A virtual, pilot randomized trial of a brief intervention to prevent suicide in an integrated healthcare setting

Riblet, Natalie; Kenneally, Lauren; Stevens, Susan; Watts, Bradley V.; Gui, Jiang; Forehand, Jenna; Cornelius, Sarah; Rousseau, Glenna S.; Schwartz, Jonathan C.; Shiner, Brian

doi:10.1016/j.genhosppsych.2022.02.002

Cited by 6 publications

(15 citation statements)

References 37 publications

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“…The studies were classified into two categories: 15 trials in the Active Contact and Follow-up group, and 11 studies in the Multi-Component Interventions group (Supplemental File 1: Table S1). The present review included 18 RCT (69.2%) [49, 50, 53–55, 57, 60, 62, 63, 65–68, 70–74]. The sample size ranges from 10 to 3068 in the intervention group (IG) and from 10 to 3694 in the control group (CG).…”

Section: Resultsmentioning

confidence: 99%

“…The mean age ranged from 23 to 45 years in the IG and from 23 to 47 years in the CG. The proportion of women in most of the studies was above 50% in both IG and CG, except in three studies [55, 70, 73]. The participants in 23 studies were patients discharged from ED for suicidal behaviour [49–53, 56–69, 71–74], the participants in the remaining studies were callers to a national 24h-helpline service with moderate-to-high psychological distress [54], or patients identified as being at risk of suicide [55, 70].…”

Section: Resultsmentioning

confidence: 99%

“…The proportion of women in most of the studies was above 50% in both IG and CG, except in three studies [55, 70, 73]. The participants in 23 studies were patients discharged from ED for suicidal behaviour [49–53, 56–69, 71–74], the participants in the remaining studies were callers to a national 24h-helpline service with moderate-to-high psychological distress [54], or patients identified as being at risk of suicide [55, 70]. The eligible articles were from 11 countries: France [56, 63, 65, 69, 71, 72], Spain [51, 52, 58, 59, 61], United States of America (USA) [55, 64, 70, 73], Iran [60, 62, 66, 67], Brazil, India, Sri Lanka, Iran, China [50, 57], French Polynesia [49], Sweden [53], Australia [54], United Kingdom (UK) [68], and China [74].…”

Section: Resultsmentioning

confidence: 99%

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Challenges in Synthesising the Effects of Synchronous Remote-based Interventions on Suicidal Behaviours: A Systematic Review and Meta-Analysis

Comendador,

Jiménez-Villamizar,

Losilla

et al. 2024

Preprint

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Introduction. Suicide is one of the leading causes of preventable death worldwide. Evidence reported in the literature seems to support the impact of providing active contact for people that have attempted suicide. The current systematic review and meta–analysis aim to investigate the effects of suicide prevention strategies implemented through remote and synchronous technology–based interventions. Methods. The systematic review and meta–analysis followed the PRISMA 2020 guidelines. The searches were conducted in PubMed, PsycInfo, Scopus, and Web of Science. Screening, selection process, data extraction, and risk of bias (RoB) assessment have been performed independently by two reviewers. A systematic review and narrative synthesis of the data has been performed. Data on adherence to treatment and suicide–related factors to explain heterogeneity were extracted. A meta–analysis was conducted to determine effect sizes (Hedge′s g) for suicidal ideation, odds ratios (OR) and 95% confidence intervals (95% CI) for lethal and non–lethal suicide behaviours. Data were pooled using a random–effects model. Subgroup analyses were performed by classifying the studies according to the evaluation period. Results. A total of 26 publications were finally included. Synchronous remote–based interventions were effective in preventing repeated suicide attempts (OR = 0.75; 95% CI 0.62 – 0.90) and suicide deaths (Peto OR = 0.37; 95% CI 0.18 – 0.77); however, considerable heterogeneity was reported. The effects on suicidal ideation were not confirmed (Hedge′s g = 0.23; 95% CI –1.54 – 1.07). Conclusions. The observed heterogeneity suggests that the effects should be considered under caution. Methodological and procedural guidelines are proposed to improve the quality of future research studies.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Challenges in Synthesising the Effects of Synchronous Remote-based Interventions on Suicidal Behaviours: A Systematic Review and Meta-Analysis

Comendador,

Jiménez-Villamizar,

Losilla

et al. 2024

Preprint

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“…Twenty-three RCTs (reported in 36 articles [n = 22 632]) of suicide prevention among people at increased risk of suicide were included (eTable 13 in the Supplement). One study examined the impact of a pharmacologic intervention (lithium), and the remaining studies examined psychological treatment interventions, along with usual mental health care. The impact of the interventions on suicide deaths could not be determined, with only 1 death reported in the included studies.…”

Section: Resultsmentioning

confidence: 99%

Depression and Suicide Risk Screening

O’Connor

Perdue

Coppola

et al. 2023

JAMA

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ImportanceDepression is common and associated with substantial burden. Suicide rates have increased over the past decade, and both suicide attempts and deaths have devastating effects on individuals and families.ObjectiveTo review the benefits and harms of screening and treatment for depression and suicide risk and the accuracy of instruments to detect these conditions among primary care patients.Data SourcesMEDLINE, PsychINFO, Cochrane library through September 7, 2022; references of existing reviews; ongoing surveillance for relevant literature through November 25, 2022.Study SelectionEnglish-language studies of screening or treatment compared with control conditions, or test accuracy of screening instruments (for depression, instruments were selected a priori; for suicide risk, all were included). Existing systematic reviews were used for treatment and test accuracy for depression.Data Extraction and SynthesisOne investigator abstracted data; a second checked accuracy. Two investigators independently rated study quality. Findings were synthesized qualitatively, including reporting of meta-analysis results from existing systematic reviews; meta-analyses were conducted on original research when evidence was sufficient.Main Outcomes and MeasuresDepression outcomes; suicidal ideation, attempts, and deaths; sensitivity and specificity of screening tools.ResultsFor depression, 105 studies were included: 32 original studies (N=385 607) and 73 systematic reviews (including ≈2138 studies [N ≈ 9.8 million]). Depression screening interventions, many of which included additional components beyond screening, were associated with a lower prevalence of depression or clinically important depressive symptomatology after 6 to 12 months (pooled odds ratio, 0.60 [95% CI, 0.50-0.73]; reported in 8 randomized clinical trials [n=10 244]; I2 = 0%). Several instruments demonstrated adequate test accuracy (eg, for the 9-item Patient Health Questionnaire at a cutoff of 10 or greater, the pooled sensitivity was 0.85 [95% CI, 0.79-0.89] and specificity was 0.85 [95% CI, 0.82-0.88]; reported in 47 studies [n = 11 234]). A large body of evidence supported benefits of psychological and pharmacologic treatment of depression. A pooled estimate from trials used for US Food and Drug Administration approval suggested a very small increase in the absolute risk of a suicide attempt with second-generation antidepressants (odds ratio, 1.53 [95% CI, 1.09-2.15]; n = 40 857; 0.7% of antidepressant users had a suicide attempt vs 0.3% of placebo users; median follow-up, 8 weeks). Twenty-seven studies (n = 24 826) addressed suicide risk. One randomized clinical trial (n=443) of a suicide risk screening intervention found no difference in suicidal ideation after 2 weeks between primary care patients who were and were not screened for suicide risk. Three studies of suicide risk test accuracy were included; none included replication of any instrument. The included suicide prevention studies generally did not demonstrate an improvement over usual care, which typically included specialty mental health treatment.Conclusions and RelevanceEvidence supported depression screening in primary care settings, including during pregnancy and postpartum. There are numerous important gaps in the evidence for suicide risk screening in primary care settings.

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“…A social media campaign facilitated recruitment, and study procedures—including randomization, intervention delivery, and follow-up assessment—were conducted through a participant-facing, online interface. The scalability of this design allowed us to include many more participants than is common in a pilot of a behavioral intervention [ 31 ]. While there was a regional preference linked to the location of our study site, our study sample showed geographical distribution across the United States.…”

Section: Discussionmentioning

confidence: 99%

Feasibility of recruitment and retention in a remote trial of gatekeeper training for close supports of military veterans: Mixed methods study

Teo¹,

Call²,

Hooker³

et al. 2022

Contemporary Clinical Trials Communications

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A virtual, pilot randomized trial of a brief intervention to prevent suicide in an integrated healthcare setting

Cited by 6 publications

References 37 publications

Challenges in Synthesising the Effects of Synchronous Remote-based Interventions on Suicidal Behaviours: A Systematic Review and Meta-Analysis

Challenges in Synthesising the Effects of Synchronous Remote-based Interventions on Suicidal Behaviours: A Systematic Review and Meta-Analysis

Depression and Suicide Risk Screening

Feasibility of recruitment and retention in a remote trial of gatekeeper training for close supports of military veterans: Mixed methods study

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