Cognitive behavioural therapy halves the risk of repeated suicide attempts: systematic review.

Gøtzsche, Peter C; Gøtzsche, Pernille K

doi:10.1177/0141076817731904

Cited by 79Suicide and Self-Harm StudiesAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesPsychotherapy Techniques and Applications

Cognitive behavioural therapy halves the risk of repeated suicide attempts: systematic review.

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Gøtzsche, Peter C, Gøtzsche, Pernille K·2017·Journal of the Royal Society of Medicine

DOI 10.1177/0141076817731904PMC PMC5650127

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Abstract

Objective: To study whether cognitive behavioural therapy decreases suicide attempts in people with previous suicide attempts. Design: Systematic review and meta-analysis. Setting: Randomised trials that compare cognitive behavioural therapy with treatment as usual. Participants: Patients who had engaged in any type of suicide attempt in the six months prior to trial entry resulting in presentation to clinical services. Main outcome measure: Suicide attempt. Results: We included ten trials, eight from Cochrane reviews and two from our updated searches (1241 patients, 219 of whom had at least one new suicide attempt). Cognitive behavioural therapy compared to treatment as usual reduced the risk of a new suicide attempt; risk ratio 0.47; 95% confidence interval 0.30–0.73; p = 0.0009; I 2 = 57%. Only seven suicides were reported (3 versus 4). One trial had an unusually large effect; if this trial is excluded, the risk ratio becomes 0.61 (0.46–0.80) and the heterogeneity in the results disappears (I 2 = 0%). Conclusions: Cognitive behavioural therapy reduces not only repeated self-harm but also repeated suicide attempts. It should be the preferred treatment for all patients with depression.

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Multiple interventions have evidence of efficacy in reducing suicide risk, including cognitive behavioral therapy, dialectical behavioral therapy, and active contact and follow-up interventions.
“Multiple interventions have evidence of efficacy in reducing suicide risk, including cognitive behavioral therapy,3,4 dialectical behavioral therapy,3 and active contact and follow-up interventions.5,6”
From Accuracy requirements for cost-effective suicide risk prediction among primary care patients in the US (2021) · cites this paper as [4]
Cognitive behavioral therapy (CBT) has a relative risk of suicide attempt of 0.47 (95% CI, 0.30-0.73).
“a 2017 meta-analysis4 of 10 randomized clinical trials found a relative risk of suicide attempts of 0.47 (95% CI, 0.30-0.73)”
From Accuracy requirements for cost-effective suicide risk prediction among primary care patients in the US (2021) · cites this paper as [4]
Although this study evaluates risk prediction in an outpatient population, most data on the efficacy of risk reduction interventions are based on individuals seeking help at an emergency department, often after a suicide attempt.
“although this study evaluates risk prediction in an outpatient population, most data on the efficacy of risk reduction interventions are based on individuals seeking help at an emergency department, often after a suicide attempt.4,5”
From Accuracy requirements for cost-effective suicide risk prediction among primary care patients in the US (2021) · cites this paper as [4]
Previous meta-analyses have estimated varying effect sizes for primary benefits of risk reduction interventions, with not all showing statistically significant benefits.
“previous meta-analyses4,5,6,45 have estimated varying effect sizes, with not all showing statistically significant benefits”
From Accuracy requirements for cost-effective suicide risk prediction among primary care patients in the US (2021) · cites this paper as [4]

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Authors: Gøtzsche, P. C., & Gøtzsche, P. K.
Affiliations: Rigshospitalet (DK)
Corresponding author: Gøtzsche, Peter C
ORCID: Gøtzsche, Peter C
Venue: Journal of the Royal Society of Medicine
Publisher: SAGE Publications
Published: 2017-10
Volume: 110
Issue: 10
Pages: 404-410
ISSN: 0141-0768 (ISSN-L)
1758-1095
DOI: 10.1177/0141076817731904
PMC: PMC5650127
OpenAlex: W2765875828
Cited by: 79
References: 35
Citations by year: 2026: 6 · 2025: 6 · 2024: 6 · 2023: 8 · 2022: 12 · 2021: 16 · 2020: 14 · 2019: 5 · 2018: 1 · 2017: 3 · 2016: 1 · 2013: 1
FWCI: 0.97
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations: Journal of the Royal Society of Medicine (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Research at the University of Copenhagen (University of Copenhagen) (publishedVersion, other-oa)
Topics: Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
Keywords: cognitive behavioral therapy, suicide attempts, repeated suicide attempts, self-harm, depression, suicide prevention, usual care
MeSH terms: Adolescent, Adult, Aged, Female, Humans, Male, Middle Aged, Risk Factors, Suicide, Attempted, Cognitive Behavioral Therapy

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Cognitive behavioural therapy halves the risk of repeated suicide attempts: systematic review.

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