Institute of Applied Health Research, Public Health Building, University of Birmingham, Birmingham, B15 2TT, UK.
Syst Rev. 2019 Apr 4;8(1):87. doi: 10.1186/s13643-019-1007-7.
Self-harm and suicide have been identified as serious public health problems in children, adolescents, and young people across the world. Suicide is a major cause of mortality in this population and is commonly preceded by self-harm. Both suicide and self-harm are difficult to predict, and several risk scales and tools are in use for this purpose. Currently, there is only a small amount of evidence available regarding their predictive ability in clinical practice, and no consensus as to which is the most suitable for particular populations or settings. The aim of this review is to evaluate the ability of risk scales to predict future episodes of suicide or self-harm in adolescents and young adults presenting to clinical services with attempted suicide or an episode of self-harm.
A comprehensive search of electronic databases (MEDLINE, EMBASE, CINAHL, and PsycINFO) from inception will be conducted to identify studies that look at the ability of risk scales to predict suicide or future episodes of self-harm in adolescents and young adults presenting to clinical services with attempted suicide or an episode of self-harm. Two authors will independently carry out key methodological steps such as study screening and selection and data extraction. Quality assessment will be carried out using a checklist developed from the QUIPS and QUADAS-2 tools. Data will be grouped by tool and a narrative synthesis undertaken. For each tool, meta-analysis will be undertaken for ability to predict suicide or repeat self-harm where clinical and methodological homogeneity exists.
This systematic review will be the first to explore the use of assessment scales/tools in an adolescent population and will help to inform current practice regarding scales/tools with higher predictive ability. There is currently no evidence specifically for this population and a clear need with a high prevalence of self-harm and suicide in adolescents. Additionally, this review will help guide future research into suicide and self-harm prediction and prevention.
PROSPERO CRD42017058686.
自残和自杀已被确定为全球儿童、青少年和年轻人的严重公共卫生问题。自杀是该人群的主要死亡原因，通常发生在自残之前。自杀和自残都很难预测，为此目的已经使用了几种风险量表和工具。目前，关于这些量表在临床实践中的预测能力，只有少量证据，也没有共识认为哪种工具最适合特定人群或环境。本综述的目的是评估风险量表在因自杀未遂或自残发作而就诊于临床服务的青少年和年轻人中预测未来自杀或自残发作的能力。
将对从初始时间起的电子数据库（MEDLINE、EMBASE、CINAHL 和 PsycINFO）进行全面搜索，以确定研究自杀未遂或自残发作而就诊于临床服务的青少年和年轻人中评估量表预测自杀或未来自残发作能力的研究。两位作者将独立进行关键的方法学步骤，如研究筛选和选择以及数据提取。使用 QUIPS 和 QUADAS-2 工具制定的清单进行质量评估。将根据工具对数据进行分组，并进行叙述性综合。对于每个工具，如果存在临床和方法学同质性，将进行元分析以预测自杀或重复自残的能力。
这是首次在青少年人群中探索使用评估量表/工具的系统综述，将有助于为具有更高预测能力的量表/工具提供当前实践信息。目前尚无专门针对该人群的证据，而且由于青少年自残和自杀的患病率很高，因此非常需要这种证据。此外，本综述将有助于指导未来关于自杀和自残预测和预防的研究。
PROSPERO CRD42017058686。
