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Übersichtsarbeit

Psychotherapeutische Interventionen für suizidale Jugendliche – eine systematische Übersicht aktueller Publikationen

Published Online:August 03, 2017https://doi.org/10.1024/1422-4917/a000538

Abstract

Zusammenfassung. Obwohl suizidale Gedanken und Verhaltensweisen bei Jugendlichen ein häufiges Phänomen sind, wird die Datenlage zur Evaluation von spezifischen Therapieverfahren in der aktuellen AWMF-Leitlinie zur Suizidalität im Kindes- und Jugendalter als unzureichend eingestuft. Ziel dieser systematischen Literaturübersicht war es, die aktuellsten Erkenntnisse zu psychotherapeutischen Verfahren bei suizidalen Kindern und Jugendlichen zusammenzutragen und kritisch zu diskutieren. Aufbauend auf anderen aktuellen systematischen Reviews wurden in die aktuelle Übersicht 11 Studien eingeschlossen, die ab dem Jahr 2013 veröffentlicht wurden. Dabei handelt es sich um Studien zu Interventionen in Notaufnahmen, zu spezifischen psychotherapeutischen Ansätzen zur Suizidalität, zu Ansätzen, die auf bestimmte Patienten- oder Risikogruppen zugeschnitten sind, und um eine Studie zu einem Online-Therapieverfahren. Erste positive Effekte lassen sich für eine familienbasierte Intervention in der Notaufnahme (hinsichtlich geringerer Hospitalisierungsraten) und für dialektisch-behaviorale, kognitiv-verhaltenstherapeutische Maßnahmen sowie familienfokussierte Verfahren (hinsichtlich der Reduktion der Suizidalität) finden. Auch eine Studie zu einer online durchgeführten Therapie konnte erste unkontrollierte, positive Effekte zeigen. Dennoch lässt sich in der Zusammenschau der Studien festhalten, dass es weiterer Evaluation von Therapieverfahren für suizidale Jugendliche bedarf. Insbesondere sind hier Replikationen der bisherigen Evaluationsergebnisse sowie die Durchführung von Studien mit größeren Stichproben sowie längeren Follow-Up-Zeitabständen vonnöten.


Psychotherapeutic interventions for suicidal adolescents – a systematic review of the current literature

Abstract. Although suicidal thoughts and behaviors are common in adolescents, the German guidelines for suicidality in children and adolescents state a lack of evidence for the effectiveness of specific psychotherapies for those patients. The aim of this systematic review was to summarize and critically discuss newest advances in the evaluation of specific therapeutic approaches for suicidality in youths. Building on other recent systematic reviews, 11 manuscripts published between 2013 and 2017 were included in this review. Included are studies on interventions in emergency departments, psychotherapeutic approaches specifically targeting suicidality despite other psychopathology, interventions for youth with specific disorders or risk-factors, and one study evaluating an online-intervention. First positive effects can be claimed for family interventions in emergency departments (regarding lower hospitalization rates) as well as cognitive-behavioral, dialectical-behavioral, and family-oriented interventions (regarding reducing suicidality). Promising results were also found in a pilot study on an online-intervention. However, further research is necessary, as replication of outcomes has not been attempted or published in most cases and studies including large sample sizes with long-term follow-up evaluation are very rare.

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