Produção Nacional
Revisado por pares
Brazilian Psychiatric Association guidelines for the management of suicidal behavior. Part 2. Screening, intervention, and prevention
2020; Associação Brasileira de Psiquiatria; Volume: 43; Issue: 5 Linguagem: Inglês
10.1590/1516-4446-2020-1108
ISSN1809-452X
AutoresLeonardo Baldaçara, Roberta Rossi Grüdtner, Verônica da Silveira Leite, Deisy Mendes Porto, Kelly Pereira Robis, Thiago Marques Fidalgo, Gislene A. Rocha, Alexandre Paim Díaz, Alexandrina Maria Augusto da Silva Meleiro, Humberto Corrêa, Teng Chei Tung, Leandro Fernandes Malloy‐Diniz, João Quevedo, Antônio Geraldo da Silva,
Tópico(s)Bipolar Disorder and Treatment
ResumoThis article continues our presentation of the Brazilian Psychiatric Association guidelines for the management of patients with suicidal behavior, with a focus on screening, intervention, postvention, prevention, and promotion. For the development of these guidelines, we conducted a systematic review of the MEDLINE (via PubMed), Cochrane Database of Systematic Reviews, Web of Science, and SciELO databases for research published from 1997 to 2020. Systematic reviews, clinical trials, and cohort/observational studies on screening, intervention, and prevention in suicidal behavior were included. This project involved 14 Brazilian psychiatry professionals and 1 psychologist selected by the Psychiatric Emergencies Committee of the Brazilian Psychiatric Association for their experience and knowledge in psychiatry and psychiatric emergencies. Publications were evaluated according to the 2011 Oxford Center for Evidence-Based Medicine (OCEBM) Levels of Evidence Classification. Eighty-five articles were reviewed (of 5,362 initially collected and 755 abstracts on the drug approach). Forms of screening, intervention, and prevention are presented. The intervention section presents evidence for psychotherapeutic and drug interventions. For the latter, it is important to remember that each medication is effective only for specific groups and should not replace treatment protocols. We maintain our recommendation for the use of universal screening plus intervention. Although the various studies differ in terms of the populations evaluated and several proposals are presented, there is already significant evidence for certain interventions. Suicidal behavior can be analyzed by evidence-based medicine protocols. Currently, the best strategy is to combine several techniques through the Safety Plan. Nevertheless, further research on the topic is needed to elucidate some approaches with particular potential for intervention and prevention. Systematic review registry number: CRD42020206517
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