Abstract

Objective

In response to the increasing rates of suicide in military personnel throughout the world, there is an increasing focus on the development and implement of interventions aimed at preventing suicide among this group. Therefore, the goal of the present systematic review was to examine the effectiveness of interventions focused on preventing suicidal ideation and behavior in military personnel.

Method

Search for articles was conducted in PsycINFO, PubMed, Web of Science, EMBASE, Google Scholar, Cochrane Central Register of Controlled Trials (CENTRAL), IranMedex, Scientific Information Database (SID), and MagIran. International databases were searched from June 2008 to May 2019, and Iranian databases were searched from their inception to May 2019. RCT and non-RCT studies focused on the effectiveness of preventive interventions for suicide in military personnel were included in the analysis. Narrative synthesis of results was the main strategy for data analysis.

Results

According to the inclusion and exclusion criteria, 18 articles were selected. Interventions were divided into four categories according to their nature: interventions based on psychotherapy, interventions based on crisis management, interventions based on pharmacotherapy, and community-based interventions. In addition, most studies had moderate methodological quality.

Conclusion

Most of the preventive interventions were effective in reducing suicidal ideation and behavior in military personnel; however, in some cases, there were serious challenges in terms of effectiveness. Interventions based on cognitive-behavioral approaches constitute a significant portion of the interventions. Overall, RCTs and non-RCTs, especially community-based studies, need to use more rigorous examinations in order to gain research and clinical support.

• HIGHLIGHTS

• Interventions based on psychotherapy and community-based interventions were the most commonly used interventions, respectively.

• The majority of interventions based on psychotherapy came from cognitive-behavioral approaches.

• There are few evidence-based studies on prevention of suicide in military personnel.

中文翻译：

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军人自杀预防干预的系统评价

摘要

客观的

为了应对全世界军事人员自杀率的上升，人们越来越关注旨在预防这一群体自杀的干预措施的制定和实施。因此，本系统评价的目的是检查干预措施的有效性，重点是预防军人的自杀意念和行为。

方法

在 PsycINFO、PubMed、Web of Science、EMBASE、Google Scholar、Cochrane Central Register of Controlled Trials (CENTRAL)、IranMedex、科学信​​息数据库 (SID) 和 MagIran 中搜索文章。检索了 2008 年 6 月至 2019 年 5 月的国际数据库，检索了从成立到 2019 年 5 月的伊朗数据库。分析中包括了侧重于军事人员自杀预防干预有效性的 RCT 和非 RCT 研究。结果的叙述性综合是数据分析的主要策略。

结果

根据纳入和排除标准，共筛选出18篇文章。干预措施按性质分为四类：基于心理治疗的干预措施、基于危机管理的干预措施、基于药物治疗的干预措施和基于社区的干预措施。此外，大多数研究的方法学质量中等。

结论

大多数预防性干预措施在减少军人的自杀意念和行为方面是有效的；然而，在某些情况下，在有效性方面存在严重挑战。基于认知行为方法的干预构成了干预的重要部分。总体而言，RCTs和非RCTs，尤其是基于社区的研究，需要使用更严格的检查才能获得研究和临床支持。

• 强调

• 基于心理治疗的干预和基于社区的干预分别是最常用的干预措施。

• 大多数基于心理治疗的干预来自认知行为方法。

• 关于预防军人自杀的循证研究很少。