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The effectiveness of psychoanalytic/ psychodynamic psychotherapy for reducing suicide attempts and self-harm: systematic review and meta-analysis

Forfatter(e)
Briggs, S. Netuveli, G. Gould, N. Gkaravella, A. Gluckman, N. S. Kangogyere, P. Farr, R. Goldblatt, M. J. Lindner, R.
År
2019
DOI
https://doi.org/10.1192/bjp.2019.33
Tidsskrift
British Journal of Psychiatry
Sider
320-328
Kategori(er)
Selvskading/selvmord
Tiltakstype(r)
Psykodynamisk/interpersonlig terapi
Abstract

Background: Preventing suicide and self-harm is a global health priority. Although there is a growing evidence base for the effectiveness of psychoanalytic and psychodynamic psychotherapies for a range of disorders, to date there has been no systematic review of its effectiveness in reducing suicidal and self-harming behaviours.

Aims: To systematically review randomised controlled trials of psychoanalytic and psychodynamic psychotherapies for suicidal attempts and self-harm.

Method: We searched PubMed, PsycINFO, Psycharticles, CINAHL, EMBASE and the Cochrane Central Register of Controlled Trials for randomise controlled trials of psychoanalytic and psychodynamic psychotherapies for reducing suicide attempts and self-harm.

Results: Twelve trials (17 articles) were included in the meta-analyses. Psychoanalytic and psychodynamic therapies were effective in reducing the number of patients attempting suicide (pooled odds ratio, 0.469; 95% CI 0.274-0.804). We found some evidence for significantly reduced repetition of self-harm at 6-month but not 12-month follow-up. Significant treatment effects were also found for improvements in psychosocial functioning and reduction in number of hospital admissions.

Conclusions: Psychoanalytic and psychodynamic psychotherapies are indicated to be effective in reducing suicidal behaviour and to have short-term effectiveness in reducing self-harm. They can also be beneficial in improving psychosocial well-being. However, the small number of trials and moderate quality of the evidence means further high-quality trials are needed to confirm our findings and to identity which specific components of the psychotherapies are effective.