Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2021 Mar 7;3(3):CD013667.
doi: 10.1002/14651858.CD013667.pub2.

Interventions for self-harm in children and adolescents

Katrina G Witt  1   2 , Sarah E Hetrick  3   4 , Gowri Rajaram  1   2 , Philip Hazell  5 , Tatiana L Taylor Salisbury  6 , Ellen Townsend  7 , Keith Hawton  8
Affiliations
Meta-Analysis

Interventions for self-harm in children and adolescents

Katrina G Witt et al. Cochrane Database Syst Rev. .

Abstract

Background: Self-harm (SH; intentional self-poisoning or self-injury regardless of degree of suicidal intent or other types of motivation) is a growing problem in most countries, often repeated, and associated with suicide. Evidence assessing the effectiveness of interventions in the treatment of SH in children and adolescents is lacking, especially when compared with the evidence for psychosocial interventions in adults. This review therefore updates a previous Cochrane Review (last published in 2015) on the role of interventions for SH in children and adolescents.

Objectives: To assess the effects of psychosocial interventions or pharmacological agents or natural products for SH compared to comparison types of care (e.g. treatment-as-usual, routine psychiatric care, enhanced usual care, active comparator, placebo, alternative pharmacological treatment, or a combination of these) for children and adolescents (up to 18 years of age) who engage in SH.

Search methods: We searched the Cochrane Common Mental Disorders Specialized Register, the Cochrane Library (Central Register of Controlled Trials [CENTRAL] and Cochrane Database of Systematic Reviews [CDSR]), together with MEDLINE, Ovid Embase, and PsycINFO (to 4 July 2020).

Selection criteria: We included all randomised controlled trials (RCTs) comparing specific psychosocial interventions or pharmacological agents or natural products with treatment-as-usual (TAU), routine psychiatric care, enhanced usual care (EUC), active comparator, placebo, alternative pharmacological treatment, or a combination of these, in children and adolescents with a recent (within six months of trial entry) episode of SH resulting in presentation to hospital or clinical services. The primary outcome was the occurrence of a repeated episode of SH over a maximum follow-up period of two years. Secondary outcomes included treatment adherence, depression, hopelessness, general functioning, social functioning, suicidal ideation, and suicide.

Data collection and analysis: We independently selected trials, extracted data, and appraised trial quality. For binary outcomes, we calculated odds ratios (ORs) and their 95% confidence internals (CIs). For continuous outcomes, we calculated the mean difference (MD) or standardised mean difference (SMD) and 95% CIs. The overall quality of evidence for the primary outcome (i.e. repetition of SH at post-intervention) was appraised for each intervention using the GRADE approach.

Main results: We included data from 17 trials with a total of 2280 participants. Participants in these trials were predominately female (87.6%) with a mean age of 14.7 years (standard deviation (SD) 1.5 years). The trials included in this review investigated the effectiveness of various forms of psychosocial interventions. None of the included trials evaluated the effectiveness of pharmacological agents in this clinical population. There was a lower rate of SH repetition for DBT-A (30%) as compared to TAU, EUC, or alternative psychotherapy (43%) on repetition of SH at post-intervention in four trials (OR 0.46, 95% CI 0.26 to 0.82; N = 270; k = 4; high-certainty evidence). There may be no evidence of a difference for individual cognitive behavioural therapy (CBT)-based psychotherapy and TAU for repetition of SH at post-intervention (OR 0.93, 95% CI 0.12 to 7.24; N = 51; k = 2; low-certainty evidence). We are uncertain whether mentalisation based therapy for adolescents (MBT-A) reduces repetition of SH at post-intervention as compared to TAU (OR 0.70, 95% CI 0.06 to 8.46; N = 85; k = 2; very low-certainty evidence). Heterogeneity for this outcome was substantial ( I² = 68%). There is probably no evidence of a difference between family therapy and either TAU or EUC on repetition of SH at post-intervention (OR 1.00, 95% CI 0.49 to 2.07; N = 191; k = 2; moderate-certainty evidence). However, there was no evidence of a difference for compliance enhancement approaches on repetition of SH by the six-month follow-up assessment, for group-based psychotherapy at the six- or 12-month follow-up assessments, for a remote contact intervention (emergency cards) at the 12-month assessment, or for therapeutic assessment at the 12- or 24-month follow-up assessments.

Authors' conclusions: Given the moderate or very low quality of the available evidence, and the small number of trials identified, there is only uncertain evidence regarding a number of psychosocial interventions in children and adolescents who engage in SH. Further evaluation of DBT-A is warranted. Given the evidence for its benefit in adults who engage in SH, individual CBT-based psychotherapy should also be further developed and evaluated in children and adolescents.

Trial registration: ClinicalTrials.gov NCT02771691 NCT01528020 NCT00675129 NCT02406625 NCT01195740 NCT01537419 NCT02272179 NCT00071617 NCT03463980 NCT02877316 NCT02762734 NCT03353961 NCT03550521 NCT03709472 NCT04131179 NCT04243603.

PubMed Disclaimer

Conflict of interest statement

KGW: is an editor for the Cochrane Common Mental Disorders Group, and senior editor for the Self‐Harm and Suicide Satellite of the group. SEH: is the joint co‐ordinating editor of the Cochrane Common Mental Disorders Group. She is funded by an Auckland Medical Research Foundation Douglas Goodfellow Repatriation Fellowship to develop and test a digital intervention for young people who engage in self‐harm. She is the Principal Clinical Advisor of the Suicide Prevention Office of the Ministry of Health for the New Zealand Government. GR: no declarations of interest to report in relation to this review PH: no declarations of interest to report in relation to this review TLTS: no declarations of interest to report in relation to this review ET: no declarations of interest to report in relation to this review KH: no declarations of interest to report in relation to this review

Figures

1
1
Study Flow Diagram
2
2
Results of 'Risk of bias' assessments for each study
1.1
1.1. Analysis
Comparison 1: Individual CBT‐based psychotherapy versus TAU or other comparator, Outcome 1: Repetition of SH by post‐intervention
1.2
1.2. Analysis
Comparison 1: Individual CBT‐based psychotherapy versus TAU or other comparator, Outcome 2: Treatment adherence: Proportion completing treatment
1.3
1.3. Analysis
Comparison 1: Individual CBT‐based psychotherapy versus TAU or other comparator, Outcome 3: Treatment adherence: Number of treatment sessions attended
1.4
1.4. Analysis
Comparison 1: Individual CBT‐based psychotherapy versus TAU or other comparator, Outcome 4: Depression scores at post‐intervention
1.5
1.5. Analysis
Comparison 1: Individual CBT‐based psychotherapy versus TAU or other comparator, Outcome 5: Suicidal ideation scores at post‐intervention
2.1
2.1. Analysis
Comparison 2: DBT‐A versus TAU or another comparator, Outcome 1: Repetition of SH at post‐intervention
2.2
2.2. Analysis
Comparison 2: DBT‐A versus TAU or another comparator, Outcome 2: Frequency of SH repetition at post‐intervention
2.3
2.3. Analysis
Comparison 2: DBT‐A versus TAU or another comparator, Outcome 3: Treatment adherence: Number of individual therapy sessions attended
2.4
2.4. Analysis
Comparison 2: DBT‐A versus TAU or another comparator, Outcome 4: Treatment adherence: Number of group therapy sessions attended
2.5
2.5. Analysis
Comparison 2: DBT‐A versus TAU or another comparator, Outcome 5: Treatment adherence: Number of family therapy sessions attended
2.6
2.6. Analysis
Comparison 2: DBT‐A versus TAU or another comparator, Outcome 6: Treatment adherence: Number of telephone therapy sessions
2.7
2.7. Analysis
Comparison 2: DBT‐A versus TAU or another comparator, Outcome 7: Depression scores at post‐intervention
2.8
2.8. Analysis
Comparison 2: DBT‐A versus TAU or another comparator, Outcome 8: Hopelessness scores at post‐intervention
2.9
2.9. Analysis
Comparison 2: DBT‐A versus TAU or another comparator, Outcome 9: General functioning scores at post‐intervention
2.10
2.10. Analysis
Comparison 2: DBT‐A versus TAU or another comparator, Outcome 10: Suicidal ideation scores at post‐intervention
2.11
2.11. Analysis
Comparison 2: DBT‐A versus TAU or another comparator, Outcome 11: Suicidal ideation scores by 12‐months
3.1
3.1. Analysis
Comparison 3: MBT‐A versus TAU or another comparator, Outcome 1: Repetition of SH by post‐intervention
3.2
3.2. Analysis
Comparison 3: MBT‐A versus TAU or another comparator, Outcome 2: Repetition of SH at post‐intervention (Risk‐Taking and Self‐Harm Inventory)
3.3
3.3. Analysis
Comparison 3: MBT‐A versus TAU or another comparator, Outcome 3: Depression scores at post‐intervention
4.1
4.1. Analysis
Comparison 4: Group‐based psychotherapy, Outcome 1: Repetition of SH by six months
4.2
4.2. Analysis
Comparison 4: Group‐based psychotherapy, Outcome 2: Repetition of SH by 12 months
4.3
4.3. Analysis
Comparison 4: Group‐based psychotherapy, Outcome 3: Depression scores at six months
4.4
4.4. Analysis
Comparison 4: Group‐based psychotherapy, Outcome 4: Depression scores at 12 months
4.5
4.5. Analysis
Comparison 4: Group‐based psychotherapy, Outcome 5: General functioning scores at six months
4.6
4.6. Analysis
Comparison 4: Group‐based psychotherapy, Outcome 6: General functioning scores at 12 months
4.7
4.7. Analysis
Comparison 4: Group‐based psychotherapy, Outcome 7: Suicidal ideation scores at six months
4.8
4.8. Analysis
Comparison 4: Group‐based psychotherapy, Outcome 8: Suicidal ideation scores at 12 months
5.1
5.1. Analysis
Comparison 5: Family therapy, Outcome 1: Repetition of SH at post‐intervention
5.2
5.2. Analysis
Comparison 5: Family therapy, Outcome 2: Treatment adherence by six months
See this image and copyright information in PMC

Update of

  • doi: 10.1002/14651858.CD013667

References

References to studies included in this review

Asarnow 2017 {published data only}
    1. Asarnow JR, Berk M, Hughes JL, Anderson NL. The SAFETY Program: a treatment-development trial of a cognitive-behavioral family treatment for adolescent suicide attempters. Journal of Clinical Child and Adolescent Psychology 2015;44:194-203. - PMC - PubMed
    1. Asarnow JR, Hughes JL, Babeva KN, Sugar CA. Cognitive-behavioral family treatment for suicide attempt prevention: a randomized controlled trial. Journal of the American Academy Child and Adolescent Psychiatry 2017;56:506-14. - PMC - PubMed
Cooney 2010 {published and unpublished data}
    1. Cooney E, Davis K, Thompson P, Wharewera-Mika J, Stewart J. Feasibility of Evaluating DBT for Self-Harming Adolescents: A Small Randomised Controlled Trial. Auckland, New Zealand: Te Pou o Te Whakaaro Nui and The National Centre of Mental Health Research, Information and Workforce Development, 2010.
Cotgrove 1995 {published data only}
    1. Cotgrove A, Zirnisky L, Black D, Weston D. Secondary prevention of attempted suicide in adolescence. Journal of Adolescence 1995;18:569-77.
Cottrell 2018 {published and unpublished data}ISRCTN59793150
    1. Cottrell DJ, Wright-Hughes A, Collinson M, Boston P, Eisler I, Fortune S, et al. A pragmatic randomised controlled trial and economic evaluation of family therapy versus treatment as usual for young people seen after second or subsequent episodes of self-harm: the Self-Harm Intervention – Family Therapy (SHIFT) trial. Health Technology Assessment 2018;22:1-222. [DOI: 10.3310/hta22120] - DOI - PMC - PubMed
    1. Cottrell DJ, Wright-Hughes A, Collinson M, Boston P, Eisler I, Fortune S, et al. Effectiveness of systemic family therapy versus treatment as usual for young people after self-harm: a pragmatic, phase 3, multicentre, randomised controlled trial. Lancet Psychiatry 2018;5:203-16. - PMC - PubMed
    1. Cottrell DJ, Wright-Hughes A, Eisler I, Fortune S, Green J, House AO, et al. Longer-term effectiveness of systemic family therapy compared with treatment as usual for young people after self-harm: an extended follow-up of pragmatic randomised controlled trial. eClinical Medicine 2020;18:100246. - PMC - PubMed
    1. Holliday R, Brennan C, Cottrell D. Understanding adolescents' experiences of self-harm: secondary analysis of family therapy sessions from the SHIFT trial. Archives of Suicide Research 2020;24:190-203. - PubMed
    1. Tubeuf S, Saloniki E-C, Cottrell D. Parental health spillover in cost-effectiveness analysis: evidence from self-harming adolescents in England. PharmacoEconomics 2019;37:513–30. - PubMed
Donaldson 2005 {published data only}
    1. Donaldson D, Spirito A, Esposito-Smythers C. Treatment for adolescents following a suicide attempt: results of a pilot trial. Journal of the American Academy of Child and Adolescent Psychiatry 2005;44:113-20. - PubMed
    1. Donaldson D, Spirito A, Overholser J. Treatment of adolescent suicide attempters. In: Spirito A, Overholser JC, editors(s). Evaluating and Treating Adolescent Suicide Attempters: From Research to Practice. San Diego, CA: Academic Press, 2003:295-321.
Green 2011 {published data only}
    1. Ayodeji E, Green J, Roberts C, Trainor G, Rothwell J, Woodham E, et al. The influence of personality disorder on outcome in adolescent self-harm. British Journal of Psychiatry 2015;207:313-9. - PubMed
    1. Green JM, Wood AJ, Kerfoot MJ, Trainor G, Roberts C, Rothwell J, et al. Group therapy for adolescents with repeated self harm: randomised controlled trial with economic evaluation. British Medical Journal 2011;342:d682. - PMC - PubMed
Griffiths 2019 {published data only}
    1. Griffiths H, Duffy F, Duffy L, Brown S, Hockaday H, Eliasson E, et al. Efficacy of mentalization-based group therapy for adolescents: the results of a pilot randomised controlled trial. BMC Psychiatry 2019;19:167. - PMC - PubMed
Harrington 1998 {published data only}
    1. Aglan A, Kerfoot M, Pickles A. Pathways from adolescent deliberate self-poisoning to early adult outcomes: a six-year follow-up. Journal of Child Psychology and Psychiatry 2008;49:508-15. - PubMed
    1. Byford S, Harrington R, Torgerson D, Kerfoot M, Dyer E, Harrington V, et al. Cost-effectiveness analysis of a home-based social work intervention for children and adolescents who have deliberately poisoned themselves: results of a randomised controlled trial. British Journal of Psychiatry 1999;174:56-62. - PubMed
    1. Chitsabesan P, Harrington R, Harrington V, Tomenson B. Predicting repeat self-harm in children: how accurate can we expect to be? European Child and Adolescent Psychiatry 2003;12:23-9. - PubMed
    1. Harrington R, Kerfoot M, Dyer E, McNiven F, Gill J, Harrington V, et al. Deliberate self-poisoning in adolescence: why does a brief family intervention work in some cases and not others? Journal of Adolescence 2000;23:13-20. - PubMed
    1. Harrington R, Kerfoot M, Dyer E, McNiven F, Gill J, Harrington V, et al. Randomized trial of a home-based family intervention for children who have deliberately poisoned themselves. Journal of the American Academy of Child and Adolescent Psychiatry 1998;37:512-8. - PubMed
Hazell 2009 {published data only}
    1. Hazell PL, Martin G, McGill K, Kay T, Wood A, Trainor G, et al. Group therapy for repeated deliberate self-harming adolescents: failure of replication of a randomized trial. Journal of the American Academy of Child and Adolescent Psychiatry 2009;48:662-70. - PubMed
McCauley 2018 {published data only}
    1. Adrian M, McCauley E, Berk MS, Asarnow JR, Korslund K, Avina C, et al. Predictors and moderators of recurring self-harm in adolescents participating in a comparative treatment trial of psychological interventions. Journal of Child Psychology and Psychiatry 2019;60:1123-32. - PMC - PubMed
    1. McCauley E, Adrian M, Curtis A. 5.5. Youth suicide: how gender, sexual orientation, and gender-nonconforming status shape risk and inform intervention strategies. Journal of the American Academy of Child and Adolescent Psychiatry 2018;57:S128.
    1. McCauley E, Berk MS, Asarnow JR, Adrian M, Cohen J, Korslund K, et al. Efficacy of dialectical behavior therapy for adolescents at high risk for suicide: a randomized clinical trial. JAMA Psychiatry 2018;75:777-85. - PMC - PubMed
Mehlum 2014 {published and unpublished data}
    1. Haga E, Aas E, Grøholt B, Tørmoen AJ, Mehlum L. Cost-effectiveness of dialectical behaviour therapy vs. enhanced usual care in the treatment of adolescents with self-harm. Child and Adolescent Psychiatry and Mental Health 2018;12:22. - PMC - PubMed
    1. Mehlum L, Ramberg M, Tørmoen AJ, Haga E, Diep LM, Stanley BH. Dialectical behavior therapy compared with enhanced usual care for adolescents with repeated suicidal and self-harming behavior: outcomes over a one-year follow-up. Journal of the American Academy of Child and Adolescent Psychiatry 2016;55:295-300. - PubMed
    1. Mehlum L, Tømoen AJ, Ramberg M, Haga E, Diep LM, Laberg S, et al. Dialectical behavior therapy for adolescents with repeated suicidal and self-harming behavior - a randomized trial. Journal of the American Academy of Child and Adolescent Psychiatry 2014;53:1082-91. - PubMed
    1. Ramleth R-K, Groholt B, Diep LM, Walby FA, Mehlum L. The impact of borderline personality disorder and sub-threshold borderline personality disorder on the course of self-reported and clinician-rated depression in self-harming adolescents. Borderline Personality Disorder and Emotion Dysregulation 2017;4:22. - PMC - PubMed
Ougrin 2011 {published and unpublished data}
    1. Ougrin D, Boege I, Stahl D, Banarsee R, Taylor E. Randomised controlled trial of therapeutic assessment versus usual assessment in adolescents with self-harm: 2-year follow-up. Archives of Diseases in Childhood 2013;98:772-6. - PubMed
    1. Ougrin D, Zundel T, Kyriakopoulos M, Banarsee R, Stahl D, Taylor E. Adolescents with suicidal and nonsuicidal self harm: clinical characteristics and response to therapeutic assessment. Psychological Assessment 2012;24:11-20. - PubMed
    1. Ougrin D, Zundel T, Ng A, Banarsee R, Bottle A, Taylor E. Trial of therapeutic assessment in London: randomised controlled trial of therapeutic assessment versus standard psychosocial assessment in adolescents presenting with self harm. Archives of Disease in Childhood 2011;96:148-53. - PubMed
Rossouw 2012 {published and unpublished data}
    1. Rossouw T. Self-harm in young people: is MBT the answer? In: Midgley N, Vrouva I, editors(s). Minding the Child: Mentalization-Based Interventions with Children, Young People and their Families. New York, NY: Routledge, 2012:131-44.
    1. Rossouw T. W1-02-02. Mentalisation based treatment for adolescents with self harm: an RCT. European Child and Adolescent Psychiatry 2015;24:S113.
    1. Rossouw TI, Fonagy P. Mentalization-based treatment for self-harm in adolescents: a randomized controlled trial. Journal of the American Academy of Child and Adolescent Psychiatry 2012;51:304-13. - PubMed
Santamarina‐Pérez 2020 {published and unpublished data}
    1. Santamarina P, Mendez-Blanco I, Picado M, Font E, Moreno E, Martínez E, et al. 3.65. Dialectical behavior therapy versus supportive therapy for adolescents with suicidal behavior: a randomized controlled trial. Journal of the American Academy of Child and Adolescent Psychiatry 2017;56:S226.
    1. Santamarina-Pérez P, Cela R, Méndez-Blanco I, Font-Martínez E, Picado-Rossi M, Martínez-Mallén E, et al. P.2.f.013. Efficacy of dialectical behavior therapy compared to supportive therapy in adolescents with suicidal behavior. European Neuropsychopharmacology 2017;27:S853.
    1. Santamarina-Pérez P, Mendez I, Singh MK, Berk M, Picado M, Font E, et al. Adapted dialectical behavior therapy for adolescents with a high risk of suicide in a community clinic: a pragmatic randomized controlled trial. Suicide and Life Threatening Behavior 2020;50:652-67. - PubMed
Sinyor 2020 {published data only}
    1. Sinyor M, Williams M, Mitchell R, Zaheer R, Bryan CJ, Schaffer A, et al. Cognitive behavioral therapy for suicide prevention in youth admitted to hospital following an episode of self-harm: a pilot randomized controlled trial. Journal of Affective Disorders 2020;266:686-94. - PubMed
    1. Williams M, Tien H, Schaffer A, Ellis J, Cheung A, Goldstein B, et al. T68. Hope and borderline-personality disorder as predictors of study drop-out among inpatient youth receiving psychotherapy treatment for an episode of deliberate self-harm. Biological Psychiatry 2018;83:S155.
Spirito 2002 {published data only}
    1. Spirito A, Boergers J, Donaldson D, Bishop D, Lewander W. An intervention trial to improve adherence to community treatment by adolescents after a suicide attempt. Journal of Child and Adolescent Psychiatry 2002;41:435-42. - PubMed
    1. Spirito A, Stanton C, Donaldson D, Boergers J. Treatment-as-usual for adolescent suicide attempters: implications for the choice of comparison groups in psychotherapy research. Journal of Clinical Child and Adolescent Psychology 2002;31:41-7. - PubMed
Wood 2001a {published data only}
    1. Wood A, Trainor G, Rothwell J, Moore A, Harrington R. Randomized trial of group therapy for repeated deliberate self-harm in adolescents. Journal of the American Academy of Child and Adolescent Psychiatry 2001;40:1246-53. - PubMed
    1. Wood A, Trainor G. Developmental Group Psychotherapy for Adolescents: A Manual for Mental Health Professionals. Manchester, UK: University of Manchester, 2001.

References to studies excluded from this review

Alavi 2013 {published and unpublished data}
    1. Alavi A, Sharifi B, Ghanizadeh A, Dehbozorgi G. Effectiveness of cognitive-behavioral therapy in decreasing suicidal ideation and hopelessness of the adolescents with previous suicidal attempts. Iranian Journal of Pediatrics 2013;23:467-72. - PMC - PubMed
    1. Alavi AS, Sharifi B, Ghanizadeh A, Dehbozorgi G. Cognitive-behavioral therapy in decreasing suicidal ideation and hopelessness in depressed adolescents with previous suicidal attempt. Neuropsychiatrie de l’Enfance et de l’Adolescence 2012;60S:S172-3. - PMC - PubMed
Czyz 2019 {published data only}
    1. Czyz EK, King CA, Biermann BJ. Motivational interviewing-enhanced safety planning for adolescents at high suicide risk: a pilot randomized controlled trial. Journal of Clinical Child and Adolescent Psychology 2019;48:250-62. - PubMed
Diamond 2012 {published data only}
    1. Diamond GS, Levy S. Attachment-oriented family therapy as an outpatient follow-up care for adolescents after attempted suicide [Bindungsorientierte familientherapie als ambulante nachsorge für jugendliche nach suizidversuch]. Psychotherapie im Dialog 2012;13:41-5.
Diamond 2019 {published data only}
    1. Diamond GS, Kobak RR, Ewing ESK, Levy SA, Herres JL, Russon JM, et al. A randomized controlled trial: attachment-based family and nondirective supportive treatments for youth who are suicidal. Journal of the American Academy of Child and Adolescent Psychiatry 2019;58:721-31. - PMC - PubMed
    1. Lifshitz C, Tsvieli N, Bar-Kalifa E, Abbott C, Diamond GS, Kobak RR, et al. Emotional processing in attachment-based family therapy for suicidal adolescents. Psychotherapy Research 2021;31(2):267-79. [DOI: 10.1080/10503307.2020.1745315] - DOI - PubMed
English 2019 {published data only}
    1. English O, Wellings C, Banerjea P, Ougrin D. Specialized therapeutic assessment-based recovery-focused treatment for young people with self-harm: pilot study. Frontiers in Psychiatry 2019;10:895. - PMC - PubMed
Esposito‐Smythers 2017 {published data only}
    1. Esposito-Smythers C, Hadley W, Curby TW, Brown LK. Randomized pilot trial of a cognitive-behavioral alcohol, self-harm, and HIV prevention program for teens in mental health treatment. Behaviour Research and Therapy 2017;89:49-56. - PMC - PubMed
Esposito‐Smythers 2019 {published data only}
    1. Esposito-Smythers C, Wolff JC, Liu RT, Hunt JI, Adams L, Kim K, et al. 2019. Family-focused cognitive behavioral treatment for depressed adolescents in suicidal crisis with co-occurring risk factors: a randomized trial 2019;60:1133-41. - PMC - PubMed
Gillespie 2019 {published data only}
    1. Gillespie C, Joyce M, Flynn D, Corcoran P. Dialectical behaviour therapy for adolescents: a comparison of 16-week and 24-week programmes delivered in a public community setting. Child and Adolescent Mental Health 2019;24:266-73. - PubMed
Kaess 2020a {published and unpublished data}
    1. Fischer G, Brunner R, Parzer P, Resch F, Kaess M. Short term psychotherapeutic treatment in adolescents engaging in non-suicidal self-injury: a randomized controlled trial. Trials 2013;14:294. - PMC - PubMed
    1. Kaess M, Edinger A, Fischer-Waldschmidt G, Parzer P, Brunner R, Resch F. Effectiveness of a brief psychotherapeutic intervention compared with treatment as usual for adolescent nonsuicidal self-injury: a single-centre, randomised controlled trial. European Child and Adolescent Psychiatry 2020;29:881-91. - PMC - PubMed
Kennard 2018 {published and unpublished data}
    1. Brent DA, Kennard BD. 22.4. Impact of a brief inpatient intervention and suicide safety planning app to decrease suicidal behavior after hospital discharge. Journal of the American Academy of Child and Adolescent Psychiatry 2018;57:S33.
    1. Kennard BD, Biernesser C, Wolfe KL, Foxwell AA, Craddock-Lee SJ, Rial KV, et al. Developing a brief suicide prevention intervention and mobile phone application: a qualitative report. Journal of Technology in Human Services 2015;33:345-57. - PMC - PubMed
    1. Kennard BD, Goldstein T, Foxwell AA, McMakin DL, Wolfe K, Biernesser C, et al. As Safe As Possible (ASAP): a brief app-supported inpatient intervention to prevent postdischarge suicidal behavior in hospitalized, suicidal adolescents. American Journal of Psychiatry 2018;175:864-72. - PMC - PubMed
King 2019 {published data only}
    1. King C, Arango A, Kramer A, Busby D, Czyz E, Foster CE, et al. 6.35. Effect of a Youth-Nominated Support Team on 10- to 12-year mortality outcomes of suicidal adolescents: an RCT. Journal of the American Academy of Child and Adolescent Psychiatry 2018;57:s260.
    1. King CA, Arango A, Kramer A, Busby D, Czyz E, Foster CE, et al. Association of the Youth-Nominated Support Team intervention for suicidal adolescents with 11- to 14-year mortality outcomes. JAMA Psychiatry 2019;76:492-8. - PMC - PubMed
Latimer 2014 {published data only}
    1. Greenfield B, Larson C, Hetchman L, Rousseau C, Platt R. A rapid-response outpatient model for reducing hospitalization rates among suicidal adolescents. Psychiatric Services 2002;53:1574-9. - PubMed
    1. Latimer EA, Gariépy G, Greenfield B. Cost-effectiveness of a rapid response team intervention for suicidal youth presenting at an emergency department. Canadian Journal of Psychiatry 2014;59:310-8. - PMC - PubMed
LoParo 2018 {published and unpublished data}
    1. LoParo D, Mack SA, Patterson B, Negi LT, Kaslow NJ. The efficacy of cognitively-based compassion training for African American suicide attempters. Mindfulness 2018;9:1941-54. - PMC - PubMed
Mubarak 2017 {published data only}
    1. Mubarak AR, Zeitz J, Slee P. Effectiveness of an intervention programme for teenage girls with self-harm in Adelaide, South Australia. In: Child and Adolescent Wellbeing and Violence Prevention in School. London, UK: Routledge, 2017:209-16.
NCT02726035 {unpublished data only}
    1. NCT02726035. Evaluation of naltrexone as a treatment for self-injurious behavior. clinicaltrials.gov/ct2/show/NCT02726035 (first received 1 April 2016).
Perera Ramani 2011 {published and unpublished data}
    1. Perera Ramani EA, Kathriarachchi ST. Problem-solving counselling as a therapeutic tool on youth suicidal behavior in the suburban population in Sri Lanka. Indian Journal of Psychiatry 2011;53:30-5. - PMC - PubMed
Pineda 2013 {published and unpublished data}
    1. Pineda J, Dadds MR. Family intervention for adolescents with suicidal behavior: a randomized controlled trial and mediation analysis. Journal of the American Academy of Child and Adolescent Psychiatry 2013;52:851-62. - PubMed
Rees 2015 {published data only}
    1. Rees CS, Hasking P, Breen LJ, Lipp OV, Marmotte C. Group mindfulness based cognitive therapy vs group support for self-injury among young people: study protocol for a randomised controlled trial. BMC Psychiatry 2015;15:154. - PMC - PubMed
Rengasamy 2019 {published and unpublished data}
    1. Rengasamy M, Phelps-Tschang J, Simpson M, Tew Jr JD, Sparks G. 6.50. Reduction of adolescent suicide attempts after telephone-based intervention. Journal of the American Academy of Child and Adolescent Psychiatry 2018;57:S265.
    1. Rengasamy M, Sparks G. Reduction of postdischarge suicidal behavior among adolescents through a telephone-based intervention. Psychiatric Services 2019;70:545-52. - PubMed
Rowe 2018 {published data only}ISRCTN11230559
    1. Rowe SL, French RS, Henderson C, Ougrin D, Slade M, Moran P. Decisional support for young people who self-harm: protocol for a feasibility trial. British Medical Journal Open 2016;6:e012161. - PMC - PubMed
    1. Rowe SL, Patel K, French RS, Henderson C, Ougrin D, Slade M, et al. Web-based decision aid to assist help-seeking choices for young people who self-harm: outcomes from a randomized controlled feasibility trial. Journal of Medical Internet Research Mental Health 2018;5:e10-13. - PMC - PubMed
Stallard 2016 {published data only}
    1. Stallard P, Porter J, Grist R. Safety, acceptability, and use of a smartphone app, BlueIce, for young people who self-harm: protocol for an open phase I trial. Journal of Medical Internet Research: Research Protocols 2016;5:e217. - PMC - PubMed
Tracey 2018 {published data only}
    1. Tracey M, Rowney G, Pignatiello A, Monga S, Korczak D. Feasibility of a manualized family-based suicide prevention strategy to reduce adolescent suicide risk among emergency department referred youth: a quality improvement project. Paediatrics and Child Health 2018;23:e54.
Wharff 2019 {published and unpublished data}
    1. Wharff EA, Ginnis KB, Ross AM, White EM, White MT, Forbes PW. Family-based crisis intervention with suicidal adolescents: a randomized clinical trial. Pediatric Emergency Care 2019;35:170-5. - PubMed
Xavier 2019 {published data only}
    1. Xavier A, Otero P, Blanco V, Vázquez FL. Efficacy of a problem-solving intervention for the indicated prevention of suicidal risk in young Brazilians: randomized controlled trial. Suicide and Life-Threatening Behavior 2019;49:1746-61. - PubMed
Yen 2019 {published and unpublished data}
    1. Yen S, Spirito A, Weinstock LM, Tezanos K, Kolobaric A, Miller I. Coping long term with active suicide in adolescents: results from a pilot randomized controlled trial. Clinical Child Psychology and Psychiatry 2019;24:847-59. - PMC - PubMed
Yen 2020 {published and unpublished data}
    1. Yen S, Ranney ML, Krek M, Peters JR, Mereish E, Tezanos KM, et al. Skills to enhance positivity in suicidal adolescents: results from a pilot randomized clinical trial. Journal of Positive Psychology 2020;15(3):348-61. [DOI: 10.1080/17439760.2019.1615105] - DOI - PMC - PubMed

References to ongoing studies

ACTRN12617000668303p {unpublished data only}
    1. ACTRN12617000668303p. Testing the efficacy of an Emotion Regulation Group Therapy for adolescent non-suicidal self-injury in Aotearoa New Zealand [A randomised control trial on the effect of Emotion Regulation Group Therapy on non-suicidal self-injury in adolescent]. www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12617000668303 (first received 1 May 2017).
ACTRN12618000085279p {unpublished data only}
    1. ACTRN12618000085279p. Improving care for adolescents during an inpatient admission following self-harm and suicidal acts [A pilot randomised trial of standard care versus structured care during an inpatient admission following self-harm and suicidal acts in adolescents]. www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12618000085279 (first received 29 December 2017).
Andreasson 2017 {published and unpublished data}
    1. Andreasson K, Krogh J, Bech P, Frandsen H, Buus N, Stanley B, et al. MYPLAN – mobile phone application to manage crisis of persons at risk of suicide: study protocol for a randomized controlled trial. Trials 2017;18:171. - PMC - PubMed
De Silva 2018 {published and unpublished data}
    1. De Silva ANLM, Dawson AH, Gawarammana IB, Tennakoon S, Rajapakse T. Study protocol: a pilot randomized controlled trial to evaluate the acceptability and feasibility of a counseling intervention, delivered by nurses, for those who have attempted self-poisoning in Sri Lanka. Pilot and Feasibility Studies 2018;4:150. - PMC - PubMed
ISRCTN10541045 {unpublished data only}ISRCTN10541045
    1. ISRCTN10541045. A comparison of usual care versus usual care plus a smartphone self-harm prevention app (BlueIce) in young adolescents aged 12-17 who self-harm: Beating Adolescent Self-Harm (BASH) - Version 1. www.isrctn.com/ISRCTN10541045 (first received 15 July 2019).
Kaess 2019 {published data only}
    1. Edinger A, Koenig J, Bauer S, Moessner M, Fischer-Waldschmidt G, Herpertz SC, et al. Development of an online intervention for the care of self-harming adolescents and young adults [Entwicklung einer online-Intervention für die versorgung von sich selbstverletzenden jugendlichen und jungen erwachsenen]. Praxis der Kinderpsychologie und Kinderpsychiatrie 2020;69:141-55. - PubMed
    1. Kaess M, Koenig J, Bauer S, Moessner M, Fischer-Waldschmidt G, Mattern M, et al. Self-injury: Treatment, Assessment, Recovery (STAR): online intervention for adolescent non-suicidal self-injury - study protocol for a randomized controlled trial. Trials 2019;20:425. - PMC - PubMed
Ligier 2016 {published and unpublished data}
    1. Ligier F, Kabuth B, Guillemin F. MEDIACONNEX: a multicenter randomised trial based on short message service to reduce suicide attempt recurrence in adolescents. BMC Psychiatry 2016;16:251. - PMC - PubMed
    1. NCT02762734. Prevention of recurrence of suicide attempt by adolescent by sending SMS: MEDIACONNEX. clinicaltrials.gov/ct2/show/NCT02762734 (first received 5 May 2016).
NCT03353961 {unpublished data only}
    1. NCT03353961. Internet delivered Emotion Regulation Individual Therapy for Adolescents (ERITA) with nonsuicidal self-Injury: a randomized controlled study. www.clinicaltrials.gov/ct2/show/NCT03353961 (first received 1 October 2020).
NCT03550521 {unpublished data only}
    1. NCT03550521. Interrupting self-harm study [A mixed methods investigation of brief mindfulness training and self-injury attentional bias among self-injuring adolescents]. clinicaltrials.gov/ct2/show/NCT03550521 (first received 8 June 2018).
NCT03709472 {unpublished data only}
    1. NCT03709472. Computer assisted family intervention to treat self-harm disparities in Latinas and sexual/gender minority youth (CA CIFFTA). clinicaltrials.gov/ct2/show/NCT03709472 (first received 17 October 2018).
NCT04131179 {unpublished data only}
    1. NCT04131179. Multicenter study to evaluate the clinical and cost effectiveness of a Youth Culturally Adapted Therapy (YCMAP) [Youth Culturally adapted Manual-Assisted Psychological therapy (Y-CMAP) in adolescents Pakistani patients with a history of self harm]. clinicaltrials.gov/ct2/show/NCT04131179 (first received 18 October 2019).
NCT04243603 {unpublished data only}
    1. NCT04243603. Effects of internet-based ERITA added to TAU in young people with non-suicidal self-injury (TEENS) feasibility trial [Treatment effects of internet-based Emotion Regulation Individual Therapy for Adolescents (ERITA) added to treatment as usual in young people with non-suicidal self-injury]. clinicaltrials.gov/ct2/show/results/NCT04243603 (first received 28 January 2020).
R000011786 {unpublished data only}
    1. R000011786-UMIN000010065. Randomized controlled trial of eye movement desensitization and reprocessing (EMDR) and interpersonal psychotherapy (IPT) for non-suicidal self injury in adolescent and young adult females: JNSSIAP study. upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000011786 (first received 18 February 2013).

Additional references

Albrecht 2014
    1. Albrecht B, Staiger PK, Hall K, Miller P, Best D, Lubman DI. Benzodiazepine use and aggressive behaviour: a systematic review. Australian and New Zealand Journal of Psychiatry 2014;48:1096-114. - PubMed
Allen 2008
    1. Allen JG, Fonagy P, Bateman AW. Mentalizing in Clinical Practice. Washington DC, USA: American Psychiatric Publishing, 2008.
Andover 2012
    1. Andover MS, Morris BW, Wren A, Bruzzese ME. The co-occurrence of non-suicidal self-injury and attempted suicide among adolescents: distinguishing risk and psychosocial correlates. Child and Adolescent Psychiatry and Mental Health 2012;6:11. - PMC - PubMed
Angold 1995
    1. Angold A, Costello EJ, Messer SC, Pickles A. The development of a short questionnaire for use in epidemiological studies in depression in children and adolescents. International Journal of Methods in Psychiatric Research 1995;5:237-49.
APA 2000
    1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR). Washington, DC: American Psychiatric Association, 2000.
Asarnow 2019
    1. Asarnow JR, Mehlum L. Practitioner review: treatment for suicidal and self-harming adolescents - advances in suicide prevention care. Journal of Child Psychology and Psychiatry 2019;60:1046-54. - PMC - PubMed
Beck 1961
    1. Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Archives of General Psychiatry 1961;4:561. - PubMed
Beck 1974
    1. Beck AT, Weissman A, Lester D, Trexler L. The measurement of pessimism: the Hopelessness Scale. Journal of Consulting and Clinical Psychology 1974;42:861-5. - PubMed
Beck 1988
    1. Beck AT, Steet RA, Ranieri WF. Scale for Suicide Ideation: psychometric properties of a self-report version. Journal of Clinical Psychology 1988;44:499-505. - PubMed
Bennardi 2016
    1. Bennardi M, McMahon E, Corcoran P, Griffin E, Arensman E. Risk of repeated self-harm and associated factors in children, adolescents, and young adults. BMC Psychiatry 2016;16:421. - PMC - PubMed
Berk 2016
    1. Berk MS, Hughes J. Cognitive behavioral approaches for treating suicidal behavior in adolescents. Current Psychiatry Reviews 2016;12:4-13.
Bird 1993
    1. Bird HR, Shaffer D, Fisher P, Gould MS. The Columbia Impairment Scale (CIS): pilot findings on a measure of global impairment for children and adolescents. International Journal of Methods in Psychiatric Research 1993;3:167-76.
Bohus 2007
    1. Bohus M, Limberger MF, Frank U, Chapman AL, Kuhler T, Stieglitz RD. Psychometric properties of the Borderline Symptom List (BSL). Psychopathology 2007;40:126-32. - PubMed
Bould 2019
    1. Bould H, Mars B, Moran P, Biddle L, Gunnell D. Rising suicide rates among adolescents in England and Wales. Lancet 2019;394:116-7. - PubMed
Boyce 1989
    1. Boyce P, Parker G. Development of a scale to measure interpersonal sensitivity. Australian and New Zealand Journal of Psychiatry 1989;23:341-51. - PubMed
Brausch 2019
    1. Brausch AM, Woods SE. Emotion regulation deficits and nonsuicidal self-injury prospectively predict suicidal ideation in adolescents. Suicide & Life-threatening Behavior 2019;49:868-80. - PMC - PubMed
Brennan 1998
    1. Brennan KA, Clark CL, Shaver PR. Self-report measurement of adult attachment: an integrative overview. In: Simpson JA, Rholes WS, editors(s). Attachment Theory and Close Relationships. New York, NY: Guilford Press, 1998.
Brenning 2014
    1. Brenning K, Van Petegem S, Vanhalst J, Soenens B. The psychometric qualities of a short version of the Experiences in Close Relationships Scale – Revised Child version. Personality and Individual Differences 2014;68:118-23.
Brent 2019
    1. Brent DA. Master clinician review: saving Holden Caulfield: suicide prevention in children and adolescents. Journal of the American Academy of Child and Adolescent Psychiatry 2019;58:25-35. - PubMed
Brunner 2002
    1. Brunner J, Parhofer KG, Schwandt P, Bronisch T. Cholesterol, essential fatty acids, and suicide. Pharmacopsychiatry 2002;35:1-5. - PubMed
Busby 2020
    1. Busby DR, Hatkevich C, McGuire TC, King CA. Evidence-based interventions for youth suicide risk. Current Psychiatry Reports 2020;22:5. - PubMed
Bustamante‐Madsen 2018
    1. Bustamante-Madsen L, Eddleston M, Schultz-Hansen K, Konradsen F. Quality assessment of economic evaluations of suicide and self-harm interventions. Crisis 2018;39:82-95. - PubMed
Cairns 2019
    1. Cairns R, Karanges EA, Wong A, Brown JA, Robinson J, Pearson S-A, et al. Tends in self-poisoning and psychotropic drug use in people aged 5 – 19 years: a retrospective cohort study in Australia. BMJ Open 2019;9:e026001. [DOI: 10.1136/bmjopen-2018-026001] - DOI - PMC - PubMed
Calear 2016
    1. Calear AL, Christensen H, Freeman A, Fenton K, Busby Grant J, Van Spijker B, et al. A systematic review of psychosocial suicide prevention interventions for youth. European Child and Adolescent Psychiatry 2016;25:467-82. - PubMed
Carter 2016
    1. Carter G, Page A, Large M, Hetrick S, Milner AJ, Bendit N, et al. Royal Australian and New Zealand College of Psychiatrists clinical practice guideline for the management of deliberate self-harm. Australian and New Zealand Journal of Psychiatry 2016;50:939-1000. - PubMed
Chezan 2017
    1. Chezan LC, Gable RA, McWhorter GZ, White SD. Current perspectives on interventions for self-injurious behavior of children with autism spectrum disorder: a systematic review of the literature. Journal of Behavioral Education 2017;26:293-329.
Chorpita 2000
    1. Chorpita BF, Yim L, Moffitt C, Umemoto LA, Francis SE. Assessment of symptoms of DSM-IV anxiety and depression in children: a revised child anxiety and depression scale. Behaviour Research and Therapy 2000;38:835-55. - PubMed
Cipriani 2013a
    1. Cipriani A, Hawton K, Stockton S, Geddes JR. Lithium in the prevention of suicide in mood disorders: updated systematic review and meta-analysis. BMJ 2013;346:f3646. - PubMed
Cipriani 2013b
    1. Cipriani A, Reid K, Young AH, Macritchie K, Geddes J. Valproic acid, valproate and divalproex in the maintenance treatment of bipolar disorder. Cochrane Database of Systematic Reviews 2013, Issue 10. Art. No: CD003196. [DOI: 10.1002/14651858.CD003196.pub2] - DOI - PMC - PubMed
Claes 2007
    1. Claes L, Wandereycken W, Vertommen H. Self-injury in female versus male psychiatric patients: a comparison of characteristics, psychopathology and aggression regulation. Personality and Individual Differences 2007;42:611-21.
Courtney 2019
    1. Courtney DB, Duda S, Szatmari P, Henderson J, Bennett K. Systematic review and quality appraisal of practice guidelines for self-harm in children and adolescents. Suicide & Life-threatening Behavior 2019;49:707-23. - PubMed
Cox 2014
    1. Cox GR, Callahan P, Churchill R, Hunot V, Merry SN, Parker AG, et al. Psychological therapies versus antidepressant medication, alone and in combination, for depression in children and adolescents. Cochrane Database of Systematic Reviews 2014, Issue 11. Art. No: CD008324. [DOI: 10.1002/14651858.CD008324.pub3] - DOI - PMC - PubMed
Cox 2017
    1. Cox G, Hetrick S. Psychosocial interventions for self-harm, suicidal ideation and suicide attempt in children and young people: What? How? Who? and Where? Evidence Based Mental Health 2017;20:35-40. - PMC - PubMed
Crowell 2012
    1. Crowell SE, Beauchaine TP, Hsiao RC, Wasilev CA, Yaptangco M, Linehan MM. Differentiating adolescent self-injury from adolescent depression: possible implications for borderline personality development. Journal of Abnormal Child Psychology 2012;40:45-57. - PMC - PubMed
Curtin 2002a
    1. Curtin F, Elbourne D, Altman DG. Meta-analysis combining parallel and cross-over clinical trials. III. The issue of carry-over. Statistics in Medicine 2002;21:2161-73. - PubMed
Curtin 2002b
    1. Curtin F, Altman DG, Elbourne D. Meta-analysis combining parallel and cross-over clinical. I. Continuous outcomes. Statistics in Medicine 2002;21:2131-44. - PubMed
D'Zurilla 2010
    1. D'Zurilla TJ, Nezu AM. Problem-solving therapy. In: Dobson KS, editors(s). Handbook of Cognitive-Behavioral Therapies. 3rd edition. New York, NY: Guilford Press, 2010.
Davasaambuu 2019
    1. Davasaambuu S, Itzhaky L, Ellis SP, Cisneros S, Scolaro K, Lemberansky J, et al. Systematic review and meta-analysis of randomized clinical trials of nonpharmacologic interventions to reduce suicide risk among adolescents. Neuropsychopharmacology 2019;44:S103-4.
De Beurs 2018
    1. De Beurs D, Vancayseele N, Van Borkulo C, Portzky G, Van Heeringen K. The association between motives, perceived problems and current thoughts of self-harm following an episode of self-harm: a network analysis. Journal of Affective Disorders 2018;240:262-70. - PubMed
Deeks 2019
    1. Deeks JJ, Higgins JPT, Altman DG, editor(s). Chapter 10: Analysing data and undertaking meta-analyses. In: Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, et al, editor(s). Cochrane Handbook for Systematic Reviews of Interventions version 6.0 (updated July 2019). Cochrane, 2019. Available from www.training.cochrane.org/handbook.
Devenish 2016
    1. Devenish B, Berk L, Lewis AJ. The treatment of suicidality in adolescents by psychosocial interventions for depression: a systematic literature review. Australian and New Zealand Journal of Psychiatry 2016;50:726-40. - PubMed
Diamond 2014
    1. Diamond GS, Diamond GM, Levy SA. Attachment Based Family Therapy for Depressed Adolescents. Washington DC, USA: American Psychological Association, 2014.
Diggins 2017
    1. Diggins E, Kelley R, Cottrell D, House A, Owens D. Age-related differences in self-harm presentations and subsequent management of adolescents and young adults at the emergency department. Journal of Affective Disorders 2017;208:399-405. - PubMed
Donner 2002
    1. Donner A, Klar N. Issues in the meta-analysis of cluster randomized trials. Statistics in Medicine 2002;21:2971-80. - PubMed
Easterbrook 1991
    1. Easterbrook PJ, Gopalan R, Berlin JA, Matthews DR. Publication bias in clinical research. Lancet 1991;337:867-72. - PubMed
Egger 1997
    1. Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ 1997;315:629-34. - PMC - PubMed
Elbourne 2002
    1. Elbourne DR, Altman DG, Higgins JPT, Curtin F, Worthington HV, Vail A. Meta-analyses involving cross-over trials: methodological issues. International Journal of Epidemiology 2002;31:140-9. - PubMed
EMA 2005
    1. European Medicines Agency. European Medicines Agency finalises review of antidepressants in children and adolescents. www.ema.europa.eu/en/news/european-medicines-agency-finalises-review-ant... (accessed 7 July 2020).
Endicott 2006
    1. Endicott J, Nee J, Yang R, Wohlberg C. Pediatric Quality of Life Enjoyment and Satisfaction Questionnaire (PQ-LES-Q): reliability and validity. Journal of the American Academy of Child and Adolescent Psychiatry 2006;45:401-7. - PubMed
Engles 2003
    1. Engles JM, Diehr P. Imputation of missing longitudinal data: a comparison of methods. Journal of Clinical Epidemiology 2003;56:968-76. - PubMed
Epstein 1983
    1. Epstein NB, Baldwin LM, Bishop DS. The McMaster Family Assessment Device. Journal of Marital and Family Therapy 1983;9:171-80.
Erez 1996
    1. Erez A, Bloom MC, Wells MT. Using random rather than fixed effects models in meta-analysis: implications for situation specificity and validity generalization. Personnel Psychology 1996;49:275-306.
EuroQol Group 1990
    1. The EuroQol Group. EuroQol - a new facility for the measurement of health-related quality of life. Health Policy 1990;16:199-208. - PubMed
FDA 2004
    1. US Food and Drug Administration. Relationship between psychotropic drugs and pediatric suicidality: review and evaluation of clinical data. www.fda.gov/ohrms/dockets/ac/04/briefing/2004-4065b1-10-TAB08-Hammads-Re... (accessed prior to 10 Feb 2021).
FDA 2019
    1. US Food and Drug Administration. FDA approves new nasal spray medication for treatment-resistant depression. www.fda.gov/news-events/press-announcements/fda-approves-new-nasal-spray... (accessed 18 March 2020).
First 1997
    1. First MB, Gibbon M, Spitzer RL, Benjamin LS. User’s Guide for the Structured Clinical Interview for DSM-IV Axis II Personality Disorders: SCID-II. 1st edition. Washington, DC: American Psychiatric Association Publishing, 1997.
Flaherty 2018
    1. Flaherty HB. Treating adolescent nonsuicidal self-injury: a review of psychosocial interventions to guide clinical practice. Child and Adolescent Social Work Journal 2018;35:85-95.
Fleiss 1994
    1. Fleiss JL. Measures of effect size for categorical data. In: Cooper H, Hedges LV, editors(s). The Handbook of Research Synthesis. New York, NY: Russell Sage Foundation, 1994.
Fonagy 2019
    1. Fonagy P, Campbell C, Rossouw T, Bateman A. Mentalization-based therapy for adolescents. In: Evidence-Based Treatment Approaches for Suicidal Adolescents: Translating Science into Practice. Washington, DC: American Psychiatric Publishing, 2019.
Fortune 2016
    1. Fortune S, Cottrell D, Fife S. Family factors associated with adolescent self-harm: a review. Journal of Family Therapy 2016;38:226-56.
Friedlander 2006
    1. Friedlander ML, Escudero V, Horvath AO, Heatherington L, Cabero A, Martens MP. System for observing family therapy alliances: a tool for research and practice. Journal of Counseling Psychology 2006;53:214-25.
Furlong 2001
    1. Furlong WJ, Feeny DH, Torrance GW, Barr RD. The Health Utilities Index (HUI) system for assessing health-related quality of life in clinical studies. Annals of Medicine 2001;33:375-84. - PubMed
Gardner 2019
    1. Gardner W, Pajer K, Cloutier P, Zemek R, Currie L, Hatcher S, et al. Changing rates of self-harm and mental disorders by sex in youths presenting to Ontario emergency departments: repeated cross-sectional study. Canadian Journal of Psychiatry 2019;64:789-97. - PMC - PubMed
Geulayov 2018
    1. Geulayov G, Casey D, McDonald KC, Foster P, Pritchard K, Wells C, et al. Incidence of suicide, hospital-presenting non-fatal self-harm, and community-occurring non-fatal self-harm in adolescents in England (the Iceberg Model of Self-Harm): a retrospective study. Lancet Psychiatry 2018;5:167-74. - PubMed
Gibbons 2007
    1. Gibbons RD, Brown CH, Hur K, Marcus SM, Bhaumik DK, Erkens JA, et al. Early evidence on the effects of regulators' suicidality warnings on SSRI prescriptions and suicide in children and adolescents. American Journal of Psychiatry 2007;164:1356-63. - PubMed
Gilbert 2020
    1. Gilbert AC, DeYoung LLA, Barthelemy CM, Jenkins GA, MacPherson HA, Kim KL, et al. The treatment of suicide and self-injurious behaviors in children and adolescents. Current Treatment Options in Psychiatry 2020;7:39-52.
Gjelsvik 2014
    1. Gjelsvik B, Heyerdahl F, Lunn D, Hawton K. Change in access to prescribed medication following an episode of deliberate self-poisoning: a multilevel approach. PLOS One 2014;9:e98086. - PMC - PubMed
Glenn 2019
    1. Glenn CR, Esposito EC, Porter AC, Robinson DJ. Evidence base update of psychosocial treatments for self-injurious thoughts and behaviors in youth. Journal of Clinical Child and Adolescent Psychology 2019;48:357-92. - PMC - PubMed
Goldberg 1972
    1. Goldberg DP. The Detection of Psychiatric Illnesss by Questionnaire. London, UK: Oxford University Press, 1972.
Good 2006
    1. Good CR. Adjunctive quetiapine targets self-harm behaviors in adolescent females with major depressive disorder. Journal of Child and Adolescent Psychopharmacology 2006;16:235-6. - PubMed
Goodman 1998
    1. Goodman R, Meltzer H, Bailey V. The Strengths and Difficulties Questionnaire: a pilot study on the validity of the self-report version. European Child and Adolescent Psychiatry 1998;7:125-30. - PubMed
Gowers 1999
    1. Gowers SG, Harrington RC, Whitton A, Lelliott P, Beevor A, Wing J, et al. Brief scale for measuring the outcomes of emotional and behavioural disorders in children: the Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA). British Journal of Psychiatry 1999;174:413-6. - PubMed
GRADEpro GDT 2015 [Computer program]
    1. GRADEpro GDT. Version accessed 26 June 2020. Hamilton (ON): McMaster University (developed by Evidence Prime). Available at www.gradepro.org.
Granboulan 2001
    1. Granboulan V, Roudot-Thoraval F, Lemerle S, Alvin P. Predictive factors of post-discharge follow-up care among adolescent suicide attempters. Acta Psychiatrica Scandinavica 2001;104:31-6. - PubMed
Gratz 2004
    1. Gratz KL, Roemer L. Multidimensional assessment of emotion regulation and dysregulation: development, factor structure, and initial validation of the Difficulties in Emotion Regulation Scale. Journal of Psychopathology and Behavioral Assessment 2004;26:41-54.
Griffin 2018
    1. Griffin E, McMahon E, McNicholas F, Corcoran P, Perry IJ, Arensman E. Increasing rates of self-harm among children, adolescents and young adults: a 10-year national registry study 2007-2016. Social Psychiatry and Psychiatric Epidemiology 2018;53:663-71. - PubMed
Grist 2018
    1. Grist R, Porter J, Stallard P. Acceptability, use, and safety of a mobile phone app (BlueIce) for young people who self-harm: qualitative study of service users’ experience. Journal of Medical Internet Research Mental Health 2018;5:e16. - PMC - PubMed
Guy 1976
    1. Guy W. Assessment Manual for Psychopharmacology. Rockville, MD: US Department of Heath, Education, and Welfare Public Health Service Alcohol, Drug Abuse, and Mental Health Administration, 1976.
Ha 2013
    1. Ha C, Sharp C, Ensink K, Fonagy P, Cirino P. The measurement of reflective function in adolescents with and without borderline traits. Journal of Adolescence 2013;36:1215-23. - PubMed
Hassett 2017
    1. Hassett A, Isbister C. Young men's experiences of accessing and receiving help from Child and Adolescent Mental Health Services following self-harm. SAGE Open 2017;1:1-14.
Hawton 2003
    1. Hawton K, Hariss L, Hall S, Simkin S, Bale E, Bond A. Deliberate self-harm in Oxford, 1990-2000: a time of change in patient characteristics. Psychological Medicine 2003;33:987-96. - PubMed
Hawton 2004
    1. Hawton K, Harriss L, Simkin S, Bale E, Bond A. Self-cutting: patient characteristics compared with self-poisoners. Suicide and Life-Threatening Behavior 2004;34:199-208. - PubMed
Hawton 2007
    1. Hawton K, Bergen H, Casey D, Simkin S, Palmer B, Cooper J, et al. Self-harm in England: a tale of three cities. Multicentre study of self-harm. Social Psychiatry and Psychiatric Epidemiology 2007;42:513-21. - PubMed
Hawton 2008
    1. Hawton K, Harriss L. The changing gender ratio in occurrence of deliberate self-harm across the lifecycle. Crisis 2008;29:4-10. - PubMed
Hawton 2010
    1. Hawton K, Bergen H, Simkin S, Cooper K, Water K, Gunnell D, et al. Toxicity of antidepressants: rates of suicide relative to prescribing and non-fatal overdose. British Journal of Psychiatry 2010;196:354-8. - PMC - PubMed
Hawton 2012a
    1. Hawton K, Bergen H, Kapur N, Cooper J, Steeg S, Ness J, et al. Repetition of self-harm and suicide following self-harm in children and adolescents: findings from the Multicentre Study of Self-Harm in England. Journal of Child Psychology and Psychiatry 2012;53:1212-9. - PubMed
Hawton 2012b
    1. Hawton K, Saunders KEA, O'Connor R. Self-harm and suicide in adolescents. Lancet 2012;379:2373-82. - PubMed
Hawton 2012c
    1. Hawton K, Bergen H, Waters K, Ness J, Cooper J, Steeg S, et al. Epidemiology and nature of self-harm in children and adolescents: findings from the Multicentre Study of Self-harm in England. European Child & Adolescent Psychiatry 2012;21:369-77. - PubMed
Hawton 2013
    1. Hawton K, Saunders KEA, Topiwala A, Haw C. Psychiatric disorders in patients presenting to hospital following self-harm: a systematic review. Journal of Affective Disorders 2013;151:821-30. - PubMed
Hawton 2016
    1. Hawton K, Witt KG, Taylor Salisbury TL, Arensman E, Gunnell D, Hazell P, et al. Psychosocial interventions for self-harm in adults. Cochrane Database of Systematic Reviews 2016, Issue 5. Art. No: CD012189. [DOI: 10.1002/14651858.CD012189] - DOI - PMC - PubMed
Hawton 2020a
    1. Hawton K, Bale L, Brand F, Townsend E, Ness J, Waters K, et al. Mortality in children and adolescents following presentation to hospital after non-fatal self-harm in the Multicentre Study of Self-harm: a prospective observational cohort study. Lancet Child & Adolescent Health 2020;4(2):111-20. [DOI: 10.1016/S2352-4642(19)30373-6] - DOI - PubMed
Hawton 2020b
    1. Hawton K, Hill NTM, Gould M, John A, Lascelles K, Robinson J. Clustering of suicides in children and adolescents. Lancet Child and Adolescent Health 2020;4:58-67. - PubMed
Healy 2003
    1. Healy D. Lines of evidence on the risks of suicide with selective serotonin reuptake inhibitors. Psychotherapy and Psychosomatics 2003;72:71-9. - PubMed
Heerde 2019
    1. Heerde JA, Hemphill SA. Are bullying perpetration and victimization associated with adolescent deliberate self-harm? A meta-analysis. Archives of Suicide Research 2019;23:353-81. - PubMed
Hetrick 2012
    1. Hetrick SE, McKenzie JE, Cox GR, Simmons MB, Merry SN. Newer generation antidepressants for depressive disorder in children and adolescents. Cochrane Database of Systematic Reviews 2012, Issue 11. Art. No: CD004851. [DOI: 10.1002/14651858.CD004851.pub3] - DOI - PMC - PubMed
Hetrick 2016
    1. Hetrick SE, Robinson J, Spittal MJ, Carter G. Effective psychological and psychosocial approaches to reduce repetition of self-harm: a systematic review, meta-analysis and meta-regression. BMJ Open 2016;6:e011024. - PMC - PubMed
Higgins 2011
    1. Higgins JPT, Deeks JJ. Chapter 7: Selecting studies and collecting data. In: Higgins JP, Green S, editor(s). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011. Available from training.cochrane.org/handbook/archive/v5.1.
Higgins 2019a
    1. Higgins JPT, Eldridge S, Li T, editor(s). Chapter 23: Including variants on randomized trials. In: Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, et al, editor(s). Cochrane Handbook for Systematic Reviews of Interventions version 6.0 (updated July 2019). Cochrane, 2019. Available from www.training.cochrane.org/handbook.
Higgins 2019b
    1. Higgins JPT, Li T, Deeks JJ, editor(s). Chapter 6: Choosing effect measures and computing estimates of effect. In: Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA (editors). Cochrane Handbook for Systematic Reviews of Interventions version 6.0 (updated July 2019). Cochrane, 2019. Available from www.training.cochrane.org/handbook.
Hopewell 2009
    1. Hopewell S, Loudon K, Clarke MJ, Oxman AD, Dickersin K. Publication bias in clinical trials due to statistical significance or direction of trial results. Cochrane Database of Systematic Reviews 2009, Issue 1. Art. No: MR000006. [DOI: 10.1002/14651858.MR000006.pub3] - DOI - PMC - PubMed
Hunt 2013
    1. Hunt GE, Siegfried N, Morley K, Sitharthan T, Cleary M. Psychosocial interventions for people with both severe mental illness and substance misuse. Cochrane Database of Systematic Reviews 2013, Issue 10. Art. No: CD001088. [DOI: 10.1002/14651858.CD001088.pub3] - DOI - PubMed
Husain 2014
    1. Husain N, Afsar S, Ara J, Fayyaz H, Ur Rahman R, Tomenson B, et al. Brief psychological intervention after self-harm: randomised controlled trial from Pakistan. British Journal of Psychiatry 2014;204:462-70. - PubMed
Iyengar 2018
    1. Iyengar U, Snowden N, Asarnow JR, Moran P, Tranah T, Ougrin D. A further look at therapeutic interventions for suicide attempts and self-harm in adolescents: an updated systematic review of randomized controlled trials. Frontiers in Psychiatry 2018;9:583. - PMC - PubMed
James 2008
    1. James AC, Taylor A, Winmill L, Alfoadari K. A preliminary community study of dialectical behavior therapy (DBT) with adolescent females demonstrating persistent, deliberate self-harm (DSH). Child and Adolescent Mental Health 2008;13:7. - PubMed
Joe 2018
    1. Joe S, Scott ML, Banks A. What works for adolescent black males at risk of suicide: a review. Research on Social Work Practice 2018;28:340-5. - PMC - PubMed
John 2018
    1. John A, Glendenning AC, Marchant A, Montgomery P, Stewart A, Wood S, et al. Self-Harm, suicidal behaviours, and cyberbullying in children and young people: systematic review. Journal of Medical Internet Research 2018;20:e129. - PMC - PubMed
Jones 2012
    1. Jones C, Hacker D, Cormac I, Meaden A, Irving CB. Cognitive behavioural therapy versus other psychosocial treatments for schizophrenia. Cochrane Database of Systematic Reviews 2012, Issue 4. Art. No: CD008712. [DOI: 10.1002/14651858.CD008712.pub2] - DOI - PMC - PubMed
Jung 2018
    1. Jung KY, Kim T, Hwang SY, Lee TR, Yoon H, Shin TG, et al. Deliberate self-harm among young people begins to increase at the very early age: a nationwide study. Journal of Korean Medical Science 2018;33:e191. - PMC - PubMed
Kaess 2020b
    1. Kaess M, Eppelmann L, Brunner R, Parzer P, Resch F, Carli V, et al. Life events predicting the first onset of adolescent direct self-injurious behavior — a prospective multicentre study. Journal of Adolescent Health 2020;66:195-201. - PubMed
Kandemir 2008
    1. Kandemir H, Yumru M, Kul M, Kandemir SB. Behavioural disinhibition, suicidal ideation, and self-mutilation related to clonazepam. Journal of Child and Adolescent Psychopharmacology 2008;18:409. - PubMed
Kaufman 2009
    1. Kaufman AS, Kaufman NL. Kaufman Brief Intelligence Test — Second Edition (KBIT-2). Circle Pines, MN: American Guidance Service, 2009.
Kazdin 1983
    1. Kazdin AE, French NH, Unis AS, Esveldt-Dawson K, Sherick RB. The Hopelessness Scale for Children: psychometric characteristics and concurrent validity. Journal of Consulting and Clinical Psychology 1983;51:504-10. - PubMed
Kerry 1998
    1. Kerry SM, Bland JM. Analysis of a trial randomised in clusters. BMJ 1998;316:54. - PMC - PubMed
Kinchin 2017
    1. Kinchin I, Doran CM, Hall WD, Meurk C. Understanding the true economic impact of self-harming behaviour. Lancet Psychiatry 2017;4:900-1. - PubMed
Klonsky 2011
    1. Klonsky ED. Non-suicidal self-injury in United States adults: prevalence, socio-demographics, topography and functions. Psychological Medicine 2011;41:1981-6. - PubMed
Kothgassner 2020
    1. Kothgassner OD, Robinson K, Goreis A, Ougrin D, Plener PL. Does treatment method matter? A meta-analysis of the past 20 years of research on therapeutic interventions for self-harm and suicidal ideation in adolescents. Borderline Personality Disorder and Emotion Dysregulation 2020;7:9. - PMC - PubMed
Labelle 2015
    1. Labelle R, Pouliot L, Janelle A. A systematic review and meta-analysis of cognitive behavioural treatments for suicidal and self-harm behaviours in adolescents. Canadian Psychology 2015;56:368-78.
Lahti 2011
    1. Lahti A, Räsänen P, Riala K, Keränen S, Hakko H. Youth suicide trends in Finland, 1969-2008. Journal of Child Psychology and Psychiatry, and Allied Disciplines 2011;52:984-91. - PubMed
Liberati 2009
    1. Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JP, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. PLOS Medicine 2009;6:e1000100. - PMC - PubMed
Linehan 1993
    1. Linehan MM. Skills Training Manual for Treating Borderline Personality Disorder. New York, NY: Guildford Press, 1993.
Linehan 2006
    1. Linehan MM, Comtois KA, Brown MZ, Heard HL, Wagner A. Suicide Attempt Self-Injury Interview (SASII): development, reliability, and validity of a scale to assess suicide attempts and intentional self-injury. Psychological Assessment 2006;18:303-12. - PubMed
Liu 2018
    1. Liu RT, Scopelliti KM, Pittman SK, Zamora AS. Childhood maltreatment and non-suicidal self-injury: a systematic review and meta-analysis. Lancet Psychiatry 2018;5:51-64. - PMC - PubMed
Lu 2014
    1. Lu C, Zhang F, Lakoma MD, Madden JM, Rusinak D, Penford RB, et al. Changes in antidepressant use by young people and suicidal behavior after FDA warnings and media coverage: a quasi-experimental study. BMJ 2014;348:g3596. - PMC - PubMed
Lynch 2006
    1. Lynch TR, Chapman AL, Rosenthal MZ, Kuo JR, Linehan MM. Mechanisms of change in dialectical behavior therapy: theoretical and empirical observations. Journal of Clinical Psychology 2006;62:459-80. - PubMed
Ma 2018
    1. Ma C-H, Chang S-S, Tsai H-J, Gau SS-F, Chen I-M, Lian S-C, et al. Comparative effect of antipsychotics on risk of self-harm among patients with schizophrenia. Acta Psychiatrica Scandinavica 2018;137:296-305. - PubMed
Madge 2008
    1. Madge N, Hewitt A, Hawton K, De Wilde EJ, Corcoran P, Fekete S, et al. Deliberate self-harm within an international community sample of young people: comparative findings from the Child & Adolescent Self-harm in Europe (CASE) study. Journal of Child Psychology and Psychiatry, and Allied Disciplines 2008;49:667-77. - PubMed
Madge 2011
    1. Madge N, Hawton K, McMahon EM, Corcoran P, De Leo D, De Wilde EJ, et al. Psychological characteristics, stressful life events and deliberate self-harm: findings from the Child and Adolescent Self-harm in Europe (CASE) Study. European Child & Adolescent Psychiatry 2011;20:499-508. - PubMed
Mann 2013
    1. Mann JJ. The serotonergic system in mood disorders and suicidal behaviour. Philosophical Transactions of The Royal Society (B Biological Sciences) 2013;368:20120537. - PMC - PubMed
Mars 2016
    1. Mars B, Cornish R, Heron J, Boyd A, Crane C, Hawton K, et al. Using data linkage to investigate inconsistent reporting of self-harm and questionnaire non-response. Archives of Suicide Research 2016;20:113-41. - PMC - PubMed
Marshall 2000
    1. Marshall M, Lockwood A, Bradley C, Adams C, Joy C, Fenton M. Unpublished rating scales: a major source of bias in randomised controlled trials of treatments for schizophrenia. British Journal of Psychiatry 2000;176:249-52. - PubMed
Maslach 1986
    1. Maslach C, Jackson SE. Maslach Burnout Inventory Manual. Palo Alto, CA: Consulting Psychologists Press, 1986.
Maydeu‐Olivares 1996
    1. Maydeu-Olivares A, D’Zurilla TJ. A factor analytic study of the Social Problem-Solving Inventory: an integration of theory and data. Cognitive Therapy and Research 1996;20:115-33.
McGill 2018
    1. McGill K, Hiles S, Handley TE, Page A, Lewin TJ, Whyte I, et al. Is the reported increase in young female hospital-treated intentional self-harm real or artefactual? Australian and New Zealand Journal of Psychiatry 2018;53:663-72. - PubMed
McMahon 2013
    1. McMahon EM, Corcoran P, Keeley H, Perry IJ, Arensman E. Adolescents exposed to suicidal behavior of others: prevalence of self-harm and associated psychological, lifestyle, and life event factors. Suicide & Life-threatening Behavior 2013;43:634-45. - PubMed
McMahon 2014
    1. McMahon EM, Keeley H, Cannon M, Arensman E, Perry IJ, Clarke M, et al. The iceberg model of suicide and self-harm in Irish adolescents: a population-based study. Social Psychiatry and Psychiatric Epidemiology 2014;49:1929-35. - PubMed
MHRA 2003
    1. Medicines and Healthcare Products Regulatory Authority (MHRA). Selective Serotonin Reuptake Inhibitors (SSRIs): overview of regulatory status and CSM advice relating to major depressive disorder (MDD) in children and adolescents including a summary of available safety and efficacy data. www.mhra.gov.uk/Safetyinformation/Safetywarningsalertandrecalls/Safetywa... (accessed 18 September 2014).
Microsoft Excel RoB2 Macro [Computer program]
    1. Version 6. Risk of Bias 2 Development Group, 22 August 2019. Available at: sites.google.com/site/riskofbiastool/welcome/rob-2-0-tool/current-versio....
Mikolajczak 2009
    1. Mikolajczak M, Petrides KV, Hurry J. Adolescents choosing self-harm as an emotion regulation strategy: the protective role of trait emotional intelligence. British Journal of Clinical Psychology 2009;48:191-3. - PubMed
Miller 2007
    1. Miller AL, Rathus JH, Linehan MM. Dialectical Behavior Therapy with Suicidal Adolescents. New York, NY: Guilford Press, 2007.
Miller 2014
    1. Miller M, Swanson SA, Azrael D, Pate V, Strumer T. Antidepressant dose, age, and the risk of deliberate self-harm. JAMA Internal Medicine 2014;174(6):899-909. - PubMed
Milner 2016
    1. Milner A, Spittal MJ, Kapur N, Witt K, Pirkis J, Carter G. Mechanisms of brief contact interventions in clinical populations: a systematic review. BMC Psychiatry 2016;16:194. - PMC - PubMed
Moher 1998
    1. Moher D, Pham B, Jones A, Cook DJ, Jadad AR, Moher M, et al. Does quality of reports of randomised trials affect estimates of intervention efficacy reported in meta-analyses? Lancet 1998;352:609-13. - PubMed
Montgomery 1979
    1. Montgomery SA, Åsberg M. A new depression scale designed to be sensitive to change. British Journal of Psychiatry 1979;134:382-9. - PubMed
Morgan 2017
    1. Morgan C, Webb RT, Carr MJ, Kontopantelis E, Green J, Chew-Graham C, et al. Incidence, clinical management, and mortality risk following self harm among children and adolescents. BMJ Open 2017;359:j4351. - PMC - PubMed
Morken 2020
    1. Morken IS, Dahlgren A, Lunde I, Toven S. The effects of interventions preventing self-harm and suicide in children and adolescents: an overview of systematic reviews. F1000Research 2020;8:890. - PMC - PubMed
Müller 2016
    1. Müller A, Claes L, Brähler E, De Zwaan M. Prevalence and correlates of self-harm in the German general population. PLOS One 2016;11:e0157928. - PMC - PubMed
NCCMH 2004
    1. National Collaborating Centre for Mental Health. Clinical Guideline 16. Self-Harm: The Short-Term Physical and Psychological Management and Secondary Prevention of Self-Harm in Primary and Secondary Care. London, UK: National Institute for Clinical Excellence, 2004.
Nezu 2010
    1. Nezu AM, Nezu CM, D'Zurilla TJ. Problem-solving therapy. In: Kazantzis N, Reinecke MA, Freeman A, editors(s). Cognitive and Behavioral Theories in Clinical Practice. New York, NY: Guilford Press, 2010.
NICE 2011
    1. National Institute for Health and Clinical Excellence. Self-harm: Longer-Term Management [National Institute for Health and Care Excellence clinical guideline 133]. Accessed 26 June 2020 from: www.nice.org.uk/guidance/cg133/evidence/full-guideline-pdf-184901581. London, UK: National Institute for Health and Clinical Excellence, 2011.
O'Connor 2012
    1. O'Connor RC, Rasmussen S, Hawton K. Distinguishing adolescents who think about self-harm from those who engage in self-harm. British Journal of Psychiatry 2012;200:330-5. - PubMed
Ohlis 2020
    1. Ohlis A, Bjureberg J, Lichtenstein P, D’Onofrio BM, Fruzzetti AE, Cederlöf M, et al. Comparison of suicide risk and other outcomes among boys and girls who self-harm. European Child and Adolescent Psychiatry 2020;29(12):1741-6. [DOI: 10.1007/s00787-020-01490-y] - DOI - PMC - PubMed
Osman 1998
    1. Osman A, Downs WR, Kopper BA, Barrios FX, Besett FX, Linehan MM, et al. The Reasons for Living Inventory for Adolescents (RFL-A): development and psychometric properties. Journal of Clinical Psychology 1998;54:1063-78. - PubMed
Ougrin 2012
    1. Ougrin D, Zundel T, Kyriakopoulos M, Banarsee R, Stahl D, Taylor E. Adolescents with suicidal and nonsuicidal self-harm: clinical characteristics and response to therapeutic assessment. Psychological Assessment 2012;24:11-20. - PubMed
Owens 2020
    1. Owens C, Fox F, Redwood S, Davies R, Foote L, Salisbury N, et al. Measuring outcomes in trials of interventions for people who self-harm: qualitative study of service users' views. British Journal of Psychiatry Open 2020;6:e22. - PMC - PubMed
Perera 2018
    1. Perera J, Wand T, Bein KJ, Chalkley D, Ivers R, Steinbeck KS, et al. Presentations to NSW emergency departments with self-harm, suicidal ideation, or intentional poisoning, 2010-2014. Medical Journal of Australia 2018;208:348-53. - PubMed
Platt 1971
    1. Platt JJ, Spivack G, Bloom M. Means-End Problem Solving Procedure (MEPS): Manual and Tentative Norms. Philadelphia, PA, USA: Department of Health Services, Hahnemann Medical College and Hospital, 1971.
Plener 2016
    1. Plener PL, Brunner R, Fegert JM, Groschwitz RC, In-Albon T, Kaess M, et al. Treating nonsuicidal self-injury (NSSI) in adolescents: consensus based German guidelines. Child and Adolescent Psychiatry and Mental Health 2016;10:46. - PMC - PubMed
Plöderl 2019
    1. Plöderl M, Hengartner MP. Antidepressant prescription rates and suicide attempt rates from 2004 to 2016 in a nationally representative sample of adolescents in the USA. Epidemiology and Psychiatric Sciences 2019;28:589-91. - PMC - PubMed
Poznanski 1985
    1. Poznanski EO, Freeman LN, Mokros HB. Children's Depression Rating Scale - Revised. Psychopharmacology Bulletin 1985;21:979-89.
Radloff 1991
    1. Radloff LS. The use of the Center for Epidemiologic Studies Depression Scale in adolescents and young adults. Journal of Youth and Adolescence 1991;20:149-66. - PubMed
Review Manager 2020 [Computer program]
    1. Review Manager 5 (RevMan 5). Version 5.4. Copenhagen: Nordic Cochrane Centre, The Cochrane Collaboration, 2020.
Reynolds 1985
    1. Reynolds WM. Suicidal Ideation Questionnaire: Professional Manual. Odessa, FL: Psychological Assessment Resources, 1985.
Reynolds 1988
    1. Reynolds WM. Suicidal Ideation Questionnaire: Professional Manual. Odessa, FL: Psychological Assessment Resources, 1988.
Rhodes 2014
    1. Rhodes AE, Boyle MH, Bridge JA, Sinyor M, Links TS, Tonmyr L, et al. Antecedents and sex/gender differences in youth suicidal behavior. World Journal of Psychiatry 2014;4:120-32. - PMC - PubMed
Robinson 2018
    1. Robinson J, Bailey E, Witt K, Stefanac N, Milner A, Currier D, et al. What works in youth suicide prevention? A systematic review and meta-analysis. eClinical Medicine 2018;4:P52-91. - PMC - PubMed
Roh 2018
    1. Roh BR, Jung EH, Hong HJ. A comparative study of suicide rates among 10-19-year-olds in 29 OECD countries. Psychiatry Investigations 2018;15:376-83. - PMC - PubMed
Rossouw 2018
    1. Rossouw T. Mentalization-based therapy for adolescents: managing storms in youth presenting with self-harm and suicidal states. In: Steele H, Steele M, editors(s). Handbook of Attachment-Based Interventions. New York, NY: Guilford Press, 2018.
Royal College of Psychiatrists 2014
    1. Royal College of Psychiatrists. Managing Self-Harm in Young People (Guideline number CR192). London, UK: Royal College of Psychiatrists, 2014.
Sadowski 1991
    1. Sadowski C, Kelley ML. Social problem solving in suicidal adolescents. Journal of Consulting and Clinical Psychology 1991;61:121-7. - PubMed
Sanacora 2017
    1. Sanacora G, Frye MA, McDonald W, Mathew SJ, Turner MS, Schatzberg AF, et al, American Psychiatric Association (APA) Council of Research Task Force on Novel Biomarkers and Treatments. A consensus statement on the use of ketamine in the treatment of mood disorders. JAMA Psychiatry 2017;74:399-405. - PubMed
Schünemann 2019
    1. Schünemann HJ, Higgins JP, Vist GE, Glasziou P, Akl EA, Skoetz N, et al. Chapter 14: Completing ‘Summary of findings’ tables and grading the certainty of the evidence. In: Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, et al, editor(s). Cochrane Handbook for Systematic Reviews of Interventions version 6.0 (updated July 2019). Cochrane, 2019. Available from www.training.cochrane.org/handbook.
Selph 2014
    1. Selph SS, Ginsburg AD, Chou R. Impact of contacting study authors to obtain additional data for systematic reviews: diagnostic accuracy studies for hepatic fibrosis. Systematic Reviews 2014;3:107. - PMC - PubMed
Shaffer 1985
    1. Shaffer D, Gould MS, Brasic P, Ambrosini P, Fisher P, Bird H, et al. A Children's Global Assessment Scale (CGAS). Psychopharmacology Bulletin 1985;21:747-8. - PubMed
Sharp 2014
    1. Sharp C, Steinberg L, Temple J, Newlin E. An 11-item measure to assess borderline traits in adolescents: refinement of the BPFSC using IRT. Personality Disorders 2014;5:70-8. - PMC - PubMed
Sheen 2002
    1. Sheen CL, Dillon JF, Bateman DN, Simpson KJ, MacDonald TM. Paracetamol toxicity: epidemiology, prevention and costs to the health-care system. Quarterly Journal of Medicine 2002;95:609-19. - PubMed
Sinclair 2011
    1. Sinclair JMA, Gray A, Rivero-Arias O, Saunders KEA, Hawton K. Healthcare and social services resource use and costs of self-harm patients. Social Psychiatry and Psychiatric Epidemiology 2011;46:263-71. - PubMed
Skinner 2012
    1. Skinner R, McFaull S. Suicide among children and adolescents in Canada: trends and sex differences, 1980-2008. Canadian Medical Association Journal 2012;184:1029-34. - PMC - PubMed
Spielberger 1988
    1. Spielberger CD. State-Trait Anger Expression Inventory. Odess, FL, USA: Psychological Assessment Resources, 1988.
Stefanac 2019
    1. Stefanac N, Hetrick S, Hulbert C, Spittal MJ, Witt K, Robinson J. Are young female suicides increasing? A comparison of sex-specific rates and characteristics of youth suicides in Australia over 2004-2014. BMC Public Health 2019;19:1389. - PMC - PubMed
Sterne 2019
    1. Sterne JAC, Savović J, Page MJ, Elbers RG, Blencowe NS, Boutron I, et al. RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ 2019;366:I4898. - PubMed
Stiffman 2000
    1. Stiffman AR, Horwitz SM, Hoagwood K, Compton W, Cottler L, Bean DL, et al. The Service Assessment for Children and Adolescents (SACA): adult and child reports. Journal of the American Academy of Child and Adolescent Psychiatry 2000;39:1032-9. - PubMed
Sublette 2006
    1. Sublette ME, Hibbeln JR, Galfalvy H, Oquendo MA, Mann JJ. Omega-3 polyunsaturated essential fatty acid status as a predictor of future suicide risk. American Journal of Psychiatry 2006;163:1100-02. - PubMed
Sullivan 2015
    1. Sullivan EM, Annest JL, Simon TR, Luo F, Dahlberg LL. Suicide trends among persons aged 10-24 years — United States, 1994-2012. Morbidity and Mortality Weekly Report. Surveillance Summaries: MMWR 2015;64:201-5. - PMC - PubMed
Tanskanen 2001
    1. Tanskanen A, Hibbeln JR, Hintikka J, Haatainen K, Honkalampi K, Viinamaki H. Fish consumption, depression, and suicidality in a general population. Archives of General Psychiatry 2001;58:512-3. - PubMed
Taylor 1984
    1. Taylor EA, Stansfeld SA. Children who poison themselves. II. Prediction of attendance for treatment. British Journal of Psychiatry 1984;145:132-5. - PubMed
Taylor 2011
    1. Taylor LMW, Oldershaw A, Richards C, Davidson K, Schmidt U, Simic M. Development and pilot evaluation of a manualized cognitive-behavioural treatment package for adolescent self-harm. Behavioural and Cognitive Psychotherapy 2011;39:619-25. - PubMed
Torgerson 2004
    1. Torgerson D. The use of Zelen's design in randomised trials. British Journal of Obstetrics and Gynaecology 2004;111:2. - PubMed
Tyrer 2012
    1. Tyrer P. Why benzodiazepines are not going away: commentary on benzodiazepines for anxiety disorders. Advances in Psychiatric Treatment 2012;18:259-62.
Van Heeringen 2014
    1. Van Heeringen K, Mann JJ. The neurobiology of suicide. Lancet Psychiatry 2014;1:63-72. - PubMed
Viechtbauer 2020
    1. Viechtbauer W, Cheung MW-L. Outlier and influence diagnostics for meta-analysis. Research Synthesis Methods 2020;1:112-25. - PubMed
Vrouva 2010
    1. Vrouva I, Fonagy P, Fearon PRM, Roussow T. The Risk-Taking and Self-Harm Inventory for adolescents: development and psychometric evaluation. Psychological Assessment 2010;22:853-65. - PubMed
Washburn 2012
    1. Washburn JJ, Richardt SL, Styer DM, Gebhardt M, Juzwin KR, Yourek A, et al. Psychotherapeutic approaches to non-suicidal self-injury in adolescents. Child and Adolescent Psychiatry and Mental Health 2012;6:14. - PMC - PubMed
Weissman 1999
    1. Weissman MM, Staff MHS. Social Adjustment Scale - Self-Report (SAS-SR) User's Manual. North Tonawanda, NY: Multi-Health Systems, 1999.
Westbrook 2008
    1. Westbrook D, Kennerley H, Kirk J. An Introduction to Cognitive Behaviour Therapy: Skills and Applications. London, UK: SAGE Publications, 2008.
Whitely 2020
    1. Whitely M, Raven M, Jureidini J. Antidepressant prescribing and suicide/self-harm by young Australians: regulatory warnings, contradictory advice, and long-term trends. Frontiers in Psychiatry 2020;11:478. - PMC - PubMed
WHO 2014a
    1. World Health Organization. Preventing Suicide: A Global Imperative. Geneva, Switzerland: World Health Organization, 2014.
WHO 2014b
    1. World Health Organization Collaborating Centre for Drug Statistics and Methodology. Guidelines for ATC Classification and DDD Assignment. Oslo, Norway: World Health Organization, 2014.
Wilkinson 2018
    1. Wilkinson ST, Ballard ED, Bloch MH, Mathew SJ, Murrough JW, Feder A, et al. The effect of a single dose of intravenous ketamine on suicidal ideation: a systematic review and individual participant data meta-analysis. American Journal of Psychiatry 2018;175:150-8. - PMC - PubMed
Witt 2018
    1. Witt K, Pache de Moraes D, Taylor Salisbury T, Arensman E, Gunnell D, Hazell P, et al. Treatment as usual (TAU) as a control condition in trials of cognitive behavioural-based psychotherapy for self-harm: impact of content and quality on outcomes in a systematic review. Journal of Affective Disorders 2018;235:434-47. - PubMed
Witt 2019a
    1. Witt K, Milner A, Spittal MJ, Hetrick S, Robinson J, Pirkis J, et al. Population attributable risk of factors associated with the repetition of self-harm behaviour in young people presenting to clinical services: a systematic review and meta-analysis. European Child & Adolescent Psychiatry 2019;28:5-18. - PubMed
Witt 2019b
    1. Witt K, Daly C, Arensman E, Pirkis J, Lubman D. Patterns of self-harm methods over time and the association with methods used at repeat episodes of non-fatal self-harm and suicide: a systematic review. Journal of Affective Disorders 2019;245:250-64. - PubMed
Witt 2020a
    1. Witt K, Potts J, Hubers A, Grunebaum MF, Murrough JW, Loo C, et al. Ketamine for suicidal ideation in adults with psychiatric disorders: a systematic review and meta-analysis of treatment trials. Australian and New Zealand Journal of Psychiatry 2020;54:29-45. - PubMed
Witt 2020b
    1. Witt K, Townsend E, Arensman E, Gunnell D, Hazell P, Taylor Salisbury T, et al. Psychosocial interventions for people who self-harm: methodological issues involved in trials to evaluate effectiveness. Archives of Suicide Research 2020;24(sup2):S32-93. [DOI: 10.1080/13811118.2019.1592043] - DOI - PubMed
Witt 2020c
    1. Witt KG, Hawton K, Hetrick SE, Taylor Salisbury TL, Townsend E, Hazell P. Psychosocial interventions for self‐harm in adults. Cochrane Database of Systematic Reviews 2020, Issue 7. Art. No: CD013668. [DOI: 10.1002/14651858.CD013668] - DOI - PMC - PubMed
Witt 2021
    1. Witt KG, Hetrick SE, Rajaram G, Hazell P, Taylor Salisbury TL, Townsend E, et al. Pharmacological interventions for self‐harm in adults. Cochrane Database of Systematic Reviews 2021, Issue 1. Art. No: CD013669. [DOI: 10.1002/14651858.CD013669.pub2] - DOI - PMC - PubMed
Wong 2020
    1. Wong J, Bahji A, Khalid-Khan S. Psychotherapies for adolescents with subclinical and borderline personality disorder: a systematic review and meta-analysis. Canadian Journal of Psychiatry 2020;65:5-15. - PMC - PubMed
Wood 2001b
    1. Wood A, Trainor G. Developmental Group Psychotherapy for Adolescents: A Manual for Mental Health Professionals. Manchester, UK: University of Manchester, 2001.
Yuan 2019
    1. Yuan SNV, Kwok KHR, Ougrin D. Treatment engagement in specific psychological treatment vs. treatment as usual for adolescents with self-harm: systematic review and meta-analysis. Frontiers in Psychology 2019;10:104. - PMC - PubMed
Zahl 2004
    1. Zahl DL, Hawton K. Repetition of deliberate self-harm and subsequent suicide risk: long-term follow-up study of 11 583 patients. British Journal of Psychiatry 2004;185:70-5. - PubMed
Zanarini 2007
    1. Zanarini MC. In: Childhood prevalence of borderline personality disorder. 54th Annual Meeting of the American Academy of Child and Adolescent Psychiatry. Boston, MA, 2007.
Zelen 1979
    1. Zelen M. A new design for randomized clinical trials. New England Journal of Medicine 1979;300:1242-5. - PubMed
Zigmond 1983
    1. Zigmond AS, Snaith RP. The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica 1983;67:361-70. - PubMed

References to other published versions of this review

Hawton 2015
    1. Hawton K, Witt KG, Taylor Salisbury TL, Arensman E, Gunnell D, Townsend E, et al. Interventions for self-harm in children and adolescents. Cochrane Database of Systematic Reviews 2015, Issue 12. Art. No: CD012013. [DOI: 10.1002/14651858.CD012013] - DOI - PMC - PubMed
Witt 2020d
    1. Witt KG, Hawton K, Hetrick SE, Taylor Salisbury TL, Townsend E, Hazell P. Interventions for self-harm in children and adolescents. Cochrane Database of Systematic Reviews 2020, Issue 7. Art. No: CD013667. [DOI: 10.1002/14651858.CD013667] - DOI - PMC - PubMed

Publication types

MeSH terms

Associated data