Should intensive inpatient and community treatment versus treatment as usual (TAU) be used for self-harm?

Quality assessmentNo. of patientsEffectQualityImportance
No. of studiesDesignLimitationsInconsistencyIndirectnessImprecisionOther considerationsIntensive inpatient and community treatmentTAURelative risk (95% CI)Absolute
Per protocol repetition of self-harm – at last follow-up
1Randomised trialsNo serious limitations--Serious1,2None119/140 (85%)64/143 (44.8%)RR 1.9 (1.56 to 2.31)403 more per 1000 (from 251 more to 586 more)-CRITICAL
-15.8%142 more per 1000 (from 88 more to 207 more)
Attendance at treatment – at 12 months
1Randomised trials----None119/140 (85%)64/143 (44.8%)Not pooledNot pooled--
-44.8%Not pooled
Attendance (better indicated by lower values)
1Randomised trials----None140134-Not pooled--
Depression (better indicated by lower values)
1Randomised trialsNo serious limitations--Serious1,2None9450-SMD 0.31 lower (0.66 lower to 0.03 higher)--
Hopelessness (better indicated by lower values)
1Randomised trialsNo serious limitations--Serious1,2None9450-SMD 0.26 lower (0.61 lower to 0.08 higher)--
1

Not statistically significant.

2

Total sample size is lower than 400 participants.

From: Appendix 17, GRADE evidence profiles

Cover of Self-Harm: Longer-Term Management
Self-Harm: Longer-Term Management.
NICE Clinical Guidelines, No. 133.
National Collaborating Centre for Mental Health (UK).
Leicester (UK): British Psychological Society; 2012.
Copyright © 2012, The British Psychological Society & The Royal College of Psychiatrists.

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