Psychosocial Treatment of Youth Suicide: A Systematic Review of the Research

Macgowan, Mark J.

doi:10.1177/1049731503257889

Cited by 15 publications

(11 citation statements)

References 46 publications

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“…Even with the stated federal priorities for evaluating suicide prevention programmes (US Public Health Service, 1999), there has been little rigorous testing of suicide prevention programmes for youths despite a wide range of psychosocial suicide prevention programmes being used (Macgowan, 2004). A primary challenge in developing randomized field trials of psychosocial interventions for suicide prevention is the size of the study that is needed in order to test effectiveness.…”

Section: Changing Prevalence Of Youth Suicidementioning

confidence: 96%

“…As with most trend data, it is challenging to find clear causes of such changes. Some of this change may be due to the large reduction in drug use among youths (American Academy of Child and Adolescent Psychiatry, 2001;Macgowan, 2004), but drug use does not explain the turnaround in 2004 (Gibbons et al, in press). Many scientists and clinicians suspect that these changes are primarily due to the increased use of antidepressants to treat youths through 2003 (Gould et al, 2003), followed by the large drop in paediatric prescriptions following the FDA public health advisory in 2003 and black box warning in 2004 (Gibbons et al, in press).…”

Section: Changing Prevalence Of Youth Suicidementioning

confidence: 97%

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The role of randomized trials in testing interventions for the prevention of youth suicide

Brown

Wyman

Brinales

et al. 2007

International Review of Psychiatry

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Epidemiological considerations point to a small handful of prevention strategies that have the potential for dramatically reducing suicide rates. Nearly all of those prevention approaches involve population-based strategies to either find an increased number of individuals at high risk for suicide or to reduce the prevalence of risk factors in members of a population that, as a whole, has a relatively low rate of suicide. Few of these approaches have been evaluated in rigorous trials. We argue that there are rigorous randomized trial designs that are both feasible and ethical and can be used to test both programmes and implementation strategies for population-based suicide prevention. We review existing suicide prevention trials and introduce two new randomized trial designs that are likely to achieve sufficient statistical power. The 'dynamic wait-listed design' randomizes across different time periods and is now being used to test a gatekeeper training programme in 32 schools. It could also be used to examine suicide prevention programmes in rural areas. The multi-trial follow-up study builds on the large number of successful population-based preventive interventions aimed at reducing known risk factors for suicide in youths to see whether these also cause a reduction in rates of completed suicide.

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Section: Changing Prevalence Of Youth Suicidementioning

confidence: 96%

Section: Changing Prevalence Of Youth Suicidementioning

confidence: 97%

The role of randomized trials in testing interventions for the prevention of youth suicide

Brown

Wyman

Brinales

et al. 2007

International Review of Psychiatry

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“…Several reviews agree that more evidence to support one type of intervention over another for youth suicide is needed. [17][18][19][20][21][22] The interest in outpatient treatment alternatives lies not only in improving patient outcome but also in the potential for cost savings. Health care costs associated with inpatient care of youth suicidal behaviour can be substantial.…”

Section: Limitationsmentioning

confidence: 99%

Cost-Effectiveness of a Rapid Response Team Intervention for Suicidal Youth Presenting at an Emergency Department

2014

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Objective: To investigate the cost-effectiveness of a rapid response team (RRT), compared with usual care (UC), for treating suicidal adolescents. Methods:Suicidal adolescents (n = 286) presenting at an emergency department were enrolled in a trial to compare UC with enhanced outpatient care provided by an RRT of health professionals. Functioning (Child Global Assessment Scale) and suicidality (Spectrum of Suicidal Behavior Scale) scores were measured at baseline and 6 months later. Resource use and cost data were collected from several sources during the same period.Results: As previously reported, there was no statistically or clinically significant difference in either functioning or suicidality between the groups. Costs of the RRT were lower by $1886, thus -$1886 (95% CI -$4238 to $466), from the perspective of the treating hospital, and by $991, thus -$991 (95% CI -$5580 to $3598), from the perspective of society. If decision makers are not willing to pay for any improvement in functioning or suicidality, the RRT has a 95% probability of being cost-effective from the perspective of the treating hospital. From the point of view of society, the probability of the intervention being cost-effective is about 70% for functioning and 63% for suicidality. The difference between the 2 perspectives is mainly attributable to the cost of hospitalizations outside the treating hospital. Conclusions:An RRT intervention appears to be cost-effective, compared with UC, from the point of view of the treating hospital, but there is no difference from the point of view of society. W W W Rentabilité d'une équipe d'intervention rapide pour les adolescents suicidaires qui se présentent au service d'urgenceObjectif : Étudier la rentabilité d'une équipe d'intervention rapide (EIR), comparativement aux soins usuels (SU), pour traiter des adolescents suicidaires. Méthodes :Des adolescents suicidaires (n = 286) qui se sont présentés à un service d'urgence ont été inscrits dans un essai pour comparer les SU avec des soins ambulatoires améliorés fournis par une EIR de professionnels de la santé. Les scores de fonctionnement (échelle d'évaluation globale pour enfants) et de suicidabilité (échelle du spectre du comportement suicidaire) ont été mesurés au départ et au suivi de 6 mois. Les données sur l'utilisation des ressources et les coûts ont été recueillies auprès de plusieurs sources durant la même période.Résultats : Comme il a été précédemment constaté, il n'y avait pas de différence statistiquement ou cliniquement significative de fonctionnement ou de suicidabilité entre les groupes. Les coûts de l'EIR étaient inférieurs de 1886 $, donc −1886 $ (IC à 95 % −4238 $ à 466 $), du point de vue de l'hôpital traitant, et de 991 $, donc −991 $ (IC à 95 % −5580 $ à 3598 $), du point de vue de la société. Si les décideurs ne sont pas disposés à payer pour toute amélioration du fonctionnement ou de la suicidabilité, l'EIR a une probabilité de 95 % d'être rentable du point de vue de l'hôpital traitant. Du point de vue de la société, la probabil...

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“…Suicidal adolescents may be less likely to seek help for mental illness and few suicide attempters receive appropriate assessment and follow-up care (6)(7)(8). Whereas many children and adolescents are at risk for suicide, few psychosocial treatment methods have been empirically validated as effective for its prevention (9). Herein, we aimed to compare the demographical and clinical characteristics of suicide attempts in early and late adolescents.…”

Section: Introductionmentioning

confidence: 99%

Presentation of Suicide Attempts to the Emergency Department: Clinical Features of Early and Late Adolescents

Gökdemir¹,

Kaya²,

Erdoğan³

et al. 2013

JAEM

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Objective: The purpose of this study was to compare the demographic and clinical features of early and late adolescents attempted suicide. Material and Methods: A cross-sectional study was conducted to examine the clinical characteristics of adolescents who attempted suicide and presented to our Emergency Department (ED) from January 2009 to December 2011. Patients were divided into two groups; Group 1 consisted of early adolescents (10-14 years) and Group 2 consisted of late adolescents (15-18 years). Results: A total of 22 (34%) patients were early adolescents and 42 (66%) were late adolescents. Thirty-one (48%) of the 64 patients were male, and 33 (52%) were female (p=0.730). We found a statistically significant difference between early and late adolescents in time to ED admission (p<0.001), length of stay (p=0.040), having parents who were divorced or had a history of multiple marriages (p<0.001), prior suicide attempts (p<0.001), lower economic status (p=0.013), and mortality rate (p=0.008). Self cutting and expressed dissatisfaction with their bodies were significantly more common in late adolescents (p<0.001, p=0.006, respectively). Conclusion: Some families may be inadequate for the normal development of children. Psychological and social support units must be installed by governments. (JAEM 2013; 12: 185-8)

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Psychosocial Treatment of Youth Suicide: A Systematic Review of the Research

Cited by 15 publications

References 46 publications

The role of randomized trials in testing interventions for the prevention of youth suicide

The role of randomized trials in testing interventions for the prevention of youth suicide

Cost-Effectiveness of a Rapid Response Team Intervention for Suicidal Youth Presenting at an Emergency Department

Presentation of Suicide Attempts to the Emergency Department: Clinical Features of Early and Late Adolescents

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