TY - JOUR
T1 - Interventions to prevent repeat suicidal behavior in patients admitted to an emergency department for a suicide attempt
T2 - A meta-analysis
AU - Inagaki, Masatoshi
AU - Kawashima, Yoshitaka
AU - Kawanishi, Chiaki
AU - Yonemoto, Naohiro
AU - Sugimoto, Tatsuya
AU - Furuno, Taku
AU - Ikeshita, Katsumi
AU - Eto, Nobuaki
AU - Tachikawa, Hirokazu
AU - Shiraishi, Yohko
AU - Yamada, Mitsuhiko
PY - 2015/4/1
Y1 - 2015/4/1
N2 - Background: A huge number of patients with self-harm and suicide attempt visit emergency departments (EDs). We systematically reviewed studies and examined the effect of interventions to prevent repeat suicidal behavior in patients admitted to EDs for a suicidal attempt. Method: We searched the databases of MEDLINE, PsychoINFO, CINAHL, and EMBASE through August 2013. Eligible studies were randomized controlled trials assessing the effects on repeat suicidal behavior of interventions initiated in suicidal patients admitted to EDs. Interventions in each trial were classified into groups by consensus. Meta-analyses were performed to determine pooled relative risks (RRs) and 95% confidence intervals (CIs) of repetition of suicide attempt for interventions in each group. Results: Out of 5390 retrieved articles, 24 trials were included and classified into four groups (11 trials in the Active contact and follow-up, nine in the Psychotherapy, one in the Pharmacotherapy, and three in the Miscellaneous). Active contact and follow-up type interventions were effective in preventing a repeat suicide within 12 months (n = 5319; pooled RR = 0.83; 95% CI: 0.71 to 0.97). However, the effect at 24 months was not confirmed (n = 925; pooled RR = 0.98; 95% CI: 0.76-1.22). The effects of the other interventions on preventing a repetition of suicidal behavior remain unclear. Limitation: Caution is needed regarding the heterogeneity of the effects. Conclusion: Interventions of active contact and follow-up are recommended to reduce the risk of a repeat suicide attempt at 12 months in patients admitted to EDs with a suicide attempt. However, the long-term effect was not confirmed.
AB - Background: A huge number of patients with self-harm and suicide attempt visit emergency departments (EDs). We systematically reviewed studies and examined the effect of interventions to prevent repeat suicidal behavior in patients admitted to EDs for a suicidal attempt. Method: We searched the databases of MEDLINE, PsychoINFO, CINAHL, and EMBASE through August 2013. Eligible studies were randomized controlled trials assessing the effects on repeat suicidal behavior of interventions initiated in suicidal patients admitted to EDs. Interventions in each trial were classified into groups by consensus. Meta-analyses were performed to determine pooled relative risks (RRs) and 95% confidence intervals (CIs) of repetition of suicide attempt for interventions in each group. Results: Out of 5390 retrieved articles, 24 trials were included and classified into four groups (11 trials in the Active contact and follow-up, nine in the Psychotherapy, one in the Pharmacotherapy, and three in the Miscellaneous). Active contact and follow-up type interventions were effective in preventing a repeat suicide within 12 months (n = 5319; pooled RR = 0.83; 95% CI: 0.71 to 0.97). However, the effect at 24 months was not confirmed (n = 925; pooled RR = 0.98; 95% CI: 0.76-1.22). The effects of the other interventions on preventing a repetition of suicidal behavior remain unclear. Limitation: Caution is needed regarding the heterogeneity of the effects. Conclusion: Interventions of active contact and follow-up are recommended to reduce the risk of a repeat suicide attempt at 12 months in patients admitted to EDs with a suicide attempt. However, the long-term effect was not confirmed.
KW - Emergency department
KW - Meta-analysis
KW - Self-harm
KW - Suicide
KW - Systematic review
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U2 - 10.1016/j.jad.2014.12.048
DO - 10.1016/j.jad.2014.12.048
M3 - Review article
C2 - 25594513
AN - SCOPUS:84921791095
VL - 175
SP - 66
EP - 78
JO - Journal of Affective Disorders
JF - Journal of Affective Disorders
SN - 0165-0327
ER -