Burns Jane, Dudley Michael, Hazell Philip, Patton George
'beyondblue; the national depression initiative' Hawthorn West, Victoria, Australia.
Aust N Z J Psychiatry. 2005 Mar;39(3):121-8. doi: 10.1080/j.1440-1614.2005.01532.x.
To examine the evidence for the effectiveness of clinical interventions designed to reduce the repetition of deliberate self-harm (DSH) in adolescents and young adults.
Electronic databases were searched for papers describing randomised and clinical control trials (RCTs) and quasi-experimental studies of interventions targeting adolescents and young adults presenting to clinical services following DSH or suicidal ideation.
Three RCTs, four clinical control trials and three quasi-experimental studies were identified. Group therapy, trialled in a RCT, was the only specific programme which led to a significant reduction in rates of repetition of self-harm. Attendance at follow-up did not improve significantly regardless of the intervention, while one clinically controlled trial of intensive intervention resulted in poorer attendance at follow-up. One quasi-experimental study of family therapy resulted in a significant reduction in suicidal ideation.
The evidence base for treatments designed to reduce the repetition of self-harm in adolescents and young adults is very limited. Expensive interventions such as intensive aftercare offer no clear benefit over routine aftercare. Given that deliberate self-harm among young people is a common clinical problem further good quality treatment studies are warranted. Careful consideration should be given to process evaluation to determine which individual components of any given intervention are effective.
研究旨在减少青少年和青年故意自伤（DSH）重复发生的临床干预措施有效性的证据。
检索电子数据库，查找描述针对因故意自伤或自杀意念而寻求临床服务的青少年和青年的干预措施的随机对照试验（RCT）和准实验研究的论文。
共识别出三项随机对照试验、四项临床对照试验和三项准实验研究。在一项随机对照试验中进行试验的团体治疗是唯一一项能显著降低自伤重复率的特定项目。无论采取何种干预措施，随访的参与率均未显著提高，而一项强化干预的临床对照试验导致随访参与率更低。一项家庭治疗的准实验研究使自杀意念显著减少。
旨在减少青少年和青年自伤重复发生的治疗的证据基础非常有限。诸如强化后续护理等昂贵的干预措施与常规后续护理相比并无明显益处。鉴于年轻人故意自伤是一个常见的临床问题，有必要开展进一步高质量的治疗研究。应仔细考虑进行过程评估，以确定任何给定干预措施的哪些个别组成部分是有效的。
