Sylwer fod y cymhwysiad hwn dan ddatblygiad. Os ydych chi'n gweld unrhyw gamgymeriadau neu os nad yw rhywbeth yn gweithio, cysylltwch â ni yn evidence.service@wales.nhs.uk.
Adolygiad Systematig
Dywed yr awduron: "To synthesise available evidence on the clinical effectiveness of suicide-specific psychotherapies, and comparative clinical effectiveness of suicide-specific psychotherapies in those experiencing a suicidal crisis."
Dywed yr awduron: "Suicidality was reported as either SI (also measured as suicidal cognition in one study) or suicidal behaviour (including self-injury, suicide attempt and/or suicide) and was measured in all four studies included in this review. SI was reported in all four included studies in this review. Sustained, statistically significant differences in SI between Collaborative Assessment of Management of Suicidality (CAMS) and standard care comparator interventions were not observed using any measure of this outcome in any of the included studies. Similarly, no significant differences in SI were found in the one study examining DBT- Brief Suicide Intervention (DBT-BSI) versus relaxation therapy. One RCT examining 32 patients reported no statistically significant difference in SI in a repeat-measures analysis, but did highlight a statistically significant improvement in CAMS patients at 12 months compared to those receiving enhanced care as usual. Another RCT measured the proportion of patients with SI at five points across time and reported a statistically significant difference favouring CAMS patients at three months follow-up (i.e., P= 0.028); however, no other statistically significant differences between CAMS and enhanced care as usual were found at any other follow-up time point, nor were any differences in mean scores using the Scale for suicide ideation-C. The two reports of non-randomised analyses emphasised a statistically significant improvement in CAMS patients between hospital admission and discharge in one and three measures of SI or suicidal cognition (P < 0.05); however, the between-group difference was no longer observed at six months of follow-up. Four of five included papers reported on suicidal behaviours —including self-injury, suicide attempt, and/or suicide —reported no statistically significant differences in numbers, proportions of patients, or median suicide and self-injury counts between the suicide-specific versus nonsuicide specific interventions investigated. One of these studies did report finding a significant improvement in Item 9 of the PHQ-9 for CAMS patients at hospital discharge as compared to TAU patients; however, this difference was no longer observed at six months follow-up; nor was any statistically significant between-group difference observed in numbers of patients re-hospitalised at six-month follow up. What is the comparative clinical effectiveness of the various suicide-specific psychotherapies for the treatment of suicidal crisis? No eligible studies were identified addressing the comparative clinical effectiveness of two or more suicide-specific interventions for treating patients with suicidal crisis, therefore, no summary can be provided."
Dywed yr awduron: "No eligible studies were identified describing the comparative clinical effectiveness of two or more suicide-specific interventions for suicidal crisis. Three RCTs reported improvements in SI and behaviour after both suicide-specific and non-suicide-specific interventions; but described no consistent, statistically significant differences overall between groups of patients receiving these interventions. Two reports of a non-randomised study emphasized a statistically significant improvement in SI and behaviour between hospital admission and discharge for inpatients receiving a suicide-specific intervention versus a non-suicide-specific intervention; however, these relative improvements were not sustained at six months of follow up. Other outcomes investigated included measures of mental health, well-being, and health care utilisation. Similar to the suicide-specific outcomes, included studies generally reported improvements in mental health, well-being and health care utilisation outcomes in patients receiving either suicide-specific or non-suicide-specific interventions; however, sustained differences between treatment groups were not observed. Authors of most included studies suggested that suicide-specific and non-suicide-specific interventions are effective interventions for patients experiencing suicidal crisis. However, given the lack of long-term or consistent data supporting the comparative effectiveness of suicide-specific versus non-suicide specific interventions; research from additional studies remains necessary."