Suicidal Ideation and Suicide Attempts After Direct or Indirect Psychotherapy

自杀意念 心理信息 荟萃分析 精神科 毒物控制 自杀预防 心理健康 临床心理学 心理学 随机对照试验 医学 梅德林 医疗急救 内科学 政治学 法学
作者
Wouter van Ballegooijen,Josine Rawee,Christina Palantza,Clara Miguel,Mathias Harrer,Ioana A. Cristea,Remco F. P. de Winter,Renske Gilissen,Merijn Eikelenboom,Aartjan T.F. Beekman,Pim Cuijpers
出处
期刊:JAMA Psychiatry [American Medical Association]
被引量:4
标识
DOI:10.1001/jamapsychiatry.2024.2854
摘要

Importance Suicidal ideation and suicide attempts are debilitating mental health problems that are often treated with indirect psychotherapy (ie, psychotherapy that focuses on other mental health problems, such as depression or personality disorders). The effects of direct and indirect psychotherapy on suicidal ideation have not yet been examined in a meta-analysis, and several trials have been published since a previous meta-analysis examined the effect size of direct and indirect psychotherapy on suicide attempts. Objective To investigate the effect sizes of direct and indirect psychotherapy on suicidal ideation and the incidence of suicide attempts. Data Sources PubMed, Embase, PsycInfo, Web of Science, Scopus, and the Cochrane Central Register of Controlled Trials were searched for articles published up until April 1, 2023. Study Selection Randomized clinical trials of psychotherapy for any mental health problem, delivered in any setting, compared with any control group, and reporting suicidal ideation or suicide attempts were included. Studies measuring suicidal ideation with 1 item were excluded. Data Extraction and Synthesis PRISMA guidelines were followed. Summary data were extracted by 2 independent researchers and pooled using 3-level meta-analyses. Main Outcomes and Measures Hedges g was pooled for suicidal ideation and relative risk (RR) was pooled for suicide attempts. Results Of 15 006 studies identified, 147 comprising 193 comparisons and 11 001 participants were included. Direct and indirect psychotherapy conditions were associated with reduced suicidal ideation (direct: g , −0.39; 95% CI, −0.53 to −0.24; I 2 , 83.2; indirect: g , −0.30; 95% CI, −0.42 to −0.18; I 2 , 52.2). Direct and indirect psychotherapy conditions were also associated with reduced suicide attempts (direct: RR, 0.72; 95% CI, 0.62 to 0.84; I 2 , 40.5; indirect: RR, 0.68; 95% CI, 0.48 to 0.95; I 2 , 0). Sensitivity analyses largely confirmed these results. Conclusions and Relevance Direct and indirect interventions had similar effect sizes for reducing suicidal ideation and suicide attempts. Suicide prevention strategies could make greater use of indirect treatments to provide effective interventions for people who would not likely seek treatment for suicidal ideation or self-harm.
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