The effectiveness of psychoanalytic/ psychodynamic psychotherapy for reducing suicide attempts and self-harm

systematic review and meta-analysis

Nicholas Gould, Stephen Briggs, Gopalakrishnan Netuveli, Antigone Gkaravella, Nicole Gluckman, Patricia Kangogyere, Ruby Farr, Mark Goldblatt, Reinhard Lindner

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background Preventing suicide and self-harm is a global health priority. Although there is a growing evidence base for the effectiveness of psychoanalytic and psychodynamic psychotherapies for a range of disorders, to date there has been no systematic review of its effectiveness in reducing suicidal and self-harming behaviours.Aims To systematically review randomised controlled trials of psychoanalytic and psychodynamic psychotherapies for suicidal attempts and self-harm.Method We searched PubMed, PsycINFO, Psycharticles, CINAHL, EMBASE and the Cochrane Central Register of Controlled Trials for randomise controlled trials of psychoanalytic and psychodynamic psychotherapies for reducing suicide attempts and self-harm.Results Twelve trials (17 articles) were included in the meta-analyses. Psychoanalytic and psychodynamic therapies were effective in reducing the number of patients attempting suicide (pooled odds ratio, 0.469; 95% CI 0.274-0.804). We found some evidence for significantly reduced repetition of self-harm at 6-month but not 12-month follow-up. Significant treatment effects were also found for improvements in psychosocial functioning and reduction in number of hospital admissions.Conclusions Psychoanalytic and psychodynamic psychotherapies are indicated to be effective in reducing suicidal behaviour and to have short-term effectiveness in reducing self-harm. They can also be beneficial in improving psychosocial well-being. However, the small number of trials and moderate quality of the evidence means further high-quality trials are needed to confirm our findings and to identity which specific components of the psychotherapies are effective.Declaration of interest None.

Original languageEnglish
Pages (from-to)320-328
Number of pages9
JournalBritish Journal of Psychiatry
Volume214
Issue number6
Early online date28 Feb 2019
DOIs
Publication statusPublished - 1 Jun 2019

Keywords

  • Suicide
  • Self-harm
  • Psychotherapy
  • Psychoanalysis
  • psychodynamic
  • systematic review
  • Meta-analysis
  • psychoanalytic psychotherapy
  • meta-analysis
  • self-harm
  • psychodynamic psychotherapy

ASJC Scopus subject areas

  • Social Sciences(all)
  • Psychology(all)
  • Medicine(all)
  • Psychiatry and Mental health

Cite this

The effectiveness of psychoanalytic/ psychodynamic psychotherapy for reducing suicide attempts and self-harm : systematic review and meta-analysis. / Gould, Nicholas; Briggs, Stephen; Netuveli, Gopalakrishnan; Gkaravella, Antigone; Gluckman, Nicole; Kangogyere, Patricia; Farr, Ruby; Goldblatt, Mark; Lindner, Reinhard.

In: British Journal of Psychiatry, Vol. 214, No. 6, 01.06.2019, p. 320-328.

Research output: Contribution to journalArticle

Gould, N, Briggs, S, Netuveli, G, Gkaravella, A, Gluckman, N, Kangogyere, P, Farr, R, Goldblatt, M & Lindner, R 2019, 'The effectiveness of psychoanalytic/ psychodynamic psychotherapy for reducing suicide attempts and self-harm: systematic review and meta-analysis', British Journal of Psychiatry, vol. 214, no. 6, pp. 320-328. https://doi.org/10.1192/bjp.2019.33
Gould, Nicholas ; Briggs, Stephen ; Netuveli, Gopalakrishnan ; Gkaravella, Antigone ; Gluckman, Nicole ; Kangogyere, Patricia ; Farr, Ruby ; Goldblatt, Mark ; Lindner, Reinhard. / The effectiveness of psychoanalytic/ psychodynamic psychotherapy for reducing suicide attempts and self-harm : systematic review and meta-analysis. In: British Journal of Psychiatry. 2019 ; Vol. 214, No. 6. pp. 320-328.
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abstract = "Background Preventing suicide and self-harm is a global health priority. Although there is a growing evidence base for the effectiveness of psychoanalytic and psychodynamic psychotherapies for a range of disorders, to date there has been no systematic review of its effectiveness in reducing suicidal and self-harming behaviours.Aims To systematically review randomised controlled trials of psychoanalytic and psychodynamic psychotherapies for suicidal attempts and self-harm.Method We searched PubMed, PsycINFO, Psycharticles, CINAHL, EMBASE and the Cochrane Central Register of Controlled Trials for randomise controlled trials of psychoanalytic and psychodynamic psychotherapies for reducing suicide attempts and self-harm.Results Twelve trials (17 articles) were included in the meta-analyses. Psychoanalytic and psychodynamic therapies were effective in reducing the number of patients attempting suicide (pooled odds ratio, 0.469; 95{\%} CI 0.274-0.804). We found some evidence for significantly reduced repetition of self-harm at 6-month but not 12-month follow-up. Significant treatment effects were also found for improvements in psychosocial functioning and reduction in number of hospital admissions.Conclusions Psychoanalytic and psychodynamic psychotherapies are indicated to be effective in reducing suicidal behaviour and to have short-term effectiveness in reducing self-harm. They can also be beneficial in improving psychosocial well-being. However, the small number of trials and moderate quality of the evidence means further high-quality trials are needed to confirm our findings and to identity which specific components of the psychotherapies are effective.Declaration of interest None.",
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