• About
  • Masthead
  • License Content
  • Advertise
  • Submit Press Release
  • RSS/Email List
  • Write for us
  • Contact us
2 Minute Medicine
No Result
View All Result

No products in the cart.

SUBSCRIBE
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
2 Minute Medicine
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
SUBSCRIBE
2 Minute Medicine
Subscribe
Home All Specialties Pediatrics

Comparative efficacy of psychotherapies for reducing self-harm and suicidality in young individuals shows inconsistent and low-quality evidence

byYuchen DaiandMichael Pratte
June 2, 2021
in Pediatrics, Psychiatry
Reading Time: 3 mins read
0
Share on FacebookShare on Twitter

1. Although some psychotherapeutic modalities are well-tolerated and efficacious in reducing self-harm and suicidality in children and adolescents, methodological concerns and high risk of bias prevent a consistent and objective assessment of their comparative performance.

2. This lack of consistent evidence precludes a definitive hierarchy of psychotherapeutic treatments during clinical decision-making, indicating the need for further high-quality randomized clinical trials (RCTs).

Evidence Rating Level: 1 (Excellent)

Study Rundown: Self-harm and suicidal behavior are associated with substantial morbidity and mortality and known to peak in incidence and prevalence during adolescent years. These behaviors cause substantial burdens for patients, families, communities, and health systems, thus, evidence-based prevention strategies and therapeutic efforts aimed at young people are needed. Despite this, the comparative performance of various psychotherapeutic modalities for reducing self-harm and suicidality in young individuals is unclear due to a lack of precise head-to-head clinical trials. This systematic review and network meta-analysis (NMA) sought to investigate the comparative efficacy and acceptability of psychosocial interventions for the treatment of self-harm and suicidality among children and adolescents. The primary outcomes of the review were dichotomized self-harm frequency and retention in treatment while secondary outcomes included dichotomized all-cause treatment discontinuation and scores on instruments measuring suicidal ideation and depressive symptoms. From 1,272 unique records generated from four major bibliographic databases, the review included 44 RCTs (5,406 total participants; 4,109 female [76.0%]) from a total of 49 selected articles (including 5 follow-up studies). The selected RCTs spanned from 1995 to 2020 with a median duration of treatment of 3 months (range, 0.25-12.00 months) and a median follow-up period of 12 months (range, 1-36 months). None of the investigated psychotherapies were associated with more study withdrawals when compared with treatment as usual. However, efficacy was inconsistent across outcomes and psychotherapies. Therefore, although the NMA found that most psychotherapies were well tolerated and efficacious for particular measures of self-harm or suicidality, caution is recommended when interpreting these findings due to low RCT quality, lack of consistency across outcome measures and treatment periods, and publication bias. A limitation of this study was the reliance on indirect treatment observations as evidence when comparing psychotherapeutic modalities head-to-head. Indirect observations are more susceptible to bias and when interpreted from a few RCTs with small samples, has the potential to create imprecise and underpowered estimates.

Click to read the study in JAMA

Relevant Reading: A further look at therapeutic interventions for suicide attempts and self-harm in adolescents: an updated systematic review of randomized controlled trials

In-Depth [systematic review and meta-analysis]: This systematic review and NMA pooled data from eligible RCTs comparing psychotherapies for suicidality and/or self-harm with control conditions among children and adolescents after a blinded review by three independent reviewers. The systematic search was conducted from four major bibliographic databases (PubMed, MEDLINE, PsycINFO, and Embase) in September 2020 and generated 1,272 original studies. From these, 44 eligible RCTs (5,406 total participants; 4,109 female [76.0%]) from 49 articles were selected, spanning from 1995 to 2020 (5 follow-up studies were merged with their primary RCTs to avoid publication bias). The median duration of psychotherapy was 3 months (range, 0.25-12.00 months) while the median duration of follow-up was 12 months (range, 1-36 months). None of the investigated psychotherapies were associated with increases in study withdrawals or improvements in retention in treatment when compared with control conditions. However, efficacy was inconsistent across outcomes and psychotherapies in the selected studies due to low-quality evidence, heterogeneity, and a high risk of bias overall. Dialectical behavioral therapies (DBT) were associated with reductions in self-harm (OR, 0.28; 95%CI, 0.12-0.64) and suicidal ideation (Cohen d SMD, −0.71; 95%CI, −1.19 to −0.23) at the end of the treatment period, while mentalization-based therapies (MBT) were associated with decreases in self-harm (OR, 0.38; 95%CI, 0.15-0.97) and suicidal ideation (Cohen d SMD, −1.22; 95%CI, −2.18 to −0.26) at the end of the follow-up period. These findings indicate that although certain psychotherapeutic modalities appeared to be acceptable and efficacious for reducing self-harm and suicidality among young people, intrinsic methodological issues and high risk of publication bias suggests the need for additional high-quality RCTs.

RELATED REPORTS

2 Minute Medicine Rewind June 6, 2022

Ambient air pollution associated with increased risk of Kawasaki disease in children

#VisualAbstract: Canakinumab treatment did not reduce pain to clinical significance but shows anti-inflammatory effects in children and young adults with sickle cell anemia

Image: PD

©2021 2 Minute Medicine, Inc. All rights reserved. No works may be reproduced without expressed written consent from 2 Minute Medicine, Inc. Inquire about licensing here. No article should be construed as medical advice and is not intended as such by the authors or by 2 Minute Medicine, Inc.

Tags: pediatricspsychotherapyself-harmsystematic review
Previous Post

Epidural labor analgesia not associated with increased risk of autism spectrum disorder in offspring

Next Post

#VisualAbstract: Lenvatinib plus pembrolizumab improves overall survival and progression free survival for advanced renal cell carcinoma treatment

RelatedReports

Weekly Rewinds

2 Minute Medicine Rewind June 6, 2022

June 6, 2022
Isolated mild/moderate thrombocytopenia may not require intervention
Pediatrics

Ambient air pollution associated with increased risk of Kawasaki disease in children

May 9, 2022
#VisualAbstract: Canakinumab treatment did not reduce pain to clinical significance but shows anti-inflammatory effects in children and young adults with sickle cell anemia
StudyGraphics

#VisualAbstract: Canakinumab treatment did not reduce pain to clinical significance but shows anti-inflammatory effects in children and young adults with sickle cell anemia

May 4, 2022
Late gestation antidepressant use linked to postpartum hemorrhage
Weekly Rewinds

2 Minute Medicine Rewind April 13, 2022

April 18, 2022
Next Post
#VisualAbstract: Polypill plus aspirin treatment decreases cardiovascular event incidence

#VisualAbstract: Lenvatinib plus pembrolizumab improves overall survival and progression free survival for advanced renal cell carcinoma treatment

Implementation of pneumococcal vaccine programs linked to decreased antibiotic prescription

Use of bamlanivimab for patients with mild to moderate COVID-19 infection

Radiation plus chemotherapy confers survival benefit compared to radiation alone in low-grade gliomas

Immunovirotherapy showed acceptable adverse-event profile in pediatric high-grade gliomas

License Our Award-Winning Physician-Written Medical News and Visual Abstracts

2 Minute Medicine is the leading authoritative medical news licensing service, and the only with reports written by practicing doctors.

LICENSE CONTENT

2MM+ Premium Access

No ads & unlimited access to all current reports, over 9000 searchable archived reports, visual abstracts, Weekly Rewinds, and the online edition of The Classics Series™ textbook.

Subscription Options
2 Minute Medicine

2 Minute Medicine® is an award winning, physician-run, expert medical media company. Our content is curated, written and edited by practicing health professionals who have clinical and scientific expertise in their field of reporting. Our editorial management team is comprised of highly-trained MD physicians. Join numerous brands, companies, and hospitals who trust our licensed content.

Recent Reports

  • Cognitive behavioral therapy efficacious for treatment of comorbid posttraumatic headache and posttraumatic stress disorder symptoms among US veterans
  • Sickle cell trait associated with preexisting kidney comorbidities and increased COVID-19 mortality
  • Adding atezolizumab to standard of care treatment for human epidermal growth factor receptor 2 (HER2) positive early breast cancer does not improve pathologic response outcomes
License Content
Terms of Use | Disclaimer
Cookie Policy
Privacy Statement (EU)
Disclaimer

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.