Factors associated with first suicide attempt vs. re-attempt in children and adolescents: A systematic review and meta-analysis
Introduction Suicide among children, adolescents and young adults is a major health problem, as it represents the fourth leading cause of death among people aged 15-29 (WHO, 2022). A recent study showed that the years of potential life lost (YPLL) due to suicide in 2018 were 1,344,552, which is ver...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2023-03-01
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| Series: | European Psychiatry |
| Online Access: | https://www.cambridge.org/core/product/identifier/S0924933823012208/type/journal_article |
| _version_ | 1827754454282141696 |
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| author | S. Abascal-Peiró A. Alacreu-Crespo I. Peñuelas-Calvo B. Ezquerra-de la Cruz L. Jiménez-Muñoz E. Baca-García A. Porras-Segovia |
| author_facet | S. Abascal-Peiró A. Alacreu-Crespo I. Peñuelas-Calvo B. Ezquerra-de la Cruz L. Jiménez-Muñoz E. Baca-García A. Porras-Segovia |
| author_sort | S. Abascal-Peiró |
| collection | DOAJ |
| description |
Introduction
Suicide among children, adolescents and young adults is a major health problem, as it represents the fourth leading cause of death among people aged 15-29 (WHO, 2022). A recent study showed that the years of potential life lost (YPLL) due to suicide in 2018 were 1,344,552, which is very close to the 1,591,487 YPLL caused by COVID-19 in the year 2020 (Porras-Segovia et al, 2021). In the recent years, there is a growing interest in suicide prevention research in differentiating attempter profiles in terms of lifetime suicide attempts. Specifically, studies suggest that there may be meaningful differences concerning risk factors between patients with a history of one versus multiple suicide attempts. Multiple attempters (MA) show more suicidal ideation, depressive symptoms and hopelessness than single attempters (SA) (Esposito et al, 2003; Goldston et al, 1998).
Objectives
We aimed to answer the question ‘What are the factors associated with attempting suicide for the first time and are they different from the factors associated with re-attempting suicide in children and adolescents?’
Methods
We conducted a systematic literature search in four databases. Article selection and data extraction according to a predefined protocol, including bias risk assessment, were performed by independent peer reviewers. Due to the different way to present data in the studies effect sizes were pre-calculated to standard mean differences (SMD). Random effects model was used to calculate the pooled effect size for all meta-analysis. Publication bias was assessed using funnel plots.
Results
14 studies were included in the systematic review, and 13 in the meta-analysis. Original articles used in the meta-analysis included a total of 4286 participants of whom 1579 were multiple suicide-attempters and 2707 single suicide attempters.
MAs showed significantly higher proportion of anxiety disorders (SMD = 0.387, 95%CI [0.09, 0.68], p < 0.022), alcohol abuse disorder (SMD = 0.382, 95%CI [0.07, 0.70], p < 0.036) and substance abuse disorder (SMD = 0.526, 95%CI [0.21, 0.84], p <0.013) than SAs. Mean depression severity was higher among MAs than SAs (SMD = 0.515, 95%CI [0.17, 0.86], p < 0.011). MAs showed higher impulsivity (SMD = 0.28, 95%CI [-0.03, 0.60], p < 0.068) and aggressiveness (SMD = 0.688, 95%CI [0.42, 0.96], p < 0.00) than SAs. Hopelessness (SMD = 0.482, 95%CI [0.06, 0.91], p < 0.03) and suicidal ideation (SMD = 0.399, 95%CI [0.34, 0.46], p < 0.007) was significantly higher in MA.
Conclusions
On the basis of the current results, multiple attempters may represent a distinct patient population in terms of being a more severe clinical profile. This can provide the basis of stronger suicide prevention and vigilance programs focused in this suicidal phenotype.
Disclosure of Interest
None Declared |
| first_indexed | 2024-03-11T07:49:22Z |
| format | Article |
| id | doaj.art-6efe03d8625e467c9393043a530a1f33 |
| institution | Directory Open Access Journal |
| issn | 0924-9338 1778-3585 |
| language | English |
| last_indexed | 2024-03-11T07:49:22Z |
| publishDate | 2023-03-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | European Psychiatry |
| spelling | doaj.art-6efe03d8625e467c9393043a530a1f332023-11-17T05:07:00ZengCambridge University PressEuropean Psychiatry0924-93381778-35852023-03-0166S584S58410.1192/j.eurpsy.2023.1220Factors associated with first suicide attempt vs. re-attempt in children and adolescents: A systematic review and meta-analysisS. Abascal-Peiró0A. Alacreu-Crespo1I. Peñuelas-Calvo2B. Ezquerra-de la Cruz3L. Jiménez-Muñoz4E. Baca-García5A. Porras-Segovia6Psychiatry, Hospital Universitario Rey Juan Carlos, MadridPsychology and Sociology, Area of Personality, Assessment and Psychological Treatment, University of Zaragoza, TeruelPsychiatry, Hospital Universitario 12 de OctubrePsychiatry, Hospital Universitario Rey Juan Carlos, MadridPsychiatry, Jimenez Diaz Foundation Health Research Institute (IIS)Psychiatry, Autonomous University of Madrid, Madrid, SpainPsychiatry, Imperial College, London, United Kingdom Introduction Suicide among children, adolescents and young adults is a major health problem, as it represents the fourth leading cause of death among people aged 15-29 (WHO, 2022). A recent study showed that the years of potential life lost (YPLL) due to suicide in 2018 were 1,344,552, which is very close to the 1,591,487 YPLL caused by COVID-19 in the year 2020 (Porras-Segovia et al, 2021). In the recent years, there is a growing interest in suicide prevention research in differentiating attempter profiles in terms of lifetime suicide attempts. Specifically, studies suggest that there may be meaningful differences concerning risk factors between patients with a history of one versus multiple suicide attempts. Multiple attempters (MA) show more suicidal ideation, depressive symptoms and hopelessness than single attempters (SA) (Esposito et al, 2003; Goldston et al, 1998). Objectives We aimed to answer the question ‘What are the factors associated with attempting suicide for the first time and are they different from the factors associated with re-attempting suicide in children and adolescents?’ Methods We conducted a systematic literature search in four databases. Article selection and data extraction according to a predefined protocol, including bias risk assessment, were performed by independent peer reviewers. Due to the different way to present data in the studies effect sizes were pre-calculated to standard mean differences (SMD). Random effects model was used to calculate the pooled effect size for all meta-analysis. Publication bias was assessed using funnel plots. Results 14 studies were included in the systematic review, and 13 in the meta-analysis. Original articles used in the meta-analysis included a total of 4286 participants of whom 1579 were multiple suicide-attempters and 2707 single suicide attempters. MAs showed significantly higher proportion of anxiety disorders (SMD = 0.387, 95%CI [0.09, 0.68], p < 0.022), alcohol abuse disorder (SMD = 0.382, 95%CI [0.07, 0.70], p < 0.036) and substance abuse disorder (SMD = 0.526, 95%CI [0.21, 0.84], p <0.013) than SAs. Mean depression severity was higher among MAs than SAs (SMD = 0.515, 95%CI [0.17, 0.86], p < 0.011). MAs showed higher impulsivity (SMD = 0.28, 95%CI [-0.03, 0.60], p < 0.068) and aggressiveness (SMD = 0.688, 95%CI [0.42, 0.96], p < 0.00) than SAs. Hopelessness (SMD = 0.482, 95%CI [0.06, 0.91], p < 0.03) and suicidal ideation (SMD = 0.399, 95%CI [0.34, 0.46], p < 0.007) was significantly higher in MA. Conclusions On the basis of the current results, multiple attempters may represent a distinct patient population in terms of being a more severe clinical profile. This can provide the basis of stronger suicide prevention and vigilance programs focused in this suicidal phenotype. Disclosure of Interest None Declaredhttps://www.cambridge.org/core/product/identifier/S0924933823012208/type/journal_article |
| spellingShingle | S. Abascal-Peiró A. Alacreu-Crespo I. Peñuelas-Calvo B. Ezquerra-de la Cruz L. Jiménez-Muñoz E. Baca-García A. Porras-Segovia Factors associated with first suicide attempt vs. re-attempt in children and adolescents: A systematic review and meta-analysis European Psychiatry |
| title | Factors associated with first suicide attempt vs. re-attempt in children and adolescents: A systematic review and meta-analysis |
| title_full | Factors associated with first suicide attempt vs. re-attempt in children and adolescents: A systematic review and meta-analysis |
| title_fullStr | Factors associated with first suicide attempt vs. re-attempt in children and adolescents: A systematic review and meta-analysis |
| title_full_unstemmed | Factors associated with first suicide attempt vs. re-attempt in children and adolescents: A systematic review and meta-analysis |
| title_short | Factors associated with first suicide attempt vs. re-attempt in children and adolescents: A systematic review and meta-analysis |
| title_sort | factors associated with first suicide attempt vs re attempt in children and adolescents a systematic review and meta analysis |
| url | https://www.cambridge.org/core/product/identifier/S0924933823012208/type/journal_article |
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