Gender differences in suicidal behavior in adolescents and young adults: systematic review and meta-analysis of longitudinal studies

Abstract

Objectives: To assess the association between gender and suicide attempt/death and identify gender-specific risk/protective factors in adolescents/young adults.

Methods: Systematic review (5 databases until January 2017). Population-based longitudinal studies considering non-clinical populations, aged 12-26 years, assessing associations between gender and suicide attempts/death, or evaluating their gender risk/protective factors, were included. Random effect meta-analyses were performed.

Results: Sixty-seven studies were included. Females presented higher risk of suicide attempt (OR 1.96, 95% CI 1.54-2.50), and males for suicide death (HR 2.50, 95% CI 1.8-3.6). Common risk factors of suicidal behaviors for both genders are previous mental or substance abuse disorder and exposure to interpersonal violence. Female-specific risk factors for suicide attempts are eating disorder, posttraumatic stress disorder, bipolar disorder, being victim of dating violence, depressive symptoms, interpersonal problems and previous abortion. Male-specific risk factors for suicide attempt are disruptive behavior/conduct problems, hopelessness, parental separation/divorce, friend's suicidal behavior, and access to means. Male-specific risk factors for suicide death are drug abuse, externalizing disorders, and access to means. For females, no risk factors for suicide death were studied.

Conclusions: More evidence about female-specific risk/protective factors of suicide death, for adolescent/young adults, is needed.

Keywords: Adolescents; Gender; Risk factors; Suicide; Suicide attempt; Young adults.

Fig. 1

Modified version of PRISMA diagram of the included studies in the systematic review of gender differences in suicidal behavior in adolescents and young adults (covered up until January 2017)

Fig. 2

Forest plot of being female as risk factor of suicide attempt—results of the systematic review of gender differences in suicidal behavior in adolescents and young adults (covered up until January 2017)