Metaanalysis of mood and substance use disorders in proximal risk for suicide deaths
Open accessAbstract
Evidence for proximal risk factors for suicide is based on case-control psychological autopsy studies, with these reports showing that mood and substance use disorders are the most prevalent mental disorders among suicide decedents worldwide and are associated with marked risk. However, moderators of risk and the degree of risk associated with (nonalcohol) drug use disorder are unknown. A comprehensive search was used to identify 35 case-control psychological autopsy studies published worldwide over a 30-year period that were metaanalyzed using random effects models. Major depression, odds ratio (95% confidence interval) = 9.14 (5.53, 15.09), and drug use disorder, OR (95% CI) = 7.18 (3.22, 16.01), had large effect sizes, among other results. Risk estimates associated with major depression were greater in studies with a larger proportion of women and those conducted in Asia compared with other regions. There was no evidence of publication bias or that any one study had a disproportionate impact on findings. Risk for suicide associated with major depression appears to be moderated by sex and/or world region. Drug use disorder is a potent risk factor, illustrating the importance of assessing drug use in clinical risk assessment.
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Combining alcohol-related exposures into a single measure does not lead to a significant loss of information.
“A recent meta-analysis indicated that combining these variables into a single measure does not lead to a significant loss of information.9”
From Risk factors for suicide in adults: systematic review and meta-analysis of psychological autopsy studies (2022) · cites this paper as [9]
The most recent meta-analysis, based on studies published up to 2016, only examined associations with mood and substance use disorders.
“The most recent meta-analysis, based on studies published up to 2016, only examined associations with mood and substance use disorders.9”
From Risk factors for suicide in adults: systematic review and meta-analysis of psychological autopsy studies (2022) · cites this paper as [9]
The inclusion of studies with controls who died by causes other than suicide is consistent with previous reviews of psychological autopsy studies.
“The inclusion of studies with controls who died by causes other than suicide is consistent with previous reviews of psychological autopsy studies.5–9”
From Risk factors for suicide in adults: systematic review and meta-analysis of psychological autopsy studies (2022) · cites this paper as [9]
Previous reviews of psychological autopsy studies have been limited in scope (primarily focusing on mental disorders) and samples (including selected populations such as psychiatric patients).
“To our knowledge, five previous reviews have quantitatively summarised findings from psychological autopsy studies,5–9 but these have been limited in scope (primarily focusing on mental disorders) and samples (including selected populations such as psychiatric patients).”
From Risk factors for suicide in adults: systematic review and meta-analysis of psychological autopsy studies (2022) · cites this paper as [9]
Bibliographical searches were complemented by manual searches of reference lists of included studies and previous systematic reviews.
“Bibliographical searches were complemented by manual searches of reference lists of included studies and previous systematic reviews.5–9”
From Risk factors for suicide in adults: systematic review and meta-analysis of psychological autopsy studies (2022) · cites this paper as [9]
Previous reviews of psychological autopsy studies have not captured the breadth of individual-level risk factors for suicide and mainly focused on the contribution of mental disorders to suicide risk.
“First, previous reviews of psychological autopsy studies5–9 have not captured the breadth of individual-level risk factors for suicide, and instead mainly focused on the contribution of mental disorders to suicide risk.”
From Risk factors for suicide in adults: systematic review and meta-analysis of psychological autopsy studies (2022) · cites this paper as [9]
Effects might be smaller in prospective studies owing to long follow-up periods, whereas psychological autopsies focus on the time window close to death.
“Among other reasons, effects might be smaller in prospective studies owing to long follow-up periods, whereas psychological autopsies focus on the time window close to death.9”
From Risk factors for suicide in adults: systematic review and meta-analysis of psychological autopsy studies (2022) · cites this paper as [9]
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- Authors
- Conner, K. R., Bridge, J. A., Davidson, D. J., Pilcher, C., & Brent, D. A.
- Affiliations
- University of Rochester Medicine (US)
- Nationwide Children's Hospital (US)
- University of Pittsburgh (US)
- Corresponding author
- Conner, Kenneth R.
- Venue
- Suicide and Life-Threatening Behavior
- Publisher
- Wiley
- Published
- 2017-11-28
- Volume
- 49
- Issue
- 1
- Pages
- 278-292
- ISSN
- 0363-0234 (ISSN-L)
- 1943-278X
- PMC
- PMC8378507
- OpenAlex
- W2769357572
- Cited by
- 140
- References
- 65
- Citations by year
- 2026: 14 · 2025: 7 · 2024: 10 · 2023: 52 · 2022: 18 · 2021: 14 · 2020: 16 · 2019: 4 · 2018: 4 · 2012: 1
- FWCI
- 1.00
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Suicide and Life-Threatening Behavior (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- American Foundation for Suicide Prevention
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Social Sciences › Sociology and Political Science › Homicide, Infanticide, and Child Abuse
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Keywords
- suicide risk factors, major depressive disorder, substance use disorders, drug use disorders, mood disorders, psychological autopsy, suicide decedents, suicide risk assessment
- MeSH terms
- Adult, Affect, Depressive Disorder, Major, Major Depressive Disorder, Female, Humans, Male, Risk Factors, Suicide, Risk Assessment, Substance-Related Disorders
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