Depression

Okolie et al. (2017)

21

359

RCT / QES

PST / PATH / HGT

ST, ST-CI, personalized treatment plan

SI / Suicide risk

HDRS suicide item / CSD / Self-reported suicidal ideation

Significantly greater reductions in SI in older adults with MDD and executive dysfunction after 12 weekly sessions of PST at 12 and 36 weeks post-treatment vs ST.
In older adults with MDD and dementia, PATH and ST-CI showed comparable reductions in SI after 12 weeks, with no significant differences in the course of SI between the two.
Evident improvements in suicidal tendency in older patients with MDD in both the HGT participants and untreated controls

PST vs ST: 12 weeks (OR: 0.50, Z=−2.16, p=0.031) and 36 weeks (OR: 0.50, Z=−1.96, p=0.05).
PATH vs ST-CI: 12 weeks (time: F[1, 95.8]=10.06, p=0.0020); (time by treatment interaction: F[1, 95.8]=0.75, p=0.3897).
HGT vs no treatment: (main effect: F=21.65, p<0.001).

Cuijpers et al. (2013)

13

616

RCT

CBT / MBCT

CAU, EHC

SI / Suicide risk

BSS / SRM

Only three randomized controlled studies on depression in adults were identified in which suicide was used as a clearly specified outcome measure. The combined results indicated very small and nonsignificant effects on suicidal tendencies, but there was limited statistical power to consider this as the true effect. The quality of the included studies was suboptimal.

Hedges' g=0.12 (95% CI: -0.20 - 0.44), not statistically significant. Post hoc power calculation, g=0.47

Schmelefske et al. (2020)

13

627

Pre-post studies

MBCT

CPE / TAU / WL / CBASP

SI

SCS / BSS / BDI-II item 9 / HDRS item 3 / IDS-SR

In studies utilizing samples of individuals with depressive disorders (k=5), MBIs were found to have a significant moderate effect.

Hedges´ g=0,45 (IC del 95% [0,28, 0,62], p<0,001).

CI, Confidence interval; F, F-statistic; g, Hedges ́ g; OR, Odds ratio; p, p-value; QES, Quasi-experimental studies; QES, Quasi-experimental studies; RCT, Randomized Controlled Trial; RCT, Randomized Controlled Trial; RR, Relative risk; SMD, Standardized Mean Difference; Z, Z- value.

Assessment tools: BDI, Beck Depression Inventory; BSS, Beck Scale for Suicide Ideation; CSD, Cornell Scale for Depression; HDRS, Hamilton Depression Rating Scale; IDS-SR, Inventory of Depressive Symptomology Self-Report; SCS, Suicidal Cognitions Scale; SI, Suicide Ideation; SRM, Suicide Risk Module of the MINI.

Psychotherapy: CAU, Care-as-usual; CBASP, Cognitive Behavioral Analysis System of Psychotherapy; CBT, Cognitive Behavioral Therapy; EHC, Existential Humanistic Cognitive Therapy; HGT, Humor Group Therapy; MBIs, Mindfulness-based Interventions; MBCT, Mindfulness- based Cognitive Therapy; PATH, Problem Adaptation Therapy; PST, Problem Solving Therapy; ST-CI, Supportive Therapy for Cognitively Impaired Older Adults; ST, Supportive Therapy; TAU, Treatment-as-usual; WL, Wait-list.

Table 4: Characteristics of Borderline Personality Disorder Studies.

Diagnosis

Author (year)

No. of studies

No. of patients

Primary study design

Psychotherapy

Control

Suicidal outcome

Outcome measure

Summary of results

Effect size (SMD/OR/RR, 95% CI)

BPD

Rameckers et al. (2021)

87

5881

RCT, Open trials, NRCT

DBT / DBTmin / SchT / MBT / PDT / CBT / TFP / Mixed therapies / Other (CAT, IT, CCT, SCM, GPM, TC, DDP)

TAU / CTBE / Active treatment

Suicidality/Self-harm

NA

With large effect sizes, SchT and MBT were strongly associated with greater reductions in suicidal tendencies compared to the average treatment effect.

Effect size in suicidality/self-harm
SchT: g=1.161 (CI 95% 0.669, 1.653, p=0.013);
MBT: g=0.872 (CI 95% 0.612, 1.132, p=0.042)

Stoffers-Winterling et al. (2022)

32

1870

RCT

DBT / MBT / IPT-BPD / CBT / DDP

TAU / WL / Supportive treatment / Clinical management

Self-harm / Suicide-related outcomes (Suicidal ideation and suicidal behavior)

NA

Statistically significant effects of low overall certainty were observed for self-harm in DBT and for self-harm and suicide outcomes in MBT.

DBT self-harm: (SMD −0.54, 95%CI -0.92 to -0.16, P=0.006, n=3 studies, n=110 participants)
MBT self-harm: (RR 0.51, 95%CI 0.34-0.75, P<0.0007, n=2 studies, n=172 participants)
MBT sucidal-related outcomes (suicidal behavior): (RR 0.10, 95%CI 0.03-0.32, P<0.0001, n=2 studies, n=172 participants).

Cristea et al. (2017)

33

2256

RCT

DBT-C / DBT / PFPR / IGP

WL / CVT / TAU

Self-harm/ Parasuicidal behavior/ Suicide

NA

In subgroup analysis within the category of all bordeline-relevant outcomes (BPD symptoms, self-harm and parasuicidal behavior, and suicide), DBT and PDT were more effective than control interventions.

DBT: g=0.34 (IC95% 0.15-0.53), NNT=5.26, n=9 studies
PDT: g=0.41 (IC95% 0.12-0.69), NNT=4.39, n=7 studies
TCC: g=0.24 (IC95% -0.01-0.49), NNT=7.46, n=5 studies
Other: g=0.38 (IC95% -0.15-0.92), NNT=4.72, n=6 studies

Kröger et al. (2010)

16

794

RCT, Neither randomized nor controlled

DBT

ST / TFP / CTBE / TAU

Suicidal and self-injurious behaviors

LPC/OAS-M/SASII/Rate of patients (self-harm and suicide attempts)

A moderate effect size was found for suicidal and self-injurious behaviors when including a moderator for RCTs with treatments specific to BPD.

g=0,56, CI 95% [0,52, 0,60], t(9)=27,04, p>0.001 (two-tailed)