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Martínez-Rives NL, Martín Chaparro MDP, Dhungel B, Gilmour S, Colman RD, Kotera Y. Suicide Interventions in Spain and Japan: A Comparative Systematic Review. Healthcare (Basel) 2024; 12:792. [PMID: 38610214 PMCID: PMC11011319 DOI: 10.3390/healthcare12070792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 02/24/2024] [Accepted: 04/04/2024] [Indexed: 04/14/2024] Open
Abstract
(1) Background: This systematic review presents an overview of psychological interventions in suicide published between 2013 and 2023 in Spain and Japan, sparked by Spain's alarming recent increase in suicide rates and the potential exemplar of Japan's reduction efforts. (2) Methods: Following the PRISMA checklist, the databases Web of Science, Scopus, PubMed, and PsycInfo were searched using the terms [("suicide" OR "suicidal behavior" OR "suicidal attempt" OR "suicidal thought" OR "suicidal intention") AND ("prevention" OR "intervention" OR "psychosocial treatment" OR "Dialectical Behavior Therapy" OR "Cognitive Therapy" OR "psychotherap*")] AND [("Spain" OR "Spanish") OR ("Japan" OR "Japanese")]. We included articles published in peer-reviewed academic journals, written in English, Spanish, and Japanese between 2013 and 2023 that presented, designed, implemented, or assessed psychological interventions focused on suicidal behavior. (3) Results: 46 studies were included, concerning prevention, treatment, and training interventions. The risk of bias was low in both Spanish and Japanese studies, despite the lack of randomization of the samples. We identified common characteristics, such as psychoeducation and coping skills. Assertive case management was only highlighted in Japan, making an emphasis on active patient involvement in his/her care plan. (4) Conclusions: The findings will help professionals to incorporate into their interventions broader, more comprehensive approaches to consider more interpersonal components.
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Affiliation(s)
| | | | - Bibha Dhungel
- School of International Liberal Studies, Waseda University, Tokyo 169-0051, Japan;
- Department of Health Policy, National Centre for Child Health and Development, Tokyo 157-0074, Japan
| | - Stuart Gilmour
- Graduate School of Public Health, St. Luke’s International University, Tokyo 104-0045, Japan;
| | - Rory D. Colman
- College of Health, Psychology and Social Care, University of Derby, Derby DE22 1GB, UK;
| | - Yasuhiro Kotera
- Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham NG7 2TU, UK;
- Center for Infectious Disease Education and Research, Osaka University, Suita 565-0871, Japan
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Stevens GJ, Sperandei S, Carter GL, Munasinghe S, Hammond TE, Gunja N, de la Riva A, Brakoulias V, Page A. Efficacy of a short message service brief contact intervention (SMS-SOS) in reducing repetition of hospital-treated self-harm: randomised controlled trial. Br J Psychiatry 2024; 224:106-113. [PMID: 38083861 PMCID: PMC10884824 DOI: 10.1192/bjp.2023.152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 10/10/2023] [Accepted: 10/29/2023] [Indexed: 02/23/2024]
Abstract
BACKGROUND Hospital-treated self-harm is common and costly, and is associated with repeated self-harm and suicide. AIMS To investigate the effectiveness of a brief contact intervention delivered via short message service (SMS) text messages in reducing hospital-treated self-harm re-presentations in three hospitals in Sydney (2017-2019), Australia. Trial registration number: ACTRN12617000607370. METHOD A randomised controlled trial with parallel arms allocated 804 participants presenting with self-harm, stratified by previous self-harm, to a control condition of treatment as usual (TAU) (n = 431) or an intervention condition of nine automated SMS contacts (plus TAU) (n = 373), over 12 months following the index self-harm episode. The primary outcomes were (a) repeat self-harm event rate (number of self-harm events per person per year) at 6-, 12- and 24-month follow-up and (b) the time to first repeat at 24-month follow-up. RESULTS The event rate for self-harm repetition was lower for the SMS compared with TAU group at 6 months (IRR = 0.79, 95% CI 0.61-1.01), 12 months (IRR = 0.78, 95% CI 0.64-0.95) and 24 months (IRR = 0.78, 95% CI 0.66-0.91). There was no difference between the SMS and TAU groups in the time to first repeat self-harm event over 24 months (HR = 0.96, 95% CI 0.72-1.26). There were four suicides in the TAU group and none in the SMS group. CONCLUSIONS The 22% reduction in repetition of hospital-treated self-harm was clinically meaningful. SMS text messages are an inexpensive, scalable and universal intervention that can be used in hospital-treated self-harm populations but further work is needed to establish efficacy and cost-effectiveness across settings.
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Affiliation(s)
- Garry John Stevens
- School of Social Sciences, Western Sydney University, Penrith, New South Wales, Australia
| | - Sandro Sperandei
- Translational Health Research Institute, Western Sydney University, Penrith, New South Wales, Australia
| | - Gregory Leigh Carter
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
| | - Sithum Munasinghe
- Translational Health Research Institute, Western Sydney University, Penrith, New South Wales, Australia
| | - Trent Ernest Hammond
- Nepean Clinical School, Faculty of Medicine and Health, University of Sydney, Penrith, New South Wales, Australia
| | - Naren Gunja
- Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Westmead, New South Wales, Australia; and Emergency Department, Westmead Hospital, Westmead, New South Wales, Australia
| | - Anabel de la Riva
- Westmead Hospital, Western Sydney Local Health District, Westmead, New South Wales, Australia
| | - Vlasios Brakoulias
- Nepean Clinical School, Faculty of Medicine and Health, University of Sydney, Penrith, New South Wales, Australia
| | - Andrew Page
- Translational Health Research Institute, Western Sydney University, Penrith, New South Wales, Australia
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Porras-Segovia A, De Granda-Beltrán AM, Gallardo C, Abascal-Peiró S, Barrigón ML, Artés-Rodríguez A, López-Castroman J, Courtet P, Baca-García E. Smartphone-based safety plan for suicidal crisis: The SmartCrisis 2.0 pilot study. J Psychiatr Res 2024; 169:284-291. [PMID: 38065053 DOI: 10.1016/j.jpsychires.2023.11.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 11/17/2023] [Accepted: 11/22/2023] [Indexed: 01/15/2024]
Abstract
Here we present the findings of the pilot phase of the SmartCrisis 2.0 Randomized Clinical Trial. This pilot study aimed to explore the feasibility and acceptability of a safety plan contained in a smartphone app. Our sample consisted patients with a history of recent suicidal behaviour who installed a smartphone-based safety plan. To explore the satisfaction with of the safety plan, two patient satisfaction surveys were conducted: one qualitative and one quantitative. To explore the objective use of the safety plan, we gained access to texts contained in the safety plans completed by the patients. Participation rate was 77%, while 48.9% patients completed both satisfaction surveys at the end of the pilot phase. N = 105 successfully installed the safety plan. In a scale from 1 to 10, users rated the usefulness of the security plan at 7.4, the usability at 8.9, the degree to which they would recommend it to others at 8.6 and the overall satisfaction with the project including evaluations at 9.6. The most widely completed tab was warning signs. Feeling sad or lonely was the warning sign most commonly reported by patients. The second most completed tab was internal coping strategies. Walking or practicing any other exercise was the strategy most commonly resorted to. Our smartphone-based safety plan appears to be a feasible intervention. Data obtained from this pilot study showed high participation rates and high acceptability by patients. This, together with the general satisfaction with the project, supports its implementation in the clinical practice.
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Affiliation(s)
- Alejandro Porras-Segovia
- Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain; Departamento de Psiquiatría, Hospital Rey Juan Carlos Móstoles, Madrid, Spain
| | | | - Claudia Gallardo
- Facultad de Psicología General Sanitaria, Universidad de Villanueva, Madrid, Spain
| | - Sofía Abascal-Peiró
- Departamento de Psiquiatría, Hospital Rey Juan Carlos Móstoles, Madrid, Spain
| | - María Luisa Barrigón
- Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Antonio Artés-Rodríguez
- Department of Signal Theory and Communications, Universidad Carlos III de Madrid, Leganés, Madrid, Spain
| | | | - Philippe Courtet
- Department of Emergency Psychiatry and Acute Care, Centre Hospitalier Universitaire Montpellier, University of Montpellier, Montpellier, France
| | - Enrique Baca-García
- Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain; Departamento de Psiquiatría, Hospital Rey Juan Carlos Móstoles, Madrid, Spain; Departamento de Psiquiatría, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain; Department of Emergency Psychiatry and Acute Care, Centre Hospitalier Universitaire Montpellier, University of Montpellier, Montpellier, France; Departamento de Psiquiatría, Universidad Autónoma de Madrid, Madrid, Spain; Departamento de Psiquiatría, Hospital Central de Villalba Villalba, Madrid, Spain; Departamento de Psiquiatría, Hospital Universitario Infanta Elena Valdemoro, Madrid, Spain; CIBERSAM, Research Group CB/07/09/0025, Madrid, Spain.
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Ezquerra B, Alacreu-Crespo A, Peñuelas-Calvo I, Abascal-Peiró S, Jiménez-Muñoz L, Nicholls D, Baca-García E, Porras-Segovia A. Characteristics of single vs. multiple suicide attempters among adolescents: a systematic review and meta-analysis. Eur Child Adolesc Psychiatry 2023:10.1007/s00787-023-02260-2. [PMID: 37470845 DOI: 10.1007/s00787-023-02260-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 07/07/2023] [Indexed: 07/21/2023]
Abstract
There might be differential characteristics between those who have attempted suicide once in their lifetime (single attempters) and those who have attempted suicide two or more times (multiple attempters). We aimed to identify the factors that differentiate single and multiple attempters in child and adolescents. This study was conducted following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, and the review protocol was registered in PROSPERO. We conducted a systematic literature search in three databases to identify original studies exploring the characteristics of single attempters vs. multiple attempters among adolescents. We considered a wide range for the definition of adolescent, following most recent recommendations: 10-24 years. We carried out a meta-analysis. Fourteen studies were included in the systematic review and 13 in the meta-analysis with a total sample of with a total of 4286 participants. The factors statistically significantly associated with being a multiple attempter in the meta-analysis were: anxiety disorders, depression severity, alcohol abuse, substance abuse, aggressiveness, and hopelessness. Multiple attempters have a more severe clinical profile, with greater severity of symptoms. Knowledge of the risk factors associated with being a multiple attempter could help us to predict which patients are more likely to reattempt suicide and need further monitoring and a tailored treatment. Prevention programs tailored for the adolescent population, along with identification of early risk factors, could help to prevent suicidal behavior among this vulnerable population.
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Affiliation(s)
- Berta Ezquerra
- Department of Psychiatry, Hospital Universitario Rey Juan Carlos, Móstoles, Spain
| | - Adrián Alacreu-Crespo
- Department of Psychology and Sociology, Area of Personality, Assessment and Psychological Treatment, Universidad of Zaragoza, Teruel, Spain
| | - Inmaculada Peñuelas-Calvo
- Department of Child and Adolescent Psychiatry, Hospital 12 de Octubre, Madrid, Spain.
- Department of Legal Medicine, Psychiatry and Pathology, Universidad Complutense de Madrid, Madrid, Spain.
| | - Sofía Abascal-Peiró
- Department of Psychiatry, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | | | | | - Enrique Baca-García
- Department of Psychiatry, Hospital Universitario Rey Juan Carlos, Móstoles, Spain
- Department of Child and Adolescent Psychiatry, Hospital 12 de Octubre, Madrid, Spain
- Department of Legal Medicine, Psychiatry and Pathology, Universidad Complutense de Madrid, Madrid, Spain
- Department of Psychiatry, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
- Department of Psychiatry, Hospital Universitario Infanta Elena, Valdemoro, Madrid, Spain
- Department of Psychiatry, Hospital Universitario Central de Villalba, Madrid, Spain
- Universidad Católica del Maule, Talca, Chile
- CIBERSAM, Madrid, Spain
- Université de Nîmes, Nîmes, France
- Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain
| | - Alejandro Porras-Segovia
- Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain.
- Division of Psychiatry, Imperial College, London, UK.
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