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Review: no reliable evidence of the effect of psychotherapy upon suicide risk in people with depression

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Question

Question: Does psychotherapy reduce suicidal ideation or suicide risk in people with depression?

Outcomes: Suicidal ideation or suicide risk. Hopelessness was also examined as an indicator of depression.

Methods

Design: Systematic review and meta-analysis.

Data sources: A database on the psychological treatment of depression, continuously updated through comprehensive literature searches (1966–2012) with identified abstracts in PubMed, PsycInfo, EMBASE and the Cochrane Register of Controlled Trials. All trials included in previous meta-analyses of psychological treatment for depression were also reviewed.

Study selection and analysis: Randomised controlled trials investigating psychological treatment compared to control (waiting list, care as usual or placebo) in adults (aged ≥18 years) with depression (according to diagnostic interview or self-report questionnaire) and which reported treatment effects on suicidal ideation or risk, or hopelessness. Effect sizes were calculated using Cohen's d and applying Hedge's g correction for small sample bias. Overall effect sizes were pooled using a random effects model. Heterogeneity was assessed with the Q and I2 statistics. Publication …

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