Psychosocial interventions for suicidal and self-injurious-related behaviors among adolescents: a systematic review and meta-analysis of Chinese practices

Junjie Lu; Wanting Gao; Zexin Wang; Nan Yang; Weng Ian Phoenix Pang; Grace Ka In Lok; Wenwang Rao

doi:10.3389/fpubh.2023.1281696

Psychosocial interventions for suicidal and self-injurious-related behaviors among adolescents: a systematic review and meta-analysis of Chinese practices

Front Public Health. 2023 Dec 18:11:1281696. doi: 10.3389/fpubh.2023.1281696. eCollection 2023.

Authors

Junjie Lu¹, Wanting Gao¹, Zexin Wang², Nan Yang², Weng Ian Phoenix Pang², Grace Ka In Lok³, Wenwang Rao¹

Affiliations

¹ Department of Preventive Medicine, Shantou University Medical College, Shantou, Guangdong, China.
² Faculty of Health Sciences and Sports, Macao Polytechnic University, Macao, Macao SAR, China.
³ Macao Polytechnic University, Peking University Health Science Center-Macao Polytechnic University Nursing Academy, Macao, Macao SAR, China.

Abstract

Background: Suicidal and self-injurious-related behaviors (SSIRBs) are a serious public health challenge in China. However, a comprehensive systematic review of psychosocial interventions for SSIRBs among Chinese adolescents has not been performed. To fill this gap, this systematic review and meta-analysis aimed to examine psychosocial interventions for SSIRBs among Chinese adolescents.

Methods: Eight international (PubMed, EMBASE, Cochrane Library, ScienceDirect, Clinical Trial, CINAHL, PsycINFO, and Web of Science) and four Chinese (Wanfang, SinoMed, CEPS, and CNKI) databases were searched from inception to 31 January 2023. Data extraction and quality assessment were independently conducted by two groups of researchers. Qualitative synthesis and meta-analysis were both used.

Results: The initial search yielded 16,872 titles. Of the 649 full texts reviewed, 19 intervention articles focusing on SSIRBs met the inclusion criteria. Thirteen out of the 19 included studies involved cognitive-behavioral therapy (CBT). Seven non-suicidal self-injury (NSSI) studies assessing self-injurious behaviors were included (six short-term studies and three long-term studies). Compared with long-term interventions [-1.30 (95% CI: -1.84, -0.76)], short-term psychosocial interventions had a higher standardized mean difference (SMD) value [1.86 (95% CI: -2.72, -0.99)]. Meta-regression showed an inverse relationship between the treatment response and sample size (slope = 0.068, Z = 2.914, p = 0.004) and proportion of females (slope = 1.096, Z = 5.848, p < 0.001). Subgroup analyses showed that compared with the "less than 1 month" group [-0.494 (-0.783, -0.205)], in the "immediate postintervention" group, the pooled estimate was significantly lower [-2.800 (-4.050, -1.550), p < 0.001].

Conclusion: Our review systematically summarized the key characteristics and effectiveness of existing psychosocial interventions for SSIRBs among Chinese adolescents. Short-term psychosocial interventions for NSSI were significantly effective in reducing self-injurious behavior scores, especially in the immediate postintervention period. More favorable treatment responses could be observed in both male and small samples.

Keywords: China; adolescent; psychosocial intervention; self-injurious behavior; suicide.

Publication types

Meta-Analysis
Systematic Review
Review
Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
China
Cognitive Behavioral Therapy*
Female
Humans
Male
Psychosocial Intervention*
Self-Injurious Behavior* / psychology
Self-Injurious Behavior* / therapy
Suicidal Ideation*

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This study was funded by the SUMC Scientific Research Foundation for Talents (SRFT, No. 510858060) and the Guangdong-Macau Youth Talent Exchange Program (No. 002–14202212).