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Psychoanalytic psychotherapy shows promise for treating suicidal behaviour

11 Jun 2019

Psychoanalytic psychotherapy may effectively reduce suicidal and self-harming behaviours, with an additional benefit of improving psychosocial well-being, according to a recent study.

Researchers performed a systematic review and meta-analysis of randomized controlled trials evaluating psychoanalytic psychotherapy for suicidal behaviour, self-harm or self-injury in comparison with treatment as usual (TAU), routine psychiatric care, enhanced usual care, placebo or any other comparison, including with a different psychological therapy.

The meta-analysis included 12 trials involving 939 participants, with nine conducted on adult patients and the remaining three on adolescents. The primary endpoint was the occurrence of repeated self-harm (ie, suicide attempts and self-injuries during follow-up at intervals up to 18 months post-treatment). Secondary endpoints included depression, anxiety, psychosocial functioning and hospital admissions.

Pooled data revealed the efficacy of psychoanalytic and psychodynamic therapies in reducing the number of patients attempting suicide (odds ratio [OR], 0.469, 95 percent CI, 0.274–0.804). There was some evidence for a significantly reduced repetition of self-harm at the 6-month but not 12-month follow-up.

Moreover, psychoanalytic psychotherapy produced improvements in psychosocial functioning and reductions in a number of hospital admissions.

The intervention evaluated in all studies utilized core psychoanalytic methods to increase awareness and self-reflection; to manage, regulate or contain emotions; and to produce change through the therapeutic relationship.

The findings highlight the potential of psychoanalytic psychotherapy as an intervention that could be provided to individuals at risk of, or with a history of, suicidal or self-harming behaviour, the researchers said. Still, additional high-quality trials are needed to validate the present data and identify which specific components of the psychotherapies are effective.

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