The following is a summary of “Assessment of suicidality in trials of psychological interventions for depression: a meta-analysis,” published in the February 2024 issue of Psychiatry by Miguel et al.

Depression is frequently linked with suicide-related outcomes, which is treated with psychotherapy, but no conclusive study has been done to prove trials linkage with preventing suicide. 

Researchers conducted a retrospective study to examine suicidal thoughts and behaviors as eligibility criteria, outcomes, and adverse events across trials of psychotherapy for depression.

They used a meta-analytic database (updated till May 2023) to identify if any psychological treatments for depression helped prevent suicide in adults compared to not getting any treatment. Inpatient trials and unguided digital intervention studies were excluded, and the risk of bias was assessed using Cochrane’s tool. 

The results showed that out of 469 trials, 251 excluded people judged at risk of suicide. Assessment of suicide was included in only 45 trials, 12 of which assessed suicide as a risk of outcome. These 12 trials had 3930 participants (71% female, 29% male). Psychological interventions slightly reduced suicidal ideation and risk after intervention (0.31 [95%CI – 0.60 to -0.03]) but not at follow-up ( -0.49 [-1.31 to 0.32]). Adverse events were reported in 25 trials, including serious ones in 13. Heterogeneity was high, and prediction intervals crossed zero. 

Investigators concluded that studies rarely check for suicidal thoughts during depression treatment trials. While initial findings suggest some treatments might lower these thoughts, more research is needed. 

Source: thelancet.com/journals/lanpsy/article/PIIS2215-0366(24)00027-0/abstract