Background Given the widespread nature and clinical consequences of self-harm and suicidal ideation among adolescents, establishing the efficacy of developmentally appropriate treatments that reduce both self-harm and suicidal ideation in the context of broader adolescent psychopathology is critical. Methods We conducted a systematic review and meta-analysis of the Dialectical Behaviour Therapy for Adolescents (DBT-A) literature on treating self-injury in adolescents (12–19 years). We searched for eligible trials and treatment evaluations published prior to July 2020 in MEDLINE/PubMed, Scopus, Google Scholar, EMBASE, and the Cochrane Library databases for clinical trials. Twenty-one studies were identified [five randomized-controlled trials (RCTs), three controlled clinical trials (CCTs), and 13 pre-post evaluations]. We extracted data for predefined primary (self-harm, suicidal ideation) and secondary outcomes (borderline personality symptoms; BPD) and calculated treatment effects for RCTs/CCTs and pre-post evaluations. This meta-analysis was pre-registered with OSF: osf.io/v83e7. Results Overall, the studies comprised 1673 adolescents. Compared to control groups, DBT-A showed small to moderate effects for reducing self-harm (g = −0.44; 95% CI −0.81 to −0.07) and suicidal ideation (g = −0.31, 95% CI −0.52 to −0.09). Pre-post evaluations suggested large effects for all outcomes (self-harm: g = −0.98, 95% CI −1.15 to −0.81; suicidal ideation: g = −1.16, 95% CI −1.51 to −0.80; BPD symptoms: g = −0.97, 95% CI −1.31 to −0.63). Conclusions DBT-A appears to be a valuable treatment in reducing both adolescent self-harm and suicidal ideation. However, evidence that DBT-A reduces BPD symptoms was only found in pre-post evaluations.

中文翻译：

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辩证行为疗法对青少年自残和自杀意念的疗效：系统评价和荟萃分析

背景 鉴于青少年自残和自杀意念的广泛性质和临床后果，确定在更广泛的青少年精神病理学背景下减少自伤和自杀意念的发育适当治疗的功效至关重要。方法 我们对青少年（12-19 岁）自我伤害治疗的青少年辩证行为疗法 (DBT-A) 文献进行了系统回顾和荟萃分析。我们在 MEDLINE/PubMed、Scopus、Google Scholar、EMBASE 和 Cochrane Library 数据库中搜索了 2020 年 7 月之前发表的符合条件的临床试验试验和治疗评估。确定了 21 项研究 [5 项随机对照试验 (RCT)、3 项对照临床试验 (CCT) 和 13 项事前评估]。我们提取了预定义的主要结果（自残、自杀意念）和次要结果（边缘人格症状；BPD）的数据，并计算了 RCT/CCT 和事后评估的治疗效果。该荟萃分析已在 OSF 预先注册：osf.io/v83e7。结果 总体而言，这些研究包括 1673 名青少年。与对照组相比，DBT-A 在减少自残方面表现出小到中度的效果（G= -0.44；95% CI -0.81 至 -0.07）和自杀意念（G= -0.31, 95% CI -0.52 至 -0.09）。事前评估表明对所有结果都有很大影响（自我伤害：G= -0.98, 95% CI -1.15 至 -0.81；自杀意念：G= -1.16, 95% CI -1.51 至 -0.80；BPD症状：G= -0.97, 95% CI -1.31 至 -0.63）。结论 DBT-A 似乎是减少青少年自残和自杀意念的一种有价值的治疗方法。然而，DBT-A 减轻 BPD 症状的证据仅在事前评估中发现。