Margalida Gili1, Pere Castellví2, Margalida Vives3, Alejandro de la Torre-Luque4, José Almenara5, Maria J Blasco6, Ana I Cebrià7, Andrea Gabilondo8, Mª Angeles Pérez-Ara9, Miranda-Mendizábal A10, Carolina Lagares11, Oleguer Parés-Badell12, José A Piqueras13, Tiscar Rodríguez-Jiménez13, Jesús Rodríguez-Marín13, Victoria Soto-Sanz13, Jordi Alonso6, Miquel Roca3. 1. Institut Universitari d'Investigació en Ciències de la Salut (IUNICS-IDISBA), University of Balearic Islands, Palma de Mallorca, Spain; Red de Actividades Preventivas y Promoción de la Salud en Atención Primaria (RediAPP), Institute Carlos III, Barcelona, Spain. Electronic address: mgili@uib.es. 2. Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; CIBER en Epidemiología y Salud Pública (CIBERESP), Spain. 3. Institut Universitari d'Investigació en Ciències de la Salut (IUNICS-IDISBA), University of Balearic Islands, Palma de Mallorca, Spain; Red de Actividades Preventivas y Promoción de la Salud en Atención Primaria (RediAPP), Institute Carlos III, Barcelona, Spain. 4. Universidad Autónoma de Madrid, Spain; CIBER de Salud Mental (CIBERSAM), Spain. 5. Area of Preventive Medicine and Public Health. University of Cadiz, Cadiz, Spain. 6. Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; CIBER en Epidemiología y Salud Pública (CIBERESP), Spain; Department of Health & Experimental Sciences, Pompeu Fabra University (UPF), Barcelona, Spain. 7. Parc Taulí Hospital Universitari. Universitat Autònoma de Barcelona. Sabadell, Spain; CIBER de Salud Mental (CIBERSAM), Spain. 8. Outpatient Mental Health Care Network, Osakidetza-Basque Health Service, Spain; Mental Health and Psychiatric Care Research Unit. BioDonosti Health Research Institute, Spain. 9. Institut Universitari d'Investigació en Ciències de la Salut (IUNICS-IDISBA), University of Balearic Islands, Palma de Mallorca, Spain. 10. Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Department of Health & Experimental Sciences, Pompeu Fabra University (UPF), Barcelona, Spain. 11. Department of Statistics and Operative Research. University of Cadiz. Cadiz. Spain. 12. Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain. 13. Department of Health Psychology, Miguel Hernández University of Elche, Elche, Spain.
Abstract
BACKGROUND: Suicide is the second leading cause of death for young people. OBJECTIVE: To assess mental disorders as risk factors for suicidal behaviour among adolescents and young adults including population-based longitudinal studies. METHOD: We conducted a systematic literature review. Bibliographic searches undertaken in five international databases and grey literature sources until January 2017 yielded a total of 26,883 potential papers. 1701 full-text articles were assessed for eligibility of which 1677 were excluded because they did not meet our eligibility criteria. Separate meta-analyses were conducted for each outcome (suicide death and suicide attempts). Odds ratio (OR) and 95% confidence intervals (95%CI) and beta coefficients and standard errors were calculated. RESULTS: 24 studies were finally included involving 25,354 participants (12-26 years). The presence of any mental disorder was associated with higher risk of suicide death (OR = 10.83, 95%CI = 4.69-25.00) and suicide attempt (OR = 3.56; 95%CI 2.24-5.67). When considering suicidal attempt as the outcome, only affective disorders (OR = 1.54; 95%CI = 1.21-1.96) were significant. Finally, the results revealed that psychiatric comorbidity was a primary risk factor for suicide attempts. LIMITATIONS: Data were obtained from studies with heterogeneous diagnostic assessments of mental disorders. Nine case-control studies were included and some data were collected in students, not in general population. CONCLUSIONS: Mental disorders and comorbidity are strong predictors of suicide behaviour in young people. Detection and management of the affective disorders as well as their psychiatric comorbidity could be a crucial strategy to prevent suicidality in this age group.
BACKGROUND: Suicide is the second leading cause of death for young people. OBJECTIVE: To assess mental disorders as risk factors for suicidal behaviour among adolescents and young adults including population-based longitudinal studies. METHOD: We conducted a systematic literature review. Bibliographic searches undertaken in five international databases and grey literature sources until January 2017 yielded a total of 26,883 potential papers. 1701 full-text articles were assessed for eligibility of which 1677 were excluded because they did not meet our eligibility criteria. Separate meta-analyses were conducted for each outcome (suicide death and suicide attempts). Odds ratio (OR) and 95% confidence intervals (95%CI) and beta coefficients and standard errors were calculated. RESULTS: 24 studies were finally included involving 25,354 participants (12-26 years). The presence of any mental disorder was associated with higher risk of suicide death (OR = 10.83, 95%CI = 4.69-25.00) and suicide attempt (OR = 3.56; 95%CI 2.24-5.67). When considering suicidal attempt as the outcome, only affective disorders (OR = 1.54; 95%CI = 1.21-1.96) were significant. Finally, the results revealed that psychiatric comorbidity was a primary risk factor for suicide attempts. LIMITATIONS: Data were obtained from studies with heterogeneous diagnostic assessments of mental disorders. Nine case-control studies were included and some data were collected in students, not in general population. CONCLUSIONS:Mental disorders and comorbidity are strong predictors of suicide behaviour in young people. Detection and management of the affective disorders as well as their psychiatric comorbidity could be a crucial strategy to prevent suicidality in this age group.
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