Chani Nuij1, Wouter van Ballegooijen2, Derek de Beurs3, Dilfa Juniar4, Annette Erlangsen5, Gwendolyn Portzky6, Rory C O'Connor7, Johannes H Smit8, Ad Kerkhof1, Heleen Riper9. 1. Section Clinical Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, The Netherlands. 2. Section Clinical Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, The Netherlands; Department of Research and Innovation, GGZ inGeest Specialized Mental Health Care, The Netherlands; Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam University Medical Center, The Netherlands. 3. Section Clinical Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, The Netherlands; and Department of epidemiology, Trimbos-institute, The Netherlands. 4. Section Clinical Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, The Netherlands; and Faculty of Psychology, Universitas YARSI, Indonesia. 5. Danish Research Institute for Suicide Prevention, Mental Health Centre Copenhagen, Denmark; Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, USA; and Centre for Mental Health Research, Australian National University, Australia. 6. Flemish Centre of Expertise in Suicide Prevention, Department of Head and Skin, Faculty of Medicine and Health Science, Ghent University, Belgium. 7. Suicidal Behaviour Research Laboratory, Institute of Health and Wellbeing, University of Glasgow, UK. 8. Department of Research and Innovation, GGZ inGeest Specialized Mental Health Care, The Netherlands; and Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam University Medical Center, The Netherlands. 9. Section Clinical Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, The Netherlands; Department of Research and Innovation, GGZ inGeest Specialized Mental Health Care, The Netherlands; and Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam University Medical Center, The Netherlands.
Abstract
BACKGROUND: Safety planning-type interventions (SPTIs) for patients at risk of suicide are often used in clinical practice, but it is unclear whether these interventions are effective. AIMS: This article reports on a meta-analysis of studies that have evaluated the effectiveness of SPTIs in reducing suicidal behaviour and ideation. METHOD: We searched Medline, EMBASE, PsycINFO, Web of Science and Scopus from their inception to 9 December 2019, for studies that compared an SPTI with a control condition and had suicidal behaviour or ideation as outcomes. Two researchers independently extracted the data. To assess suicidal behaviour, we used a random-effects model of relative risk based on a pooled measure of suicidal behaviour. For suicidal ideation, we calculated effect sizes with Hedges' g. The study was registered at PROSPERO (registration number CRD42020129185). RESULTS: Of 1816 unique abstracts screened, 6 studies with 3536 participants were eligible for analysis. The relative risk of suicidal behaviour among patients who received an SPTI compared with control was 0.570 (95% CI 0.408-0.795, P = 0.001; number needed to treat, 16). No significant effect was found for suicidal ideation. CONCLUSIONS: To our knowledge, this is the first study to report a meta-analysis on SPTIs for suicide prevention. Results support the use of SPTIs to help preventing suicidal behaviour and the inclusion of SPTIs in clinical guidelines for suicide prevention. We found no evidence for an effect of SPTIs on suicidal ideation, and other interventions may be needed for this purpose.
BACKGROUND: Safety planning-type interventions (SPTIs) for patients at risk of suicide are often used in clinical practice, but it is unclear whether these interventions are effective. AIMS: This article reports on a meta-analysis of studies that have evaluated the effectiveness of SPTIs in reducing suicidal behaviour and ideation. METHOD: We searched Medline, EMBASE, PsycINFO, Web of Science and Scopus from their inception to 9 December 2019, for studies that compared an SPTI with a control condition and had suicidal behaviour or ideation as outcomes. Two researchers independently extracted the data. To assess suicidal behaviour, we used a random-effects model of relative risk based on a pooled measure of suicidal behaviour. For suicidal ideation, we calculated effect sizes with Hedges' g. The study was registered at PROSPERO (registration number CRD42020129185). RESULTS: Of 1816 unique abstracts screened, 6 studies with 3536 participants were eligible for analysis. The relative risk of suicidal behaviour among patients who received an SPTI compared with control was 0.570 (95% CI 0.408-0.795, P = 0.001; number needed to treat, 16). No significant effect was found for suicidal ideation. CONCLUSIONS: To our knowledge, this is the first study to report a meta-analysis on SPTIs for suicide prevention. Results support the use of SPTIs to help preventing suicidal behaviour and the inclusion of SPTIs in clinical guidelines for suicide prevention. We found no evidence for an effect of SPTIs on suicidal ideation, and other interventions may be needed for this purpose.
Authors: Petri Arvilommi; Jukka Valkonen; Lars H Lindholm; Selma Gaily-Luoma; Kirsi Suominen; Outi M Ruishalme; Marena Kukkonen; Harri Sihvola; Erkki Isometsä Journal: Psychother Psychosom Date: 2022-01-20 Impact factor: 25.617
Authors: Chani Nuij; Wouter van Ballegooijen; Derek de Beurs; Remco F P de Winter; Renske Gilissen; Rory C O'Connor; Jan H Smit; Ad Kerkhof; Heleen Riper Journal: Front Psychiatry Date: 2022-09-27 Impact factor: 5.435