Brief psychotherapy effective after ED suicide presentation

  • BMC Psychiatry

  • curated by Jim Kling
  • Clinical Essentials
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Takeaway

  • A meta-analysis of 4 studies shows that among patients at emergency departments (EDs) presenting with suicidality, psychotherapy interventions of 3 or fewer sessions reduced suicidal activity during the following 12 months.
  • Interventions involved 2-way communication between patient and healthcare worker and focused on suicidal thoughts and plans instead of mental health diagnoses.

Why this matters

  • Persons who complete suicide frequently have contact with the healthcare system because of suicidality in the year preceding death.

Study design

  • Systematic review (narrative synthesis) of 4 studies assessed effectiveness of brief psychological interventions (duration, 12-24 months).
  • Studies reported interventions in ED setting (n=3412).
  • Funding: National Institute for Health Research Collaboration for Leadership in Applied Health Research; Care South West Peninsula.

Key results

  • 1 study showed interventions were effective in reducing suicide over the course of 18 months (risk reduction [RR], 0.10; P=.0025).
  • 2 studies found fewer suicide attempts with intervention (HR, 0.17 [95% CI, 0.07-0.46]; RR, 0.80 [95% CI, 0.63-1.02]).
  • Intervention vs control group had lower depression, according to a study (P<.01>
  • Intervention group in 1 study showed 72% fewer days in hospital after 1 year (P=.038).

Limitations

  • Small evidence base.
  • Findings may not be generalizable.

Coauthored with Chitra Ravi, MPharm

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