Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 May:137:242-249.
doi: 10.1016/j.jpsychires.2021.02.053. Epub 2021 Mar 2.

Estimating the risk of suicide associated with mental disorders: A systematic review and meta-regression analysis

Modhurima Moitra  1 , Damian Santomauro  2 , Louisa Degenhardt  3 , Pamela Y Collins  4 , Harvey Whiteford  2 , Theo Vos  5 , Alize Ferrari  2
Affiliations

Estimating the risk of suicide associated with mental disorders: A systematic review and meta-regression analysis

Modhurima Moitra et al. J Psychiatr Res. 2021 May.

Abstract

Background: Mental disorders (MDs) are known risk factors for suicide. This systematic review updates the evidence base for this association and improves upon analytic approaches by incorporating study-level and methodological variables to account for measurement error in pooled suicide risk estimates.

Methods: A systematic review was conducted to review studies on MDs as risk factors for suicide. Relevant studies were searched using PubMed, Embase, PsychINFO, and existing reviews from 2010 to 19. Studies were eligible if they were longitudinal/case-control studies, representative of the general population, used diagnostic instruments, and quantified suicide risk. The outcome assessed was relative risks (RRs) for suicide due to MDs. A multi-level meta-regression approach was used to obtain pooled RRs adjusted for covariates and between-study effects.

Findings: We identified 20 eligible studies yielding 69 RRs. Disorder type, age, sex, use of psychological autopsy, study design, and adjustment for confounders were tested as predictors of pooled suicide risk. Overall, all disorders were significant predictors of suicide with predicted adjusted RRs ranging from 4·11 [2·09, 8·09] for dysthymia to 7·64 [4·3, 13·58] for major depressive disorder.

Interpretation: Our results indicate that MDs are important risk factors for suicide. This systematic review provides pooled RRs that have been adjusted for methodological sources of bias. Findings from our paper may inform suicide prevention strategies as part of national health agendas.

Keywords: Global mental health; Mental disorders; Meta-regression; Suicide; Systematic review.

PubMed Disclaimer

Conflict of interest statement

We declare no competing interests.

Figures

Fig. 1
Fig. 1
Study selection flowchart.
See this image and copyright information in PMC

References

    1. Ajdacic-Gross V., Weiss M.G., Ring M., Hepp U., Bopp M., Gutzwiller F., Rössler W. Methods of suicide: international suicide patterns derived from the WHO mortality database. Bull. World Health Organ. 2008;86:726–732. - PMC - PubMed
    1. Ali G.-C., Ryan G., de Silva M.J. Validated screening tools for common mental disorders in low and middle income countries: a systematic review. PloS One. 2016;11 - PMC - PubMed
    1. American Psychiatric Association A.P. 1994. Diagnostic and Statistical Manual of Mental Disorders (DSM-IV)
    1. Anderberg J., Bogren M., Mattisson C., Brådvik L. Long-term suicide risk in anxiety—the Lundby study 1947–2011. Arch. Suicide Res. 2016;20:463–475. - PubMed
    1. Arango C., Díaz-Caneja C.M., McGorry P.D., Rapoport J., Sommer I.E., Vorstman J.A., McDaid D., Marín O., Serrano-Drozdowskyj E., Freedman R. Preventive strategies for mental health. Lancet Psychiatr. 2018;5:591–604. - PubMed

Publication types