Dagens FSV-oversigt: Interventions for primary prevention of suicide in university and other post-secondary educational settings.

From: Folkesundhedsvidenskabelige forskningsoversigter <liste@xxxxxxxxxxxxxxxx>
To: fsvoversigter@xxxxxxxxxxxxx
Date: Tue, 23 Dec 2014 11:14:06 -0000
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Dagens #fsvoversigt:

Interventions for primary prevention of suicide in university and other 
post-secondary educational settings.

Cochrane Database Syst Rev. 2014;10:CD009439

Authors: Harrod CS, Goss CW, Stallones L, DiGuiseppi C

Abstract

BACKGROUND: Suicide is a leading cause of death among post-secondary students 
worldwide. Suicidal thoughts and planning are common among post-secondary 
students. Previous reviews have examined the effectiveness of interventions for 
symptomatic individuals; however, many students at high risk of suicide are 
undiagnosed and untreated.

OBJECTIVES: We evaluated the effect on suicide and suicide-related outcomes of 
primary suicide prevention interventions that targeted students within the 
post-secondary setting.

SEARCH METHODS: We searched the following sources up to June 2011: Specialised 
Registers of two Cochrane Groups, Cochrane Central Register of Controlled 
Trials, and nine other databases, trial registers, conference proceedings, and 
websites of national and international organizations. We screened reference 
lists and contacted authors of included studies to identify additional studies. 
We updated the search in November 2013; we will include these results in the 
review's next update.

SELECTION CRITERIA: We included studies that tested an intervention for the 
primary prevention of suicide using a randomized controlled trial (RCT), 
controlled before-and-after (CBA), controlled interrupted time series (CITS), 
or interrupted time series (ITS) study design. Interventions targeted students 
within the post-secondary setting (i.e. college, university, academy, 
vocational, or any other post-secondary educational institution) without known 
mental illness, previous suicide attempt or self-harm, or suicidal ideation. 
Outcomes included suicides, suicide attempts, suicidal ideation, changes in 
suicide-related knowledge, attitudes and behavior, and availability of means of 
suicide.

DATA COLLECTION AND ANALYSIS: We used standardized electronic forms for data 
extraction, risk of bias and quality of evidence determination, and analysis. 
We estimated standardised mean differences (SMD) with 95% confidence intervals 
(CIs). We analysed studies by intervention type and study design. We summarized 
RCT effect sizes using random-effects models meta-analyses; and analysed 
statistical heterogeneity using the Chi(2) test and I(2) statistic. We 
described narratively the results from studies that used other study designs.

MAIN RESULTS: Eight studies met inclusion criteria. They were heterogeneous in 
terms of participants, study designs, and interventions. Five of eight studies 
had high risk of bias. In 3 RCTs (312 participants), classroom-based didactic 
and experiential programs increased short-term knowledge of suicide (SMD = 
1.51, 95% CI 0.57 to 2.45; moderate quality evidence) and knowledge of suicide 
prevention (SMD = 0.72, 95% CI 0.36 to 1.07; moderate quality evidence). The 
effect on suicide prevention self-efficacy in one RCT (152 participants) was 
uncertain (SMD = 0.20, 95% CI -0.13 to 0.54; low quality evidence). One CBA 
analysed the effects of an institutional policy that restricted student access 
to laboratory cyanide and mandated professional assessment for suicidal 
students. The incidence of student suicide decreased significantly at one 
university with the policy relative to 11 control universities, 2.00 vs. 8.68 
per 100,000 (Z = 5.90; P PMID: 25353703 [PubMed - indexed for MEDLI
 NE]

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Dette abstract er hentet via PubMed fra National Library of Medicine, USA 
(http://www.ncbi.nlm.nih.gov/About/disclaimer.html).
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Se abstractet i PubMed: http://evidens.link/1CAAC5W

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Dagens FSV-oversigt: Interventions for primary prevention of suicide in university and other post-secondary educational settings.

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