Disorders - suicide or self-harm behaviours
Rengasamy, M., Phelps-Tschang, J., Simpson, M., Tew, J. D., Sparks, G.
Objectives: Few studies have examined the efficacy of telephone-based interventions in reducing suicide attempt rates in adolescents
after discharge from the inpatient psychiatric setting. The time immediately after discharge is a well-known high-risk period for suicide attempts.
This abstract describes a quality improvement intervention using postdischarge telephone contacts with patients and families to assess the effect on
suicide attempts. Method(s): As part of a quality improvement initiative at a major metropolitan hospital, we randomly assigned 142 adolescents (ages
12a\"18 years) who were admitted to inpatient psychiatric units for suicidal ideation or suicide attempt to either a recurrent telephone intervention
over a 3-month period or a single phone call at 3 months after discharge. The recurrent intervention consisted of up to 6 phone contacts to
adolescents and their parents, whereas the single intervention consisted of up to one telephone intervention. The intervention of 10a\"15 minutes
consisted of inquiring about any suicide attempts, a safety plan review that includes medication/weapon safety, and offering assistance with
treatment follow-up evaluation. When possible, both the child and at least one parent were engaged during the contact. Suicide attempts were assessed
using the medical record and adolescent/family report and were defined as interrupted, aborted, or actual attempts. Result(s): Adolescents in the
recurrent intervention arm had significantly fewer suicide attempts (5.6%) compared with adolescents in the mild intervention arm (17.1%) over a 3-
month period [I++2(1, N = 142) = 4.77, p < 0.05]. In the recurrent intervention arm, 84.7% of parents and 72.2% of adolescents had at
least one phone contact. An average of 3.8 phone contacts to parents and 3.1 phone contacts were made to adolescents who received at least one phone
contact in the recurrent intervention arm. There were no differences in baseline suicide attempts, prior inpatient hospitalizations, diagnoses, age,
gender, or inpatient rehospitalizations between the 2 intervention arms. Conclusion(s): This telephone-based intervention was feasible, and recurrent
intervention outreach may be more effective than a single contact in reducing suicide attempts for adolescents in the postdischarge period. TREAT
Copyright © 2018
Journal of the American Academy of Child and Adolescent Psychiatry, 57 (10
Supplement) : S265
- Year: 2018
- Problem: Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Other service delivery and improvement
interventions
King, C., Arango, A., Kramer, A., Busby, D., Czyz, E., Foster, C. E., Gillespie,
B.
Objectives: The prevalence of suicide among adolescents is rising, yet little is known about effective interventions. No previous
intervention for suicidal adolescents has been shown to reduce mortality. This study was designed to determine whether the Youth-Nominated Support
Team Intervention for Suicidal Adolescentsa\"Version II (YST) was associated with reduced mortality 10a\"12 years after psychiatric hospitalization
for suicide risk. Method(s): We conducted a 10a\"12-year follow-up evaluation, using National Death Index (NDI) data for all participants (N = 448)
in the YST randomized clinical trial (ClinicalTrials.gov: NCT00071617) comparing treatment as usual (TAU) to YST plus TAU (YST). Participants were
inpatients with mental illness, ages 13a\"17 years, who were admitted with suicidal ideation (frequent or with suicidal plan) or a suicide attempt
within the past 4 weeks. Enrollment took place from 2002 to 2005 at 2 mental health hospitals (2002a\"2005). In YST, adolescents nominate aoecaring
adultsa (mean 3.4 support persons per adolescent from family, school, community settings) to serve as support persons after hospitalization. With
parental permission, these adults attend a psychoeducation session to learn about the youthaTMs problem list and treatment plan, suicide warning
signs, communicating with adolescents, and how to be helpful in supporting treatment adherence and positive behavioral choices. They receive weekly,
supportive telephone calls from YST professional staff for 3 months. The primary study outcome was survival, measured by NDI data, for deaths through
2014. Result(s): NDI records were reviewed for all 448 YST Study participants [72% female; mean age (SD) = 15.6 years (1.3); 83% Caucasian]. There
were 11 deaths in the TAU group and 1 death in the YST group (hazard ratio: 11.2, p < 0.01 [95% CI = 1.5a\"87.0]). No patients were withdrawn from
YST because of adverse effects. Conclusion(s): This is the first intervention for suicidal adolescents to show evidence of reduced mortality. Even at
the lowest end of the confidence interval, mortality was reduced by 50%. Results warrant replication with examination of mechanisms; however, they
suggest that YST, a psychoeducational, supportive intervention involving caring adults, favorably altered the trajectories of adolescents
contemplating suicide. S, RCT, ADOL Copyright © 2018
Journal of the American Academy of Child and Adolescent Psychiatry, 57 (10
Supplement) : S260
- Year: 2018
- Problem: 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), Psychoeducation, Other Psychological Interventions
Santamarina-Perez, P., Mendez, I., Picado, M., Eiroa, F. J., Font, E., Moreno, E., Martinez, E., Linan, A. M., Cordovilla,
C., Romero, S.
Objectives: Impaired cognitive function is a feature of
suicidal behavior. It also might be considered a risk factor in adolescents with high vulnerability to commit suicide. Previous studies have
suggested that some aspects of cognitive function improve after psychological treatment. However, to our knowledge, there are no studies that have
evaluated the influence of psychological treatment on cognitive functioning in adolescents with suicidal behavior. The aim of this study was to
examine changes on neuropsychological functioning in adolescents with suicidal behavior following a psychological treatment with DBT and supportive
therapy (ST) compared with healthy control subjects. Method(s): A total of 35 adolescents with self-harming behavior and 17 healthy control subjects
between 12 and 18 years of age completed neuropsychological testing at baseline and after 16 weeks. The neuropsychological battery consisted of the
following: 1) Wechsler Intelligence Scale for Children-Fourth Edition (WISC-IV); 2) Spain-Complutense Verbal Learning Test; 3) Rey Complex Figure
Test; 4) Trail Making Test; 5) Stroop Effect Test; 6) Controlled Oral Word Association Test (COWAT); and 7) Tower of London test. Patients were
randomized after baseline assessment into 2 psychological groups: DBT and ST. Result(s): t tests were used for baseline comparisons between suicidal
adolescents and control groups, and between repeated measure analyses of variance for the difference in change between the suicidal adolescents and
control groups from baseline and follow-up, for all neuropsychological scores. Significant neuropsychological impairment was evident at baseline in
suicidal participants compared with healthy control subjects. After 16 weeks of psychotherapy, neuropsychological scores showed significant
improvement regardless of the type of therapy. We found effect sizes between 0.10 and 0.18 in intelligence index (verbal comprehension, perceptual
reasoning, and processing speed), in verbal memory (delayed recall and recognition), and in executive functioning (Tower of London-total time).
Conclusion(s): These results suggest that both DBT and ST might improve some cognitive functions associated with adolescents with suicidal behavior.
Additional studies with larger sample groups are needed to confirm these results. COG, S, TREAT Copyright © 2018
Journal of the American
Academy of Child and Adolescent Psychiatry, 57 (10 Supplement) : S221
- Year: 2018
- 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), Dialectical behavioural therapy
(DBT), Supportive
therapy
Robinson, J., Bailey, E., Witt, K., Stefanac, N., Milner, A., Currier, D., Pirkis, J., Condron, P., Hetrick, S.
Background: Young people require specific attention when it comes to suicide
prevention, however efforts need to be based on robust evidence.\rMethods: We conducted a systematic review and meta-analysis of all studies
examining the impact of interventions that were specifically designed to reduce suicide-related behavior in young people.\rFindings: Ninety-nine
studies were identified, of which 52 were conducted in clinical settings, 31 in educational or workplace settings, and 15 in community settings.
Around half were randomized controlled trials. Large scale interventions delivered in both clinical and educational settings appear to reduce self-
harm and suicidal ideation post-intervention, and to a lesser extent at follow-up. In community settings, multi-faceted, place-based approaches seem
to have an impact. Study quality was limited.\rInterpretation: Overall whilst the number and range of studies is encouraging, gaps exist. Few studies
were conducted in low-middle income countries or with demographic populations known to be at increased risk. Similarly, there was a lack of studies
conducted in primary care, universities and workplaces. However, we identified that specific youth suicide-prevention interventions can reduce self-
harm and suicidal ideation; these types of intervention need testing in high-quality studies.
EClinicalMedicine, 4-5 : 52-
91
- Year: 2018
- Problem: 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: Service Delivery & Improvement, Psychological Interventions
(any)
Joe,
S., Scott, M. L., Banks, A.
We reviewed the controlled studies that report outcome findings for Black
adolescent males 24 years of age and younger at risk of suicide. Our review identified 48 articles published from 2000 to 2015, 33 that met our
initial criteria for full-text articles review, resulting in 6 that met all inclusion criteria. We sought to understand what works for Black males
experiencing suicide ideation or engaging in suicidal behaviors (e.g., attempts). We identified crossover effects for multisystemic therapy for
reducing the risk for suicide ideation and attempts. Attachment-based family therapy was salient for use as a component of clinical practice for
Black males being treated for suicide ideation. While remaining randomized control trials did involve Black youth, dis-aggregated data based on
ethnicity and gender were not reported. Overall, the located studies are too few to provide unequivocal guidance for practice.
Research on Social Work Practice, 28(3) : 340-
345
- Year: 2018
- 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: Biological Interventions
(any), Selective serotonin reuptake inhibitors (SSRIs), Antidepressants
(any), Psychological Interventions
(any), Family therapy, Multisystemic
therapy, Other Psychological Interventions
Frey, L.
M., Hunt, Q. A.
The purpose of this article is to review the scientific evidence on the effects of family based
interventions for suicidal ideation and behavior. We conducted an extensive search of electronic databases using a comprehensive search strategy.
This search resulted in 16 studies that tested 13 interventions for treating suicidal ideation and behavior using family based interventions. Of the
interventions identified, three yielded an overall improvement in suicidal ideation and behavior while an additional three interventions produced
partial improvement in mental health symptoms. These studies targeted suicidal ideation and behavior in youth or adolescents while no studies
examined family interventions for adults with suicidal ideation and behavior. The limitations of these studies and the need for additional research
are examined. Copyright © 2017 American Association for Marriage and Family Therapy.
Journal of marital and family
therapy, 44(1) : 107-124
- Year: 2018
- 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), Family therapy, Other Psychological Interventions
Gabbay, V., Freed, R. D., Alonso, C. M., Senger, S., Stadterman, J., Davison, B. A., Klein, R. G.
Objective: Reports are mixed on the efficacy of omega-3 fatty acids (O3FA) for the treatment of major depressive disorder (MDD), with
only limited data in adolescents. The present trial aimed to investigate systematically the efficacy of O3FA as a monotherapy, compared to a placebo,
in adolescents with MDD. Secondarily, we explored O3FA effects on anhedonia, irritability, and suicidality-all key features of adolescent MDD.
Method(s): Fifty-one psychotropic medication-free adolescents with DSM-IV-TR diagnoses of MDD (aged 12-19 years; 57% female) were randomized to
receive O3FA or a placebo for 10 weeks. Data were collected between January 2006 and June 2013. O3FA and a placebo were administered on a fixed-
flexible dose titration schedule based on clinical response and side effects. The initial dose of 1.2 g/d was increased 0.6 g/d every 2 weeks, up to
a maximum of 3.6 g/d. Clinician-rated and self-rated depression severity, along with treatment response, served as primary outcome measures.
Additionally, we examined O3FA effects on depression-related symptoms, including anhedonia, irritability, and suicidality. Treatment differences were
analyzed via intent-to-treat analyses. Result(s): O3FA were not superior to a placebo on any clinical feature, including depression severity and
levels of anhedonia, irritability, or suicidality. Additionally, response rates were comparable between treatment groups. Within-treatment analyses
indicated that both treatments were associated with significant improvement in depression severity on self- (O3FA: t= -4.38, P< .001; placebo: t= -
3.52, P= .002) and clinician (O3FA: t= -6.47, P< .001; placebo: t= -8.10, P< .001) ratings. Conclusion(s): In adolescents with MDD, O3FA do not
appear to be superior to placebo. © Copyright 2018 Physicians Postgraduate Press, Inc.
Journal of Clinical Psychiatry, 79 (4) (no
pagination)(17m11596) :
- Year: 2018
- 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: Complementary & Alternative
Interventions (CAM), Fish oil (Omega-3 fatty acids), Omega 3 fatty
acids (e.g. fish oil, flax oil)
Hooley, J.
M., Fox, K. R., Wang, S. B., Kwashie, A. N. D.
Background: Nonsuicidal self-injury (NSSI), which involves self-damaging
behavior (e.g., cutting) causes tissue damage and places people at elevated risk for future suicidal behaviors. Yet few specific treatments for NSSI
currently exist. Extreme self-criticism is implicated in the development and maintenance of NSSI. We conducted a randomized controlled trial to
evaluate Autobiographical Self-Enhancement Training (ASET), a novel, cognitive intervention for NSSI focused on reducing self-criticism and enhancing
positive self-worth. We also examined whether Expressive Writing (EW) was a helpful treatment for NSSI. Method(s): Participants (N = 144) who had
engaged in NSSI at least twice in the past month were recruited online and then randomly assigned via Qualtrics to receive the ASET intervention (N =
49), the EW intervention (N = 49), or Daily Journaling [JNL; N = 46]), an active comparison condition. Treatments were designed as month-long daily
diaries. Participants in ASET wrote about something that made them feel good about themselves that day, participants in EW described something that
had been on their mind that day, and participants in JNL reported on the events of the day in a factually descriptive manner without emotional
content. Result(s): Intent-to-treat analyses revealed that, regardless of treatment group, participants showed significant reductions in self-
criticism, NSSI episodes, depression, and suicide ideation from baseline to the end of active treatment. Relative to the JNL group, the ASET group
reported significantly less self-criticism at post-treatment; this was not maintained at follow-up. There was also a trend toward ASET being
associated with less suicide ideation at the end of treatment compared to EW. This difference was significant at the 3-month follow-up. Unexpectedly,
the JNL group reported significantly less suicide ideation than the EW group at post-treatment; this was maintained at 3-month follow-up. No
significant treatment effects were detected for suicide plans, suicidal behaviors, desire to discontinue NSSI, or likelihood of future NSSI.
Conclusion(s): Self-criticism is an important treatment target in NSSI, but changing self-criticism in people with an established history of NSSI
presents challenges. Nonetheless, all approaches provided benefits. This study also established the feasibility of inexpensive and easily
disseminated treatments for NSSI. Copyright © 2018 The Author(s).
BMC Psychiatry, 18 (1) (no
pagination)(264) :
- Year: 2018
- Problem: Non-suicidal self-harm behaviours, Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder), At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Service Delivery & Improvement, Creative expression: music, dance, drama, art, Technology, interventions delivered using technology (e.g. online, SMS)
Robinson, J., Bailey, E., Witt, K., Stefanac, N., Milner, A., Currier, D., Pirkis, J., Condron, P., Hetrick, S.
Background: Young people require specific attention when it comes to suicide
prevention, however efforts need to be based on robust evidence.\rMethods: We conducted a systematic review and meta-analysis of all studies
examining the impact of interventions that were specifically designed to reduce suicide-related behavior in young people.\rFindings: Ninety-nine
studies were identified, of which 52 were conducted in clinical settings, 31 in educational or workplace settings, and 15 in community settings.
Around half were randomized controlled trials. Large scale interventions delivered in both clinical and educational settings appear to reduce self-
harm and suicidal ideation post-intervention, and to a lesser extent at follow-up. In community settings, multi-faceted, place-based approaches seem
to have an impact. Study quality was limited.\rInterpretation: Overall whilst the number and range of studies is encouraging, gaps exist. Few studies
were conducted in low-middle income countries or with demographic populations known to be at increased risk. Similarly, there was a lack of studies
conducted in primary care, universities and workplaces. However, we identified that specific youth suicide-prevention interventions can reduce self-
harm and suicidal ideation; these types of intervention need testing in high-quality studies.
EClinicalMedicine, 4-5 : 52-
91
- Year: 2018
- Problem: 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: Service Delivery & Improvement, Psychological Interventions
(any)
Joe,
S., Scott, M. L., Banks, A.
We reviewed the controlled studies that report outcome findings for Black
adolescent males 24 years of age and younger at risk of suicide. Our review identified 48 articles published from 2000 to 2015, 33 that met our
initial criteria for full-text articles review, resulting in 6 that met all inclusion criteria. We sought to understand what works for Black males
experiencing suicide ideation or engaging in suicidal behaviors (e.g., attempts). We identified crossover effects for multisystemic therapy for
reducing the risk for suicide ideation and attempts. Attachment-based family therapy was salient for use as a component of clinical practice for
Black males being treated for suicide ideation. While remaining randomized control trials did involve Black youth, dis-aggregated data based on
ethnicity and gender were not reported. Overall, the located studies are too few to provide unequivocal guidance for practice.
Research on Social Work Practice, 28(3) : 340-
345
- Year: 2018
- 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: Biological Interventions
(any), Selective serotonin reuptake inhibitors (SSRIs), Antidepressants
(any), Psychological Interventions
(any), Family therapy, Multisystemic
therapy, Other Psychological Interventions
Frey, L.
M., Hunt, Q. A.
The purpose of this article is to review the scientific evidence on the effects of family based
interventions for suicidal ideation and behavior. We conducted an extensive search of electronic databases using a comprehensive search strategy.
This search resulted in 16 studies that tested 13 interventions for treating suicidal ideation and behavior using family based interventions. Of the
interventions identified, three yielded an overall improvement in suicidal ideation and behavior while an additional three interventions produced
partial improvement in mental health symptoms. These studies targeted suicidal ideation and behavior in youth or adolescents while no studies
examined family interventions for adults with suicidal ideation and behavior. The limitations of these studies and the need for additional research
are examined. Copyright © 2017 American Association for Marriage and Family Therapy.
Journal of marital and family
therapy, 44(1) : 107-124
- Year: 2018
- 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), Family therapy, Other Psychological Interventions
Torcasso, G., Hilt, L. M.
Background: Suicide is a leading cause of death among youth. Suicide
screening programs aim to identify mental health issues and prevent death by suicide. Objective: The present study evaluated outcomes of a multi-
stage screening program implemented over 3 school years in a moderately-sized Midwestern high school. Methods: One hundred ninety-three 9th-grade
students were screened in the program. Students who screened positive were referred to mental health services and followed. Suicide-related thoughts
and behaviors among 9th-grade students in the school with screening were compared to those of students in a similar school without screening.
Results: There was a significant increase in utilization of mental health services among students who screened positive and a decrease in rates of
suicidal ideation and attempts among 9th-grade students at the school with screening. Conclusions: This multi-stage screening program shows promise
in addressing suicide-related behaviors in schools. Randomized trials are needed to confirm program efficacy. (PsycINFO Database Record (c) 2017 APA,
all rights reserved)
Child & Youth Care
Forum, 46(1) : 35-49
- Year: 2017
- Problem: Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Controlled clinical trials
-
Stage: Universal prevention
-
Treatment and intervention: Service Delivery & Improvement