstraction was performed by 1 reviewer (A.B.) and confirmed by 2 independent blinded reviewers (J.W. and
M.P.). Data were analyzed from October 15, 2020, to February 15, 2021. Main Outcomes and Measures: The primary outcomes were dichotomized self-harm
and retention in treatment. The secondary outcomes were dichotomized all-cause treatment discontinuation and scores on instruments measuring suicidal
ideation and depressive symptoms. Effect sizes were pooled using frequentist random-effects network meta-analysis models to generate summary odds
ratios (ORs) and Cohen d standardized mean differences (SMDs). Negative Cohen d SMDs or ORs less than 1 indicated that the treatment reduced the
parameter of interest relative to the control condition (eg, signifying a beneficial association with suicidal ideation). Result(s): The systematic
search generated 1272 unique records. Of those, 44 randomized clinical trials (5406 total participants; 4109 female participants [76.0%]) from 49
articles were selected (5 follow-up studies were merged with their primary clinical trials to avoid publication bias). The selected clinical trials
spanned January 1, 1995, to December 31, 2020. The median duration of treatment was 3 months (range, 0.25-12.00 months), and the median follow-up
period was 12 months (range, 1-36 months). None of the investigated psychotherapies were associated with increases in study withdrawals or
improvements in retention in treatment compared with treatment as usual. Dialectical behavioral therapies were associated with reductions in self-
harm (OR, 0.28; 95% CI, 0.12-0.64) and suicidal ideation (Cohen d SMD, -0.71; 95% CI, -1.19 to -0.23) at the end of treatment, while mentalization-
based therapies were associated with decreases in self-harm (OR, 0.38; 95% CI, 0.15-0.97) and suicidal ideation (Cohen d SMD, -1.22; 95% CI, -2.18 to
-0.26) at the end of follow-up. The quality of evidence was downgraded because of high risk of bias overall, heterogeneity, publication bias,
inconsistency, and imprecision. Conclusions and Relevance: Although some psychotherapeutic modalities appear to be acceptable and efficacious for
reducing self-harm and suicidality among children and adolescents, methodological issues and high risk of bias prevent a consistent estimate of their
comparative performance. Copyright © 2021 Georg Thieme Verlag. All rights reserved.
, 4(4) :
- Year: 2021
- Problem: 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)