Suicide methods and severe mental illness: A systematic review and meta-analysis.

IF 5.3 2区医学 Q1 PSYCHIATRY

Acta Psychiatrica Scandinavica Pub Date : 2024-10-01 DOI:10.1111/acps.13759

M Trott, S Suetani, U Arnautovska, S Kisely, M Kar Ray, T Theodoros, V Le, S Leske, M Lu, R Soole, N Warren, D Siskind

{"title":"Suicide methods and severe mental illness: A systematic review and meta-analysis.","authors":"M Trott, S Suetani, U Arnautovska, S Kisely, M Kar Ray, T Theodoros, V Le, S Leske, M Lu, R Soole, N Warren, D Siskind","doi":"10.1111/acps.13759","DOIUrl":null,"url":null,"abstract":"Introduction: People with severe mental illness (SMI) have a higher risk of suicide compared with the general population. However, variations in suicide methods between people with different SMIs have not been examined. The aim of this pre-registered (PROSPERO CRD42022351748) systematic review was to pool the odds of people with SMI who die by suicide versus those with no SMI, stratified by suicide method.Methods: Searches were conducted on December 11, 2023 across PubMed, PsycInfo, CINAHL, and Embase. Eligible studies were those that reported suicide deaths stratified by SMI and suicide methods. Studies were pooled in a random-effects meta-analysis, and risk of bias was measured by the Joanna Briggs Institute checklist.Results: After screening, 12 studies were eligible (n = 380,523). Compared with those with no SMI, people with schizophrenia had 3.38× higher odds of jumping from heights (95% CI: 2.08-5.50), 1.93× higher odds of drowning (95% CI: 1.50-2.48). People with bipolar disorder also had 3.2× higher odds of jumping from heights (95% CI: 2.70-3.78). Finally, people with major depression had 3.11× higher odds of drug overdose (95% CI: 1.53-6.31), 2.11× higher odds of jumping from heights (95% CI: 1.93-2.31), and 2.33× lower odds of dying by firearms (OR = 0.43, 95% CI: 0.33-0.56). No studies were classified as high risk of bias, and no outcomes had high levels of imprecision or indirectness.Conclusion: These findings could inform lethal means counselling practices in this population. Additionally individual, clinical, community and public health interventions for people with SMI should prioritise, where feasible, means restriction including access to heights or drugs to overdose.","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":" ","pages":""},"PeriodicalIF":5.3000,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Acta Psychiatrica Scandinavica","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/acps.13759","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PSYCHIATRY","Score":null,"Total":0}

引用次数: 0

Abstract

Introduction: People with severe mental illness (SMI) have a higher risk of suicide compared with the general population. However, variations in suicide methods between people with different SMIs have not been examined. The aim of this pre-registered (PROSPERO CRD42022351748) systematic review was to pool the odds of people with SMI who die by suicide versus those with no SMI, stratified by suicide method.

Methods: Searches were conducted on December 11, 2023 across PubMed, PsycInfo, CINAHL, and Embase. Eligible studies were those that reported suicide deaths stratified by SMI and suicide methods. Studies were pooled in a random-effects meta-analysis, and risk of bias was measured by the Joanna Briggs Institute checklist.

Results: After screening, 12 studies were eligible (n = 380,523). Compared with those with no SMI, people with schizophrenia had 3.38× higher odds of jumping from heights (95% CI: 2.08-5.50), 1.93× higher odds of drowning (95% CI: 1.50-2.48). People with bipolar disorder also had 3.2× higher odds of jumping from heights (95% CI: 2.70-3.78). Finally, people with major depression had 3.11× higher odds of drug overdose (95% CI: 1.53-6.31), 2.11× higher odds of jumping from heights (95% CI: 1.93-2.31), and 2.33× lower odds of dying by firearms (OR = 0.43, 95% CI: 0.33-0.56). No studies were classified as high risk of bias, and no outcomes had high levels of imprecision or indirectness.

Conclusion: These findings could inform lethal means counselling practices in this population. Additionally individual, clinical, community and public health interventions for people with SMI should prioritise, where feasible, means restriction including access to heights or drugs to overdose.

查看原文本刊更多论文

自杀方法与重性精神病：系统回顾和荟萃分析。

导言：与普通人群相比，严重精神疾病患者（SMI）的自杀风险更高。然而，不同 SMI 患者自杀方式的差异尚未得到研究。这项预先注册（PROSPERO CRD42022351748）的系统性综述旨在汇集按自杀方式分层的 SMI 患者与非 SMI 患者自杀死亡的几率：于 2023 年 12 月 11 日在 PubMed、PsycInfo、CINAHL 和 Embase 中进行了检索。符合条件的研究是那些报告了按 SMI 和自杀方式分层的自杀死亡案例的研究。通过随机效应荟萃分析对研究进行汇总，并采用乔安娜-布里格斯研究所（Joanna Briggs Institute）的检查表对偏倚风险进行测量：经过筛选，12 项研究符合条件（n = 380,523 人）。与没有精神分裂症的患者相比，精神分裂症患者跳楼的几率要高出3.38倍（95% CI：2.08-5.50），溺水的几率要高出1.93倍（95% CI：1.50-2.48）。双相情感障碍患者跳楼的几率也高出 3.2 倍（95% CI：2.70-3.78）。最后，重度抑郁症患者吸毒过量的几率比正常人高 3.11 倍（95% CI：1.53-6.31），跳楼的几率比正常人高 2.11 倍（95% CI：1.93-2.31），死于枪支的几率比正常人低 2.33 倍（OR = 0.43，95% CI：0.33-0.56）。没有研究被归类为高偏倚风险，也没有结果存在高度不精确或间接性：这些研究结果可为该人群的致命手段咨询实践提供参考。此外，在可行的情况下，针对 SMI 患者的个人、临床、社区和公共卫生干预措施应优先考虑限制手段，包括获取高处或药物过量。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Acta Psychiatrica Scandinavica 医学-精神病学

CiteScore

11.20

自引率

3.00%

发文量

135

审稿时长

6-12 weeks

期刊介绍： Acta Psychiatrica Scandinavica acts as an international forum for the dissemination of information advancing the science and practice of psychiatry. In particular we focus on communicating frontline research to clinical psychiatrists and psychiatric researchers. Acta Psychiatrica Scandinavica has traditionally been and remains a journal focusing predominantly on clinical psychiatry, but translational psychiatry is a topic of growing importance to our readers. Therefore, the journal welcomes submission of manuscripts based on both clinical- and more translational (e.g. preclinical and epidemiological) research. When preparing manuscripts based on translational studies for submission to Acta Psychiatrica Scandinavica, the authors should place emphasis on the clinical significance of the research question and the findings. Manuscripts based solely on preclinical research (e.g. animal models) are normally not considered for publication in the Journal.