Estrategias de prevención del suicidio y de las conduites suicidas a la adolescencia: Revue systématique de la littérature.

BACKGROUND:

In France and in the USA, suicide is respectively the second and third leading cause of death in adolescents. Over the last three decades, many prevention programs have emerged, but their effectiveness has rarely been evaluated.

OBJECTIVE:

To critically review the past 30 years of research regarding youth suicide and suicidal behavior prevention strategies.

METHOD:

We reviewed research literature on suicide prevention strategies following a systematic search in MEDLINE, the Cochrane Library, and PsychINFO. We included studies, published between 1980 and June 2013, that evaluated preventative interventions in adolescents aged 13 to 18 years. We excluded studies that explicitly addressed self-mutilatory behaviors. We extracted data on primary outcomes of interest: suicide and suicidal behavior and intermediary or secondary outcomes (help-seeking strategies, compliance, identification of at-risk individuals, antidepressant prescription/use rates), or both.

RESULTS:

We included 37 studies in five key domains of suicide prevention intervention: education and awareness (n =12), screening tools for at-risk individuals (n =6), restricting access to lethal means (n =4), treatment of psychiatric disorders including follow-up care (n =14) and responsible media reporting of suicide (n =1). Physician education in depression recognition and treatment, restricting access to lethal methods reduce suicide rates. Although evidence exists that school-based programs to prevent suicide in adolescents improve help-seeking behaviors, to date no evidence exists that these prevention programs reduce suicide rates. Tertiary preventative interventions to prevent repetition of suicidal behaviors need more evidence of efficacy. Lastly, few studies have formally documented response strategies to suicide cluster in young people.

CONCLUSION:

Although significant progress in prevention programs has substantially reduced the suicide rate in young people, few have been properly evaluated for their effectiveness and impact. In addition, several methodological difficulties limit generalization to other populations. Given the complexity of the mechanism of suicide in adolescents, it seems likely that no one prevention/intervention strategy, by itself, is enough to fight this public health issue. Looking to the future, evaluations and appropriate treatment of patients with psychiatric illnesses should help to improve the efficacy of preventive interventions of suicide and suicide attempts. But, it is also clear that more researches using new approaches regarding prevention and treatment of suicidal behavior remains essential. (PsycINFO Database Record (c) 2016 APA, all rights reserved)