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  • 1
    Online Resource
    Online Resource
    Which psychotherapy is most effective and acceptable in the treatment of adults with a (sub)clinical borderline personality disorder? A systematic review and network meta-analysis
    Cambridge University Press (CUP) ; 2023
    In:  Psychological Medicine Vol. 53, No. 8 ( 2023-06), p. 3261-3280
    Details
    In: Psychological Medicine, Cambridge University Press (CUP), Vol. 53, No. 8 ( 2023-06), p. 3261-3280
    Abstract: A broad range of psychotherapies have been proposed and evaluated in the treatment of borderline personality disorder (BPD), but the question which specific type of psychotherapy is most effective remains unanswered. In this study, two network meta-analyses (NMAs) were conducted investigating the comparative effectiveness of psychotherapies on (1) BPD severity and (2) suicidal behaviour (combined rate). Study drop-out was included as a secondary outcome. Six databases were searched until 21 January 2022, including RCTs on the efficacy of any psychotherapy in adults (⩾18 years) with a diagnosis of (sub)clinical BPD. Data were extracted using a predefined table format. PROSPERO ID:CRD42020175411. In our study, a total of 43 studies ( N = 3273) were included. We found significant differences between several active comparisons in the treatment of (sub)clinical BPD, however, these findings were based on very few trials and should therefore be interpreted with caution. Some therapies were more efficacious compared to GT or TAU. Furthermore, some treatments more than halved the risk of attempted suicide and committed suicide (combined rate), reporting RRs around 0.5 or lower, however, these RRs were not statistically significantly better compared to other therapies or to TAU. Study drop-out significantly differed between some treatments. In conclusion, no single treatment seems to be the best choice to treat people with BPD compared to other treatments. Nevertheless, psychotherapies for BPD are perceived as first-line treatments, and should therefore be investigated further on their long-term effectiveness, preferably in head-to-head trials. DBT was the best connected treatment, providing solid evidence of its effectiveness.
    Type of Medium: Online Resource
    ISSN: 0033-2917 , 1469-8978
    URL: Article
    DOI: 10.1017/S0033291723000685
    RVK:
    XA 10000
    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 2023
    detail.hit.zdb_id: 1470300-2
    SSG: 5,2
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  • 2
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    Identifying populations at ultra-high risk of suicide using a novel machine learning method
    Elsevier BV ; 2023
    In:  Comprehensive Psychiatry Vol. 123 ( 2023-05), p. 152380-
    Details
    In: Comprehensive Psychiatry, Elsevier BV, Vol. 123 ( 2023-05), p. 152380-
    Type of Medium: Online Resource
    ISSN: 0010-440X
    URL: Article
    DOI: 10.1016/j.comppsych.2023.152380
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2023
    detail.hit.zdb_id: 2049049-5
    SSG: 5,2
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  • 3
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    Breaking Down Barriers to a Suicide Prevention Helpline: Protocol for a Web-Based Randomized Controlled Trial
    JMIR Publications Inc. ; 2023
    In:  JMIR Research Protocols Vol. 12 ( 2023-4-24), p. e41078-
    Details
    In: JMIR Research Protocols, JMIR Publications Inc., Vol. 12 ( 2023-4-24), p. e41078-
    Abstract: Globally, suicide is among the leading causes of death, with men being more at risk to die from suicide than women. Research suggests that people with suicidal ideation often struggle to find adequate help. Every month, around 4000 people fill in the anonymous self-test for suicidal thoughts on the website of the Dutch suicide prevention helpline. This self-test includes the Suicidal Ideation Attributes Scale (SIDAS), which educates users about the severity of their suicidal thoughts. The vast majority (70%) of people who complete the self-test score higher than the cutoff point (≥21) for severe suicidal thoughts. Unfortunately, despite this, less than 10% of test-takers navigate to the web page about contacting the helpline. Objective This protocol presents the design of a web-based randomized controlled trial that aims to reduce barriers to contacting the suicide prevention helpline. The aim of this study is 2-fold: (1) to measure the effectiveness of a brief barrier reduction intervention (BRI) provided in the self-test motivating people with severe suicidal thoughts to contact the Dutch suicide prevention helpline and (2) to specifically evaluate the effectiveness of the BRI in increasing service use by high-risk groups for suicide such as men and middle-aged people. Methods People visiting the self-test for suicidal thoughts on the website of the suicide prevention helpline will be asked to participate in a study to improve the self-test. Individuals with severe suicidal thoughts and little motivation to contact the helpline will be randomly allocated either to a brief BRI, in which they will receive a short tailored message based on their self-reported barrier to the helpline (n=388) or care as usual (general advisory text, n=388). The primary outcome measure is the use of a direct link to contact the helpline after receiving the intervention or control condition. Secondary outcomes are the self-reported likelihood of contacting the helpline (on a 5-point scale) and satisfaction with the self-test. In the BRI, participants receive tailored information to address underlying concerns and misconceptions of barriers to the helpline. A pilot study was conducted among current test-takers to identify these specific barriers. Results The pilot study (N=1083) revealed multiple barriers to contacting the helpline. The most prominent were the belief that a conversation with a counselor would not be effective, fear of the conversation itself, and emotional concerns about talking about suicidal thoughts. Conclusions Our study will provide insight into the effectiveness of a brief BRI designed to increase the use of a suicide prevention helpline provided in a self-test on suicidal thoughts. If successful, this intervention has the potential to be a low-cost, easily scalable, and feasible method to increase service use for helplines across the world. Trial Registration ClinicalTrials.gov NCT05458830; https://clinicaltrials.gov/ct2/show/NCT05458830 International Registered Report Identifier (IRRID) PRR1-10.2196/41078
    Type of Medium: Online Resource
    ISSN: 1929-0748
    URL: Article
    DOI: 10.2196/41078
    Language: English
    Publisher: JMIR Publications Inc.
    Publication Date: 2023
    detail.hit.zdb_id: 2719222-2
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  • 4
    Online Resource
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    Suicide trends in the early months of the COVID-19 pandemic: an interrupted time-series analysis of preliminary data from 21 countries
    Elsevier BV ; 2021
    In:  The Lancet Psychiatry Vol. 8, No. 7 ( 2021-07), p. 579-588
    Details
    In: The Lancet Psychiatry, Elsevier BV, Vol. 8, No. 7 ( 2021-07), p. 579-588
    Type of Medium: Online Resource
    ISSN: 2215-0366
    URL: Article
    DOI: 10.1016/S2215-0366(21)00091-2
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2021
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  • 5
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    Online Resource
    Suicide prevention gatekeeper training in the Netherlands improves gatekeepers’ knowledge of suicide prevention and their confidence to discuss suicidality, an observational study
    Springer Science and Business Media LLC ; 2018
    In:  BMC Public Health Vol. 18, No. 1 ( 2018-12)
    Details
    In: BMC Public Health, Springer Science and Business Media LLC, Vol. 18, No. 1 ( 2018-12)
    Type of Medium: Online Resource
    ISSN: 1471-2458
    URL: Article
    DOI: 10.1186/s12889-018-5512-8
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2018
    detail.hit.zdb_id: 2041338-5
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  • 6
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    Forecasting call and chat volumes at online helplines for mental health
    Springer Science and Business Media LLC ; 2023
    In:  BMC Public Health Vol. 23, No. 1 ( 2023-05-27)
    Details
    In: BMC Public Health, Springer Science and Business Media LLC, Vol. 23, No. 1 ( 2023-05-27)
    Abstract: Each year, many help seekers in need contact health helplines for mental support. It is crucial that they receive support immediately, and that waiting times are minimal. In order to minimize delay, helplines must have adequate staffing levels, especially during peak hours. This has raised the need for means to predict the call and chat volumes ahead of time accurately. Motivated by this, in this paper, we analyze real-life data to develop models for accurately forecasting call volumes, for both phone and chat conversations for online mental health support. Methods This research was conducted on real call and chat data (adequately anonymized) provided by 113 Suicide Prevention (Over ons | 113 Zelfmoordpreventie) (throughout referred to as ‘113’), the online helpline for suicide prevention in the Netherlands. Chat and phone call data were analyzed to better understand the important factors that influence the call arrival process. These factors were then used as input to several Machine Learning (ML) models to forecast the number of call and chat arrivals. Next to that, senior counselors of the helpline completed a web-based questionnaire after each shift to assess their perception of the workload. Results This study has led to several remarkable and key insights. First, the most important factors that determine the call volumes for the helpline are the trend , and weekly and daily cyclic patterns (cycles), while monthly and yearly cycles were found to be non-significant predictors for the number of phone and chat conversations. Second, media events that were included in this study only have limited—and only short-term—impact on the call volumes. Third, so-called (S)ARIMA models are shown to lead to the most accurate prediction in the case of short-term forecasting, while simple linear models work best for long-term forecasting. Fourth, questionnaires filled in by senior counselors show that the experienced workload is mainly correlated to the number of chat conversations compared to phone calls. Conclusion (S)ARIMA models can best be used to forecast the number of daily chats and phone calls with a MAPE of less than 10 in short-term forecasting. These models perform better than other models showing that the number of arrivals depends on historical data. These forecasts can be used as support for planning the number of counselors needed. Furthermore, the questionnaire data show that the workload experienced by senior counselors is more dependent on the number of chat arrivals and less on the number of available agents, showing the value of insight into the arrival process of conversations.
    Type of Medium: Online Resource
    ISSN: 1471-2458
    URL: Article
    DOI: 10.1186/s12889-023-15887-2
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 2041338-5
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  • 7
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    Online Resource
    Content-Based Recommender Support System for Counselors in a Suicide Prevention Chat Helpline: Design and Evaluation Study
    JMIR Publications Inc. ; 2021
    In:  Journal of Medical Internet Research Vol. 23, No. 1 ( 2021-1-7), p. e21690-
    Details
    In: Journal of Medical Internet Research, JMIR Publications Inc., Vol. 23, No. 1 ( 2021-1-7), p. e21690-
    Abstract: The working environment of a suicide prevention helpline requires high emotional and cognitive awareness from chat counselors. A shared opinion among counselors is that as a chat conversation becomes more difficult, it takes more effort and a longer amount of time to compose a response, which, in turn, can lead to writer’s block. Objective This study evaluates and then designs supportive technology to determine if a support system that provides inspiration can help counselors resolve writer’s block when they encounter difficult situations in chats with help-seekers. Methods A content-based recommender system with sentence embedding was used to search a chat corpus for similar chat situations. The system showed a counselor the most similar parts of former chat conversations so that the counselor would be able to use approaches previously taken by their colleagues as inspiration. In a within-subject experiment, counselors’ chat replies when confronted with a difficult situation were analyzed to determine if experts could see a noticeable difference in chat replies that were obtained in 3 conditions: (1) with the help of the support system, (2) with written advice from a senior counselor, or (3) when receiving no help. In addition, the system’s utility and usability were measured, and the validity of the algorithm was examined. Results A total of 24 counselors used a prototype of the support system; the results showed that, by reading chat replies, experts were able to significantly predict if counselors had received help from the support system or from a senior counselor (P=.004). Counselors scored the information they received from a senior counselor (M=1.46, SD 1.91) as significantly more helpful than the information received from the support system or when no help was given at all (M=–0.21, SD 2.26). Finally, compared with randomly selected former chat conversations, counselors rated the ones identified by the content-based recommendation system as significantly more similar to their current chats (β=.30, P 〈 .001). Conclusions Support given to counselors influenced how they responded in difficult conversations. However, the higher utility scores given for the advice from senior counselors seem to indicate that specific actionable instructions are preferred. We expect that these findings will be beneficial for developing a system that can use similar chat situations to generate advice in a descriptive style, hence helping counselors through writer’s block.
    Type of Medium: Online Resource
    ISSN: 1438-8871
    URL: Article
    DOI: 10.2196/21690
    Language: English
    Publisher: JMIR Publications Inc.
    Publication Date: 2021
    detail.hit.zdb_id: 2028830-X
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  • 8
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    Discussing suicidality with depressed patients: an observational study in Dutch sentinel general practices
    BMJ ; 2019
    In:  BMJ Open Vol. 9, No. 4 ( 2019-04), p. e027624-
    Details
    In: BMJ Open, BMJ, Vol. 9, No. 4 ( 2019-04), p. e027624-
    Abstract: This paper aims to describe the degree to which general practitioners (GPs) explore suicidal behaviour among depressed patients in the Netherlands. Design An observational study of consultations between GPs and depressed patients. Setting 39 sentinel GP practices within the Netherlands in 2017. Participants Patients with a registration of depression. Primary and secondary outcome measures Primary outcome measure is suicide exploration by the GP. Secondary outcome measures at patient level, assessed by surveying GPs, include prevalence and severity of suicidal thoughts. Secondary outcome measures at GP level include follow-up actions of GP and reasons not to explore suicidality. Results A total of 1034 questionnaires were included in the analyses. GPs assessed and explored suicidality in 44% of patients with depression (66% in patients with a new episode of depression). GPs explored suicidal feelings more often in patients with a new episode of depression (OR 4.027, p 〈 0.001, 95% CI 2.924 to 5.588), male patients (OR 1.709, p 〈 0.001, 95% CI 1.256 to 2.330) or younger patients (OR 1.017, p 〈 0.001, 95% CI 1.009 to 1.026). Multilevel analysis showed that 22% of the variation in suicide exploration is due to differences in GP practice. Thirty-eight per cent of the patients who were asked by their GP, reported (severe) suicidal ideation. Most GPs (68%) did not explore suicidal feelings because they thought the patient would not be suicidal. Conclusion GPs explored suicidal thoughts in less than half of all depressed patients and in two-thirds of patients with a new episode of depression. Suicide prevention training is recommended to enhance suicide exploration.
    Type of Medium: Online Resource
    ISSN: 2044-6055 , 2044-6055
    URL: Article
    DOI: 10.1136/bmjopen-2018-027624
    Language: English
    Publisher: BMJ
    Publication Date: 2019
    detail.hit.zdb_id: 2599832-8
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  • 9
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    Comprehensive database and individual patient data meta-analysis of randomised controlled trials on psychotherapies reducing suicidal thoughts and behaviour: study protocol
    BMJ ; 2020
    In:  BMJ Open Vol. 10, No. 12 ( 2020-12), p. e037566-
    Details
    In: BMJ Open, BMJ, Vol. 10, No. 12 ( 2020-12), p. e037566-
    Abstract: Psychotherapy may reduce suicidal thoughts and behaviour, but its effectiveness is not well examined. Furthermore, conventional meta-analyses are unable to test possible effects of moderators affecting this relationship. This protocol outlines the building of a comprehensive database of the literature in this research field. In addition, we will conduct an individual patient data meta-analysis (IPD-MA) to establish the effectiveness of psychotherapy in reducing suicidality, and to examine which factors moderate the efficacy of these interventions. Methods and analysis To build a comprehensive database, randomised controlled trials examining the effect of any psychotherapy targeting any psychiatric disorder on suicidal thoughts or behaviour will be identified by running a systematic search in PubMed, Embase, PsycINFO, Web of Science, Scopus and The Cochrane Central Register of Controlled Trials from data inception to 12 August 2019. For the IPD-MA, we will focus on adult outpatients with suicidal ideation or behaviour. In addition, as a comparison group we will focus on a control group (waiting-list, care as usual or placebo). A 1-stage IPD-MA will be used to determine the effectiveness of psychotherapy on suicidal ideation, suicide attempts and/or suicide deaths, and to investigate potential patient-related and intervention-related moderators. Subgroup and sensitivity analyses will be conducted to test the robustness of the findings. Additionally, a conventional MA will be conducted to determine the differences between studies that provided IPD and those that did not. IPD-MA may determine the effectiveness of psychotherapy in reducing suicidality and provide insights into the moderating factors influencing the efficacy of psychotherapy. Answering these questions will inform mental healthcare practitioners about optimal treatments for different groups of individuals with suicidal ideation and/or behaviour and consequently help to reduce suicide risk. Ethics and dissemination An ethical approval is not required for this study. The results will be published in a peer-review journal. PROSPERO registration number CRD42020140573
    Type of Medium: Online Resource
    ISSN: 2044-6055 , 2044-6055
    URL: Article
    DOI: 10.1136/bmjopen-2020-037566
    Language: English
    Publisher: BMJ
    Publication Date: 2020
    detail.hit.zdb_id: 2599832-8
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  • 10
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    A multi-method psychological autopsy study on youth suicides in the Netherlands in 2017: Feasibility, main outcomes, and recommendations
    Public Library of Science (PLoS) ; 2020
    In:  PLOS ONE Vol. 15, No. 8 ( 2020-8-27), p. e0238031-
    Details
    In: PLOS ONE, Public Library of Science (PLoS), Vol. 15, No. 8 ( 2020-8-27), p. e0238031-
    Type of Medium: Online Resource
    ISSN: 1932-6203
    URL: Article
    URL: Article
    URL: Article
    URL: Article
    URL: Article
    URL: Article
    URL: Article
    DOI: 10.1371/journal.pone.0238031
    DOI: 10.1371/journal.pone.0238031.t001
    DOI: 10.1371/journal.pone.0238031.s001
    DOI: 10.1371/journal.pone.0238031.s002
    DOI: 10.1371/journal.pone.0238031.s003
    DOI: 10.1371/journal.pone.0238031.r001
    DOI: 10.1371/journal.pone.0238031.r002
    Language: English
    Publisher: Public Library of Science (PLoS)
    Publication Date: 2020
    detail.hit.zdb_id: 2267670-3
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