Strategies to prevent death by suicide: meta-analysis of randomised controlled trials.

Background Few randomised controlled trials (RCTs) have shown decreases in suicide. Aims To identify interventions for preventing suicide. Method We searched EMBASE and Medline from inception until 31 December 2015. We included RCTs comparing prevention strategies with control. We pooled odds ratios (ORs) for suicide using the Peto method. Results Among 8647 citations, 72 RCTs and 6 pooled analyses met inclusion criteria. Three RCTs ( n = 2028) found that the World Health Organization (WHO) brief intervention and contact (BIC) was associated with significantly lower odds of suicide (OR = 0.20, 95% CI 0.09-0.42). Six RCTs ( n = 1040) of cognitive-behavioural therapy (CBT) for suicide prevention and six RCTs of lithium ( n = 619) yielded non-significant findings (OR = 0.34, 95% CI 0.12-1.03 and OR = 0.23, 95% CI 0.05-1.02, respectively). Conclusions The WHO BIC is a promising suicide prevention strategy. No other intervention showed a statistically significant effect in reducing suicide.