Pharmacological interventions

TopicPharmacological interventions
Review question(s)For people who self-harm, do pharmacological interventions (compared with no treatment or other interventions) improve outcomes? What are the associated adverse effects?
Sub-question(s)3.2 For people who self-harm, what are the key principles underlying safer prescribing?
Chapter8 – Pharmacological interventions
Topic group8 – Suzanne Kearney, Alison Wood, Paul Gill
Sub-section leadN/A
ObjectivesTo review the effectiveness of interventions for the management of repetition of self-harm behaviour
Criteria for considering studies for the review
  • Intervention
Chapter 8 – Antidepressants, antipsychotics, lithium, anticonvulsants (for example, valproate, carbamazepine, lamotrigine), benzodiazepines, analgesics
  • Comparator
Treatment as usual or placebo
  • Types of participants
Participants (aged 8 years old or above) admitted to hospital for treatment of index episode of self-harm). Self-endorsed self-harming behaviour are also included.
  • Critical outcomes
Repetition (fatal outcome: completed suicide; non-fatal repetition)
  • Important, but not critical outcomes
Depression, hopelessness, suicide ideation scores
  • Other outcomes
  • Study design
  • Include unpublished data?
  • Restriction by date?
  • Dosage
  • Minimum sample size
Ten in each treatment arm
  • Study setting
Inpatient and outpatient (as long as participants had history of previous self-harm)
Search strategyDatabases: CINAHL, EMBASE, MEDLINE, HMIC, PsycBOOKS, PsycEXTRA, PsycINFO

New search:
Searching other resourcesExperts in the field were contacted to identify if any key studies were missed.
Existing reviews
  • Updated
Hawton and colleagues' (2011) updated Cochrane review for self-harm interventions
  • Not updated
General search filter usedSee search strategy in Appendix 9
Question specific search filterSee search strategy in Appendix 9
Amendments to filter/search strategySee search strategy in Appendix 9
The review strategyData from the Cochrane review update will be used for meta-analysis. Studies will be checked for the inclusion criteria.
Additional assessments
  1. Exclude non-randomised studies
  2. Exclude studies that were designed for people with borderline personality disorder (refer to the NICE guideline).

From: Appendix 8, Review protocols

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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