Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry 605006, India.
SNEHA.
Curr Opin Psychiatry. 2022 Sep 1;35(5):317-323. doi: 10.1097/YCO.0000000000000807. Epub 2022 Jul 18.
Suicide is a major, global, public health issue. Those who attempt suicide represent a high-risk subgroup for eventual death by suicide. We provide an update on emerging evidence for interventions for attempted suicide to reduce subsequent suicidal behavior.
Major approaches that have been examined recently include pharmacological, psychosocial, brief active contact and outreach interventions, and digitally driven interventions. Notwithstanding the limited evidence base for most of these approaches, brief contact and follow-up interventions appear to have more robust effects on reduction of repeat suicidal behavior, including attempts; such approaches may have especial significance in emergency settings because of their brevity. Digital interventions for self-harm appear promising in the short-term whereas the evidence for pharmacological and psychosocial strategies remain inconclusive.
Although current evidence supports the use of brief interventions, contact, and outreach for reducing risk of subsequent suicide attempts and suicidal behavior, there are large gaps and limitations in the evidence base related to trial design, lack of long-term efficacy data, and implementational challenges. More robustly designed long-term trials that examine integrated intervention approaches with well defined outcomes are needed to develop recommendations in this area.
自杀是一个重大的、全球性的公共卫生问题。尝试自杀的人代表了最终自杀死亡的高风险亚组。我们提供了最新的关于尝试自杀干预措施的研究进展，以减少随后的自杀行为。
最近研究的主要方法包括药理学、心理社会、简短积极接触和外展干预以及数字化驱动的干预措施。尽管这些方法中的大多数都缺乏有限的证据基础，但简短的接触和随访干预措施似乎对减少重复自杀行为，包括尝试自杀，具有更强大的效果；这些方法在紧急情况下可能具有特殊意义，因为它们的时间较短。数字干预措施对自伤行为在短期内似乎有希望，但药物和心理社会策略的证据仍然没有定论。
尽管目前的证据支持使用简短的干预措施、接触和外展来降低随后自杀企图和自杀行为的风险，但与试验设计、缺乏长期疗效数据以及实施方面的挑战相关，证据基础存在很大差距和局限性。需要设计更稳健的长期试验，以明确的结果来检验综合干预措施方法，从而为这一领域提出建议。
