Effectiveness of online and mobile telephone applications ('apps') for the self-management of suicidal ideation and self-harm: A systematic review and meta-analysis

BMC Psychiatry

Volumn 17, Issue 1, 2017, Pages

  Witt, Katrina ^a   Spittal, Matthew J ^b   Carter, Gregory ^c   Pirkis, Jane ^b   Hetrick, Sarah ^d   Currier, Dianne ^b   Robinson, Jo ^d   Milner, Allison ^b  

^a MONASH UNIVERSITY   (Australia)

^b UNIVERSITY OF MELBOURNE   (Australia)

^c UNIVERSITY OF NEWCASTLE   (Australia)

^d UNIVERSITY OF MELBOURNE   (Australia)

Author keywords

Application; Digital; Mobile telephone; Self harm; Suicide; Suicide ideation

Indexed keywords

ARTICLE; AUTOMUTILATION; COGNITIVE BEHAVIORAL THERAPY; DEPRESSION; HOSPITAL ADMISSION; HUMAN; META ANALYSIS; MOBILE PHONE; OBSERVATIONAL STUDY; ONLINE SYSTEM; PATIENT SAFETY; PSYCHOSOCIAL CARE; RANDOMIZED CONTROLLED TRIAL (TOPIC); RATING SCALE; SCORING SYSTEM; SELF CARE; SENSITIVITY ANALYSIS; SUICIDAL BEHAVIOR; SUICIDAL IDEATION; SUICIDE ATTEMPT; SYMPTOMATOLOGY; SYSTEMATIC REVIEW; MOBILE APPLICATION; PROCEDURES;

HUMANS; MOBILE APPLICATIONS; SELF-INJURIOUS BEHAVIOR; SELF-MANAGEMENT; SUICIDAL IDEATION; SUICIDE, ATTEMPTED;

EID: 85027505930     PISSN: None     EISSN: 1471244X     Source Type: Journal    
DOI: 10.1186/s12888-017-1458-0     Document Type: Article

References (75)

1. Hawton K, Zhal D, Weatherall R. Suicide following deliberate self-harm: long term follow-up of patients who presented to a general hospital. Br J Psychiatry. 2003;182:537-42.
2. Logan C. Managing Clinical Risk: A Guide to Effective Practice. In: Logan C, Johnstone L, editors. Suicide and self-harm: Clinical risk assessment and management using a structured professional judgement approach. Abingdon: United Kingdom: Routledge; 2013. p. 115-25.
3. McLean J, Maxwell M, Platt S, Harris F, Jepson R. Risk and protective factors for suicide and suicidal behaviour: a literature review. Edinbrugh, United Kingdom: Scottish Government; 2008.
4. Paul E, Tsypes A, Eidlitz L, Ernhout C, Whitlock J. Frequency and functions of non-suicidal self-injury: associations with suicidal thoughts and behaviors. Psychiatry Res. 2015;255:276-82.
5. Carroll R, Metcalfe C, Gunnell D. Hospital presenting self-harm and risk of fatal and non-fatal repetition: systematic review and meta-analysis. PLoS One. 2014;9(2):e89944.
6. Franklin J, Nock M. The Oxford Handbook of Behavioral Emergencies and Crises. In: Keleespies P, editor. Nonsuicidal self-injury and its relation to suicidal behavior. New York, NY: Oxford University Press; 2017.
7. Kapur N, Cooper J, O'Connor R, Hawton K. Non-suicidal self-injury v. Attempted suicide: new diagnosis or false dichotomy? Br J Psychiatry. 2013;202(5):326-8.
8. Hawton K, Harriss L, Hall S, Simkin S, Bale E, Bond A. Deliberate self-harm in Oxford, 1990-2000: A time of change in patient characteristics. Psychol Med. 2003;33:987-95.
9. Hawton K, Witt K, Taylor Sailsbury T, Arensman E, Gunnell D, Townsend E, van Heeringen K, Hazell P. Interventions for self-harm in children and adolescents. Cochrane Database Syst Rev. 2015;9:CD012013.
10. Hawton K, Witt K, Taylor Salisbury T, Arensman E, Gunnell D, Hazell P, van Heeringen K. Psychosocial interventions for self-harm in adults. Cochrane Database Sys Rev. 2016;14:CD012189.
11. Hawton K, Witt KG, Salisbury TLT, Arensman E, Gunnell D, Hazell P, Townsend E, van Heeringen K. Psychosocial interventions following self-harm in adults: a systematic review and meta-analysis. Lancet Psychiatry. 2016;3(8):740-50.
12. Tondo L, Albert M, Baldessarini R. Suicide in relation to health care access in the United States: an ecological study. J Clin Psychiatry. 2006;67(4):517-23.
13. Kapusta N, Poschm N, Niederkrotenthaler T, Fischer-Kern M, Etzersdorfer M, Sonneck G. Availability of mental health service providers and suicide rates in Austria: a nationwide survey. Psychiar Serv. 2010;61(12):1198-203.
14. Kawaguchi H, Koike S. Association between the density of physicians and suicide rates in Japan: Nationwide ecological study using a spatial Bayesian model. PLoS One. 2016;11(2):e0148288.
15. Bruffaerts R, Demytenaere K, Hwang I, Chiu W, Sampson N, Kessler R, Alonso J, Borges G, de Girolamo G, de Graaf R, et al. Treatment of suicidal people around the world. Br J Psychiatry. 2011;199(1):64-70.
16. Czyz E, Horwitz A, Eisenberg D, Kramer A, King C. Self-reported barriers to professional help seeking among college students at elevated risk for suicide. J Am College Health. 2013;61(7):398-406.
17. Aggarwal N. Applying mobile technologies to mental health service delivery in South Asia. Asian J Psychiatr. 2012;5(3):225-30.
18. de Beurs D, Kirtley O, Kerkhof A, Portzky G, O'Connor R. The role of mobile phone technology in understanding and preventing suicidal behavior. Crisis. 2015;36(2):79-82.
19. Kerkhof A, van Spijker B, Mokkenstorm J. Suicide Prevention and New Technologies: Evidence-Based Practice. In: Mishara B, Kerkhof A, editors. Reducing the burden of suicidal thoughts through online cognitive behavioural therapy self-help. New York, NY: Palgrave Macmillian; 2013.
20. Hayes J, Maughan D, Grant-Peterkin H. Interconnected or disconnected? Promotion of mental health and prevention of mental disorder in the digital age. Br J Psychiatry. 2016;208(3):205-7.
21. Moher D, Liberati A, Tetzlaff J, Altman D. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ. 2009;339(7):b2535.
22. Christensen H, Batterham P, O'Dea B. E-health interventions for suicide prevention. Int J Environ Res Public Health. 2014;11(8):8193-212.
23. Donker T, Petrie K, Proudfoot J, Clarke J, Birch M-R, Christensen H. Smartphones for smarter delivery of mental health programs: a systematic review. J Med Internet Res. 2013;15(11):e247.
24. Lai M, Maniam T, Chan L, Ravindran A. Caught in the web: a review of web-based suicide prevention. J Med Internet Res. 2014;16(1):e30.
25. Jacob N, Scourfield J, Evans R. Suicide prevention via the internet: a descriptive review. Crisis. 2014;35(4):261-7.
26. Perry Y, Werner-Seidler A, Calear A, Christensen H. Web-based and mobile suicide prevention interventions for young people: a systematic review. J Can Acad Child Adolesc Psychiatry. 2016;25(2):73-9.
27. Deeks J, Higgins J, Altman D. Analysing data and undertaking meta-analyses. In: Higgins JPT, Green S, (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0. The Cochrane Collaboration; 2011. Available from http://handbook.cochrane.org.
28. Beck A, Kovacs M, Weissman A. Assessment of suicidal intention: the scale for suicidal ideation. J Consult Clin Psychol. 1979;47(2):343-52.
29. DerSimonian R, Laird N. Meta-analysis in clinical trials. Control Clin Trials. 1986;7(3):177-88.
30. Higgins J, Thompson S, Deeks J, Altman D. Measuring inconsistency in meta-analysis. BMJ. 2003;327(7414):557-60.
31. Meerwijk E, Parekh A, Oquendo M, Allen I, Franck L, Lee K. Direct versus indirect psychosocial and behavioural interventions to prevent suicide and suicide attempts: a systematic review and meta-analysis. Lancet Psychiatry. 2016;3:544-54.
32. Faber T, Ravaud P, Riveros C, Perrodeau E, Dechartres A. Meta-analyses including non-randomized studies of therapeutic interventions: a methodological review. BMC Med Res Methol. 2016;16:35.
33. Kennedy-Martin T, Curtis S, Faries D, Robinson S, Johnston J. A literature review on the representativeness of randomized controlled trial samples and implications for the external validity of trial results. Trials. 2015;16:495.
34. Parker L, Saez N, Porta M, Hernández-Aguado I, Lumbreras B. The impact of including different study designs in meta-analyses of diagnostic accuracy studies. Eur J Epidemiol. 2013;28:713-20.
35. Higgins J, Altman D, Sterne J. Assessing risk of bias in included studies. In: Higgins JPT, Green S, (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0. The Cochrane Collaboration; 2011. Available from http://handbook.cochrane.org.
36. A tool for assessing Risk Of Bias In Non-randomized Studies of Interventions (ROBINS-I), version 7.0. http://www.riskofbias.info. Accessed 7 Mar 2016.
37. Christensen H, Farrer L, Batterham P, Mackinnon A, Griffiths K, Donker T. The effect of a web-based depression intervention on suicidal ideation: secondary outcome from a randomised controlled trial in a helpline. BMJ Open. 2013;3(6):e002886.
38. Mewton L, Andrews G. Cognitive behaviour therapy via the internet for depression: a useful strategy to reduce suicidal ideation. J Affect Disord. 2015;170(1):78-84.
39. Robinson J, Hetrick S, Cox G, Bendall S, Yuen H, Yung A, Pirkis J. Can an internet-based intervention reduce suicidal ideation, depression and hopelessness among secondary school students: results from a pilot study. Early Interv Psychiatry. 2016;10(1):28-35.
40. Tighe J, Shand F, Ridani R, Mackinnon A, de la Mata N, Christensen H. iBobbly mobile health intervention for suicide prevention in Australian indigenous youth: a pilot randomised controlled trial. BMJ Open. 2017;7:e013518.
41. Guille C, Zhao Z, Krystal J, Nichols B, Brady K, Sen S. Web-based cognitive behavioral therapy intervention for the prevention of suicidal behaviour in medical interns: a randomized clinical trial. JAMA Psychiatry. 2015;72(12):1192-8.
42. van Voorhees B, Fogel J, Reinecke M, Gladstone T, Stuart S, Gollan J, Bradford N, Domanico R, Fagan B, Ross R, et al. Randomized clinical trial of an internet-based depression prevention program for adolescents (project CATCH-IT) in primary care: 12-week outcomes. J Dev Behav Pediatr. 2009;30(1):23-37.
43. Whiteside U, Richards J, Steinfeld B, Simon G, Caka S, Tachibana C, Stuckey S, Ludman E. Online cognitive behavioral therapy for depressed primary care patients: a pilot feasibility project. Perm J. 2014;18(2):21-7.
44. Hill RM, Pettit JW. Pilot Randomized Controlled Trial of LEAP: A Selective Preventive Intervention to Reduce Adolescents' Perceived Burdensomeness. J Clin Child Adolesc Psychol. 2016. ePub ahead of print. doi: 10.1080/15374416.15372016.11188705.
45. Moritz S, Schilling L, Hauschildt M, Schröder J, Treszel A. A randomized controlled trial of internet-based therapy in depression. Behav Res Ther. 2012;50(7-8):513-21.
46. Kordy H, Wolf M, Aulich K, Bürgy M, Hegerl U, Hüsing J, Puschner B, Rummel-Kluge C, Vegger H, Backenstrass M. Internet-delivered disease management for recurrent depression: a multicentre randomized controlled trial. Psychother Psychosom. 2016;85(2):91-8.
47. van Spijker B, van Straten A, Kerkhof A. Effectiveness of online self-help for suicidal thoughts: results of a randomised controlled trial. PLoS One. 2014;9(2):e90118.
48. Hedman E, Ljótsson B, Kaldo V, Hesser H, Alaoui S, Kraepelien M, Andersson E, Rück C, Svanborg C, Andersson G, et al. Effectiveness of internet-based cognitive behaviour therapy for depression in routine psychiatric care. J Affective Disord. 2014;155(2):49-58.
49. Wagner B, Horn A, Maercker A. Internet-based versus face-to-face cognitive behavioral intervention for depression: a randomized controlled non-inferority trial. J Affective Disord. 2014;152(7):113-21.
50. Franklin J, Fox K, Franklin C, Kleiman E, Ribeiro J, Jaroszewski A, Hooley J, Nock M. A brief mobile app reduces nonsuicidal and suicidal self-injury: evidence from three randomized controlled trials. J Consult Clin Psychol. 2016;84(6):544-57.
51. Elbourne D, Altman D, Higgins J, Curtin F, Worthington H, Vail A. Meta-analyses involving cross-over trials: methodological issues. Int J Epidemiol. 2002;31:140-9.
52. Boele F, Verdonck-de-Leeuw I, Cuijpers P, Reijneveld J, Heimans J, Klein M. Internet-based guided self-help for glioma patients with depressive symptoms: design of a randomized controlled trial. BMC Neurol. 2014;14:81.
53. Eylem O, van Straten A, Bhui K, Kerkhof AJ. Reducing suicidal ideation among Turkish migrants in the Netherlands and in the UK: effectiveness of an online intervention. Int Rev Psychiatry. 2015;27(1):72-81.
54. Mühlmann C, Madsen T, Hjorthøj C, Kerkhof A, Nordentoft M, Erlangsen A. The self-help online against suicidal thoguhts (SOS) trial: study protocol for a randomized controlled trial. Trials. 2017;18:45.
55. Perry Y, Calear A, Mackinnon A, Batterham P, Licinio J, King C, Thomsen N, Scott J, Donker T, Merry S, et al. Trial for the prevention of depression (TriPoD) in final-year secondary students: study protocol for a cluster randomised controlled trial. Trials. 2015;16(6):451.
56. Robinson J, Hetrick S, Cox G, Bendall S, Yung A, Yuen H, Templer K, Pirkis J. The development of a randomised controlled trial testing the effects of an online intervention among school students at risk of suicide. BMC Psychiatry. 2014;14(5):155.
57. Simon G, Beck A, Rossom R, Richards J, Kirlin B, King D, Shulman L, Ludman E, Penfold R, Shortreed S, et al. Population-based outreach versus care as usual to prevent suicide attempt: study protocol for a randomized controlled trial. Trials. 2016;17:452.
58. Stallard P, Porter J, Grist R. Safety, acceptability, and use of a smartphone app, BlueIce, for young people who self-harm: protocol for an open phase I trial. JMIR Res Protoc. 2016;5:e217.
59. van Spijker B, Calear A, Batterham P, Mackinnon A, Gosling J, Kerkhof A, Solomon D, Christensen H. Reducing suicidal thoughts in the Australian general population through web-based self-help: study protocol for a randomized controlled trial. Trials. 2015;16(8):62.
60. Joiner T, Pfaff J, Acres J. A brief screening tool for suicidal symptoms in adolescents and young adults in general health settings: reliability and validity data from the Australian national general practice youth suicide prevention project. Behav Res Ther. 2002;40:471-81.
61. Osman A, Bagge C, Gutierrez P, Konick L, Kopper B, Barrios F. The suicidal behaviors Questionniare-revised (SBQ-R): validation with clinical and nonclinical samples. Assessment. 2001;8(4):443-54.
62. Reynolds W. Suicidal Ideation Questionnaire Junior. Odessa, FL: Psychological Assessment Resources; 1987.
63. Goldberg D, Hillier V. A scaled version of the general health questionnaire. Psychol Med. 1979;9(1):139-45.
64. Derogatis L, Lipman R, Rickels K, Uhlenhuth E, Cori L. The Hopkins symptom checklist (HSCL): a self-report symptom inventory. Behav Schi. 1974;19(1):1-15.
65. van Spijker B, van Straten A, Kerkhof A. Online self-help for suicidal thoughts: 3-month follow-up results and participant evaluation. Internet Interventions. 2015;2:283-8.
66. Watts S, Turnell A, Kladnitski N, Newby J, Andrews G. Treatment-as-usual (TAU) is anything but usual: a meta-analysis of CBT versus TAU for anxiety and depression. J Affect Disord. 2015;175:152-67.
67. Wampold B, Budge S, Laska K, Del Re A, Baardseth T, Flükiger C, Minami T, Kivlighanm D, Gunn W. Evidence-based treatments for depression and anxiety versus treatment-as-usual: a meta-analysis of direct comparisons. Clin Psychol Rev. 2011;31:1304-12.
68. Mars B, Cornish R, Heron J, Boyd A, Crane C, Hawton K, Lewis G, Tilling K, Macleod J, Gunnell D. Using data linkage to investigate inconsistent reporting of self-harm and questionnaire non-response. Arch Suicide Res. 2016;20:113-41.
69. NICE. Self-harm: the short-term physical and psychological management and secondary prevention of self-harm in primary and secondary care. Leicester, UK: British Psychological Society; 2004.
70. Witt K. The use of emergency department-based psychological interventions to reduce repetition of self-harm behaviour. Lancet Psychiatry. 2017;4:428-9.
71. Milner A, Spittal M, Kapur N, Witt K, Pirkis J, Carter G. Mechanisms of brief contact interventions in clinical populations: a systematic review. BMC Psychiatry. 2016;16:194.
72. Daine K, Hawton K, Singaravelu V, Stewart A, Simkin S, Montgomery P. The power of the web: a systematic review of studies of the influence of the internet on self-harm and suicide in young people. PLoS One. 2013;8:e77555.
73. Swinkles A, Giuliano T. The measurement and conceptualization of mood awareness: attention directed towards one's mood states. Personal Soc Psychol Bull. 1995;21:934-49.
74. Hetrick S, Robinson J, Spittal M, Carter G. Effective psychological and psychosocial approaches to reduce repetition of self-harm: a systematic review, meta-analysis, and meta-regression. BMJ Open. 2016;6:e011024.
75. Larsen M, Nicholas J, Christensen H. A systematic assessment of smartphone tools for suicide prevention. PLoS One. 2016;11:e0152285.