Cochrane · systematic review · CD012189
Psychosocial interventions for self‐harm in adults
Hawton, K, Witt, KG, Taylor Salisbury, TL, et al. · Cochrane Database of Systematic Reviews · 2016 · Cochrane Library
Common Mental DisordersAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
46
current version
GRADE rated
41
No studies
5
Included studies
NR
No studies 5 · 10.9%Ungraded 0 · 0%Very low 10 · 21.7%Low 22 · 47.8%Moderate 9 · 19.6%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Comparison 1: CBT‐based psychotherapy vs treatment as usual
Population: adults who engage in SH
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Repetition of SH at post‐intervention Comparison 1: CBT‐based psychotherapy vs treatment | OR 0.66 [0.36, 1.21] | 1 study · 313 participants | Low Downgraded: risk of bias |
Repetition of SH at 6 months Comparison 1: CBT‐based psychotherapy vs treatment | OR 0.54 [0.34, 0.85] | 12 studies · 1317 participants | Moderate Downgraded: risk of bias |
Repetition of SH at 12 months Comparison 1: CBT‐based psychotherapy vs treatment | OR 0.8 [0.65, 0.98] | 10 studies · 2232 participants | Moderate Downgraded: risk of bias |
Repetition of SH at 24 months Comparison 1: CBT‐based psychotherapy vs treatment | OR 0.31 [0.14, 0.69] | 2 studies · 105 participants | Moderate Downgraded: risk of bias |
Repetition of SH at final Comparison 1: CBT‐based psychotherapy vs treatment | OR 0.7 [0.55, 0.88] | 17 studies · 2665 participants | Low Downgraded: risk of bias |
Frequency of SH at final Comparison 1: CBT‐based psychotherapy vs treatment | no estimate extracted | 6 studies · 597 participants | Low Downgraded: risk of bias |
Comparison 2: Interventions for multiple repetition of SH/probable personality disorder vs treatment as usual or other alternative forms of psychotherapy
Population: adults who engage in SH
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Repetition of SH at post‐intervention Comparison 2: Interventions for multiple repetition of SH/probable personality disorder vs treatment | OR 0.34 [0.13, 0.88] | 2 studies · 83 participants | Low Downgraded: risk of bias |
Frequency of SH at post‐intervention Comparison 2: Interventions for multiple repetition of SH/probable personality disorder vs treatment | no estimate extracted | 2 studies · 83 participants | Low Downgraded: risk of bias, imprecision |
Mentalisation vs TAU Comparison 2: Interventions for multiple repetition of SH/probable personality disorder vs treatment | no estimate extracted | NR | No studies |
DBT vs TAU Comparison 2: Interventions for multiple repetition of SH/probable personality disorder vs treatment | no estimate extracted | NR | No studies |
Repetition of SH at 12 months' Comparison 2: Interventions for multiple repetition of SH/probable personality disorder vs treatment | OR 0.36 [0.05, 2.47] | 2 studies · 172 participants | Low Downgraded: risk of bias, imprecision |
Repetition of SH at final Comparison 2: Interventions for multiple repetition of SH/probable personality disorder vs treatment | OR 0.57 [0.21, 1.59] | 3 studies · 247 participants | Low Downgraded: risk of bias, imprecision |
Repetition of SH at 12 months Comparison 2: Interventions for multiple repetition of SH/probable personality disorder vs treatment | OR 1.18 [0.35, 3.95] | 1 study · 97 participants | Very low Downgraded: risk of bias, imprecision |
Repetition of SH at 6 months' Comparison 2: Interventions for multiple repetition of SH/probable personality disorder vs treatment | OR 0.67 [0.08, 5.68] | 1 study · 18 participants | Low Downgraded: risk of bias, imprecision |
Frequency of SH at 6 months' Comparison 2: Interventions for multiple repetition of SH/probable personality disorder vs treatment | no estimate extracted | 1 study · 18 participants | Low Downgraded: risk of bias, imprecision |
Comparison 3: Case management vs treatment as usual or other alternative forms of psychotherapy
Population: adults who engage in SH
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Repetition of SH at post‐intervention Comparison 3: Case management vs treatment | OR 0.78 [0.47, 1.3] | 4 studies · 1608 participants | Moderate Downgraded: risk of bias |
Multiple readmissions for SH at post‐intervention Comparison 3: Case management vs treatment | OR 5.23 [1.12, 24.45] | 1 study · 469 participants | Moderate Downgraded: risk of bias |
Comparison 4: Adherence enhancement approaches vs treatment as usual or other alternative forms of psychotherapy
Population: adults who engage in SH
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Repetition of SH at 12 months' Comparison 4: Adherence enhancement approaches vs treatment | OR 0.57 [0.32, 1.02] | 1 study · 391 participants | Low Downgraded: risk of bias |
Comparison 5: Mixed multimodal interventions vs treatment as usual
Population: adults who engage in SH
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Repetition of SH at post‐intervention Comparison 5: Mixed multimodal interventions vs treatment | OR 0.98 [0.68, 1.43] | 1 study · 684 participants | Low Downgraded: risk of bias |
Repetition of SH at 12 months Comparison 5: Mixed multimodal interventions vs treatment | OR 0.83 [0.44, 1.55] | 1 study · 167 participants | Low Downgraded: risk of bias |
Comparison 6: Remote contact interventions vs treatment as usual
Population: adults who engage in SH
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Postcards vs TAU Comparison 6: Remote contact interventions vs treatment | no estimate extracted | NR | No studies |
Repetition of SH at post‐intervention Comparison 6: Remote contact interventions vs treatment | OR 0.87 [0.62, 1.23] | 4 studies · 3277 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Repetition of SH at 12 months Comparison 6: Remote contact interventions vs treatment | OR 0.76 [0.57, 1.02] | 2 studies · 2885 participants | Moderate Downgraded: risk of bias |
Repetition of SH at final Comparison 6: Remote contact interventions vs treatment | OR 0.88 [0.62, 1.25] | 4 studies · 3277 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Frequency of SH at post‐intervention Comparison 6: Remote contact interventions vs treatment | no estimate extracted | 3 studies · 1097 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Frequency of SH at 12 months Comparison 6: Remote contact interventions vs treatment | no estimate extracted | 2 studies · 984 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Frequency of SH at 24 months Comparison 6: Remote contact interventions vs treatment | no estimate extracted | 1 study · 472 participants | Moderate Downgraded: risk of bias |
Emergency cards vs TAU Comparison 6: Remote contact interventions vs treatment | no estimate extracted | NR | No studies |
Repetition of SH at 12 months' Comparison 6: Remote contact interventions vs treatment | OR 1.19 [0.85, 1.67] | 1 study · 827 participants | Moderate Downgraded: risk of bias |
Telephone contact vs TAU Comparison 6: Remote contact interventions vs treatment | no estimate extracted | NR | No studies |
Repetition of SH at 6 months' Comparison 6: Remote contact interventions vs treatment | OR 0.23 [0.02, 2.11] | 1 study · 81 participants | Low Downgraded: risk of bias |
Repetition of SH at 24 months' Comparison 6: Remote contact interventions vs treatment | OR 0.76 [0.49, 1.16] | 1 study · 605 participants | Low Downgraded: risk of bias |
Comparison 7: Other mixed interventions vs treatment as usual or other alternative form of psychotherapy
Population: adults who engage in SH
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Repetition of SH at 12 months Comparison 7: Other mixed interventions vs treatment | OR 0.4 [0.06, 2.57] | 1 study · 33 participants | Very low Downgraded: risk of bias |
Repetition of SH at final Comparison 7: Other mixed interventions vs treatment | OR 1.02 [0.71, 1.47] | 1 study · 1663 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Repetition of SH at final Comparison 7: Other mixed interventions vs treatment | OR 2.27 [0.97, 5.28] | 1 study · 135 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Repetition of SH at final Comparison 7: Other mixed interventions vs treatment | OR 0.55 [0.13, 2.34] | 1 study · 251 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Repetition of SH at final Comparison 7: Other mixed interventions vs treatment | OR 1.18 [0.69, 2] | 1 study · 601 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Repetition of SH at final Comparison 7: Other mixed interventions vs treatment | OR 2.01 [0.08, 50.6] | 1 study · 96 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Repetition of SH at final Comparison 7: Other mixed interventions vs treatment | OR 0.39 [0.17, 0.92] | 1 study · 561 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Frequency of SH at final Comparison 7: Other mixed interventions vs treatment | no estimate extracted | 1 study · 629 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Repetition of SH at 6 months Comparison 7: Other mixed interventions vs treatment | OR 0.57 [0.2, 1.6] | 1 study · 103 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Frequency of SH at 12 months Comparison 7: Other mixed interventions vs treatment | no estimate extracted | 1 study · 274 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Repetition of SH at post‐intervention Comparison 7: Other mixed interventions vs treatment | OR 1.03 [0.14, 7.69] | 1 study · 77 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Repetition of SH at 6 months' Comparison 7: Other mixed interventions vs treatment | OR 0.75 [0.16, 3.6] | 1 study · 77 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Repetition of SH at 24 months Comparison 7: Other mixed interventions vs treatment | OR 1.24 [0.59, 2.62] | 1 study · 126 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Repetition of SH at final Comparison 7: Other mixed interventions vs treatment | OR 0.65 [0.15, 2.85] | 2 studies · 245 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |