Introduction/

Objective:

We are conducting a systematic review of treatment studies of patients who have attempted suicide. The provision of specific treatments for attempted suicide is critical, not least because there is a significant risk of completed suicide following an attempt. The main hypothesis tested in this review is that specific treatments (e.g. cognitive-behavioural therapy or psychopharmacological therapy) are more effective than standard types of aftercare (e.g. routine psychiatric care).

Methods:

Extensive searching of electronic databases and hand searching of relevant journals identified 22 RCTs and 3 CCTs eligible for inclusion in the review. Each trial was assessed for methodological quality by two independent reviewers who did not have information about the authors, institution or type of journal. Data were extracted from each of the trials and entered into RevMan 3.0 by two independent reviewers. The results of several of these studies suggest that the interventions examined resulted in reduction of repeated suicide attempts but that they lacked the statistical power to detect significant improvements in outcome. Therefore, a meta-analysis is being conducted to compare the effects of specific treatments and standard types of aftercare.

Results/

Discussion:

An initial analysis will examine whether any specific type of aftercare is more effective lhan routine aftercare. For the purposes of the main meta-analysis the included studies have been grouped into several sub-categories constituting similar types of intervention: i) cognitive-behavioural therapy vs standard aftercare; ii) provision of an emergency contact card ('green card') plus standard aftercare vs standard aftercare alone; 111) intensive interventions vs standard aftercare; iv) psychopharmacological treatment vs placebo and v) inpatient admission vs discharge. Four main outcome measures are being used in this

analysis:

non-fatal suicide attempts, depression, problem solving (change in problems) and hopelessness. The results of the review will he discussed in greater detail at the Colloquium.