Scolaris Content Display Scolaris Content Display

Contenido relacionado

Ir a:

Revisiones y protocolos relacionados

Respuestas clínicas Cochrane

Topics

Temas

Prisma flow diagram
Figuras y tablas -
Figure 1

Prisma flow diagram

Ir a la figura de la revisiónAbrir en una pestaña nueva

Risk of bias graph: Review authors' judgements for each risk of bias item presented as percentages across all included studies.

Figuras y tablas -
Figure 2

Risk of bias graph: Review authors' judgements for each risk of bias item presented as percentages across all included studies.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Risk of bias summary graph: Review authors' judgements about each risk of bias item for each included study.

Figuras y tablas -
Figure 3

Risk of bias summary graph: Review authors' judgements about each risk of bias item for each included study.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 1: Dialectical behaviour therapy/mentalisation for adolescents vs. Treatment as usual or other routine management, Outcome 1: Repetition of SH post‐intervention

Figuras y tablas -
Analysis 1.1

Comparison 1: Dialectical behaviour therapy/mentalisation for adolescents vs. Treatment as usual or other routine management, Outcome 1: Repetition of SH post‐intervention

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 1: Dialectical behaviour therapy/mentalisation for adolescents vs. Treatment as usual or other routine management, Outcome 2: Frequency of SH post‐intervention

Figuras y tablas -
Analysis 1.2

Comparison 1: Dialectical behaviour therapy/mentalisation for adolescents vs. Treatment as usual or other routine management, Outcome 2: Frequency of SH post‐intervention

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 1: Dialectical behaviour therapy/mentalisation for adolescents vs. Treatment as usual or other routine management, Outcome 3: Number of individual psychotherapy sessions attended

Figuras y tablas -
Analysis 1.3

Comparison 1: Dialectical behaviour therapy/mentalisation for adolescents vs. Treatment as usual or other routine management, Outcome 3: Number of individual psychotherapy sessions attended

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 1: Dialectical behaviour therapy/mentalisation for adolescents vs. Treatment as usual or other routine management, Outcome 4: Number of family therapy sessions attended

Figuras y tablas -
Analysis 1.4

Comparison 1: Dialectical behaviour therapy/mentalisation for adolescents vs. Treatment as usual or other routine management, Outcome 4: Number of family therapy sessions attended

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 1: Dialectical behaviour therapy/mentalisation for adolescents vs. Treatment as usual or other routine management, Outcome 5: Number completing full course of treatment

Figuras y tablas -
Analysis 1.5

Comparison 1: Dialectical behaviour therapy/mentalisation for adolescents vs. Treatment as usual or other routine management, Outcome 5: Number completing full course of treatment

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 1: Dialectical behaviour therapy/mentalisation for adolescents vs. Treatment as usual or other routine management, Outcome 6: Depression scores post‐intervention

Figuras y tablas -
Analysis 1.6

Comparison 1: Dialectical behaviour therapy/mentalisation for adolescents vs. Treatment as usual or other routine management, Outcome 6: Depression scores post‐intervention

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 1: Dialectical behaviour therapy/mentalisation for adolescents vs. Treatment as usual or other routine management, Outcome 7: Hopelessness scores post‐intervention

Figuras y tablas -
Analysis 1.7

Comparison 1: Dialectical behaviour therapy/mentalisation for adolescents vs. Treatment as usual or other routine management, Outcome 7: Hopelessness scores post‐intervention

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 1: Dialectical behaviour therapy/mentalisation for adolescents vs. Treatment as usual or other routine management, Outcome 8: Suicidal ideation scores post‐intervention

Figuras y tablas -
Analysis 1.8

Comparison 1: Dialectical behaviour therapy/mentalisation for adolescents vs. Treatment as usual or other routine management, Outcome 8: Suicidal ideation scores post‐intervention

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 2: Group‐based psychotherapy vs. Treatment as usual or other routine management, Outcome 1: Repetition of SH at six months

Figuras y tablas -
Analysis 2.1

Comparison 2: Group‐based psychotherapy vs. Treatment as usual or other routine management, Outcome 1: Repetition of SH at six months

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 2: Group‐based psychotherapy vs. Treatment as usual or other routine management, Outcome 2: Repetition of SH at 12 months

Figuras y tablas -
Analysis 2.2

Comparison 2: Group‐based psychotherapy vs. Treatment as usual or other routine management, Outcome 2: Repetition of SH at 12 months

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 2: Group‐based psychotherapy vs. Treatment as usual or other routine management, Outcome 3: Depression scores at six months

Figuras y tablas -
Analysis 2.3

Comparison 2: Group‐based psychotherapy vs. Treatment as usual or other routine management, Outcome 3: Depression scores at six months

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 2: Group‐based psychotherapy vs. Treatment as usual or other routine management, Outcome 4: Depression scores at 12 months

Figuras y tablas -
Analysis 2.4

Comparison 2: Group‐based psychotherapy vs. Treatment as usual or other routine management, Outcome 4: Depression scores at 12 months

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 2: Group‐based psychotherapy vs. Treatment as usual or other routine management, Outcome 5: Suicidal ideation scores at six months

Figuras y tablas -
Analysis 2.5

Comparison 2: Group‐based psychotherapy vs. Treatment as usual or other routine management, Outcome 5: Suicidal ideation scores at six months

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 2: Group‐based psychotherapy vs. Treatment as usual or other routine management, Outcome 6: Suicidal ideation scores at 12 months

Figuras y tablas -
Analysis 2.6

Comparison 2: Group‐based psychotherapy vs. Treatment as usual or other routine management, Outcome 6: Suicidal ideation scores at 12 months

Ir a la figura de la revisiónAbrir en una pestaña nueva
Summary of findings 1. Comparison 1: individual CBT‐based psychotherapy versus treatment as usual

CBT‐based psychotherapy compared to treatment as usual

Patient or population: children and adolescents who engage in SH.
Settings: outpatient.
Intervention: individual CBT‐based psychotherapy.
Comparison: treatment as usual.

Outcomes

Illustrative comparative risks* (95% CI)

Relative effect
(95% CI)

Number of participants
(studies)

Quality of the evidence
(GRADE)

Comments

Assumed risk

Corresponding risk

Treatment as usual

CBT‐based psychotherapy

Repetition of SH at six months

Study population

OR 1.88
(0.3 to 11.73)

39
(1 RCT)

⊕⊝⊝⊝
VERY LOW1,2

Quality was downgraded as information on allocation concealment, participant blinding, outcome assessor blinding, and selective outcome reporting was not adequately described. The trial was further downgraded as the same therapists delivered both the intervention and control treatments leading to possible confounding which could have led to a reduction in the demonstrated effect.

111 per 1000

190 per 1000
(36 to 595)

*The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% CI) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
CBT: cognitive behavioural therapy; CI: confidence interval; OR: odds ratio; RCT: randomised controlled trial; SH: self‐harm.

GRADE Working Group grades of evidence
High quality: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: We are very uncertain about the estimate.

1 Risk of bias was rated as VERY SERIOUS as information on allocation concealment, participant blinding, outcome assessor blinding, and selective outcome reporting was not adequately described raising the possibility of selection bias, performance bias, detection bias, and reporting bias. Given that the same therapists delivered both the intervention and control treatments in this trial, there is also the possibility of confounding which could have led to a reduction in the demonstrated effect.

2 Imprecision was rated as SERIOUS owing to the wide confidence interval associated with the estimate of treatment effect.

Figuras y tablas -
Summary of findings 1. Comparison 1: individual CBT‐based psychotherapy versus treatment as usual
Ir a la tabla de la revisión
Summary of findings 2. Comparison 2: interventions for patients with multiple episodes of SH or emerging personality problems versus treatment as usual or routine management

Dialectical behaviour therapy or mentalisation for adolescents compared to treatment as usual or other routine management

Patient or population: children and adolescents who engage in SH.
Settings: outpatients.
Intervention: dialectical behaviour therapy or mentalisation for adolescents.
Comparison: treatment as usual or other routine management (i.e., enhanced usual care)

Outcomes

Illustrative comparative risks* (95% CI)

Relative effect
(95% CI)

Number of participants
(studies)

Quality of the evidence
(GRADE)

Comments

Assumed risk

Corresponding risk

Treatment as usual

Interventions for patients with multiple episodes of SH or emerging personality problems

Dialectical behaviour therapy for adolescents (DBT‐A)

Repetition of SH at post‐intervention

151 per 1000

113 per 1000

(21 per 439)

OR 0.72

(0.12 to 4.40)

105

(2 RCTs)

⊕⊕⊝⊝
LOW1,2

Quality was downgraded as neither participants nor clinical personnel were blind as to treatment allocation. Quality was further downgraded due to imprecision in the effect size estimate.

Frequency of SH at post‐intervention

The mean frequency of SH episodes at post‐intervention in the intervention group was 0.79 lower (2.78 lower to 1.20 higher)

‐

104

(2 RCTs)

⊕⊕⊝⊝
LOW1,2

Quality was downgraded as neither participants nor clinical personnel were blind as to treatment allocation. Quality was further downgraded due to imprecision in the effect size estimate.

Mentalisation

Repetition of SH at post‐intervention

829 per 1000

557 per 1000

(303 to 790)

OR 0.26

(0.09 to 0.78)

71

(1 RCT)

⊕⊕⊕⊝
MODERATE1

Quality was downgraded as the nature of this intervention means it is unlikely participants and clinical personnel would have been blind to treatment allocation.

*The basis for the assumed risk (e.g., the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% CI) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
CI: confidence interval; OR: odds ratio; RCT: randomised controlled trial; SH: self‐harm.

GRADE Working Group grades of evidence
High quality: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: We are very uncertain about the estimate.

1 Risk of bias was rated as SERIOUS as the nature of the intervention means that clinical personnel could not have remained blind to treatment allocation suggesting that performance and detection bias may have been present.

2 Imprecision was rated as SERIOUS owing to the wide confidence interval associated with the estimate of treatment effect.

Figuras y tablas -
Summary of findings 2. Comparison 2: interventions for patients with multiple episodes of SH or emerging personality problems versus treatment as usual or routine management
Ir a la tabla de la revisión
Summary of findings 3. Comparison 5: group‐based psychotherapy versus treatment as usual

Group‐based psychotherapy compared to treatment as usual

Patient or population: children and adolescents who engage in SH.
Settings: outpatient.
Intervention: group‐based psychotherapy.
Comparison: treatment as usual

Outcomes

Illustrative comparative risks* (95% CI)

Relative effect
(95% CI)

Number of participants
(studies)

Quality of the evidence
(GRADE)

Comments

Assumed risk

Corresponding risk

Treatment as usual

Group‐based psychotherapy

Repetition of SH at six months

Study population

OR 1.72
(0.56 to 5.24)

430
(2 RCTs)

⊕⊕⊝⊝
LOW1,2

Quality was downgraded as the nature of this intervention means it is unlikely participants and clinical personnel would have been blind to treatment allocation. Quality was further downgraded due to imprecision in the effect size estimate.

726 per 1000

820 per 1000
(597 to 933)

Repetition of SH at 12 months

Study population

OR 0.8
(0.22 to 2.97)

490
(3 RCTs)

⊕⊕⊝⊝
LOW1,2

Quality was downgraded as the nature of this intervention means it is unlikely participants and clinical personnel would have been blind to treatment allocation. Quality was further downgraded due to imprecision in the effect size estimate.

588 per 1000

533 per 1000
(239 to 809)

*The basis for the assumed risk (e.g., the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% CI) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
CI: confidence interval; OR: odds ratio; RCT: randomised controlled trial; SH: self‐harm.

GRADE Working Group grades of evidence
High quality: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: We are very uncertain about the estimate.

1 Risk of bias was rated as SERIOUS as the nature of the intervention means that clinical personnel could not have remained blind to treatment allocation suggesting that performance and detection bias may have been present.

2 Imprecision was rated as SERIOUS owing to the wide confidence interval associated with the estimate of treatment effect.

Figuras y tablas -
Summary of findings 3. Comparison 5: group‐based psychotherapy versus treatment as usual
Ir a la tabla de la revisión
Summary of findings 4. Comparison 6: therapeutic assessment versus treatment as usual (i.e., standard assessment)

Therapeutic assessment compared to treatment as usual (i.e., standard psychosocial assessment) for self‐harm in children and adolescents

Patient or population: children and adolescents who engage in SH.
Settings: outpatients.
Intervention: therapeutic assessment.
Comparison: treatment as usual (i.e., standard psychosocial assessment).

Outcomes

Illustrative comparative risks*
(95% CI)

Relative effect
(95% CI)

Number of participants
(studies)

Quality of the evidence
(GRADE)

Comments

Assumed risk

Corresponding risk

Standard psychosocial assessment

Therapeutic assessment

Repetition of SH at 12 months

Study population

OR 0.75
(0.18 to 3.06)

69
(1 RCT)

⊕⊕⊝⊝
LOW1,2

Quality was downgraded as the nature of this intervention means it is unlikely participants and clinical personnel would have been blind to treatment allocation. Quality was further downgraded due to imprecision in the effect size estimate.

147 per 1000

115 per 1000
(30 to 345)

Repetition of SH at 24 months

Study population

OR 0.69
(0.23 to 2.14)

69
(1 RCT)

⊕⊕⊝⊝
LOW1,2

Quality was downgraded as the nature of this intervention means it is unlikely participants and clinical personnel would have been blind to treatment allocation. Quality was further downgraded due to imprecision in the effect size estimate.

265 per 1000

199 per 1000
(76 to 435)

*The basis for the assumed risk (e.g., the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% CI) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
CI: confidence interval; OR: odds ratio; RCT: randomised controlled trial; SH: self‐harm.

GRADE Working Group grades of evidence
High quality: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: We are very uncertain about the estimate.

1 Risk of bias was rated as SERIOUS as the nature of the intervention means that clinical personnel could not have remained blind to treatment allocation suggesting that performance and detection bias may have been present.

2 Imprecision was rated as SERIOUS owing to the wide confidence interval associated with the estimate of treatment effect.

Figuras y tablas -
Summary of findings 4. Comparison 6: therapeutic assessment versus treatment as usual (i.e., standard assessment)
Ir a la tabla de la revisión
Summary of findings 5. Comparison 7: compliance enhancement plus treatment as usual (i.e., standard disposition planning) versus treatment as usual

Compliance enhancement plus treatment as usual (i.e., standard disposition planning) compared to treatment as usual

Patient or population: children and adolescents who engage in SH.
Settings: outpatient.
Intervention: compliance enhancement plus standard disposition planning.
Comparison: treatment as usual (i.e., standard disposition planning).

Outcomes

Illustrative comparative risks* (95% CI)

Relative effect
(95% CI)

Number of participants
(studies)

Quality of the evidence
(GRADE)

Comments

Assumed risk

Corresponding risk

Treatment as usual

Standard disposition planning

Repetition of SH by six months

Study population

OR 0.67
(0.15 to 3.08)

63
(1 RCT)

⊕⊝⊝⊝
VERY LOW1,2

Quality was downgraded as the nature of this intervention means it is unlikely participants and clinical personnel would have been blind to treatment allocation. Quality was further downgraded as details on blinding of outcome assessors, incomplete data and selective reporting was not adequately described. Lastly, due to imprecision in the effect size estimate, quality was further downgraded.

147 per 1000

104 per 1000
(25 to 347)

*The basis for the assumed risk (e.g., the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% CI) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
CI: confidence interval; OR: odds ratio; RCT: randomised controlled trial; SH: self‐harm.

GRADE Working Group grades of evidence
High quality: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: We are very uncertain about the estimate.

1 Risk of bias was rated as VERY SERIOUS as the nature of the intervention means that participants and clinical personnel could not have remained blind to treatment allocation suggesting that performance and detection bias may have been present. Additionally, details on blinding of outcome assessors, incomplete data and selective reporting was not adequately described.

2 Imprecision was rated as SERIOUS owing to the wide confidence interval associated with the estimate of treatment effect.

Figuras y tablas -
Summary of findings 5. Comparison 7: compliance enhancement plus treatment as usual (i.e., standard disposition planning) versus treatment as usual
Ir a la tabla de la revisión
Summary of findings 6. Comparison 8: home‐based family intervention versus treatment as usual

Home‐based family intervention compared to treatment as usual

Patient or population: children and adolescents who engage in SH.
Settings: outpatients.
Intervention: home‐based family intervention.
Comparison: treatment as usual.

Outcomes

Illustrative comparative risks* (95% CI)

Relative effect
(95% CI)

Number of participants
(studies)

Quality of the evidence
(GRADE)

Comments

Assumed risk

Corresponding
risk

Treatment as usual

Home‐based family intervention

Repetition of SH at six months

Study population

OR 1.02
(0.41 to 2.51)

149
(1 RCT)

⊕⊕⊝⊝
LOW 1

Quality was downgraded as the nature of this intervention means it is unlikely participants and clinical personnel would have been blind to treatment allocation.

147 per 1000

149 per 1000
(66 to 301)

*The basis for the assumed risk (e.g., the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% CI) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
CI: confidence interval; OR: odds ratio; RCT: randomised controlled trial; SH: self‐harm.

GRADE Working Group grades of evidence
High quality: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: We are very uncertain about the estimate.

1 Risk of bias was rated as SERIOUS as the nature of the intervention means that participants and clinical personnel could not have remained blind to treatment allocation suggesting that performance and detection bias may have been present.

Figuras y tablas -
Summary of findings 6. Comparison 8: home‐based family intervention versus treatment as usual
Ir a la tabla de la revisión
Summary of findings 7. Comparison 9: remote contact interventions versus treatment as usual

Remote contact interventions compared to treatment as usual

Patient or population: children and adolescents who engage in SH.
Settings: outpatients.
Intervention: remote contact interventions (emergency card).
Comparison: treatment as usual.

Outcomes

Illustrative comparative risks* (95% CI)

Relative effect
(95% CI)

Number of participants
(studies)

Quality of the evidence
(GRADE)

Comments

Assumed risk

Corresponding risk

Treatment as usual

Emergency card

Repetition of SH at 12 months

Study population

OR 0.5
(0.12 to 2.04)

105
(1 RCT)

⊕⊝⊝⊝
VERY LOW 1,2

Quality was downgraded as an open random numbers table was used to generate the allocation sequence and, as allocation was not concealed, there is possible selection bias. Quality was further downgraded as the nature of this intervention means it is unlikely participants and clinical personnel would have been blind to treatment allocation and, as no details on outcome assessor blinding were provided, performance and detection bias cannot be ruled out. Lastly, there was an error in the randomisation sequence such that five participants in the intervention group either did not receive emergency cards, or alternatively, received them only after a delay thereby invalidating follow‐up data for these five individuals.

121 per 1000

64 per 1000
(16 to 219)

*The basis for the assumed risk (e.g., the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% CI) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
CI: confidence interval; OR: odds ratio; RCT: randomised controlled trial; SH: self‐harm.

GRADE Working Group grades of evidence
High quality: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: We are very uncertain about the estimate.

1 Risk of bias was rated as VERY SERIOUS as the nature of the intervention means that participants and clinical personnel could not have remained blind to treatment allocation suggesting that performance and detection bias may have been present. Additionally, as an open random numbers table was used to generate the allocation sequence and, as allocation was not concealed, there is possible selection bias. There was also an error in the randomisation sequence resulting in five participants in the intervention group either not receiving the cards, or alternatively, not receiving them until after a substantial delay thereby invalidating follow‐up data for these individuals.

2 Imprecision was rated as SERIOUS owing to the wide confidence interval associated with the estimate of treatment effect.

Figuras y tablas -
Summary of findings 7. Comparison 9: remote contact interventions versus treatment as usual
Ir a la tabla de la revisión
Table 1. Methods used for the index episode of self‐harm in included studies

Reference

Method 1

Self‐poisoning

(any)

n (%)

Self‐poisoning

(alcohol)

n (%)

Self‐injury

(any)

n (%)

Combined self‐

poisoning

and self‐injury

n (%)

Cotgrove 19952

94 (89.6)

7 (6.6)

2 (1.9)

Donaldson 20053

33 (84.6)

Green 2011

5 (2.7)

67 (36.6)

111 (60.7)

Harrington 1998

162 (100)

Ougrin 2011a

28 (40.0)

37 (52.8)

5 (7.2)

Spirito 20024

54 (85.7)

1 Refers to method used for the index episode.

2 The method used by the remaining two (1.9%) participants was not reported.

3 The method used by the remaining six (15.4%) participants was not reported.

4 The method used by the remaining nine (14.3%) participants was not reported.

Figuras y tablas -
Table 1. Methods used for the index episode of self‐harm in included studies
Ir a la tabla de la revisión
Table 2. Psychiatric diagnoses in included studies

Reference

Psychiatric diagnosis1

Major

depression

n (%)

Any other
mood

disorder

n (%)

Any anxiety

disorder

n (%)

Post‐

traumatic

stress

disorder

n (%)

Any eating

disorder

n (%)

Alcohol use

disorder/

dependence

n (%)

Drug use

disorder/

dependence

n (%)

Substance use

disorder/

dependence

n (%)

Oppositional

defiance

disorder

n (%)

Conduct

disorder

n (%)

Any other

behaviour

disorder

n (%)

Borderline

personality

disorder

n (%)

Cooney 2010

23 (79.3)

24 (82.7)

7 (24.1)

9 (31.0)

8 (27.6)

Cotgrove 1995

Information on psychiatric diagnosis not provided.

Donaldson 2005

9 (29.0)

6 (19.3)

14 (45.2)

14 (45.2)

Green 2011

227 (62.0)

122 (22.2)

Harrington 1998

109 (67.3)

17 (10.5)

Hazell 2009

41 (56.9)

3 (4.2)

5 (6.9)2

Mehlum 2014

17 (22.1)

29 (37.7)

33 (42.9)

13 (16.9)

6 (7.8)

2 (2.6)

15 (20.5)

Ougrin 2011a3

Rossouw 2012a

77 (96.2)

35 (43.7)

27.5 (28.0)

58 (72.5)

Spirito 20024

1 (2.2)

6 (13.0)

4 (8.7)

6 (13.0)

5 (10.9)

6 (13.0)

Wood 2001a

52 (83.9)

42 (68.8)2

1 All diagnoses refer to current, rather than lifetime, diagnoses. The total percentages were more than 100% in some studies due to comorbidity.

2 Conduct disorder or oppositional defiance disorder.

3 The authors state that 53/70 (75.7%) participants had previous contact with mental health services. Diagnoses are only provided in broad categories, however. Specifically, 42/70 (60.0%) were diagnosed with an "emotional disorder," 9/70 (12.8%) were diagnosed with a "disruptive disorder," and 2/70 (2.8%) were diagnosed with "another disorder."

4 Information on psychiatric diagnoses were available for only 46 of the 63 participants.

Figuras y tablas -
Table 2. Psychiatric diagnoses in included studies
Ir a la tabla de la revisión
Comparison 1. Dialectical behaviour therapy/mentalisation for adolescents vs. Treatment as usual or other routine management

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1.1 Repetition of SH post‐intervention Show forest plot

3

Odds Ratio (M‐H, Random, 95% CI)

Subtotals only

1.1.1 DBT‐A

2

105

Odds Ratio (M‐H, Random, 95% CI)

0.72 [0.12, 4.40]

1.1.2 Mentalisation

1

71

Odds Ratio (M‐H, Random, 95% CI)

0.26 [0.09, 0.78]

1.2 Frequency of SH post‐intervention Show forest plot

2

104

Mean Difference (IV, Random, 95% CI)

‐0.79 [‐2.78, 1.20]

1.2.1 DBT‐A

2

104

Mean Difference (IV, Random, 95% CI)

‐0.79 [‐2.78, 1.20]

1.3 Number of individual psychotherapy sessions attended Show forest plot

2

106

Mean Difference (IV, Random, 95% CI)

9.14 [‐4.39, 22.66]

1.3.1 DBT‐A

2

106

Mean Difference (IV, Random, 95% CI)

9.14 [‐4.39, 22.66]

1.4 Number of family therapy sessions attended Show forest plot

2

106

Mean Difference (IV, Random, 95% CI)

0.93 [‐7.01, 8.86]

1.4.1 DBT‐A

2

106

Mean Difference (IV, Random, 95% CI)

0.93 [‐7.01, 8.86]

1.5 Number completing full course of treatment Show forest plot

1

80

Odds Ratio (M‐H, Random, 95% CI)

1.35 [0.56, 3.27]

1.5.1 Mentalisation

1

80

Odds Ratio (M‐H, Random, 95% CI)

1.35 [0.56, 3.27]

1.6 Depression scores post‐intervention Show forest plot

2

Mean Difference (IV, Random, 95% CI)

Subtotals only

1.6.1 DBT‐A

1

77

Mean Difference (IV, Random, 95% CI)

‐2.39 [‐5.02, 0.24]

1.6.2 Mentalisation

1

80

Mean Difference (IV, Random, 95% CI)

‐2.28 [‐2.81, ‐1.75]

1.7 Hopelessness scores post‐intervention Show forest plot

2

101

Std. Mean Difference (IV, Random, 95% CI)

‐0.13 [‐0.93, 0.67]

1.7.1 DBT‐A

2

101

Std. Mean Difference (IV, Random, 95% CI)

‐0.13 [‐0.93, 0.67]

1.8 Suicidal ideation scores post‐intervention Show forest plot

2

100

Std. Mean Difference (IV, Random, 95% CI)

‐0.62 [‐1.07, ‐0.16]

1.8.1 DBT‐A

2

100

Std. Mean Difference (IV, Random, 95% CI)

‐0.62 [‐1.07, ‐0.16]
Figuras y tablas -
Comparison 1. Dialectical behaviour therapy/mentalisation for adolescents vs. Treatment as usual or other routine management
Ir a la tabla de la revisión
Comparison 2. Group‐based psychotherapy vs. Treatment as usual or other routine management

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

2.1 Repetition of SH at six months Show forest plot

2

430

Odds Ratio (M‐H, Random, 95% CI)

1.72 [0.56, 5.24]

2.2 Repetition of SH at 12 months Show forest plot

3

490

Odds Ratio (M‐H, Random, 95% CI)

0.80 [0.22, 2.97]

2.3 Depression scores at six months Show forest plot

2

420

Mean Difference (IV, Random, 95% CI)

0.40 [‐2.76, 3.55]

2.4 Depression scores at 12 months Show forest plot

3

473

Mean Difference (IV, Random, 95% CI)

‐0.93 [‐4.03, 2.17]

2.5 Suicidal ideation scores at six months Show forest plot

2

421

Mean Difference (IV, Random, 95% CI)

1.27 [‐7.74, 10.28]

2.6 Suicidal ideation scores at 12 months Show forest plot

3

471

Mean Difference (IV, Random, 95% CI)

‐1.51 [‐9.62, 6.59]
Figuras y tablas -
Comparison 2. Group‐based psychotherapy vs. Treatment as usual or other routine management
Ir a la tabla de la revisión