"Psychotherapy in the Pressure Cooker": A Systematic Review of Single Session Psychosocial Interventions in Emergency Departments for Suicide-related Thoughts or Behaviors.

IF 1.3 4区医学 Q3 PSYCHIATRY

Journal of Psychiatric Practice Pub Date : 2023-07-01 DOI:10.1097/PRA.0000000000000725

Gabrielle Bossé Chartier, Frederick Lam, Yvonne Bergmans, Jodi Lofchy, James M Bolton, E David Klonsky, Juveria Zaheer, David Kealy

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引用次数: 0

Abstract

Objectives: Up to 20% of individuals who die by suicide have visited an emergency department (ED) within 4 weeks of their death. Limited guidance is available regarding the modification of clinical outcomes following a psychosocial intervention in the ED for pediatric and adult populations.

Methods: A systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was conducted to identify studies focused on single-session psychosocial interventions for pediatric and adult patients experiencing suicide-related thoughts or behaviors (SRTB) in the ED. Two reviewers independently screened articles identified using the key terms suicide/self-harm, emergency department, and interview. Medline, PubMed, Embase, PsycINFO, CINAHL, and CENTRAL were searched from inception to August 2018.

Results: After screening 3234 abstracts, 29 articles were selected for full-text review and 14 articles, representing 8 distinct studies (N=782), were included. A high level of heterogeneity was present in the included articles, with 7 randomized-controlled trials, 2 nonrandomized-controlled trials, 2 cohort studies, 2 observational studies, and 1 feasibility study. Most of the included studies focused on adolescents (6 articles) or military veterans (7 articles). Strong statistical evidence of ED interventions improving outpatient service linkage was supported (χ2: 81.80, P<0.0001, 7 studies).

Conclusions: The findings of this study suggested promising outcomes for patients presenting to the ED with SRTB who receive a single-session psychosocial intervention. All of the studies that measured such outcomes found significantly increased follow-up care in the intervention arm. Further research is needed to strengthen the evidence base, provide better patient representation, and improve our understanding of the mechanisms by which the psychosocial intervention for SRTB in the ED ameliorates patient outcomes (CRD42020156496).

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"高压锅里的心理治疗"：针对急诊科中自杀相关想法或行为的单次社会心理干预的系统性回顾》（A Systematic Review of Single Session Psychosocial Interventions in Emergency Departments for Suicide-related Thoughts or Behaviors）。

目标：多达 20% 的自杀死亡者在死后 4 周内曾到急诊科就诊。关于在急诊室对儿童和成人进行心理干预后临床结果的改变，目前所能提供的指导非常有限：方法：按照《系统综述和荟萃分析首选报告项目》（Preferred Reporting Items for Systematic Reviews and Meta-Analyses，PRISMA）指南进行了一项系统综述，以确定针对在急诊室有自杀相关想法或行为（SRTB）的儿童和成人患者进行单次心理干预的研究。两名审稿人使用自杀/自残、急诊科和访谈等关键术语对所识别的文章进行了独立筛选。检索了从开始到2018年8月的Medline、PubMed、Embase、PsycINFO、CINAHL和CENTRAL：在筛选了3234篇摘要后，29篇文章被选中进行全文审阅，14篇文章被纳入其中，代表了8项不同的研究（N=782）。所纳入的文章存在高度异质性，其中包括 7 项随机对照试验、2 项非随机对照试验、2 项队列研究、2 项观察性研究和 1 项可行性研究。大部分纳入研究的对象是青少年（6 篇）或退伍军人（7 篇）。ED干预改善门诊服务联系的统计证据确凿（χ2：81.80，PC结论：本研究的结果表明，在急诊室就诊的 SRTB 患者接受单次心理干预后，治疗效果很好。所有测量此类结果的研究都发现，干预组的随访护理显著增加。我们需要进一步开展研究，以加强证据基础，提供更好的患者代表性，并加深我们对急诊室 SRTB 心理干预改善患者预后的机制的理解 (CRD42020156496)。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Psychiatric Practice PSYCHIATRY-

CiteScore

2.30

自引率

10.50%

发文量

159

审稿时长

>12 weeks

期刊介绍： Journal of Psychiatric Practice® seizes the day with its emphasis on the three Rs — readability, reliability, and relevance. Featuring an eye-catching style, the journal combines clinically applicable reviews, case studies, and articles on treatment advances with practical and informative tips for treating patients. Mental health professionals will want access to this review journal — for sharpening their clinical skills, discovering the best in treatment, and navigating this rapidly changing field. Journal of Psychiatric Practice combines clinically applicable reviews, case studies, and articles on treatment advances with informative "how to" tips for surviving in a managed care environment.