Efficacité des traitements psychanalytiques des conduites suicidaires

The effectiveness of psychoanalytic/psychodynamic psychotherapy for reducing suicide attempts and self-harm : systematic review and meta-analysis.

Par Stephen Briggs (a1), Gopalakrishnan Netuveli (a2), Nick Gould (a3), Antigone Gkaravella (a4), Nicole S. Gluckman (a5), Patricia Kangogyere (a6), Ruby Farr (a6), Mark J. Goldblatt (a7) and Reinhard Lindner (a8)

    (a1) Professor of Social Work, Centre for Social Work Research, University of East London, UK
    (a2) Professor of Public Health, Institute for Health and Human Development, University of East London, UK
    (a3) Professor Emeritus, Department of Social and Policy Sciences, University of Bath, UK
    (a4)  Senior Clinical Teaching Fellow, University College, Great Ormond Street Institute of Child Health, UK
    (a5)   Research Assistant, Centre for Social Work Research, University of East London, UK
    (a6) Research Assistant, Institute for Health and Human Development, University of East London, UK
    (a7) Associate Clinical Professor of Psychiatry, Harvard Medical School; Clinical Associate, McLean Hospital; and Faculty Member, Boston Psychoanalytic Society, USA
    (a8)   Professor for Social Therapy, University Kassel, Germany

Pour citer cet article :  

Stephen Briggs, Gopalakrishnan Netuveli, Nick Gould, Antigone Gkaravella, Nicole S. Gluckman), Patricia Kangogyere, Ruby Farr, Mark J. Goldblatt and Reinhard Lindner, (2019)  The effectiveness of psychoanalytic/psychodynamic psychotherapy for reducing suicide attempts and self-harm: systematic review and meta-analysis, The British Journal of Psychiatry, Volume 214, Issue 6, June 2019 , pp. 320-328. DOI: https://doi.org/10.1192/bjp.2019.33 Published online by Cambridge University Press: 28 February 2019.

Abstract

Background : Preventing suicide and self-harm is a global health priority. Although there is a growing evidence base for the effectiveness of psychoanalytic and psychodynamic psychotherapies for a range of disorders, to date there has been no systematic review of its effectiveness in reducing suicidal and self-harming behaviours.

Aims : To systematically review randomised controlled trials of psychoanalytic and psychodynamic psychotherapies for suicidal attempts and self-harm.

Method : We searched PubMed, PsycINFO, Psycharticles, CINAHL, EMBASE and the Cochrane Central Register of Controlled Trials for randomise controlled trials of psychoanalytic and psychodynamic psychotherapies for reducing suicide attempts and self-harm.

Results : Twelve trials (17 articles) were included in the meta-analyses. Psychoanalytic and psychodynamic therapies were effective in reducing the number of patients attempting suicide (pooled odds ratio, 0.469; 95% CI 0.274–0.804). We found some evidence for significantly reduced repetition of self-harm at 6-month but not 12-month follow-up. Significant treatment effects were also found for improvements in psychosocial functioning and reduction in number of hospital admissions.

Conclusions : Psychoanalytic and psychodynamic psychotherapies are indicated to be effective in reducing suicidal behaviour and to have short-term effectiveness in reducing self-harm. They can also be beneficial in improving psychosocial well-being. However, the small number of trials and moderate quality of the evidence means further high-quality trials are needed to confirm our findings and to identity which specific components of the psychotherapies are effective.

Declaration of interest

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