Keywords
Suicide
Suicide prevention
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Abstract
Objective: To evaluate the effectiveness of multilevel interventions in suicide prevention, focusing on randomized clinical trials. Methods: This is a systematic review with meta-analysis, conducted using PRISMA guidelines and registered in PROSPERO, including searches in the PubMed and PsycINFO databases. Data were analyzed using meta-analysis, forest-plot, and I², with p < 0.05 considered. Results: Sixty studies were analyzed qualitatively and 15 quantitatively, totaling 7,327 participants in the intervention group and 8,577 in the control group. The results indicated a significant overall effect favorable to the interventions (d = -0.32; 95% CI: -0.33 to -0.31; Z = 47.43; p < 0.00001). Interventions based on cognitive-behavioral therapy showed greater effectiveness. Conclusion: It is concluded that multilevel interventions are effective in reducing suicidal ideation and associated symptoms, although the high heterogeneity and concentration of studies in high-income countries point to the need for contextual adaptations and expansion of research in different sociocultural realities.
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