Should group psychotherapy versus treatment as usual (TAU) be used for young people who self-harm?

Quality assessmentNo. of patientsEffectQualityImportance
No. of studiesDesignLimitationsInconsistencyIndirectnessImprecisionOther considerationsGroup psychotherapyTAURelative risk (95% CI)Absolute
Per protocol repetition of self-harm – during first 12 months
3Randomised trialsNo serious limitationsSerious1No serious indirectnessSerious2None136/249 (54.6%)144/248 (58.1%)RR 0.95 (0.63 to 1.45)29 fewer per 1000 (from 215 fewer to 261 more)⊕⊕○○
LOW
-
-60.1%30 fewer per 1000 (from 222 fewer to 270 more)
Per protocol suicidal ideation – at last follow-up (better indicated by lower values)
3Randomised trialsNo serious limitationsNo serious inconsistencyNo serious indirectnessSerious2None231240-SMD 0.03 lower (0.21 lower to 0.15 higher)⊕⊕⊕○
MODERATE
-
Per protocol depression – at last follow-up (better indicated by lower values)
2Randomised trialsNo serious limitationsNo serious inconsistencyNo serious indirectnessSerious2,3None6366-SMD 0.17 lower (0.52 lower to 0.18 higher)--
1

Moderate heterogeneity (50 to 79%).

2

Not statistically significant.

3

Total sample size smaller than 300.

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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