Emma J Howarth1, Daryl B O'Connor2, Maria Panagioti3, Alexander Hodkinson4, Sarah Wilding2, Judith Johnson5. 1. Clinical Psychology Training Programme, University of Leeds, Leeds, United Kingdom. Electronic address: emma.j.howarth@outlook.com. 2. School of Psychology, University of Leeds, Leeds, United Kingdom. 3. NIHR Greater Manchester Patient Safety Translational Research Centre, NIHR School for Primary Care Research, Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, United Kingdom. 4. NIHR School for Primary Care Research, Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom. 5. School of Psychology, University of Leeds, Leeds, United Kingdom; Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, United Kingdom; School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia.
Abstract
BACKGROUND: Stressful life events are a risk factor for suicidal ideation and behaviour, but the strength and nature of this association is unclear. This review examined the prospective relationship between stressful life events and subsequent suicidal ideation and behaviours. METHODS: Five databases were searched from inception to April 2019. Eligible studies included observational, quantitative longitudinal cohort studies with adult or adolescent samples. A random-effects meta-analysis model was used to examine the prospective relationship between stressful life events and subsequent suicidal ideation and behaviours. Sub-group analyses examined moderating factors. RESULTS: Eight studies were identified in the systematic review, and seven studies comprising 2,639 participants were included in the meta-analysis. Six studies investigated suicidal ideation and one investigated suicidal behaviours. Stressful life events were associated with a 37% higher odds of subsequently reported suicidal ideation and behaviours combined (Odds Ratio (OR): 1.37, 95% CI: 1.10 to 1.70), and a 45% increased risk for suicidal ideation (OR: 1.45, 95% CI: 1.20 to 1.75). This association was stronger in males, young adults, and studies with shorter term follow-up. LIMITATIONS: The analyses indicated statistical heterogeneity was high (I2 = 76. 48, 95% CI: 55.0 to 87.7%) and there was evidence of publication bias. CONCLUSIONS: Stressful life events were shown to increase the risk of subsequently reported suicidal ideation and behaviours. These findings suggest that the experience of stressful life events should be incorporated into clinical suicide risk assessments and suicide interventions could include a component on developing resilience and adaptive coping to stressful life events.
BACKGROUND: Stressful life events are a risk factor for suicidal ideation and behaviour, but the strength and nature of this association is unclear. This review examined the prospective relationship between stressful life events and subsequent suicidal ideation and behaviours. METHODS: Five databases were searched from inception to April 2019. Eligible studies included observational, quantitative longitudinal cohort studies with adult or adolescent samples. A random-effects meta-analysis model was used to examine the prospective relationship between stressful life events and subsequent suicidal ideation and behaviours. Sub-group analyses examined moderating factors. RESULTS: Eight studies were identified in the systematic review, and seven studies comprising 2,639 participants were included in the meta-analysis. Six studies investigated suicidal ideation and one investigated suicidal behaviours. Stressful life events were associated with a 37% higher odds of subsequently reported suicidal ideation and behaviours combined (Odds Ratio (OR): 1.37, 95% CI: 1.10 to 1.70), and a 45% increased risk for suicidal ideation (OR: 1.45, 95% CI: 1.20 to 1.75). This association was stronger in males, young adults, and studies with shorter term follow-up. LIMITATIONS: The analyses indicated statistical heterogeneity was high (I2 = 76. 48, 95% CI: 55.0 to 87.7%) and there was evidence of publication bias. CONCLUSIONS: Stressful life events were shown to increase the risk of subsequently reported suicidal ideation and behaviours. These findings suggest that the experience of stressful life events should be incorporated into clinical suicide risk assessments and suicide interventions could include a component on developing resilience and adaptive coping to stressful life events.
Authors: Siti Aisyah Mohd Fadhli; Jasy Liew Suet Yan; Ahmad Shahril Ab Halim; Asrenee Ab Razak; Azriani Ab Rahman Journal: Healthcare (Basel) Date: 2022-05-06