Louis Favril, Rongqin Yu, Abdo Uyar, Michael Sharpe, Seena Fazel
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引用次数: 38
摘要
问:有效预防自杀需要对危险因素有全面的了解。研究选择和分析:系统地检索了五个数据库，以确定心理尸检研究(发表至2022年2月)，这些研究报告了普通人群中成年人自杀死亡的危险因素。使用随机效应模型对至少三个独立样本中检查的每个风险因素进行优势比(or)合并效应大小。研究结果:共纳入了来自23个国家的37项病例对照研究，提供了5633例病例和7101例对照中40种危险因素的数据。效应大小的大小在风险因素域之间和域内都有很大差异。临床因素与自杀的相关性最强，包括任何精神障碍(OR=13.1, 95% CI 9.9 ~ 17.4)和自残史(OR=10.1, 95% CI 6.6 ~ 15.6)。相比之下，与社会人口状况、家族史和不良生活事件相关的其他领域的效应量较小(OR范围为2-5)。结论:在一般人群中，多种诱发因素和诱发因素与成年人自杀有关，但其相对强度有明显差异。普洛斯彼罗注册号:CRD42021232878。
Risk factors for suicide in adults: systematic review and meta-analysis of psychological autopsy studies.
Question: Effective prevention of suicide requires a comprehensive understanding of risk factors.
Study selection and analysis: Five databases were systematically searched to identify psychological autopsy studies (published up to February 2022) that reported on risk factors for suicide mortality among adults in the general population. Effect sizes were pooled as odds ratios (ORs) using random-effects models for each risk factor examined in at least three independent samples.
Findings: A total of 37 case-control studies from 23 countries were included, providing data on 40 risk factors in 5633 cases and 7101 controls. The magnitude of effect sizes varied substantially both between and within risk factor domains. Clinical factors had the strongest associations with suicide, including any mental disorder (OR=13.1, 95% CI 9.9 to 17.4) and a history of self-harm (OR=10.1, 95% CI 6.6 to 15.6). By comparison, effect sizes were smaller for other domains relating to sociodemographic status, family history, and adverse life events (OR range 2-5).
Conclusions: A wide range of predisposing and precipitating factors are associated with suicide among adults in the general population, but with clear differences in their relative strength.
期刊介绍：
Evidence-Based Mental Health alerts clinicians to important advances in treatment, diagnosis, aetiology, prognosis, continuing education, economic evaluation and qualitative research in mental health. Published by the British Psychological Society, the Royal College of Psychiatrists and the BMJ Publishing Group the journal surveys a wide range of international medical journals applying strict criteria for the quality and validity of research. Clinicians assess the relevance of the best studies and the key details of these essential studies are presented in a succinct, informative abstract with an expert commentary on its clinical application.Evidence-Based Mental Health is a multidisciplinary, quarterly publication.
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