Effectiveness of Psychosocial Interventions for Family Members and Other Informal Support Persons of Individuals Who Have Made a Suicide Attempt

Crisis ◽  
2021 ◽  
Author(s):  
Karolina Krysinska ◽  
Karl Andriessen ◽  
Ingrid Ozols ◽  
Lennart Reifels ◽  
Jo Robinson ◽  
...  

Abstract. Background: Individuals recovering from a suicide attempt may benefit from support provided by informal carers, that is, family members and other support persons, who may require support themselves. Aims: This systematic review aims to identify and synthesize available literature on the effectiveness of psychosocial interventions for this carer population. Method: A search of peer-reviewed literature in five databases was carried out. Studies using any design were eligible and results were synthesized using a narrative review. Results: Eight articles reporting on seven quantitative studies met the eligibility criteria. This included three studies on interventions designed specifically for informal carers and four studies on interventions designed for persons who have made a suicide attempt, and which involved their informal carers. Overall, informal carers were satisfied with support and psychosocial interventions they received. Interventions were related to some improvements in carers' mental health outcomes, lowered burden, and improved ability to provide care. There were mixed results regarding family functioning and quality of life. Limitations: No studies from lower- and middle-income countries were identified and the small number of heterogeneous studies precluded conducting a meta-analysis. Conclusion: Given the low number of studies and their overall poor quality, this review can only draw preliminary conclusions. More high-quality intervention studies are needed to formulate recommendations for effective psychosocial support for family members and other informal support persons after a suicide attempt.

PLoS Medicine ◽  
2021 ◽  
Vol 18 (5) ◽  
pp. e1003595
Author(s):  
Timothy B. Smith ◽  
Connor Workman ◽  
Caleb Andrews ◽  
Bonnie Barton ◽  
Matthew Cook ◽  
...  

Background Hospitals, clinics, and health organizations have provided psychosocial support interventions for medical patients to supplement curative care. Prior reviews of interventions augmenting psychosocial support in medical settings have reported mixed outcomes. This meta-analysis addresses the questions of how effective are psychosocial support interventions in improving patient survival and which potential moderating features are associated with greater effectiveness. Methods and findings We evaluated randomized controlled trials (RCTs) of psychosocial support interventions in inpatient and outpatient healthcare settings reporting survival data, including studies reporting disease-related or all-cause mortality. Literature searches included studies reported January 1980 through October 2020 accessed from Embase, Medline, Cochrane Library, CINAHL, Alt HealthWatch, PsycINFO, Social Work Abstracts, and Google Scholar databases. At least 2 reviewers screened studies, extracted data, and assessed study quality, with at least 2 independent reviewers also extracting data and assessing study quality. Odds ratio (OR) and hazard ratio (HR) data were analyzed separately using random effects weighted models. Of 42,054 studies searched, 106 RCTs including 40,280 patients met inclusion criteria. Patient average age was 57.2 years, with 52% females and 48% males; 42% had cardiovascular disease (CVD), 36% had cancer, and 22% had other conditions. Across 87 RCTs reporting data for discrete time periods, the average was OR = 1.20 (95% CI = 1.09 to 1.31, p < 0.001), indicating a 20% increased likelihood of survival among patients receiving psychosocial support compared to control groups receiving standard medical care. Among those studies, psychosocial interventions explicitly promoting health behaviors yielded improved likelihood of survival, whereas interventions without that primary focus did not. Across 22 RCTs reporting survival time, the average was HR = 1.29 (95% CI = 1.12 to 1.49, p < 0.001), indicating a 29% increased probability of survival over time among intervention recipients compared to controls. Among those studies, meta-regressions identified 3 moderating variables: control group type, patient disease severity, and risk of research bias. Studies in which control groups received health information/classes in addition to treatment as usual (TAU) averaged weaker effects than those in which control groups received only TAU. Studies with patients having relatively greater disease severity tended to yield smaller gains in survival time relative to control groups. In one of 3 analyses, studies with higher risk of research bias tended to report better outcomes. The main limitation of the data is that interventions very rarely blinded personnel and participants to study arm, such that expectations for improvement were not controlled. Conclusions In this meta-analysis, OR data indicated that psychosocial behavioral support interventions promoting patient motivation/coping to engage in health behaviors improved patient survival, but interventions focusing primarily on patients’ social or emotional outcomes did not prolong life. HR data indicated that psychosocial interventions, predominantly focused on social or emotional outcomes, improved survival but yielded similar effects to health information/classes and were less effective among patients with apparently greater disease severity. Risk of research bias remains a plausible threat to data interpretation.


2021 ◽  
Author(s):  
Jordan Mutambi Amanyire ◽  
Irene Aheisibwe ◽  
Godfrey Zari Rukundo

Abstract Background: According to the World Health Organization, depression is expected to be the largest contributor to the global disease burden by 2030. Depression is the most frequent cause of emotional distress and reduced quality of life among older people affecting over 12% of the individuals aged 65 or older, . Psychosocial interventions have been proven to be effective in the management of depression. Most of the available evidence is from high income settings, with paucity of information in low and middle income countries which carry the biggest burden of depression and other health challenges. In this systematic review, we will document evidence on psychosocial interventions that have been effective in treatment of depression among elderly people in low and middle income countries. Methods: The review will be conducted and reported in accordance to the preferred reporting items for systematic reviews and meta-analysis (PRISMA) statement. We will include journal articles that have documented the psychosocial interventions in the primary prevention of depressive symptoms in elderly people aged 60 or older. We will also include accessible grey literature about the topic. We will include articles that have documented the psychosocial interventions to address depression in elderly patients in low and middle income countries. We will search different search engines and data bases including PubMed, EMBASE, Psych-INFO, Cochrane Library. We will use a meta-analysis, should we find that there is no heterogeneity between included studies.Discussion: This protocol describes a planned systematic review of observational studies reporting psychosocial interventions in the management of depressive symptoms in elderly people aged 60 or older. We anticipate that once this review is complete and published, our findings will be of interest to the elderly with depressive symptoms, their families and caregivers, students, and other healthcare professionals, scientists and policy makers. Systematic review registration: This protocol will not be registered with PROSPERO International prospective register of systematic reviews since the system is no longer accepting new protocols.


BMJ Open ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. e024351 ◽  
Author(s):  
Douglas MacInnes ◽  
Serena Masino

ObjectiveTo examine the evidence for the use of psychological and psychosocial interventions offered to forensic mental health inpatients.DesignCINAHL, MEDLINE, PsycINFO, ScienceDirect and Web of Science databases were searched for research published in English between 1 January 1990 and 31 May 2018.Outcome measuresDisturbance, mental well-being, quality of life, recovery, violence/risk, satisfaction, seclusion, symptoms, therapeutic relationship and ward environment. There were no limits on the length of follow-up.Eligibility criteriaWe included randomised controlled trial (RCT) studies of any psychological or psychosocial intervention in an inpatient forensic setting. Pilot or feasibility studies were included if an RCT design was used.We restricted our search criteria to inpatients in low, medium and high secure units aged over 18. We focused on interventions considered applicable to most patients residing in forensic mental health settings.Data extraction and synthesisTwo independent reviewers extracted data and assessed risk of bias.Results17 232 citations were identified with 195 full manuscripts examined in detail. Nine papers were included in the review. The heterogeneity of the identified studies meant that meta-analysis was inappropriate. The results were presented in table form together with a narrative synthesis. Only 7 out of 91 comparisons revealed statistically significant results with no consistent significant findings. The most frequently reported outcomes were violence/risk and symptoms. 61% of the violence/risk comparisons and 79% of the symptom comparisons reported improvements in the intervention groups compared with the control groups.ConclusionsCurrent practice is based on limited evidence with no consistent significant findings. This review suggests psychoeducational and psychosocial interventions did not reduce violence/risk, but there is tentative support they may improve symptoms. More RCTs are required with: larger sample sizes, representative populations, standardised outcomes and control group interventions similar in treatment intensity to the intervention.PROSPERO registration numberCRD42017067099.


BMJ Open ◽  
2018 ◽  
Vol 8 (11) ◽  
pp. e022012 ◽  
Author(s):  
Alina Rigabert ◽  
Emma Motrico ◽  
Patricia Moreno-Peral ◽  
Davinia M Resurrección ◽  
Sonia Conejo-Cerón ◽  
...  

IntroductionAlthough evidence exists for the efficacy of psychosocial interventions in preventing depression, little is known about its prevention through online interventions. The objective of this study is to conduct a systematic review and meta-analysis of randomised controlled trials assessing the effectiveness of online interventions in preventing depression in heterogeneous populations.Methods and analysisWe will conduct a systematic review and meta-analysis of randomised controlled trials that will be identified through searches of PubMed, PsycINFO, WOS, Scopus, OpenGrey, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov and Australia New Zealand Clinical Trials Register . We will also search the reference lists provided in relevant studies and reviews. Experts in the field will be contacted to obtain more references. Two independent reviewers will assess the eligibility criteria of all articles, extract data and determine their risk of bias (Cochrane Collaboration Tool). Baseline depression will be required to have been discarded through standardised interviews or validated self-reports with standard cut-off points. The outcomes will be the incidence of new cases of depression and/or the reduction of depressive symptoms as measured by validated instruments. Pooled standardised mean differences will be calculated using random-effect models. Heterogeneity and publication bias will be estimated. Predefined sensitivity and subgroup analyses will be performed. If heterogeneity is relevant, random-effect meta-regression will be performed.Ethics and disseminationThe results will be disseminated through peer-reviewed publication and will be presented at a professional conference. Ethical assessment is not required as we will search and assess existing sources of literature.Trial registration numberCRD42014014804; Results.


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