title: The treatment of suicidality in adolescents by psychosocial interventions for depression: A systematic literature review.
abstract: OBJECTIVE
  Given depression is a significant risk factor for suicidal behaviour, it is possible that interventions for depression may also reduce the risk of suicide in adolescents. The purpose of this literature review is to determine whether psychological interventions aimed to prevent and/or treat depression in adolescents can also reduce suicidality.
  
  
  METHODS
  We conducted a systematic review of psychological interventions aimed to prevent and/or treat depression in adolescents in which outcomes for suicidality were reported, using five databases: PsycINFO, Embase, Medline, CINAHL and Scopus. Study quality was assessed using the Cochrane Collaboration's tool for assessing risk of bias.
  
  
  RESULTS
  A total of 35 articles pertaining to 12 treatment trials, two selective prevention trials and two universal prevention trials met inclusion criteria. No studies were identified that used a no-treatment control. In both intervention and active control groups, suicidality decreased over time; however, most structured psychological depression treatment interventions did not outperform pharmaceutical or treatment as usual control groups. Depression prevention studies demonstrated small but statistically significant reductions in suicidality.
  
  
  CONCLUSIONS
  Analysis of study quality suggested that at least 10 of the 16 studies have a high risk of bias. Conclusive comparisons across studies are problematic due to differences in measures, interventions, population differences and control groups used.
  
  
  CONCLUSIONS
  It is unclear whether psychological treatments are more effective than no treatment since no study has used a no-treatment control group. There is evidence to suggest that Cognitive Behavioural Therapy interventions produce pre-post reductions in suicidality with moderate effect sizes and are at least as efficacious as pharmacotherapy in reducing suicidality; however, it is unclear whether these effects are sustained. There are several trials showing promising evidence for family-based and interpersonal therapies, with large pre-post effect sizes, and further evaluation with improved methodology is required. Depression prevention interventions show promising short-term effects.
authors.affiliation: Faculty of Health, School of Psychology, Deakin University, Burwood, Australia.
authors.forename: Bethany
authors.initials: B
authors.lastname: Devenish
authors.affiliation: Faculty of Health, School of Psychology, Deakin University, Burwood, Australia Department of Psychiatry, Faculty of Medicine, Dentistry and Health Sciences, Deakin University, Burwood, Australia.
authors.forename: Lesley
authors.initials: L
authors.lastname: Berk
authors.affiliation: Faculty of Health, School of Psychology, Deakin University, Burwood, Australia School of Psychology and Exercise Science, Murdoch University, Murdoch WA, Australia a.lewis@murdoch.edu.au.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Lewis
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D003863:Depression / Q000628:therapy*; D006801:Humans; D011613:Psychotherapy / Q000379:methods*; D000092864:Suicide Prevention
keywords: Suicide; adolescents; depression; systematic review; treatment