Yuan Sze Ngar Vanessa, Kwok Ka Ho Robin, Ougrin Dennis
Child and Adolescent Psychiatry, King's College London, London, United Kingdom.
Front Psychol. 2019 Feb 4;10:104. doi: 10.3389/fpsyg.2019.00104. eCollection 2019.
Self-harm is a major public health problem. It is one of the best predictors of suicide in adolescents. Despite recent advances in the understanding of self-harm, poor treatment engagement remains a significant clinical obstacle. The purpose of this meta-analysis is to update and extend previous research investigating treatment engagement with specific psychological treatments (SPT) vs. treatment as usual (TAU) in adolescents who self-harm. Data sources were identified by searching the Medline, PsychINFO, EMBASE, and PubMed databases as of October 2017. Randomized Controlled Trials (RCTs) comparing SPT and TAU in adolescents (through age 18 years) with self-harm were included. The results show that 12 RCTs investigating 1,255 young people were included in the meta-analysis. The proportion of adolescents not completing four or more sessions in SPT was significantly lower (28.4%, 179/630) than TAU (45.9%, 287/625), RR = 0.64 (95% CI:0.51 -0.79), < 0.0001. There were significantly more adolescents engaged with SPT than TAU. Specific psychological treatments should be offered to adolescents with self-harm to maximize treatment engagement. Engaging adolescents with psychological treatment is necessary although not sufficient to achieve treatment goals.
自我伤害是一个重大的公共卫生问题。它是青少年自杀的最佳预测指标之一。尽管最近在对自我伤害的理解方面取得了进展，但治疗参与度低仍然是一个重大的临床障碍。本荟萃分析的目的是更新和扩展先前的研究，该研究调查了在自我伤害的青少年中，特定心理治疗（SPT）与常规治疗（TAU）的治疗参与度。通过检索截至2017年10月的Medline、PsychINFO、EMBASE和PubMed数据库来确定数据来源。纳入了比较自我伤害青少年（18岁及以下）的SPT和TAU的随机对照试验（RCT）。结果显示，荟萃分析纳入了12项调查1255名年轻人的RCT。在SPT中未完成四次或更多疗程的青少年比例（28.4%，179/630）显著低于TAU（45.9%，287/625），RR = 0.64（95% CI：0.51 - 0.79），P < 0.0001。参与SPT的青少年明显多于TAU。应向自我伤害的青少年提供特定心理治疗，以最大限度地提高治疗参与度。让青少年参与心理治疗是必要的，尽管这不足以实现治疗目标。
