Duke University School of Nursing, Durham, NC, USA; Duke Global Health Institute, Duke University, Durham, NC, USA.
Duke University School of Nursing, Durham, NC, USA; Duke Center for AIDS Research, Duke University, Durham, NC, USA.
J Affect Disord. 2023 May 1;328:183-190. doi: 10.1016/j.jad.2023.02.038. Epub 2023 Feb 16.
Nearly 800,000 people die by suicide each year, with 77 % occurring in low- and middle-income countries. Suicide is underestimated in many African settings due to challenges in data collection, stigma, and policies that promote silence; nonetheless, rates of suicide in Africa are consistently higher than global averages.
We conducted a scoping review of counseling interventions assessing suicide outcomes among adults in Africa using MEDLINE, Embase, PsycINFO, African Index Medicus, CABI Global Health, and Proquest databases. Study screening and data extraction was informed by the JBI Manual for Evidence Synthesis.
Of 2438 abstracts reviewed, 33 studies met criteria for full-text review and 13 were included in the analysis. Interventions served several populations, including people living with HIV, out of school youth, university students, and women undergoing obstetric fistula repair. There was a near-equal split in individual versus group counseling modalities and the use of professional versus lay counselors. The majority of interventions had primary outcomes focused on other mental health or social variables with a secondary focus on suicide. Mechanisms of change for suicide prevention were poorly articulated.
The review was limited to English-language studies conducted after 2001 and excluded qualitative studies and those with fewer than 10 participants.
There is a clear paucity of research in this area, particularly in the lack of randomized clinical trials and studies with suicide prevention as their primary outcome. Researchers should seek to develop or adapt evidence-based, culturally-resonant interventions to reduce the burden of suicide on the African continent.
每年有近 80 万人自杀身亡，其中 77%发生在中低收入国家。由于数据收集、污名化和促进沉默的政策方面存在挑战，许多非洲国家对自杀情况的估计都过低；尽管如此，非洲的自杀率始终高于全球平均水平。
我们使用 MEDLINE、Embase、PsycINFO、非洲医学索引、CABI 全球健康和 ProQuest 数据库，对评估非洲成年人自杀结果的咨询干预措施进行了范围综述。研究筛选和数据提取以 JBI 证据综合手册为依据。
在审查的 2438 篇摘要中，有 33 项研究符合全文审查标准，其中 13 项研究被纳入分析。干预措施服务于多个群体，包括艾滋病毒感染者、失学青年、大学生和接受产科瘘管修复的妇女。个体咨询与小组咨询模式以及专业顾问与非专业顾问的使用比例几乎相等。大多数干预措施的主要结果都集中在其他心理健康或社会变量上，其次才是自杀。预防自杀的变化机制表述不清。
该综述仅限于 2001 年后用英文进行的研究，排除了定性研究和参与者少于 10 人的研究。
这方面的研究明显不足，特别是缺乏随机临床试验和以预防自杀为主要结果的研究。研究人员应寻求制定或调整基于证据、具有文化共鸣的干预措施，以减轻非洲大陆的自杀负担。
