Prianka Padmanathan1, Katherine Hall2, Paul Moran3, Hayley E Jones4, David Gunnell3, Victoria Carlisle5, Anne Lingford-Hughes6, Matthew Hickman3. 1. Population Health Sciences, Bristol Medical School, University of Bristol, United Kingdom. Electronic address: prianka.padmanathan@bristol.ac.uk. 2. Avon & Wiltshire Mental Health Partnership NHS Trust, United Kingdom. 3. Population Health Sciences, Bristol Medical School, University of Bristol, United Kingdom; National Institute for Health Research, Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, UK. 4. Population Health Sciences, Bristol Medical School, University of Bristol, United Kingdom. 5. School of Psychological Science, University of Bristol, United Kingdom. 6. Department of Medicine, Imperial College London, United Kingdom.
Abstract
BACKGROUND: People with substance use disorder (SUD) are at significantly greater risk of suicide compared with the general population. In recent years the number of suicides resulting from drug poisoning in England and Wales has increased. We sought to identify and evaluate the effect of interventions to prevent suicide or reduce self-harm among people with SUD. METHODS: We conducted a systematic review of randomised controlled trials (RCTs) of interventions for people with SUD that included suicide or self-harm-related primary outcomes. We searched Cochrane Central Register of Controlled Trials (CENTRAL), PsycINFO, PubMed, Embase and Web of Science from inception until 13th January 2019. Studies were assessed for bias using the Cochrane Risk of Bias 2 tool. A random effects meta-analysis of standardised mean differences (SMD) was conducted. RESULTS: We identified six RCTs from four countries (Australia, Iran, the United States of America and the United Kingdom) comprising 468 participants in total. All but one study investigated psychosocial interventions. On average across studies there was weak evidence of a small positive effect of interventions on suicide or self-harm outcomes (d=-0.20, 95% CI=-0.39-0.00). LIMITATIONS: Studies were heterogeneous in terms of population, intervention, controls and outcome. There were some concerns regarding bias for all trials. All trials were liable to type II error. CONCLUSIONS: Evidence is currently lacking regarding the effectiveness of interventions to prevent suicide and reduce self-harm amongst people with SUD.
BACKGROUND: People with substance use disorder (SUD) are at significantly greater risk of suicide compared with the general population. In recent years the number of suicides resulting from drug poisoning in England and Wales has increased. We sought to identify and evaluate the effect of interventions to prevent suicide or reduce self-harm among people with SUD. METHODS: We conducted a systematic review of randomised controlled trials (RCTs) of interventions for people with SUD that included suicide or self-harm-related primary outcomes. We searched Cochrane Central Register of Controlled Trials (CENTRAL), PsycINFO, PubMed, Embase and Web of Science from inception until 13th January 2019. Studies were assessed for bias using the Cochrane Risk of Bias 2 tool. A random effects meta-analysis of standardised mean differences (SMD) was conducted. RESULTS: We identified six RCTs from four countries (Australia, Iran, the United States of America and the United Kingdom) comprising 468 participants in total. All but one study investigated psychosocial interventions. On average across studies there was weak evidence of a small positive effect of interventions on suicide or self-harm outcomes (d=-0.20, 95% CI=-0.39-0.00). LIMITATIONS: Studies were heterogeneous in terms of population, intervention, controls and outcome. There were some concerns regarding bias for all trials. All trials were liable to type II error. CONCLUSIONS: Evidence is currently lacking regarding the effectiveness of interventions to prevent suicide and reduce self-harm amongst people with SUD.
Authors: Katrina G Witt; Sarah E Hetrick; Gowri Rajaram; Philip Hazell; Tatiana L Taylor Salisbury; Ellen Townsend; Keith Hawton Journal: Cochrane Database Syst Rev Date: 2021-04-22
Authors: Ali Giusto; Savannah L Johnson; Kathryn L Lovero; Milton L Wainberg; Wilter Rono; David Ayuku; Eve S Puffer Journal: Int J Drug Policy Date: 2021-06-06
Authors: Lily A Brown; Cecile M Denis; Anthony Leon; Michael B Blank; Steven D Douglas; Knashawn H Morales; Paul F Crits-Christoph; David S Metzger; Dwight L Evans Journal: Drug Alcohol Depend Date: 2021-04-24 Impact factor: 4.852