Twenty-one RCTs were included (number of participants unclear): 15 published trials and six ongoing trials. Trial quality varied. Eight trials reported adequate randomisation procedures. Six trials reported adequate allocation concealment. Eight trials reported adequate masking procedures. Four trials used intention-to-treat analyses. Attrition rates ranged from zero to 79%. Eleven RCTs contributed to the meta-analyses.
There was no significant difference in suicide attempt or ideation for individual psychological therapy (two RCTs), group psychological therapy (three RCTs), family therapies (two RCTs), youth nominated support team (two RCTs) and emergency access card (one RCT). A significant reduction in suicide ideation was found with cognitive-behavioural therapy post intervention (one RCT) and at six months (one RCT) and nine months (one RCT) follow-up.
A significant reduction in self-harm incidents were found for dialectical behavioural therapy (one RCT) and cognitive-behavioural therapy at nine-month follow-up (one RCT) compared with control. No significant between-group differences were found for self-harm post intervention, six months follow-up and number of people who engaged in self-harm at nine-month follow-up with cognitive-behavioural therapy.
No outcome data were available for compliance enhancement intervention versus treatment as usual (one RCT), medication versus cognitive-behavioural therapy (one RCT), medication versus cognitive-behavioural therapy plus medication and cognitive-behavioural therapy versus cognitive-behavioural therapy plus medication.