Abstract

Objective

We aimed to provide a synthesis and evaluation of psychosocial interventions to prevent suicide and reduce self-harm, as well as alcohol intake, for patients with alcohol problems.

Methods

The systematic review was carried out according to the PRISMA guidelines and considered articles published in English from all countries. Terms relating to suicidality and alcohol problems were used to search Medline, EMBASE and PsycINFO databases. Randomized controlled trials of psychosocial interventions targeted for outpatient settings were included.

Results

Six studies with a total of 400 participants were included. Two investigated dialectic behavioural therapy (DBT), one internet-delivered DBT, one dynamic deconstructivist psychotherapy (DDP) and two integrated cognitive behavioural therapy (CBT). Face to face and online DBT was significantly associated with abstinence and reductions in consumption with only a trend for a reduction in suicide attempts in one study relative to treatment at usual (TAU). DDP yielded significant reductions in alcohol consumption and suicide attempts versus community care. CBT was significantly effective relative to TAU in reducing alcohol use and suicide attempts in one trial with adolescents but not in another trial in an adult population.

Conclusion

Integrated CBT has promise for adolescents, DBT may be helpful for alcohol patients with borderline personality disorder and iDBT may be useful for the wider community with heavy alcohol use. However, given the paucity of studies and the exploratory nature of these trials, there is currently no strong evidence for an effective psychosocial intervention to reduce alcohol consumption and suicidal behaviour in adults with problematic alcohol use.

中文翻译：

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减少酒精问题患者自杀行为和酒精消费的心理社会干预：随机对照试验的系统评价

摘要

客观的

我们旨在为有酒精问题的患者提供心理社会干预措施的综合和评估，以防止自杀和减少自我伤害以及酒精摄入。

方法

系统评价是根据 PRISMA 指南进行的，并考虑了所有国家以英文发表的文章。与自杀和酒精问题相关的术语被用于搜索 Medline、EMBASE 和 PsycINFO 数据库。包括针对门诊环境的心理社会干预的随机对照试验。

结果

包括六项研究，共有 400 名参与者。两项调查的辩证行为疗法 (DBT)、一项互联网提供的 DBT、一项动态解构主义心理疗​​法 (DDP) 和两项综合认知行为疗法 (CBT)。面对面和在线 DBT 与戒断和减少消费显着相关，在一项研究中，与常规治疗 (TAU) 相比，只有自杀企图减少的趋势。与社区护理相比，DDP 显着减少了饮酒和自杀企图。在一项针对青少年的试验中，CBT 相对于 TAU 在减少酒精使用和自杀企图方面显着有效，但在另一项针对成年人的试验中则不然。

结论

综合 CBT 对青少年有希望，DBT 可能对患有边缘型人格障碍的酒精患者有帮助，而 iDBT 可能对更广泛的酗酒社区有用。然而，鉴于研究的缺乏和这些试验的探索性，目前没有强有力的证据表明有效的社会心理干预可以减少酒精使用有问题的成年人的饮酒和自杀行为。