van Eijk Nikki Lyka, Gilissen Renske, Creemers Daan, Schweren Lizanne J S, van Ballegooijen Wouter
113 Suicide Prevention, Amsterdam, the Netherlands.
Leiden University, Leiden, the Netherlands.
Clin Psychol Psychother. 2025 Jul-Aug;32(4):e70112. doi: 10.1002/cpp.70112.
Through carefully choosing psychotherapeutic interventions based on treatment characteristics, we may increase the relatively small effect sizes for suicidal outcomes. This study aims to evaluate the efficacy of different psychotherapy formats in reducing suicidal ideation and attempts, including individual, group and family-based therapies, as well as combined modalities involving individual and group or individual and family interventions. We conducted a meta-analysis after systematically searching databases for randomised controlled trials up to April 1, 2024. Included studies targeted any mental health issue, were delivered in any setting, compared with any control group, and reported on suicidal ideation or attempts. Data extraction and quality assessment were performed independently by two researchers, and a mixed-effects model was used for data synthesis. One hundred and seventy-two studies were eligible, totalling 198 comparisons with a total of 22,440 participants. Individual therapy significantly reduced suicidal ideation (g = -0.33, p < 0.001, k = 72 comparisons), as did group therapy (g = -0.39, p < 0.001, k = 27 comparisons). For reducing suicide attempts, individual therapy (RR = 0.75, p < 0.001, k = 63 comparisons), and notably, combinations of individual with group (RR = 0.42, p = 0.010, k = 7 comparisons) and individual with family-based therapy (RR = 0.59, p = 0.041, k = 8 comparisons) were effective. Subgroup analysis showed that combined therapies were associated with larger effect sizes compared to single modalities in reducing suicide attempts (p < 0.001). This meta-analysis highlights that combined psychotherapy approaches, integrating individual sessions with group or family sessions, yields significantly higher effect sizes, reducing the risk of suicide attempts by 50%. These findings support the adoption of combined therapeutic strategies in clinical settings to effectively address suicidality. SUMMARY: Individual or group therapy is effective for reducing suicidal ideation. Family therapy seems less effective than other formats. Individual therapy, or combining individual therapy with group therapy or family therapy, is effective for preventing suicide attempts. A combination of individual therapy with group or family therapy seems more effective at preventing suicide attempts than other formats.
通过根据治疗特征精心选择心理治疗干预措施，我们或许能够提高对自杀结果相对较小的效应量。本研究旨在评估不同心理治疗形式在减少自杀意念和自杀未遂方面的疗效，包括个体治疗、团体治疗和家庭治疗，以及涉及个体与团体或个体与家庭干预的联合模式。我们在系统检索数据库中截至2024年4月1日的随机对照试验后进行了一项荟萃分析。纳入的研究针对任何心理健康问题，在任何环境中开展，与任何对照组进行比较，并报告自杀意念或自杀未遂情况。两名研究人员独立进行数据提取和质量评估，并使用混合效应模型进行数据合成。172项研究符合条件，总计198项比较，共有22440名参与者。个体治疗显著降低了自杀意念（g = -0.33，p < 0.001，k = 72项比较），团体治疗也有同样效果（g = -0.39，p < 0.001，k = 27项比较）。在减少自杀未遂方面，个体治疗（RR = 0.75，p < 0.001，k = 63项比较），值得注意的是，个体与团体联合治疗（RR = 0.42，p = 0.010，k = 7项比较）以及个体与家庭治疗联合治疗（RR = 0.59，p = 0.041，k = 8项比较）均有效。亚组分析表明，与单一模式相比，联合治疗在减少自杀未遂方面效应量更大（p < 0.001）。这项荟萃分析强调，将个体治疗与团体或家庭治疗相结合的联合心理治疗方法产生的效应量显著更高，可将自杀未遂风险降低50%。这些发现支持在临床环境中采用联合治疗策略来有效解决自杀问题。总结：个体或团体治疗在减少自杀意念方面有效。家庭治疗似乎不如其他形式有效。个体治疗，或将个体治疗与团体治疗或家庭治疗相结合，在预防自杀未遂方面有效。个体治疗与团体或家庭治疗相结合在预防自杀未遂方面似乎比其他形式更有效。
