Morken Ida Sund, Dahlgren Astrid, Lunde Ingeborg, Toven Siri
Regional Centre for Child and Adolescent Mental Health, Eastern and Southern Norway (RBUP), Oslo, Oslo, 0484, Norway.
Regional Centre on violence, trauma and suicide prevention, Eastern Norway, Oslo, Oslo, 0484, Norway.
F1000Res. 2019 Jun 20;8:890. doi: 10.12688/f1000research.19506.2. eCollection 2019.
Self-harm and suicide in children and adolescents are of serious consequence and increase during the adolescent years. Consequently, there is need for interventions that prevent such behaviour. The objective of this paper: to evaluate the effects of interventions preventing self-harm and suicide in children and adolescents in an overview of systematic reviews. We conducted an overview of systematic reviews (OoO). We included reviews evaluating any preventive or therapeutic intervention. The methodological quality of the included reviews was assessed independently, and data was extracted by two reviewers. We report the review findings descriptively. The certainty of evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE). Moderate certainty evidence suggests that school-based interventions prevent suicidal ideation and attempts short term, and possibly suicide attempts long term. The effects of community-based interventions following suicide clusters and local suicide plans are unknown, as are the benefits and harms of screening young people for suicide risk. The effects of most interventions targeting children and adolescents with known self-harm are unknown. However, low certainty evidence suggests that dialectical behavioural therapy and developmental group therapy are equally as effective on repetition of self-harm as enhanced treatment as usual. Research on several recommended practices, such as local suicide plans, prevention of suicide clusters and approaches to risk assessment, is lacking. When such interventions are implemented, the effects should be closely evaluated. There is also need for more research on treatment of repeated self-harm. Further research should include long term follow-up, and investigate possible adverse effects. In prevention of self-harm and suicide in children and adolescents, policy makers and health providers should consider evidence from population-based studies with mixed-age samples, adult samples, and studies on conditions associated with self-harm and/or suicidality, such as depression and psychosis. : CRD42019117942 08/02/19.
儿童和青少年的自我伤害及自杀后果严重，且在青少年时期呈上升趋势。因此，需要采取干预措施来预防此类行为。本文的目的是：在系统评价综述中评估预防儿童和青少年自我伤害及自杀的干预措施的效果。我们进行了一项系统评价综述。我们纳入了评估任何预防或治疗性干预措施的综述。对纳入综述的方法学质量进行独立评估，数据由两名评审员提取。我们以描述性方式报告综述结果。使用推荐分级评估、制定和评价（GRADE）来评估证据的确定性。中等确定性证据表明，基于学校的干预措施可在短期内预防自杀意念和自杀未遂，并可能在长期内预防自杀未遂。自杀聚集事件和地方自杀计划后基于社区的干预措施的效果尚不清楚，对年轻人进行自杀风险筛查的益处和危害也不清楚。大多数针对已知有自我伤害行为的儿童和青少年的干预措施的效果尚不清楚。然而，低确定性证据表明，辩证行为疗法和发展性团体疗法在预防自我伤害行为重复方面与强化常规治疗效果相当。缺乏对一些推荐做法的研究，如地方自杀计划、预防自杀聚集事件和风险评估方法。当实施此类干预措施时，应密切评估其效果。还需要对反复自我伤害的治疗进行更多研究。进一步的研究应包括长期随访，并调查可能的不良反应。在预防儿童和青少年的自我伤害及自杀方面，政策制定者和医疗服务提供者应考虑来自基于人群的研究的证据，这些研究涉及混合年龄样本、成人样本，以及关于与自我伤害和/或自杀倾向相关的状况（如抑郁症和精神病）的研究。：CRD42019117942 2019年2月8日
