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Clarifying which early interventions may reduce adverse outcomes is essential for informing psychiatric care and prevention strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted a systematic review and meta\u2010analysis of randomized clinical trials enrolling individuals presenting to clinical services after self\u2010harm, with interventions initiated within 1\u2009month of the index episode. PubMed, Embase, PsycINFO, the WHO International Clinical Trials Registry Platform (ICTRP), and\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrials.gov\">ClinicalTrials.gov<\/jats:ext-link>\n                      were searched from inception through April 24, 2025. Two reviewers independently screened studies and extracted data using standardized forms. Risk of bias was assessed using the Cochrane RoB 2 tool, and certainty of evidence was evaluated with GRADE. Random\u2010effects meta\u2010analyses with Hartung\u2013Knapp adjustment were conducted for intervention categories with at least three trials, and prediction intervals were calculated. Prespecified meta\u2010regressions examined participant\u2010 and intervention\u2010level moderators.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Sixty randomized clinical trials, including 22,654 participants, met the inclusion criteria. Across pooled analyses, no intervention category was associated with a statistically significant reduction in repeat self\u2010harm at any follow\u2010up interval. For suicide deaths, problem\u2010solving therapy was associated with lower mortality at medium\u2010term follow\u2010up (6\u201312\u2009months; OR 0.45, 95% CI 0.29\u20130.70;\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090%), and brief intervention and contact was associated with lower mortality at long\u2010term follow\u2010up (&gt;\u200912\u2009months; OR 0.34, 95% CI 0.15\u20130.79;\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090%). Meta\u2010regression analyses indicated that younger mean sample age and trial inclusion based on suicidal intent moderated effects on repeat self\u2010harm at &gt;\u20096\u201312\u2009months.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Among trials initiating treatment within 1\u2009month of self\u2010harm presentation, effects on repeat self\u2010harm were small and not statistically significant, likely reflecting outcome heterogeneity in the acute post\u2010presentation period. In contrast, structured problem\u2010solving and brief contact\u2010based interventions were associated with lower suicide mortality at medium\u2010 and long\u2010term follow\u2010up. These findings support the use of scalable early interventions in psychiatric services and highlight priorities for future trials powered to detect effects on suicide mortality.<\/jats:p>\n                    <jats:p>\n                      <jats:bold>Trial Registration:<\/jats:bold>\n                      PROSPERO: CRD42023458233\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/acps.70085","type":"journal-article","created":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T23:10:08Z","timestamp":1773097808000},"page":"610-626","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Acute\u2010Phase Interventions After Self\u2010Harm for Preventing Suicide and Recurrence: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1111","volume":"153","author":[{"given":"Guilherme Pimenta","family":"Roncete","sequence":"first","affiliation":[{"name":"Departamento e Instituto de Psiquiatria 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