McGill Group for Suicide Studies, Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Montreal, Quebec, Canada
Department of Epidemiology, Biostatistics, and Occupational Health, School of Population and Global Health, McGill University, Montreal, Quebec, Canada.
BMJ Open. 2023 Aug 24;13(8):e072289. doi: 10.1136/bmjopen-2023-072289.
Suicide is an important public health problem. Providing evidence-based psychosocial interventions to individuals presenting with self-harm is recognised as an important suicide prevention strategy. Therefore, it is crucial to understand which intervention is most effective in preventing self-harm repetition. We will evaluate the comparative efficacy of psychosocial interventions for the prevention of self-harm in adults.
We will perform a systematic review and network meta-analysis (NMA) of randomised controlled trials (RCTs) testing psychosocial interventions for the prevention of self-harm repetition. We will include RCTs in adults (mean age: 18 years or more) who presented with self-harm in the 6 months preceding enrolment in the trial. Interventions will be categorised according to their similarities and underpinning theoretical approaches (eg, cognitive behavioural therapy, case management). A health sciences librarian will update and adapt the search strategy from the most recent Cochrane pairwise systematic review on this topic. The searches will be performed in MEDLINE (Ovid), Embase (Ovid), PsycInfo (Ovid), CINAHL (EBSCO), Cochrane Central (Wiley), Cochrane Protocols (Wiley), LILACS and PSYNDEX from 1 July 2020 (Cochrane review last search date) to 1 September 2023. The primary efficacy outcome will be self-harm repetition. Secondary outcomes will include suicide mortality, suicidal ideation and depressive symptoms. Retention in treatment (ie, drop-outs rates) will be analysed as the main acceptability outcome. Two reviewers will independently assess the study eligibility and risk of bias (using RoB-2). An NMA will be performed to synthesise all direct and indirect comparisons. Ranked forest plots and Vitruvian plots will be used to represent graphically the results of the NMA. Credibility of network estimates will be evaluated using Confidence in NMA (CINeMA).
As this is the protocol for an aggregate-data level NMA, ethical approval will not be required. Results will be disseminated at national/international conferences and in peer-review journals.
CRD42021273057.
自杀是一个重要的公共卫生问题。为有自伤行为的个体提供循证心理社会干预措施被认为是预防自杀的重要策略。因此，了解哪种干预措施最能有效预防自伤行为的复发至关重要。我们将评估心理社会干预措施预防成年人自伤复发的比较效果。
我们将对预防自伤复发的心理社会干预措施的随机对照试验（RCT）进行系统评价和网络荟萃分析（NMA）。我们将纳入在试验入组前 6 个月内有自伤行为的成年人（平均年龄：18 岁或以上）的 RCT。干预措施将根据其相似性和潜在理论方法进行分类（例如，认知行为疗法、病例管理）。一名健康科学图书馆员将更新并调整该主题最近的 Cochrane 成对系统评价中的搜索策略。搜索将在 MEDLINE（Ovid）、Embase（Ovid）、PsycInfo（Ovid）、CINAHL（EBSCO）、Cochrane Central（Wiley）、Cochrane 方案（Wiley）、LILACS 和 PSYNDEX 中进行，检索时间从 2020 年 7 月 1 日（Cochrane 综述最后检索日期）至 2023 年 9 月 1 日。主要疗效结局将是自伤复发。次要结局将包括自杀死亡率、自杀意念和抑郁症状。保留治疗（即脱落率）将作为主要可接受性结局进行分析。两名评审员将独立评估研究资格和偏倚风险（使用 RoB-2）。将进行 NMA 以综合所有直接和间接比较。排名森林图和维特鲁威图将用于直观地表示 NMA 的结果。网络估计的可信度将使用信心等级评价（CINeMA）进行评估。
由于这是一个汇总数据水平 NMA 的方案，因此不需要伦理批准。结果将在国家/国际会议和同行评审期刊上发表。
CRD42021273057。
