• Bibtex: @inagaki2015
  • Bibliography: Inagaki, M., Kawashima, Y., Kawanishi, C., Yonemoto, N., Sugimoto, T., Furuno, T., Ikeshita, K., Eto, N., Tachikawa, H., Shiraishi, Y., & Yamada, M. (2015). Interventions to prevent repeat suicidal behavior in patients admitted to an emergency department for a suicide attempt: A meta-analysis. Journal of Affective Disorders, 175, 66–78. https://doi.org/10.1016/j.jad.2014.12.048

Example citation

My notes

  • So instead of having suicide death as outcome they use suicide attempt
  • k = 24 studies
    • Active contact and follow-up
    • Psychotherapy
    • Medication
    • Misc
  • There is a lot of heterogeneity in the “active contact and follow-up” category. Anything from intensive inpatient care plus in-home visits by nurse, to only one telephone call 3 months after suicide attempt.

Trials were included if they met the following criteria: all participants had attempted suicidal behavior within 1 month and were admitted to an ED for their suicidal behavior; assessment for eligibility or initial intervention in the trial was performed while the patients were admitted to the ED or a subsequent ward; and an effect of an intervention was examined in a randomized controlled trial and was described in the manuscript.


Background A huge number of patients with self-harm and suicide attempt visit emergency departments (EDs). We systematically reviewed studies and examined the effect of interventions to prevent repeat suicidal behavior in patients admitted to EDs for a suicidal attempt. Method We searched the databases of MEDLINE, PsychoINFO, CINAHL, and EMBASE through August 2013. Eligible studies were randomized controlled trials assessing the effects on repeat suicidal behavior of interventions initiated in suicidal patients admitted to EDs. Interventions in each trial were classified into groups by consensus. Meta-analyses were performed to determine pooled relative risks (RRs) and 95% confidence intervals (CIs) of repetition of suicide attempt for interventions in each group. Results Out of 5390 retrieved articles, 24 trials were included and classified into four groups (11 trials in the Active contact and follow-up, nine in the Psychotherapy, one in the Pharmacotherapy, and three in the Miscellaneous). Active contact and follow-up type interventions were effective in preventing a repeat suicide within 12 months (n=5319; pooled RR=0.83; 95% CI: 0.71 to 0.97). However, the effect at 24 months was not confirmed (n=925; pooled RR=0.98; 95% CI: 0.76–1.22). The effects of the other interventions on preventing a repetition of suicidal behavior remain unclear. Limitation Caution is needed regarding the heterogeneity of the effects. Conclusion Interventions of active contact and follow-up are recommended to reduce the risk of a repeat suicide attempt at 12 months in patients admitted to EDs with a suicide attempt. However, the long-term effect was not confirmed. PDF: inagaki_2015_interventions_to_prevent_repeat_suicidal_behavior_in_patients_admitted_to_an.pdf