Disorders - Suicide or self-harm behaviours
Hawton, K., Witt, K. G., Taylor-Salisbury, T. L., Arensman, E., Gunnell, D., Townsend, E., van-Heeringen, K., Hazell, P.
Background: Self-harm (SH; intentional self-poisoning or self-injury) is common in children and adolescents, often repeated, and strongly associated with suicide. This is an update of a broader Cochrane review on psychosocial and pharmacological treatments for deliberate SH first published in 1998 and previously updated in 1999. We have now divided the review into three separate reviews; this review is focused on psychosocial and pharmacological interventions for SH in children and adolescents.; Objectives: To identify all randomised controlled trials of psychosocial interventions, pharmacological agents, or natural products for SH in children and adolescents, and to conduct meta-analyses (where possible) to compare the effects of specific treatments with comparison types of treatment (e.g., treatment as usual (TAU), placebo, or alternative pharmacological treatment) for children and adolescents who SH.; Search Methods: For this update the Cochrane Depression, Anxiety and Neurosis Group (CCDAN) Trials Search Co-ordinator searched the CCDAN Specialised Register (30 January 2015).; Selection Criteria: We included randomised controlled trials comparing psychosocial or pharmacological treatments with treatment as usual, alternative treatments, or placebo or alternative pharmacological treatment in children and adolescents (up to 18 years of age) with a recent (within six months) episode of SH resulting in presentation to clinical services.; Data Collection and Analysis: Two reviewers independently selected trials, extracted data, and appraised study quality, with consensus. For binary outcomes, we calculated odds ratios (OR) and their 95% confidence intervals (CI). For continuous outcomes measured using the same scale we calculated the mean difference (MD) and 95% CI; for those measured using different scales we calculated the standard mean difference (SMD) and 95% CI. Meta-analysis was only possible for two interventions: dialectical behaviour therapy for adolescents and group-based psychotherapy. For these analyses, we pooled data using a random-effects model.; Main Results: We included 11 trials, with a total of 1,126 participants. The majority of participants were female (mean = 80.6% in 10 trials reporting gender). All trials were of psychosocial interventions; there were none of pharmacological treatments. With the exception of dialectical behaviour therapy for adolescents (DBT-A) and group-based therapy, assessments of specific interventions were based on single trials. We downgraded the quality of evidence owing to risk of bias or imprecision for many outcomes.Therapeutic assessment appeared to increase adherence with subsequent treatment compared with TAU (i.e., standard assessment; n = 70; k = 1; OR = 5.12, 95% CI 1.70 to 15.39), but this had no apparent impact on repetition of SH at either 12 (n = 69; k = 1; OR 0.75, 95% CI 0.18 to 3.06; GRADE: low quality) or 24 months (n = 69; k = 1; OR = 0.69, 05% CI 0.23 to 2.14; GRADE: low quality evidence). These results are based on a single cluster randomised trial, which may overestimate the effectiveness of the intervention.For patients with multiple episodes of SH or emerging personality problems, mentalisation therapy was associated with fewer adolescents scoring above the cut-off for repetition of SH based on the Risk-Taking and Self-Harm Inventory 12 months post-intervention (n = 71; k = 1; OR = 0.26, 95% CI 0.09 to 0.78; GRADE: moderate quality). DBT-A was not associated with a reduction in the proportion of adolescents repeating SH when compared to either TAU or enhanced usual care (n = 104; k = 2; OR 0.72, 95% CI 0.12 to 4.40; GRADE: low quality). In the latter trial, however, the authors reported a significantly greater reduction over time in frequency of repeated SH in adolescents in the DBT condition, in whom there were also significantly greater reductions in depression, hopelessness, and suicidal ideation.We found no significant treatment effects for group-based therapy on repetition of SH for individuals with multiple episodes of SH at either the six ( = 430; k = 2; OR 1.72, 95% CI 0.56 to 5.24; GRADE: low quality) or 12 month (n = 490; k = 3; OR 0.80, 95% CI 0.22 to 2.97; GRADE: low quality) assessments, although considerable heterogeneity was associated with both (I(2) = 65% and 77% respectively). We also found no significant differences between the following treatments and TAU in terms of reduced repetition of SH: compliance enhancement (three month follow-up assessment: n = 63; k = 1; OR = 0.67, 95% CI 0.15 to 3.08; GRADE: very low quality), CBT-based psychotherapy (six month follow-up assessment: n = 39; k = 1; OR = 1.88, 95% CI 0.30 to 11.73; GRADE: very low quality), home-based family intervention (six month follow-up assessment: n = 149; k = 1; OR = 1.02, 95% CI 0.41 to 2.51; GRADE: low quality), and provision of an emergency card (12 month follow-up assessment: n = 105, k = 1; OR = 0.50, 95% CI 0.12 to 2.04; GRADE: very low quality). No data on adverse effects, other than the planned outcomes relating to suicidal behaviour, were reported.; Authors' Conclusions: There are relatively few trials of interventions for children and adolescents who have engaged in SH, and only single trials contributed to all but two comparisons in this review. The quality of evidence according to GRADE criteria was mostly very low. There is little support for the effectiveness of group-based psychotherapy for adolescents with multiple episodes of SH based on the results of three trials, the evidence from which was of very low quality according to GRADE criteria. Results for therapeutic assessment, mentalisation, and dialectical behaviour therapy indicated that these approaches warrant further evaluation. Despite the scale of the problem of SH in children and adolescents there is a paucity of evidence of effective interventions. Further large-scale trials, with a range of outcome measures including adverse events, and investigation of therapeutic mechanisms underpinning these interventions, are required. It is increasingly apparent that development of new interventions should be done in collaboration with patients to ensure that these are likely to meet their needs. Use of an agreed set of outcome measures would assist evaluation and both comparison and meta-analysis of trials.;
Cochrane Database of Systematic Reviews, (12) : CD012013
- Year: 2015
- Problem: Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions (any)
, Complementary & Alternative Interventions (CAM)
, Psychological Interventions (any)
Spirito, A., Wolff, J. C., Seaboyer, L. M., Hunt, J., Esposito-Smythers, C., Nugent, N., Zlotnick, C., Miller, I.
OBJECTIVE: The purpose of this study was to conduct a treatment development study to examine the feasibility, acceptability, and preliminary efficacy of treating depressed, suicidal adolescents and their depressed parent concurrently in a cognitive behavioral therapy (CBT) protocol (Parent-Adolescent-CBT [PA-CBT]).
METHODS: A randomized, controlled, repeated measures design was used to test the hypothesis that PA-CBT would lead to greater reductions in suicidality and depression compared with Adolescent Only CBT (AO-CBT). Participants included 24 adolescent and parent dyads in which the adolescent met American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, 4th ed. (DSM-IV) criteria for current major depressive episode (MDE) and the parent met DSM-IV criteria for current or past MDE.
RESULTS: The concurrent protocol was found to be feasible to implement with most depressed adolescents and parents. Adolescent ratings of program satisfaction were somewhat lower in PA-CBT, suggesting that some teens view treatment negatively when they are required to participate with a parent. The concurrent treatment protocol was more effective in reducing depressed mood in the parent-adolescent dyad at the end of maintenance treatment (24 weeks) than treating an adolescent alone for depression; the largest effect was on parental depressed mood. This difference between dyads was no longer significant, however, at the 48 week follow-up. Adolescent and parent suicidal ideation improved equally in both groups during active and maintenance treatment, and remained low at follow-up in both groups.
CONCLUSIONS: The PA-CBT protocol is feasible to conduct and acceptable to most but not all adolescents. The strongest effect was on parental depressed mood. A larger study that has sufficient power to test efficacy and moderators of treatment outcome is necessary to better understand which adolescents would benefit most from concurrent treatment with a parent.
Journal of Child & Adolescent Psychopharmacology, 25(2) : 131-9
- Year: 2015
- 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)
, Cognitive & behavioural therapies (CBT)
Spirito, A., Wolff, J. C., Seaboyer, L. M., Hunt, J., Esposito-Smythers, C., Nugent, N., Zlotnick, C., Miller, I.
Objective: The purpose of this study was to conduct a treatment development study to examine the feasibility, acceptability, and preliminary efficacy of treating depressed, suicidal adolescents and their depressed parent concurrently in a cognitive behavioral therapy (CBT) protocol (Parent-Adolescent-CBT [PA-CBT]). Methods: A randomized, controlled, repeated measures design was used to test the hypothesis that PA-CBT would lead to greater reductions in suicidality and depression compared with Adolescent Only CBT (AO-CBT). Participants included 24 adolescent and parent dyads in which the adolescent met American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, 4th ed. (DSM-IV) criteria for current major depressive episode (MDE) and the parent met DSMIV criteria for current or past MDE. Results: The concurrent protocol was found to be feasible to implement with most depressed adolescents and parents. Adolescent ratings of program satisfaction were somewhat lower in PA-CBT, suggesting that some teens view treatment negatively when they are required to participate with a parent. The concurrent treatment protocol was more effective in reducing depressed mood in the parent-adolescent dyad at the end of maintenance treatment (24 weeks) than treating an adolescent alone for depression; the largest effect was on parental depressed mood. This difference between dyads was no longer significant, however, at the 48 week follow-up. Adolescent and parent suicidal ideation improved equally in both groups during active and maintenance treatment, and remained low at follow-up in both groups. Conclusions: The PA-CBT protocol is feasible to conduct and acceptable to most but not all adolescents. The strongest effect was on parental depressed mood. A larger study that has sufficient power to test efficacy and moderators of treatment outcome is necessary to better understand which adolescents would benefit most from concurrent treatment with a parent. (PsycINFO Database Record (c) 2015 APA, all rights reserved) (journal abstract).
Journal of Child & Adolescent Psychopharmacology, 25(2) : 131-139
- Year: 2015
- 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: Service Delivery & Improvement, Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
, Other service delivery and improvement interventions
Wei, Y., Kutcher, S., LeBlanc, J. C.
Introduction: Youth suicide is highly related to mental disorders. While communities and schools are marketed to with a plethora of suicide prevention programs, they often lack the capacity to choose evidence-based programs. Methods: We conducted a systematic review of two youth suicide prevention programs to help determine if the quality of evidence available justifies their wide spread dissemination. We searched Medline, PsycINFO, EMBASE, CINAHL, the Cochrane Library, Campbell Collaboration SPECTR database, SocIndex, Sociological Abstracts, Social Services Abstracts, ERIC, Social Work Abstracts, Research Library, and Web of Science, for relevant studies. We included studies/systematic reviews/meta-analysis that evaluated the effectiveness, cost-effectiveness, and/or safety of Signs of Suicide (SOS) and Yellow Ribbon (YR) suicide prevention programs that target adolescents. We applied the Office of Justice Program What Works Repository (OJP-R) to evaluate the quality of the included studies as effective, effective with reservation, promising, inconclusive evidence, insufficient evidence, and ineffective. Two SOS studies were ranked as "inconclusive evidence" based on the OJP-R. One SOS study was ranked as having "insufficient evidence" on OJP-R. The YR study was ranked as "ineffective" using OJP-R. We only included studies in peer-reviewed journals in English and therefore may have missed reports in grey literature or non-English publications. Results: We cannot recommend that schools and communities implement either the SOS or YR suicide prevention programs. Purchasers of these programs should be aware that there is no evidence that their use prevents suicide. Conclusions: Academics and organizations should not overstate the positive impacts of suicide prevention interventions when the evidence is lacking. (PsycINFO Database Record (c) 2015 APA, all rights reserved) (journal abstract).
Journal of the Canadian Academy of Child & Adolescent Psychiatry, 24(1) : 5-16
- Year: 2015
- Problem: Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Systematic reviews
-
Stage: Universal prevention
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Psychoeducation, Other Psychological Interventions, Other service delivery and improvement interventions
Salpekar, J. A., Joshi, P. T., Axelson, D. A., Reinblatt, S. P., Yenokyan, G., Sanyal, A., Walkup, J. T., Vitiello, B., Luby, J. L., Wagner, K. D., Nusrat, N., Riddle, M. A.
Objective: To assess the efficacy of mood-stabilizing medications for depression and suicidality in pediatric bipolar disorder. Method: The Treatment of Early Age Mania (TEAM) study is a multicenter, prospective, randomized, masked comparison of divalproex sodium (VAL), lithium carbonate (LI), and risperidone (RISP) in an 8-week parallel clinical trial. A total of 279 children and adolescents with DSM-IV diagnoses of bipolar I disorder, mixed or manic, aged 6 to 15 years were enrolled. The primary outcome measure was improvement on the Clinical Global Impression scale for depression (CGI-BP-I-D). Secondary outcome measures included the Children's Depression Rating Scale (CDRS-R) and suicidality status. Statistics included longitudinal analysis of outcomes using generalized linear mixed models with random intercept both for the complete data set and by using last observation carried forward. Results: CGI-BP-I-D ratings were better in the RISP group (60.7%) as compared to the LI (42.2%; p = .03) or VAL (35.0%; p = .003) groups from baseline to the end of the study. CDRS scores in all treatment groups improved equally by study end. In week 1, scores were lower with RISP compared to VAL (mean = 4.72, 95% CI = 2.67, 6.78), and compared to LI (mean = 3.63, 95% CI = 1.51, 5.74), although group differences were not present by the end of the study. Suicidality was infrequent, and there was no overall effect of treatment on suicidality ratings. Conclusion: Depressive symptoms, present in the acutely manic or mixed phase of pediatric bipolar disorder, improved with all 3 medications, though RISP appeared to yield more rapid improvement than LI or VAL and was superior using a global categorical outcome. (PsycINFO Database Record (c) 2016 APA, all rights reserved) (journal abstract).
Journal of the American Academy of Child & Adolescent Psychiatry, 54(12) : 999-1007
- Year: 2015
- 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: At risk (indicated or selected prevention)
-
Treatment and intervention: Biological Interventions (any)
, Atypical Antipsychotics (second generation)
, Anticonvulsants/mood stabilisers (excl. lithium), Lithium
Wasserman, D., Hoven, C. W., Wasserman, C., Wall, M., Eisenberg, R., Hadlaczky, G., Kelleher, I., Sarchiapone, M., Apter, A., Balazs, J, Bobes, J., Brunner, R., Corcoran, P., Cosman, D., Guillemin, F., Haring, C., Iosue, M., Kaess, M., Kahn, J-P., Keeley, H., Musa, G. J., Nemes, B., Postuvan, V., Saiz, P., Reiter-Theil, S., Varnik, A., Varnik, P., Carli, V.
Background: Suicidal behaviours in adolescents are a major public health problem and evidence-based prevention programmes are greatly needed. We aimed to investigate the efficacy of school-based preventive interventions of suicidal behaviours. Methods: The Saving and Empowering Young Lives in Europe (SEYLE) study is a multicentre, cluster-randomised controlled trial. The SEYLE sample consisted of 11 110 adolescent pupils, median age 15 years (IQR 14-15), recruited from 168 schools in ten European Union countries. We randomly assigned the schools to one of three interventions or a control group. The interventions were: (1) Question, Persuade, and Refer (QPR), a gatekeeper training module targeting teachers and other school personnel, (2) the Youth Aware of Mental Health Programme (YAM) targeting pupils, and (3) screening by professionals (ProfScreen) with referral of at-risk pupils. Each school was randomly assigned by random number generator to participate in one intervention (or control) group only and was unaware of the interventions undertaken in the other three trial groups. The primary outcome measure was the number of suicide attempt(s) made by 3 month and 12 month follow-up. Analysis included all pupils with data available at each timepoint, excluding those who had ever attempted suicide or who had shown severe suicidal ideation during the 2 weeks before baseline. This study is registered with the German Clinical Trials Registry, number DRKS00000214. Findings: Between Nov 1, 2009, and Dec 14, 2010, 168 schools (11 110 pupils) were randomly assigned to interventions (40 schools [2692 pupils] to QPR, 45 [2721] YAM, 43 [2764] ProfScreen, and 40 [2933] control). No significant differences between intervention groups and the control group were recorded at the 3 month follow-up. At the 12 month follow-up, YAM was associated with a significant reduction of incident suicide attempts (odds ratios [OR] 0.45, 95% CI 0.24-0.85; p = 0.014) and severe suicidal ideation (0.50, 0.27-0.92; p = 0.025), compared with the control group. 14 pupils (0.70%) reported incident suicide attempts at the 12 month follow-up in the YAM versus 34 (1.51%) in the control group, and 15 pupils (0.75%) reported incident severe suicidal ideation in the YAM group versus 31 (1.37%) in the control group. No participants completed suicide during the study period. Interpretation: YAM was effective in reducing the number of suicide attempts and severe suicidal ideation in school-based adolescents. These findings underline the benefit of this universal suicide preventive intervention in schools. (PsycINFO Database Record (c) 2015 APA, all rights reserved) (journal abstract).
Lancet, 385(9977) : 1536-1544
- Year: 2015
- 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)
, Psychoeducation, Other service delivery and improvement interventions
Ougrin, D., Tranah, T., Stahl, D., Moran, P., Asarnow, J. R.
Objective: Suicidal behavior and self-harm are common in adolescents and are associated with elevated psychopathology, risk of suicide, and demand for clinical services. Despite recent advances in the understanding and treatment of self-harm and links between self-harm and suicide and risk of suicide attempt, progress in reducing suicide death rates has been elusive, with no substantive reduction in suicide death rates over the past 60 years. Extending prior reviews of the literature on treatments for suicidal behavior and repetitive self-harm in youth, this article provides a meta-analysis of randomized controlled trials (RCTs) reporting efficacy of specific pharmacological, social, or psychological therapeutic interventions (TIs) in reducing both suicidal and nonsuicidal self-harm in adolescents. Method: Data sources were identified by searching the Cochrane, Medline, PsychINFO, EMBASE, and PubMed databases as of May 2014. RCTs comparing specific therapeutic interventions versus treatment as usual (TAU) or placebo in adolescents (through age 18 years) with self-harm were included. Results: Nineteen RCTs including 2,176 youth were analyzed. TIs included psychological and social interventions and no pharmacological interventions. The proportion of the adolescents who self-harmed over the follow-up period was lower in the intervention groups (28%) than in controls (33%) (test for overall effect z = 2.31; p = .02). TIs with the largest effect sizes were dialectical behavior therapy (DBT), cognitive-behavioral therapy (CBT), and mentalization-based therapy (MBT). There were no independent replications of efficacy of any TI. The pooled risk difference between TIs and TAU for suicide attempts and nonsuicidal self-harm considered separately was not statistically significant. Conclusion: TIs to prevent self-harm appear to be effective. Independent replication of the results achieved by DBT, MBT, and CBT is a research priority. (PsycINFO Database Record (c) 2015 APA, all rights reserved) (journal abstract).
Journal of the American Academy of Child & Adolescent Psychiatry, 54(2) : 97-107
- Year: 2015
- 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)
Ridani, R., Shand, F. L., Christensen, H., McKay, K., Tighe, J., Burns, J., Hunter, E.
A review of Aboriginal suicide prevention programs were conducted to highlight promising projects and strategies. A content analysis of gray literature was conducted to identify interventions reported to have an impact in reducing suicidal rates and behaviors. Most programs targeted the whole community and were delivered through workshops, cultural activities, or creative outlets. Curriculums included suicide risk and protective factors, warning signs, and mental health. Many programs were poorly documented and evaluations did not include suicidal outcomes. Most evaluations considered process variables. Results from available outcome evaluations suggest that employing a whole of community approach and focusing on connectedness, belongingness and cultural heritage may be of benefit. Despite the challenges, there is a clear need to evaluate outcomes if prevention is to be progressed.; © 2014 The American Association of Suicidology.
Suicide & Life-Threatening Behavior, 45(1) : 111-140
- Year: 2015
- Problem: Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Service Delivery & Improvement, Psychological Interventions (any)
Strunk, C. M., King, K. A., Vidourek, R. A., Sorter, M. T.
Youth suicide is a serious public health issue in the United States. It is currently the third leading cause of death for youth aged 10 to 19. School-based prevention programs may be an effective method of educating youth and enhancing their help-seeking. Most school-based suicide prevention programs have not been rigorously evaluated for their effectiveness. This evaluation employs a comparison group to measure whether program group participants differed significantly from comparison group participants on pretest-posttest measures while assessing the immediate impact of the Surviving the Teens® Suicide Prevention and Depression Awareness Program. Findings indicate several positive outcomes in program group students' suicide and depression knowledge, attitudes, confidence, and behavioral intentions compared with the comparison group. Suicide prevention specialists and prevention planners may benefit from study findings.
Health Education & Behavior, 41(6) : 605-613
- Year: 2014
- Problem: Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Controlled clinical trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions (any)
, Psychoeducation, Skills training, Other Psychological Interventions
Reyes-Portillo, J. A., Mufson, L., Greenhill, L. L., Gould, M. S., Fisher, P. W., Tarlow, N., Rynn, M. A.
Results Of the 14,001 citations initially identified, 25 articles met inclusion criteria for Web-based interventions. These described 9 programs, of which 8 were Internet based and 1 was a mobile application. No Web-based interventions for suicide prevention were identified. Of the randomized controlled trials (n = 14) and open trials (n = 3) identified, 10 reported significant postintervention reductions in symptoms of depression and/or anxiety or improvements in diagnostic ratings, with small to large effect sizes. Many of these studies also reported significant improvements at follow-up. The methodological quality of the studies varied. Many programs were limited by their small sample sizes and use of waitlist or no-treatment control groups.
Conclusion There is limited evidence for the effectiveness of Web-based interventions for youth depression and anxiety. Additional research and program development are needed to fill the current gaps in the literature.
Objective To review published reports on Web-based treatment and prevention programs for depression, anxiety, and suicide prevention in children, adolescents, and emerging adults.
Method A systematic search of the PsycINFO, PubMed, Medline, and Web of Science databases was conducted in December 2013. Programs were classified according to evidence-base level (Well-Established, Probably Efficacious, Possibly Efficacious, Experimental, and Of Questionable Efficacy).
Journal of the American Academy of Child & Adolescent Psychiatry, 53(12) : 1254-1270.e5
- Year: 2014
- Problem: Anxiety Disorders (any), Depressive Disorders, 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, Technology, interventions delivered using technology (e.g. online, SMS)
Taylor-Rodgers, E., Batterham, P. J.
Background Research has consistently identified a disparity between the prevalence of mental health concerns among young adults and their rates of formal help seeking. However, a few randomised controlled trials have identified effective interventions for increasing formal help seeking among young adults. The aim of this study was to evaluate the effectiveness of a brief online psychoeducational intervention, targeting depression, anxiety and suicide stigma, for increasing positive attitudes towards help seeking and increasing help seeking intentions among young adults. Method The study followed a single-blind parallel group randomized controlled trial design with 67 young adult (18-25 years) Australian participants, assigned to receive online psychoeducation (n=33) or online attention-matched control information (n=34) over 3 weeks. Participants in the experimental group received information on depression, anxiety, and suicide. The control group received information unrelated to mental health. Primary outcome measures were mental health literacy, mental illness stigma, attitudes toward professional help seeking and intentions to seek help. Secondary outcome variables were symptomology, satisfaction and adherence. Results Significant between-group differences were found for the pre- to post-test, including increased anxiety literacy (Cohens d=0.65), decreased depression stigma (d=0.53), and increased help seeking attitudes and intentions for the experimental group (d=0.58 and d=0.53, respectively). Limitations Due to the small sample size and homogenous nature of the sample, generalisations should be made with caution. Conclusions This study demonstrates the utility and effectiveness of a brief online psychoeducation intervention for promoting help seeking among young adults. © 2014 Elsevier B.V.
Journal of Affective Disorders, 168 : 65-71
- Year: 2014
- 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)
, Psychoeducation, Technology, interventions delivered using technology (e.g. online, SMS)
Vaslamatzis, G., Theodoropoulos, P., Vondikaki, S., Karamanolaki, H., Miliatsanira, M., Gourounti, K.
The aim of this study was to compare the effectiveness of combined treatment - medication plus psychodynamic psychotherapy - and psychodynamic psychotherapy alone on the outcome variables of suicidality and impulsivity in a population of adult inpatients with severe personality disorder (SPD). This is a naturalistic-empirical (observational) study under the conditions of clinical practice (an intensive specialized inpatient psychotherapeutic program [SIPP]). The sample consisted of 33 inpatients with SPD who were allocated to two subgroups (groups A and B). The patients in group A received psychodynamic psychotherapy and adjunctive pharmacotherapy, whereas the patients in group B received multimodal psychodynamic psychotherapy only. A statistically significant reduction in suicidality score was observed in the patients in group A, whereas a tendency for significant reduction in impulsivity score was observed in group B after the SIPP termination. Pharmacotherapy combined with multimodal psychodynamic psychotherapy, always within the SIPP, seems more effective in the case of suicidality rather than impulsivity.©2014 Lippincott Williams & Wilkins.
Journal of Nervous & Mental Disease, 202(2) : 138-143
- Year: 2014
- Problem: Suicide or self-harm behaviours (excluding non-suicidal self-harm)
, Suicide or self-harm with comorbid mental disorder
- Type: Controlled clinical trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Biological Interventions (any)
, Psychological Interventions (any)
, Psychodynamic/Psychoanalysis