P Castellví1, E Lucas-Romero2, A Miranda-Mendizábal3, O Parés-Badell4, J Almenara5, I Alonso6, M J Blasco7, A Cebrià8, A Gabilondo9, M Gili10, C Lagares11, J A Piqueras12, M Roca10, J Rodríguez-Marín12, T Rodríguez-Jimenez12, V Soto-Sanz12, J Alonso13. 1. Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain. 2. Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Department of Health & Experimental Sciences, Pompeu Fabra University (UPF), Barcelona, Spain; Universitat Autònoma de Barcelona (UAB), Barcelona, Spain. 3. Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Department of Health & Experimental Sciences, Pompeu Fabra University (UPF), Barcelona, Spain. 4. Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain. 5. Area of Preventive Medicine and Public Health. University of Cadiz, Spain. 6. Morales Meseguer Hospital, Murcia, Spain. 7. Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Department of Health & Experimental Sciences, Pompeu Fabra University (UPF), Barcelona, Spain. 8. Department of Mental Health, Corporació Sanitaria Parc Taulí, Sabadell, Spain. 9. Outpatient Mental Health Care Network, Osakidetza-Basque Health Service, Spain; Mental Health and Psychiatric Care Research Unit. BioDonosti Health Research Institute, Spain. 10. Institut Universitari d'Investigació en Ciències de la Salut (IUNICS-IDISPA), University of Balearic Islands, Palma de Mallorca, Spain; Network of Preventive Activities and Health Promotion, University of Balearic Islands, Palma de Mallorca, Spain. 11. Department of Statistics and Operative Research. University of Cádiz. Spain. 12. Department of Health Psychology, Miguel Hernandez University of Elche, Spain. 13. Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Department of Health & Experimental Sciences, Pompeu Fabra University (UPF), Barcelona, Spain. Electronic address: jalonso@imim.es.
Abstract
BACKGROUND: Adolescents with previous self-injurious thoughts and behaviors (SITB) have over 2-fold risk of dying by suicide, higher than older ages. This meta-analysis aims to disentangle the association of each SITB with subsequent suicidal behavior in adolescence/young adulthood, the contribution of each SITB, and the proportion of suicide deaths with no previous suicide attempt. METHODS: We searched 6 databases until June 2015. INCLUSION CRITERIA: 1. Assessment of any previous SITB [a) suicidal thoughts and behaviors (ideation; threat/gesture; plan; attempt); b) non-suicidal thoughts and behaviors (thoughts; threat/gesture; self-injury); c) self-harm] as a risk factor of suicide attempt or suicide death; 2. Case-control or cohort studies; 3. Subjects aged 12-26y. Random effect models, metaregression analyses including mental health and environmental variables, and population attributable risks (PAR)s were estimated. RESULTS: From 23,682 potentially eligible articles, 29 were included in the meta-analysis (1,122,054 individuals). While 68% of all youth suicide deaths had no previous suicide attempt, suicide death was very strongly associated with any previous SITB (OR=22.53, 95%CI: 18.40-27.58). Suicide attempts were also associated with a history of previous SITB (OR=3.48, 95%CI: 2.71-4.43). There were no moderating effects for mental health and environmental features. The PAR of previous SITB to suicide attempts is 26%. LIMITATIONS: There is considerable heterogeneity between the available studies. Due to limitations in the original studies, an over-estimation of the proportion dying at their first attempt cannot be ruled out, since they might have missed unrecognized previous suicide attempts. CONCLUSIONS: Although more than two thirds of suicide deaths in adolescence/young adulthood have occurred with no previous suicidal behavior, previous SITBs have a much higher risk of dying by suicide than previously reported in this age group.
BACKGROUND: Adolescents with previous self-injurious thoughts and behaviors (SITB) have over 2-fold risk of dying by suicide, higher than older ages. This meta-analysis aims to disentangle the association of each SITB with subsequent suicidal behavior in adolescence/young adulthood, the contribution of each SITB, and the proportion of suicide deaths with no previous suicide attempt. METHODS: We searched 6 databases until June 2015. INCLUSION CRITERIA: 1. Assessment of any previous SITB [a) suicidal thoughts and behaviors (ideation; threat/gesture; plan; attempt); b) non-suicidal thoughts and behaviors (thoughts; threat/gesture; self-injury); c) self-harm] as a risk factor of suicide attempt or suicide death; 2. Case-control or cohort studies; 3. Subjects aged 12-26y. Random effect models, metaregression analyses including mental health and environmental variables, and population attributable risks (PAR)s were estimated. RESULTS: From 23,682 potentially eligible articles, 29 were included in the meta-analysis (1,122,054 individuals). While 68% of all youth suicide deaths had no previous suicide attempt, suicide death was very strongly associated with any previous SITB (OR=22.53, 95%CI: 18.40-27.58). Suicide attempts were also associated with a history of previous SITB (OR=3.48, 95%CI: 2.71-4.43). There were no moderating effects for mental health and environmental features. The PAR of previous SITB to suicide attempts is 26%. LIMITATIONS: There is considerable heterogeneity between the available studies. Due to limitations in the original studies, an over-estimation of the proportion dying at their first attempt cannot be ruled out, since they might have missed unrecognized previous suicide attempts. CONCLUSIONS: Although more than two thirds of suicide deaths in adolescence/young adulthood have occurred with no previous suicidal behavior, previous SITBs have a much higher risk of dying by suicide than previously reported in this age group.
Authors: Paul L Plener; Michael Kaess; Christian Schmahl; Stefan Pollak; Jörg M Fegert; Rebecca C Brown Journal: Dtsch Arztebl Int Date: 2018-01-19 Impact factor: 5.594
Authors: Elizabeth Thompson; Anthony Spirito; Elisabeth Frazier; Alysha Thompson; Jeffrey Hunt; Jennifer Wolff Journal: Schizophr Res Date: 2020-01-13 Impact factor: 4.939