Cochrane · systematic review · CD013668

Psychosocial interventions for self‐harm in adults

Witt, KG, Hetrick, SE, Rajaram, G, et al. · Cochrane Database of Systematic Reviews · 2021 · 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

24

current version

GRADE rated

24

No studies

0

Included studies

NR

No studies 0 · 0%Ungraded 0 · 0%Very low 4 · 16.7%Low 8 · 33.3%Moderate 11 · 45.8%High 1 · 4.2%

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 1.1: Individual‐based CBT‐based psychotherapy compared to TAU or another comparator for self‐harm in adults

Population: self‐harm in adults

1 question

Outcome	Effect	Evidence	Status / GRADE
Repetition of SH at post‐intervention Comparison 1.1: Individual‐based CBT‐based psychotherapy vs TAU or another comparator	OR 0.35 [0.12, 1.02]	4 studies · 238 participants	Low Downgraded: risk of bias

Comparison 1.2: Group‐based CBT‐based psychotherapy compared to TAU or another comparator for self‐harm in adults

Population: self‐harm in adults

1 question

Outcome	Effect	Evidence	Status / GRADE
Repetition of SH at post‐intervention Comparison 1.2: Group‐based CBT‐based psychotherapy vs TAU or another comparator	OR 0.66 [0.36, 1.21]	1 study · 313 participants	Moderate

Comparison 2.1: DBT compared to TAU or another comparator for self‐harm in adults

Population: self‐harm in adults

1 question

Outcome	Effect	Evidence	Status / GRADE
Repetition of SH by post‐intervention Comparison 2.1: DBT vs TAU or another comparator	OR 0.71 [0.32, 1.55]	6 studies · 502 participants	Very low Downgraded: risk of bias

Comparison 2.2: DBT group‐based skills training compared to TAU or another comparator for self‐harm in adults

Population: self‐harm in adults

2 questions

Outcome	Effect	Evidence	Status / GRADE
Repetition of attempted suicide at post‐intervention Comparison 2.2: DBT group‐based skills training vs TAU or another comparator	OR 0.66 [0.23, 1.86]	1 study · 66 participants	Moderate
Repetition of NSSI at post‐intervention Comparison 2.2: DBT group‐based skills training vs TAU or another comparator	OR 0.88 [0.33, 2.34]	1 study · 66 participants	Moderate

Comparison 2.3: DBT individual therapy compared to TAU or another comparator for self‐harm in adults

Population: self‐harm in adults

2 questions

Outcome	Effect	Evidence	Status / GRADE
Repetition of attempted suicide at post‐intervention Comparison 2.3: DBT individual therapy vs TAU or another comparator	OR 1.46 [0.54, 3.91]	1 study · 66 participants	Moderate
Repetition of NSSI at post‐intervention Comparison 2.3: DBT individual therapy vs TAU or another comparator	OR 1.29 [0.48, 3.47]	1 study · 66 participants	Moderate

Comparison 2.4: DBT prolonged exposure protocol compared to TAU or another comparator for self‐harm in adults

Population: self‐harm in adults

1 question

Outcome	Effect	Evidence	Status / GRADE
Repetition of SH at post‐intervention Comparison 2.4: DBT prolonged exposure protocol vs TAU or another comparator	OR 0.67 [0.08, 5.68]	1 study · 18 participants	Moderate

Comparison 3: MBT compared to TAU or another comparator for self‐harm in adults

Population: self‐harm in adults

1 question

Outcome	Effect	Evidence	Status / GRADE
Repetition of SH at post‐intervention Comparison 3: MBT vs TAU or another comparator	OR 0.35 [0.17, 0.73]	1 study · 134 participants	High

Comparison 4: Emotion‐regulation psychotherapy compared to TAU or another comparator for self‐harm in adults

Population: self‐harm in adults

1 question

Outcome	Effect	Evidence	Status / GRADE
Repetition of SH at post‐intervention Comparison 4: Emotion‐regulation psychotherapy vs TAU or another comparator	OR 0.34 [0.13, 0.88]	2 studies · 83 participants	Moderate Downgraded: imprecision

Comparison 5: Psychodynamic psychotherapy compared to TAU or another comparator for self‐harm in adults

Population: self‐harm in adults

1 question

Outcome	Effect	Evidence	Status / GRADE
Repetition of SH at post‐intervention Comparison 5: Psychodynamic psychotherapy vs TAU or another comparator	OR 0.45 [0.13, 1.56]	1 study · 170 participants	Moderate

Comparison 6: Case management compared to TAU or another comparator for self‐harm in adults

Population: self‐harm in adults

1 question

Outcome	Effect	Evidence	Status / GRADE
Repetition of SH at post‐intervention Comparison 6: Case management vs TAU or another comparator	OR 0.78 [0.47, 1.3]	5 studies · 1608 participants	Low Downgraded: inconsistency

Comparison 7: Structured GP follow‐up compared to TAU or another comparator for self‐harm in adults

Population: self‐harm in adults

2 questions

Outcome	Effect	Evidence	Status / GRADE
Repetition of SH at post‐intervention (hospital records) Comparison 7: Structured GP follow‐up vs TAU or another comparator	OR 1.01 [0.38, 2.68]	1 study · 143 participants	Low Downgraded: risk of bias
Repetition of SH at post‐intervention (emergency records) Comparison 7: Structured GP follow‐up vs TAU or another comparator	OR 2.56 [0.8, 8.15]	1 study · 123 participants	Low Downgraded: risk of bias

Comparison 9.1: Emergency cards compared to TAU or another comparator for self‐harm in adults

Population: self‐harm in adults

1 question

Outcome	Effect	Evidence	Status / GRADE
Repetition of SH at post‐intervention Comparison 9.1: Emergency cards vs TAU or another comparator	OR 0.82 [0.31, 2.14]	2 studies · 1039 participants	Low Downgraded: inconsistency

Comparison 9.2: Coping cards compared to TAU or another comparator for self‐harm in adults

Population: self‐harm in adults

1 question

Outcome	Effect	Evidence	Status / GRADE
Repetition of SH at post‐intervention Comparison 9.2: Coping cards vs TAU or another comparator	OR 0.08 [0, 1.45]	1 study · 64 participants	Moderate

Comparison 9.4: Postcards compared to TAU or another comparator for self‐harm in adults

Population: self‐harm in adults

1 question

Outcome	Effect	Evidence	Status / GRADE
Repetition of SH at post‐intervention Comparison 9.4: Postcards vs TAU or another comparator	OR 0.87 [0.62, 1.23]	4 studies · 3277 participants	Very low Downgraded: risk of bias

Comparison 9.5: Telephone contact compared to TAU or another comparator for self‐harm in adults

Population: self‐harm in adults

1 question

Outcome	Effect	Evidence	Status / GRADE
Repetition of SH at post‐intervention Comparison 9.5: Telephone contact vs TAU or another comparator	OR 0.43 [0.04, 5.02]	1 study · 55 participants	Low Downgraded: risk of bias

Comparison 9.6: Telephone contact, emergency cards, and letters compared to TAU or another comparator for self‐harm in adults

Population: self‐harm in adults

1 question

Outcome	Effect	Evidence	Status / GRADE
Repetition of SH at post‐intervention Comparison 9.6: Telephone contact, emergency cards, and letters vs TAU or another comparator	OR 1.05 [0.55, 2]	1 study · 303 participants	Moderate

Comparison 9.7: Telephone‐based psychotherapy compared to TAU or another comparator for self‐harm in adults

Population: self‐harm in adults

1 question

Outcome	Effect	Evidence	Status / GRADE
Repetition of SH at post‐intervention Comparison 9.7: Telephone‐based psychotherapy vs TAU or another comparator	OR 0.36 [0.01, 8.94]	2 studies · 185 participants	Low Downgraded: risk of bias

Comparison 10: Provision of information and support compared to TAU or another comparator for self‐harm in adults

Population: self‐harm in adults

1 question

Outcome	Effect	Evidence	Status / GRADE
Repetition of SH at post‐intervention Comparison 10: Provision of information and support vs TAU or another comparator	OR 1.09 [0.79, 1.5]	2 studies · 1853 participants	Very low Downgraded: publication bias

Comparison 11: Other multimodal interventions compared to TAU or another comparator for self‐harm in adults

Population: self‐harm in adults

1 question

Outcome	Effect	Evidence	Status / GRADE
Repetition of SH at post‐intervention Comparison 11: Other multimodal interventions vs TAU or another comparator	OR 0.61 [0.37, 1.3]	3 studies · 1937 participants	Very low Downgraded: inconsistency

Comparison 12.5: General hospital management compared to TAU or another comparator for self‐harm in adults

Population: self‐harm in adults

1 question

Outcome	Effect	Evidence	Status / GRADE
Repetition of SH at post‐intervention Comparison 12.5: General hospital management vs TAU or another comparator	OR 1.03 [0.14, 7.69]	1 study · 77 participants	Moderate

Comparison 12.8: Long‐term therapy compared to TAU or another comparator for self‐harm in adults

Population: self‐harm in adults

1 question

Outcome	Effect	Evidence	Status / GRADE
Repetition of SH at post‐intervention Comparison 12.8: Long‐term therapy vs TAU or another comparator	OR 1 [0.35, 2.86]	1 study · 80 participants	Low Downgraded: risk of bias