Summary of findings 3. Mood stabilisers versus placebo.
| Mood stabilisers (lithium) compared to placebo for adults who engage in SH. | ||||||
| Patient or population: adults who engage in SH Settings: outpatients Intervention: mood stabilisers (lithium) Comparison: placebo | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | Number of participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Placebo | Mood stabilisers | |||||
| Repetition of SH at 12 months | Study population | OR 0.99 (0.33 to 2.95) | 167 (1 study) | ⊕⊕⊝⊝ low1,2 | Quality of evidence was downgraded as this was a single trial and there was evidence of a significant imbalance between the treatment and control groups at baseline. | |
| 84 per 1000 | 84 per 1000 (29 to 214) | |||||
| *The basis for the assumed risk (e.g., the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: Confidence interval; OR: Odds ratio; SH: self‐harm. | ||||||
| GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate. | ||||||
1 Risk of bias was rated as VERY SERIOUS as no details of allocation concealment or personnel blinding were provided leading to possible selection, performance, and detection bias. 2 The trial was further downgraded as there was substantial imbalance between the intervention and control groups in terms of the proportion of participants with a history of multiple suicide attempts, scores on the Suicide Intent Scale for the index attempt, and the proportion of participants diagnosed with any personality disorder suggesting the presence of possible confounding.