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. 2022 May 20:49:101461.
doi: 10.1016/j.eclinm.2022.101461. eCollection 2022 Jul.

Associating factors of suicide and repetition following self-harm: A systematic review and meta-analysis of longitudinal studies

Bao-Peng Liu  1   2 , Cun-Xian Jia  1   2 , Ping Qin  3 , Ying-Ying Zhang  1   2 , Yao-Kun Yu  1   2 , Xiao Luo  1   2 , Shi-Xue Li  4
Affiliations

Associating factors of suicide and repetition following self-harm: A systematic review and meta-analysis of longitudinal studies

Bao-Peng Liu et al. EClinicalMedicine. .

Abstract

Background: Longitudinal evidence for sociodemographic and clinic factors deviating risk for suicide and repetition following SH (self-harm) varied greatly.

Methods: A comprehensive search of PubMed, Web of Science, EMBASE, and PsycINFO was conducted from January 1st, 2010 to April 5th, 2022. Longitudinal studies focusing on examining associating factors for suicide and repetition following SH were included. PROSPERO registration CRD42021248695.

Findings: The present meta-analysis synthesized data from 62 studies published from Jan. 1st, 2010. The associating factors of SH repetition included female gender (RR, 95%CI: 1.11, 1.04-1.18, I2=82.8%), the elderly (compared with adolescents and young adults, RR, 95%CI: 0.67, 0.52-0.87, I2=86.3%), multiple episodes of SH (RR, 95%CI: 1.97, 1.51-2.57, I2=94.3%), diagnosis (RR, 95%CI: 1.60, 1.27-2.02, I2=92.7%) and treatment (RR, 95%CI: 1.59, 1.40-1.80, I2=93.3%) of psychiatric disorder. Male gender (RR, 95%CI: 2.03, 1.80-2.28, I2=83.8%), middle-aged adults (compared with adolescents and young adults, RR, 95%CI: 2.40, 1.87-3.08, I2=74.4%), the elderly (compared with adolescents and young adults, RR, 95%CI: 4.38, 2.98-6.44, I2=76.8%), physical illness (RR, 95%CI: 1.95, 1.56-2.43, I2=0), multiple episodes of SH (RR, 95%CI: 2.02, 1.58-2.58, I2=87.4%), diagnosis (RR, 95%CI: 2.13, 1.67-2.71, I2=90.9%) and treatment (RR, 95%CI: 1.36, 1.16-1.58, I2=58.6%) of psychiatric disorder were associated with increased risk of suicide following SH.

Interpretation: Due to the substantial heterogeneity for clinic factors of suicide and repetition following SH, these results need to be interpreted with caution. Clinics should pay more attention to the cases with SH repetition, especially with poor physical and psychiatric conditions.

Funding: This work was supported by National Natural Science Foundation of China (NSFC) [No: 82103954; 30972527; 81573233].

Keywords: Associating factors; CI, Confidence interval; Meta-analysis; NOS, Newcastle-Ottawa Scale; RR, Risk ratio; Repetition; SA, Suicide attempt; SC, Self-cutting; SH, Self-harm; SP, Self-poisoning; Self-harm; Suicide.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1
The PRISMA flow diagram showing process of study selection for inclusion in our meta-analyses.
Figure 2
Figure 2
Characteristics, heterogeneity, and pooled estimates for sociodemographic and clinical factors associated with risk for SH repetition (No.: number, RR: risk ratio, CI: confidence interval. Horizontal line span 1 represented statistically significant. The reference for middle-aged adults and elderly was adolescent and young adults. Each line represented a pool estimate by meta-analysis.).
Figure 3
Figure 3
Characteristics, heterogeneity, and pooled estimates for sociodemographic and clinical factors associated with risk for suicide following self-harm (No.: number, RR: risk ratio, CI: confidence interval, horizontal line span 1 represented statistically significant. The reference for middle-aged adults and elderly was adolescent and young adults. Each line represented a pool estimate by meta-analysis).
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