J. Med. Internet Res. - Caught in the web: a review of web-based suicide prevention.


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CKGROUND: Suicide is a serious and increasing problem worldwide. The emergence of the digital world has had a tremendous impact on people's lives, both negative and positive, including an impact on suicidal behaviors.OBJECTIVE: Our aim was to perform a review of the published literature on Web-based suicide prevention strategies, focusing on their efficacy, benefits, and challenges.METHODS: The EBSCOhost (Medline, PsycINFO, CINAHL), OvidSP, the Cochrane Library, and ScienceDirect databases were searched for literature regarding Web-based suicide prevention strategies from 1997 to 2013 according to the modified PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. The selected articles were subjected to quality rating and data extraction.RESULTS: Good quality literature was surprisingly sparse, with only 15 fulfilling criteria for inclusion in the review, and most were rated as being medium to low quality. Internet-based cognitive behavior therapy (iCBT) reduced suicidal ideation in the general population in two randomized controlled trial (effect sizes, d=0.04-0.45) and in a clinical audit of depressed primary care patients. Descriptive studies reported improved accessibility and reduced barriers to treatment with Internet among students. Besides automated iCBT, preventive strategies were mainly interactive (email communication, online individual or supervised group support) or information-based (website postings). The benefits and potential challenges of accessibility, anonymity, and text-based communication as key components for Web-based suicide prevention strategies were emphasized.CONCLUSIONS: There is preliminary evidence that suggests the probable benefit of Web-based strategies in suicide prevention. Future larger systematic research is needed to confirm the effectiveness and risk benefit ratio of such strategies.

Resumo Limpo

ckground suicid serious increas problem worldwid emerg digit world tremend impact peopl live negat posit includ impact suicid behaviorsobject aim perform review publish literatur webbas suicid prevent strategi focus efficaci benefit challengesmethod ebscohost medlin psycinfo cinahl ovidsp cochran librari sciencedirect databas search literatur regard webbas suicid prevent strategi accord modifi prisma prefer report item systemat review metaanalys statement select articl subject qualiti rate data extractionresult good qualiti literatur surpris spars fulfil criteria inclus review rate medium low qualiti internetbas cognit behavior therapi icbt reduc suicid ideat general popul two random control trial effect size d clinic audit depress primari care patient descript studi report improv access reduc barrier treatment internet among student besid autom icbt prevent strategi main interact email communic onlin individu supervis group support informationbas websit post benefit potenti challeng access anonym textbas communic key compon webbas suicid prevent strategi emphasizedconclus preliminari evid suggest probabl benefit webbas strategi suicid prevent futur larger systemat research need confirm effect risk benefit ratio strategi

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