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基层医疗中针对自杀意念的简短干预措施:一项系统评价

Brief interventions for suicidal ideation in primary care: a systematic review.

作者信息

Younesi Puya, Haas Carolin, Dreischulte Tobias, Schmitt Andrea, Gensichen Jochen, Lukaschek Karoline

机构信息

Institute of General Practice and Family Medicine, University Hospital, LMU Munich, Nussbaumstrasse 5, Munich, 80336, Germany.

Graduate Program "POKAL - Predictors and Outcomes in Primary Care Depression Care" (DFG-GrK 2621), Munich, Germany.

出版信息

BMC Prim Care. 2025 May 15;26(1):167. doi: 10.1186/s12875-025-02848-4.

Abstract

BACKGROUND

General practitioners (GPs) play a crucial role in assessing and diagnosing suicidal ideation, often acting as the first person of contact for individuals with mental health concerns. Given the time constraints faced by primary care providers, interventions need to be brief and easily implemented. This systematic review seeks to identify, compare, and critically evaluate effective brief interventions for managing suicidality in primary care, offering a comprehensive overview and discussion of key findings.

METHODS

A systematic literature review was conducted using databases including MEDLINE, EMBASE, The Cochrane Library, PSYNDEX, and PsychINFO, supplemented by manual searches. Our search strategy focused on studies from 2000 to 2023. Risk of bias was assessed using the Cochrane RoB 2 Tool, and evidence quality was evaluated using GRADE, with adherence to the PRISMA-DTA checklist. A protocol was published in PROSPERO.

RESULTS

The search yielded 1248 publications. Of those, 44 were assessed for eligibility after screening, ultimately resulting in five included studies addressing four brief interventions for suicidality in primary care. Motivational interviews, safety planning, structured follow-ups, and collaborative care models were identified as key elements for future interventions to enhance the role of primary care in suicide prevention.

CONCLUSION

This review highlights the need for further research to adapt brief interventions for primary care suicide prevention. Given their central role in patient care, GPs are well-positioned to identify and support individuals at risk. While initial promising approaches have emerged, further research in primary care suicide prevention is needed, and interventions tailored to the GP setting must be developed.

摘要

背景

全科医生(GPs)在评估和诊断自杀意念方面起着至关重要的作用,他们常常是有心理健康问题的个体的首个接触对象。鉴于基层医疗服务提供者面临时间限制,干预措施需要简短且易于实施。本系统综述旨在识别、比较并批判性地评估在基层医疗中管理自杀行为的有效简短干预措施,全面概述并讨论主要发现。

方法

使用包括MEDLINE、EMBASE、Cochrane图书馆、PSYNDEX和PsychINFO在内的数据库进行系统文献综述,并辅以手工检索。我们的检索策略聚焦于2000年至2023年的研究。使用Cochrane RoB 2工具评估偏倚风险,并使用GRADE评估证据质量,同时遵循PRISMA - DTA清单。一份方案已在PROSPERO上发表。

结果

检索共得到1248篇出版物。其中,44篇在筛选后进行了资格评估,最终有五项纳入研究涉及基层医疗中针对自杀行为的四种简短干预措施。动机访谈、安全计划、结构化随访和协作护理模式被确定为未来干预措施的关键要素,以增强基层医疗在预防自杀中的作用。

结论

本综述强调需要进一步开展研究,以调整用于基层医疗自杀预防的简短干预措施。鉴于全科医生在患者护理中的核心作用,他们处于识别和支持有风险个体的有利位置。虽然已经出现了一些初步有前景的方法,但仍需要在基层医疗自杀预防方面进行进一步研究,并且必须开发适合全科医生环境的干预措施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/663e/12080141/1280a986c769/12875_2025_2848_Fig1_HTML.jpg

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