The British Journal of Psychiatry (2007) 190: 11-17. doi: 10.1192/bjp.bp.106.025437
© 2007 The Royal College of Psychiatrists
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REVIEW ARTICLES

Psychosocial interventions following self-harm

Systematic review of their efficacy in preventing suicide

MIKE J. CRAWFORD, MD and OLIVIA THOMAS, BSc, Faculty of Medicine

Imperial College London

NUSRAT KHAN, MRCPsych

Central and North West London Mental Health NHS Trust

ELENA KULINSKAYA, PhD, Faculty of Medicine

Imperial College London, London, UK

Correspondence: Dr M. J. Crawford, Department of Psychological Medicine, Claybrook Centre, 37 Claybrook Road, London W6 8LN, UK. Tel: +44 (0)207 386 1233; fax: +44 (0)207 386 1216; e-mail: m.crawford{at}imperial.ac.uk

Declaration of interest None.

Background With almost a million people dying by suicide worldwide each year, reducing the rate of suicidal behaviour is a priority in many countries.

Aims To examine whether additional psychosocial interventions following an episode of self-harm reduce the likelihood of subsequent suicide.

Method We conducted a systematic review and meta-analysis of data from randomised controlled trials of interventions for people following self-harm. Likelihood of suicide was compared by calculating the pooled root difference in suicide rate with 95% confidence intervals.

Results We obtained suicide data from 18 studies with a total population of 3918. Eighteen suicides occurred among people offered active treatment and 19 among those offered standard care (pooled root difference in suicide rate 0.0,95% CI –0.03 to 0.03). The overall rate of suicide among people participating in trials was similar to that reported in observational studies of people who self-harm.

Conclusions Results of this meta-analysis do not provide evidence that additional psychosocial interventions following self-harm have a marked effect on the likelihood of subsequent suicide.


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eLetters:

Read all eLetters

Psychosocial interventions and the likelihood reduction of subsequent suicide
Raafat S Labib Mishriky
BJP Online, 1 Feb 2007 [Full text]
suicide prevention, still elusive?
Sangeetha Chinnadurai
BJP Online, 1 Feb 2007 [Full text]
Inaccurate conclusions based on limited data
M. David Rudd, et al.
BJP Online, 6 Feb 2007 [Full text]
Re: Inaccurate conclusions based on limited data
Michael J Crawford
BJP Online, 11 Apr 2007 [Full text]
Re: Re: Inaccurate conclusions based on limited data
M. David Rudd
BJP Online, 2 May 2007 [Full text]
Caution urged with meta-analysis
M. David Rudd
BJP Online, 29 May 2007 [Full text]
Authors reply
Mike J Crawford, et al.
BJP Online, 31 May 2007 [Full text]