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      Psychosocial interventions for self-harm in adults

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          Abstract

          Self-harm (SH; intentional self-poisoning or self-injury) is common, often repeated, and associated with suicide. This is an update of a broader Cochrane review first published in 1998, previously updated in 1999, and now split into three separate reviews. This review focuses on psychosocial interventions in adults who engage in self-harm.

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          Most cited references 219

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          Youth suicide risk and preventive interventions: a review of the past 10 years.

          To review critically the past 10 years of research on youth suicide. Research literature on youth suicide was reviewed following a systematic search of PsycINFO and Medline. The search for school-based suicide prevention programs was expanded using two education databases: ERIC and Education Full Text. Finally, manual reviews of articles' reference lists identified additional studies. The review focuses on epidemiology, risk factors, prevention strategies, and treatment protocols. There has been a dramatic decrease in the youth suicide rate during the past decade. Although a number of factors have been posited for the decline, one of the more plausible ones appears to be the increase in antidepressants being prescribed for adolescents during this period. Youth psychiatric disorder, a family history of suicide and psychopathology, stressful life events, and access to firearms are key risk factors for youth suicide. Exciting new findings have emerged on the biology of suicide in adults, but, while encouraging, these are yet to be replicated in youths. Promising prevention strategies, including school-based skills training for students, screening for at-risk youths, education of primary care physicians, media education, and lethal-means restriction, need continuing evaluation studies. Dialectical behavior therapy, cognitive-behavioral therapy, and treatment with antidepressants have been identified as promising treatments but have not yet been tested in a randomized clinical trial of youth suicide. While tremendous strides have been made in our understanding of who is at risk for suicide, it is incumbent upon future research efforts to focus on the development and evaluation of empirically based suicide prevention and treatment protocols.
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            Goal Achievement: The Role of Intentions

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              Twelve-month prevalence of and risk factors for suicide attempts in the World Health Organization World Mental Health Surveys.

              Although suicide is a leading cause of death worldwide, clinicians and researchers lack a data-driven method to assess the risk of suicide attempts. This study reports the results of an analysis of a large cross-national epidemiologic survey database that estimates the 12-month prevalence of suicidal behaviors, identifies risk factors for suicide attempts, and combines these factors to create a risk index for 12-month suicide attempts separately for developed and developing countries. Data come from the World Health Organization (WHO) World Mental Health (WMH) Surveys (conducted 2001-2007), in which 108,705 adults from 21 countries were interviewed using the WHO Composite International Diagnostic Interview. The survey assessed suicidal behaviors and potential risk factors across multiple domains, including sociodemographic characteristics, parent psychopathology, childhood adversities, DSM-IV disorders, and history of suicidal behavior. Twelve-month prevalence estimates of suicide ideation, plans, and attempts are 2.0%, 0.6%, and 0.3%, respectively, for developed countries and 2.1%, 0.7%, and 0.4%, respectively, for developing countries. Risk factors for suicidal behaviors in both developed and developing countries include female sex, younger age, lower education and income, unmarried status, unemployment, parent psychopathology, childhood adversities, and presence of diverse 12-month DSM-IV mental disorders. Combining risk factors from multiple domains produced risk indices that accurately predicted 12-month suicide attempts in both developed and developing countries (area under the receiver operating characteristic curve = 0.74-0.80). Suicidal behaviors occur at similar rates in both developed and developing countries. Risk indices assessing multiple domains can predict suicide attempts with fairly good accuracy and may be useful in aiding clinicians in the prediction of these behaviors. © Copyright 2010 Physicians Postgraduate Press, Inc.
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                Author and article information

                Journal
                Cochrane Database of Systematic Reviews
                Wiley
                14651858
                May 12 2016
                Affiliations
                [1 ]Warneford Hospital; Centre for Suicide Research, University Department of Psychiatry; Oxford UK OX3 7JX
                [2 ]University of Oxford; Department of Psychiatry; Oxford UK
                [3 ]London School of Hygiene & Tropical Medicine; Centre for Global Mental Health; London UK
                [4 ]Institute of Psychiatry, King's College London; London UK
                [5 ]University College Cork; National Suicide Research Foundation and Department of Epidemiology and Public Health; Cork Ireland
                [6 ]University of Bristol; School of Social and Community Medicine; Canynge Hall 39 Whatley Road Bristol UK BS8 2PR
                [7 ]Sydney Medical School; Discipline of Psychiatry; G03 - Thomas Walker Hospital Hospital Rd Concord West New South Wales Australia 2138
                [8 ]University of Nottingham; Self-Harm Research Group, School of Psychology; University Park Nottingham UK NG7 2RD
                [9 ]Ghent University; Unit for Suicide Research, Department of Psychiatry and Medical Psychology; Ghent Belgium 9000
                Article
                10.1002/14651858.CD012189
                27168519
                © 2016
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