A meta-analysis of targeted interventions for reducing suicide-related behaviour and ideation in adolescents: Implications for trial design
Introduction: Suicidality among young people is a significant societal issue. The current study conducted a meta-analysis of community and clinical interventions targeting suicide attempts, self-harm, and suicidal ideation in adolescents. Methods: Interventions targeting suicide attempts, self-harm...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2023-04-01
|
| Series: | Comprehensive Psychiatry |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0010440X23000111 |
| _version_ | 1828000946149392384 |
|---|---|
| author | Keith Gaynor Maeve Dwan O'Reilly David Redmond Ciara Nealon Conal Twomey Eilis Hennessy |
| author_facet | Keith Gaynor Maeve Dwan O'Reilly David Redmond Ciara Nealon Conal Twomey Eilis Hennessy |
| author_sort | Keith Gaynor |
| collection | DOAJ |
| description | Introduction: Suicidality among young people is a significant societal issue. The current study conducted a meta-analysis of community and clinical interventions targeting suicide attempts, self-harm, and suicidal ideation in adolescents. Methods: Interventions targeting suicide attempts, self-harm and suicidal ideation were identified by searching PsychINFO, Medline, CINAHL and Embase in line with the PRISMA statement. Study quality was determined using a risk of bias tool. Meta-analyses examined the efficacy of the interventions. Effect sizes were calculated for suicidal ideation data (continuous data) using Hedge's g for standardised mean differences. Suicide attempts and self-harm (dichotomous data) were calculated using odds ratios (ORs). Results: Seventeen RCTs were included in the meta-analysis. No significant differences were found between treatment and control groups on measures of suicide attempts or self-harm. A small effect-size was observed on measures of suicidal ideation (g = 0.47). A secondary meta-analysis investigated change over time in treatment as usual conditions, finding significant large effect-sizes for suicide attempts (OR = 18.67), self-harm (OR = 12.77), and suicidal ideation (g = 0.86). Limitations: The methodological decision to focus on specific outcomes over a broad definition of self-harm excluded some papers, which have been included in other reviews. It is unlikely to have significantly affected the overall results. The review was not preregistered. Conclusions: These twin findings highlight the importance overcoming the methodological difficulty of discerning effective interventions during a period of baseline improvement. We suggest that future trials should move away from broadly addressing “suicidality/self-harm” and encourage a greater targeting of at-risk individuals. |
| first_indexed | 2024-04-10T06:21:58Z |
| format | Article |
| id | doaj.art-bf1a1f9bbd294056a3e7705d2e5a7666 |
| institution | Directory Open Access Journal |
| issn | 0010-440X |
| language | English |
| last_indexed | 2024-04-10T06:21:58Z |
| publishDate | 2023-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Comprehensive Psychiatry |
| spelling | doaj.art-bf1a1f9bbd294056a3e7705d2e5a76662023-03-02T04:58:41ZengElsevierComprehensive Psychiatry0010-440X2023-04-01122152374A meta-analysis of targeted interventions for reducing suicide-related behaviour and ideation in adolescents: Implications for trial designKeith Gaynor0Maeve Dwan O'Reilly1David Redmond2Ciara Nealon3Conal Twomey4Eilis Hennessy5School of Psychology, University College Dublin, Belfield, Dublin 4, Ireland; DETECT, Early Intervention Service, Blackrock, Co. Dublin, Ireland; Corresponding author at: School of Psychology, University College Dublin, Belfield Dublin 4, Ireland.School of Psychology, University College Dublin, Belfield, Dublin 4, Ireland; Jigsaw the National Centre for Youth Mental Health, Westland Square, 16 Pearse St, Dublin, IrelandDublin City University, Collins Ave Ext, Whitehall, Dublin 9, IrelandSchool of Psychology, University College Dublin, Belfield, Dublin 4, IrelandDept. of Psychology, St Patricks University Hospital, Dublin, IrelandSchool of Psychology, University College Dublin, Belfield, Dublin 4, IrelandIntroduction: Suicidality among young people is a significant societal issue. The current study conducted a meta-analysis of community and clinical interventions targeting suicide attempts, self-harm, and suicidal ideation in adolescents. Methods: Interventions targeting suicide attempts, self-harm and suicidal ideation were identified by searching PsychINFO, Medline, CINAHL and Embase in line with the PRISMA statement. Study quality was determined using a risk of bias tool. Meta-analyses examined the efficacy of the interventions. Effect sizes were calculated for suicidal ideation data (continuous data) using Hedge's g for standardised mean differences. Suicide attempts and self-harm (dichotomous data) were calculated using odds ratios (ORs). Results: Seventeen RCTs were included in the meta-analysis. No significant differences were found between treatment and control groups on measures of suicide attempts or self-harm. A small effect-size was observed on measures of suicidal ideation (g = 0.47). A secondary meta-analysis investigated change over time in treatment as usual conditions, finding significant large effect-sizes for suicide attempts (OR = 18.67), self-harm (OR = 12.77), and suicidal ideation (g = 0.86). Limitations: The methodological decision to focus on specific outcomes over a broad definition of self-harm excluded some papers, which have been included in other reviews. It is unlikely to have significantly affected the overall results. The review was not preregistered. Conclusions: These twin findings highlight the importance overcoming the methodological difficulty of discerning effective interventions during a period of baseline improvement. We suggest that future trials should move away from broadly addressing “suicidality/self-harm” and encourage a greater targeting of at-risk individuals.http://www.sciencedirect.com/science/article/pii/S0010440X23000111Self-harmSuicide attemptSuicidal ideationClinical interventionAdolescentsMeta-analysis |
| spellingShingle | Keith Gaynor Maeve Dwan O'Reilly David Redmond Ciara Nealon Conal Twomey Eilis Hennessy A meta-analysis of targeted interventions for reducing suicide-related behaviour and ideation in adolescents: Implications for trial design Comprehensive Psychiatry Self-harm Suicide attempt Suicidal ideation Clinical intervention Adolescents Meta-analysis |
| title | A meta-analysis of targeted interventions for reducing suicide-related behaviour and ideation in adolescents: Implications for trial design |
| title_full | A meta-analysis of targeted interventions for reducing suicide-related behaviour and ideation in adolescents: Implications for trial design |
| title_fullStr | A meta-analysis of targeted interventions for reducing suicide-related behaviour and ideation in adolescents: Implications for trial design |
| title_full_unstemmed | A meta-analysis of targeted interventions for reducing suicide-related behaviour and ideation in adolescents: Implications for trial design |
| title_short | A meta-analysis of targeted interventions for reducing suicide-related behaviour and ideation in adolescents: Implications for trial design |
| title_sort | meta analysis of targeted interventions for reducing suicide related behaviour and ideation in adolescents implications for trial design |
| topic | Self-harm Suicide attempt Suicidal ideation Clinical intervention Adolescents Meta-analysis |
| url | http://www.sciencedirect.com/science/article/pii/S0010440X23000111 |
| work_keys_str_mv | AT keithgaynor ametaanalysisoftargetedinterventionsforreducingsuiciderelatedbehaviourandideationinadolescentsimplicationsfortrialdesign AT maevedwanoreilly ametaanalysisoftargetedinterventionsforreducingsuiciderelatedbehaviourandideationinadolescentsimplicationsfortrialdesign AT davidredmond ametaanalysisoftargetedinterventionsforreducingsuiciderelatedbehaviourandideationinadolescentsimplicationsfortrialdesign AT ciaranealon ametaanalysisoftargetedinterventionsforreducingsuiciderelatedbehaviourandideationinadolescentsimplicationsfortrialdesign AT conaltwomey ametaanalysisoftargetedinterventionsforreducingsuiciderelatedbehaviourandideationinadolescentsimplicationsfortrialdesign AT eilishennessy ametaanalysisoftargetedinterventionsforreducingsuiciderelatedbehaviourandideationinadolescentsimplicationsfortrialdesign AT keithgaynor metaanalysisoftargetedinterventionsforreducingsuiciderelatedbehaviourandideationinadolescentsimplicationsfortrialdesign AT maevedwanoreilly metaanalysisoftargetedinterventionsforreducingsuiciderelatedbehaviourandideationinadolescentsimplicationsfortrialdesign AT davidredmond metaanalysisoftargetedinterventionsforreducingsuiciderelatedbehaviourandideationinadolescentsimplicationsfortrialdesign AT ciaranealon metaanalysisoftargetedinterventionsforreducingsuiciderelatedbehaviourandideationinadolescentsimplicationsfortrialdesign AT conaltwomey metaanalysisoftargetedinterventionsforreducingsuiciderelatedbehaviourandideationinadolescentsimplicationsfortrialdesign AT eilishennessy metaanalysisoftargetedinterventionsforreducingsuiciderelatedbehaviourandideationinadolescentsimplicationsfortrialdesign |