Department of Neuropsychopharmacology, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1, Ogawahigashimachi, Kodaira, Tokyo 187-8553, Japan; Clinical Psychology Course, Department of Psycho-Social Studies, School of Arts and Letters, Meiji University, 1-1, Kanda-Surugadai, Chiyoda-ku, Tokyo 101-8301, Japan.
Department of Neuropsychopharmacology, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1, Ogawahigashimachi, Kodaira, Tokyo 187-8553, Japan; Department of Biostatistics, School of Public Health, Kyoto University, Yoshida Konoe-cho, Sakyo-ku, Kyoto 606-8501, Japan.
Gen Hosp Psychiatry. 2019 Sep-Oct;60:98-110. doi: 10.1016/j.genhosppsych.2019.07.003. Epub 2019 Jul 11.
This study aimed to summarize interventions for suicide prevention in patients with cancer and highlight any methodological issues.
We searched PubMed, PsycINFO, CINAHL, and the Cochrane database from their inception until July 2018. Additionally, we manually searched the references of included studies and recent systematic reviews of psychotherapy, antidepressants, and collaborative care for cancer patients with depression.
Of the 1365 retrieved articles, 11 randomized controlled trials and 11 intervention studies met the inclusion criteria. These were categorized by type of intervention: psychotherapy, pharmacotherapy, integrated collaborative care, muscle relaxation and therapeutic walking, and cancer treatment. The trials showed little evidence to confirm the effects of suicide prevention strategies. Seven trials were designed to assess the efficacy of interventions treating depression. In all studies, suicidal behavior or ideation was reported as one of the secondary outcomes. Three trials did not report information about suicidal ideation, despite assessing depressive symptoms using scales that contained suicidal ideation items. Most trials demonstrated inadequate study quality.
Our review summarized interventions for suicide prevention in patients with cancer and revealed methodological issues. The findings highlighted a need to explore new treatment strategies that focus on unique suicide risk factors among patients with cancer.
本研究旨在总结癌症患者自杀预防干预措施，并强调任何方法学问题。
我们检索了 PubMed、PsycINFO、CINAHL 和 Cochrane 数据库，检索时间从建库至 2018 年 7 月。此外，我们还手动检索了纳入研究的参考文献以及近期关于癌症合并抑郁患者心理治疗、抗抑郁药和协作式护理的系统评价。
在检索到的 1365 篇文章中，有 11 项随机对照试验和 11 项干预研究符合纳入标准。这些研究按干预类型分类：心理治疗、药物治疗、综合协作式护理、肌肉放松和治疗性步行以及癌症治疗。试验结果几乎没有证据证实预防自杀策略的效果。7 项试验旨在评估干预治疗抑郁的疗效。在所有研究中，自杀行为或自杀意念均被报告为次要结局之一。尽管使用包含自杀意念项目的量表评估抑郁症状，但有 3 项试验未报告自杀意念的信息。大多数试验的研究质量欠佳。
本综述总结了癌症患者自杀预防干预措施，并揭示了方法学问题。研究结果强调需要探索新的治疗策略，重点关注癌症患者特有的自杀风险因素。
