Servicio de Medicina Preventiva del Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain.
Centro Andaluz de Documentación e Información de Medicamentos (CADIME), Escuela Andaluza de Salud Pública, Campus Universitario de Cartuja, 18080 Granada, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Instituto de Salud Carlos III, 28029 Madrid, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain.
Actas Esp Psiquiatr. 2024 Aug;52(4):549-560. doi: 10.62641/aep.v52i4.1631.
The incidence of self-harm and suicidal behaviour in adolescents is increasing. Considering the great impact in this population, an actualization of the evidence of those psychological treatment's excellence for suicidal behaviour. Thus, the aim of this paper is to compile the available evidence on the effectiveness of cognitive behavioural therapy and dialectical behavioural therapy in preventing self-harm and suicidal behaviour in adolescents.
A umbrella review was carried out, different databases (PubMed, CINAHL, Cochrane Library, Psyinfo, Embase, Web of Science, Scopus and Google Scholar) were consulted. The 16-item measurement tool to assess systematic reviews-2 (AMSTAR-2) were performed by two independent reviewers and any discrepancies were resolved by consensus. The Rayyan-Qatar Computing Research Institute was used for the screening process.
Nine systematic reviews were included. Cognitive Behavioural Therapy appears to reduce the incidence of suicide-related events compared with treatment as usual, compared to usual treatment (which usually consists of drugs and talk therapy) especially when combined with fluoxetine. Dialectical behavioural therapy seems to be associated with a reduction in suicidal ideation and self-harm.
Although the results found show results with high heterogeneity. The evidence on cognitive behavioural therapy and dialectical behavioural therapy for suicide prevention, self-harm and suicide ideation in adolescents seems to show positive results. Considering, the special population and great impact, further research is needed and comparable studies should be sought that allow to set up robust recommendations.
青少年自残和自杀行为的发生率正在上升。鉴于这一人群的巨大影响,需要对这些心理治疗对自杀行为卓越效果的证据进行实际应用。因此,本文旨在编译关于认知行为疗法和辩证行为疗法在预防青少年自残和自杀行为方面的有效性的现有证据。
进行了伞式审查,查阅了不同的数据库(PubMed、CINAHL、Cochrane 图书馆、Psyinfo、Embase、Web of Science、Scopus 和 Google Scholar)。由两名独立评审员进行了 16 项评估系统评价的工具-2(AMSTAR-2),任何分歧均通过共识解决。使用 Rayyan-Qatar 计算研究所进行筛选过程。
纳入了 9 项系统评价。与常规治疗相比,认知行为疗法似乎可以降低与自杀相关事件的发生率,与常规治疗(通常包括药物和谈话疗法)相比,尤其是与氟西汀联合使用时。辩证行为疗法似乎与自杀意念和自残的减少有关。
尽管发现的结果存在高度异质性,但关于认知行为疗法和辩证行为疗法预防青少年自杀、自残和自杀意念的证据似乎显示出积极的结果。考虑到特殊的人群和巨大的影响,需要进一步的研究,并应寻求可比的研究,以制定可靠的建议。