Psychosocial interventions for self-harm in adults

Area of Science:

• Psychiatry
• Psychology
• Clinical Trials

Background:

• Self-harm (SH) is a significant and growing public health concern, often characterized by repetition and association with suicide.
• There's been a notable increase in research and therapeutic strategies for adult SH.
• This review updates previous findings on psychosocial interventions for adult SH.

Purpose of the Study:

• To evaluate the effectiveness of psychosocial interventions in adults (18+) who engage in self-harm.
• To compare these interventions against various control conditions, including treatment-as-usual.

Main Methods:

• Systematic review and meta-analysis of randomized controlled trials (RCTs).
• Searched multiple databases including Cochrane Library, MEDLINE, Embase, and PsycINFO up to July 2020.
• Included adults with recent SH (within 6 months) presenting to services; primary outcome was SH repetition within two years.

Main Results:

• Data from 76 RCTs involving 21,414 participants were analyzed.
• Mentalisation-based therapy (MBT) showed high-certainty evidence for reducing SH repetition and frequency.
• Cognitive behavioural therapy (CBT)-based approaches suggested potential reduction in SH repetition at longer follow-ups, though evidence quality was low.

Conclusions:

• Methodological limitations exist across included trials, leading to uncertain evidence for many interventions.
• MBT and group-based emotion regulation therapy warrant further investigation due to promising findings in single trials.
• CBT-based therapies may offer benefits for reducing repeated SH over time, but more high-quality research is needed.