Should antidepressants versus placebo be used for people who self-harm?

Quality assessmentNo. of patientsEffectQualityImportance
No. of studiesDesignLimitationsInconsistencyIndirectnessImprecisionOther considerationsAntidepressantsPlaceboRelative risk (95% CI)Absolute
Per protocol repetition of self-harm – during first 6 months
1Randomised trialsNo serious limitations--Serious1,2None16/76 (21.1%)5/38 (13.2%)RR 1.6 (0.63 to 4.04)79 more per 1000 (from 49 fewer to 400 more)--
-13.2%79 more per 1000 (from 49 fewer to 401 more)
Per protocol repetition of self-harm – at last follow-up
1Randomised trialsNo serious limitations--Serious1,2None16/76 (21.1%)5/38 (13.2%)RR 1.6 (0.63 to 4.04)79 more per 1000 (from 49 fewer to 400 more)--
-13.2%79 more per 1000 (from 49 fewer to 401 more)
1

Not statistically significant.

2

Total sample size is 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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