Citation

Gøtzsche PC, Gøtzsche PK. J. R. Soc. Med. 2017; 110(10): 404-410.

Affiliation

Nordic Cochrane Centre, Rigshospitalet, 7811, Blegdamsvej 9, 2100 København Ø, Denmark.

Copyright

(Copyright © 2017, Royal Society of Medicine)

DOI

10.1177/0141076817731904

PMID

29043894

Abstract

OBJECTIVE To study whether cognitive behavioural therapy decreases suicide attempts in people with previous suicide attempts. Design Systematic review and meta-analysis. Setting Randomised trials that compare cognitive behavioural therapy with treatment as usual. Participants Patients who had engaged in any type of suicide attempt in the six months prior to trial entry resulting in presentation to clinical services. Main outcome measure Suicide attempt.

RESULTS We included ten trials, eight from Cochrane reviews and two from our updated searches (1241 patients, 219 of whom had at least one new suicide attempt). Cognitive behavioural therapy compared to treatment as usual reduced the risk of a new suicide attempt; risk ratio 0.47; 95% confidence interval 0.30-0.73; p = 0.0009; I(2 )= 57%. Only seven suicides were reported (3 versus 4). One trial had an unusually large effect; if this trial is excluded, the risk ratio becomes 0.61 (0.46-0.80) and the heterogeneity in the results disappears (I(2 )= 0%).

CONCLUSIONS Cognitive behavioural therapy reduces not only repeated self-harm but also repeated suicide attempts. It should be the preferred treatment for all patients with depression.

Language: en

Keywords

Clinical; psychiatry; psychotherapy; suicide