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Systematic Review and Individual Participant Data Meta-Analysis: Reducing Self-Harm in Adolescents: Pooled Treatment
Alex Wright-Hughes1, Amanda J Farrin1, Peter Fonagy2
1University of Leeds, Leeds, United Kingdom.
Journal of the American Academy of Child and Adolescent Psychiatry
|February 1, 2025
Summary
This meta-analysis found no evidence that therapeutic interventions prevent repeat self-harm in adolescents. However, interventions showed promise for adolescents with multiple prior self-harm episodes.
Area of Science:
- Adolescent mental health
- Public health interventions
- Clinical trial methodology
Background:
- Self-harm is a significant public health issue among adolescents.
- Effective interventions to prevent self-harm repetition are lacking.
- This study addresses the need for robust evidence on therapeutic effects.
Purpose of the Study:
- To estimate the effectiveness of therapeutic interventions in reducing repeat self-harm in adolescents.
- To identify which interventions are most suitable for specific adolescent subgroups.
- To provide robust evidence through an individual participant data meta-analysis of randomized controlled trials.
Main Methods:
- A systematic search of databases and trial registers up to January 2022.
- Inclusion of randomized controlled trials (RCTs) comparing therapeutic interventions to control groups.
- Two-stage random-effects individual participant data (IPD) meta-analyses were performed.
Main Results:
- No significant evidence that interventions prevent repeat self-harm at 12 months (IPD OR 1.06; combined data OR 1.02).
- No evidence of heterogeneity in treatment effects across study or treatment factors.
- Participants with multiple prior self-harm episodes showed improved treatment effects (OR 0.33).
Conclusions:
- Current therapeutic interventions show no overall effectiveness in reducing adolescent repeat self-harm.
- Evidence suggests potential effectiveness for interventions in adolescents with two or more prior self-harm incidents.
- Standardized outcome measures are recommended for future research.
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