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. 2008 Sep;13(5):243-56.
doi: 10.1007/s12199-008-0037-x. Epub 2008 Jun 19.

Suicidal risk factors and completed suicide: meta-analyses based on psychological autopsy studies

Kouichi Yoshimasu  1 , Chikako Kiyohara, Kazuhisa Miyashita; Stress Research Group of the Japanese Society for Hygiene
Affiliations

Suicidal risk factors and completed suicide: meta-analyses based on psychological autopsy studies

Kouichi Yoshimasu et al. Environ Health Prev Med. 2008 Sep.

Abstract

The purpose of the present review is to evaluate the effects of common risk factors for suicide by meta-analyses using data extracted from studies based on the psychological autopsy method. We focused on five common risk factors of suicide: substance-related disorders, mood disorders, adverse marital status, adverse employment status, and self-harm behaviors. A total of 24 articles were identified from MEDLINE in which the crude odds ratio (OR) could be calculated for the above five risk factors through 30 April 2007, using such search keywords as "suicide," "psychological autopsy," and "case-control study." Overall, both substance-related disorders [OR = 5.24; 95% confidence interval (CI) = 3.30-8.31] and mood disorders [OR = 13.42; 95% CI = 8.05-22.37] were strongly associated with suicidal risk. Suicidal attempt and deliberate self-harm, which can directly lead to completed suicide, have been shown to be very strongly associated with suicidal risk [OR = 16.33; 95% CI = 7.51-35.52]. Effects of social factors such as adverse marital and employment status were relatively small. As substance-related disorders and mood disorders were strongly associated with an increased risk of completed suicide, the comorbidity of these two disorders should be paid a maximum attention. The effective prevention of suicide depends on whether we can successfully incorporate these personal factors as well as social factors into an adequate multi-factorial model.

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Figures

Fig. 1
Fig. 1
Meta-analysis of 14 studies of substance (alcohol)-related disorders and suicidal risk (a forest plot). The center of a box and the horizontal line (logarithm) indicate the odds ratio (OR) and the 95% confidence interval (CI) in each study, with the areas of the boxes representing the weight of each study. The summary OR based on random effects model is represented by the middle of a diamond whose width indicated the 95% CI. The summary OR is shown by the broken vertical line. Statistical heterogeneity between studies was assessed with Cochran’s Q test (Q = 69.05, P < 0.001). Summary OR = 5.24 (95% CI = 3.30–8.31)
Fig. 2
Fig. 2
Meta-analysis of 14 studies of depressive (mood/affective) disorders and suicidal risk (a forest plot). The center of a box and the horizontal line (logarithm) indicate the odds ratio (OR) and the 95% confidence interval (CI) in each study, with the areas of the boxes representing the weight of each study. The summary OR based on random effects model is represented by the middle of a diamond whose width indicated the 95% CI. The summary OR is shown by the broken vertical line. Statistical heterogeneity between studies was assessed with Cochran’s Q test (Q = 78.87, P < 0.001). Summary OR = 13.42 (95% CI = 8.05–22.37)
Fig. 3
Fig. 3
Two models of suicidal pathway
See this image and copyright information in PMC

References

    1. Takahashi Y. Guideline for suicide prevention of UN/WHO. In: STOP! Suicide. Tokyo, Kaimeisha, 2006. pp 18–31. (Article in Japanese)
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'PubMed', 'value': '1807959', 'is_inner': True, 'url': 'https://pubmed.ncbi.nlm.nih.gov/1807959/'}]}
    2. Sechter D, Bonin B, Bertschy G, Vandel S, Bizouard P. Prediction of suicide risk. Encephale. 1991;17:361–4. - PubMed
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'PubMed', 'value': '9989117', 'is_inner': True, 'url': 'https://pubmed.ncbi.nlm.nih.gov/9989117/'}]}
    2. Hall RC, Platt DE, Hall RC. Suicide risk assessment: a review of risk factors for suicide in 100 patients who made severe suicide attempts. Evaluation of suicide risk in a time of managed care. Psychosomatics. 1999;40:18–27. - PubMed
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'PMC', 'value': 'PMC9538610', 'is_inner': False, 'url': 'https://pmc.ncbi.nlm.nih.gov/articles/PMC9538610/'}, {'type': 'PubMed', 'value': '12587614', 'is_inner': True, 'url': 'https://pubmed.ncbi.nlm.nih.gov/12587614/'}]}
    2. Aihara H, Iki M. An ecological study of the relations between the recent high suicide rates and economic and demographic factors in Japan. J Epidemiol. 2003;13:56–61. - PMC - PubMed
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'DOI', 'value': '10.2188/jea.15.48', 'is_inner': False, 'url': 'https://doi.org/10.2188/jea.15.48'}, {'type': 'PMC', 'value': 'PMC7817379', 'is_inner': False, 'url': 'https://pmc.ncbi.nlm.nih.gov/articles/PMC7817379/'}, {'type': 'PubMed', 'value': '15762094', 'is_inner': True, 'url': 'https://pubmed.ncbi.nlm.nih.gov/15762094/'}]}
    2. Nishi N, Kurosawa M, Nohara M, Oguri S, Chida F, Otsuka K, et al. Knowledge of and attitude toward suicide and depression among Japanese in municipalities with high suicide rates. J Epidemiol. 2005;15:48–55. - PMC - PubMed