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Strategies to prevent death by suicide: meta-analysis of randomised controlled trials
Natalie B V Riblet1, Brian Shiner2, Yinong Young-Xu2
1Natalie B. V. Riblet, MD, MPH, Brian Shiner, MD, MPH, Veterans Affairs Medical Center, Vermont, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, and The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, New Hampshire, USA; Yinong Young-Xu, DSc, MS, Bradley V. Watts, MD, MPH, Veterans Affairs Medical Center, Vermont, and Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA Natalie.Riblet@dartmouth.edu.
Abstract:
BackgroundFew randomised controlled trials (RCTs) have shown decreases in suicide.AimsTo identify interventions for preventing suicide.MethodWe searched EMBASE and Medline from inception until 31 December 2015. We included RCTs comparing prevention strategies with control. We pooled odds ratios (ORs) for suicide using the Peto method.ResultsAmong 8647 citations, 72 RCTs and 6 pooled analyses met inclusion criteria. Three RCTs (n = 2028) found that the World Health Organization (WHO) brief intervention and contact (BIC) was associated with significantly lower odds of suicide (OR = 0.20, 95% CI 0.09-0.42). Six RCTs (n = 1040) of cognitive-behavioural therapy (CBT) for suicide prevention and six RCTs of lithium (n = 619) yielded non-significant findings (OR = 0.34, 95% CI 0.12-1.03 and OR = 0.23, 95% CI 0.05-1.02, respectively).ConclusionsThe WHO BIC is a promising suicide prevention strategy. No other intervention showed a statistically significant effect in reducing suicide.
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