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Cited by 143Suicide and Self-Harm StudiesAutism Spectrum Disorder ResearchDown syndrome and intellectual disability research

A systematic review and meta-analysis of suicidality in autistic and possibly autistic people without co-occurring intellectual disability

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Newell, Victoria, Phillips, Lucy, Jones, Chris, Townsend, Ellen, Richards, Caroline, Cassidy, Sarah·2023·Molecular Autism
DOI 10.1186/s13229-023-00544-7PMC PMC10018918
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Abstract

Background: Suicidality is highly prevalent in autistic people without co-occurring intellectual disabilities, and high autistic traits are found in adults who have attempted suicide. However, prevalence rates for both autistic and possibly autistic people have not been synthesised meta-analytically. Aims: To (1) calculate pooled prevalence estimates of suicidality in autistic people and possibly autistic people without co-occurring intellectual disability; (2) evaluate the influence of participant and study level characteristics on heterogeneity; and (3) determine the quality of evidence. Methods: Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines were followed. PsycINFO, Embase, MEDLINE and Web of Science were systematically searched from 1992 to January 25, 2022. Empirical quantitative studies reporting prevalence of suicidal ideation, suicide plans, or suicide attempts and behaviours were considered for inclusion. Random effects models were used to estimate pooled prevalence of each suicidality outcome with 95% confidence intervals. Heterogeneity was explored using sensitivity and moderator analyses. Results: Data from 48,186 autistic and possibly autistic participants in 36 primary studies were meta-analysed. Pooled prevalence of suicidal ideation was 34.2% (95% CI 27.9–40.5), suicide plans 21.9% (13.4–30.4), and suicidal attempts and behaviours 24.3% (18.9–29.6). High levels of heterogeneity ( I 2 > 75) were observed in all three analyses. Estimates did not differ between autistic or possibly autistic samples. Geographical location ( p = 0.005), transgender or gender non-conforming samples ( p < 0.001) and type of report ( p < 0.001) significantly moderated suicidal ideation, whereas age group ( p = 0.001) and measure of suicidality ( p = 0.001) significantly moderated suicide plans. There was a significant association between the proportion of male participants and prevalence of suicide plans, with a decrease in the proportion of males for every unit change of suicide plan prevalence ( p = 0.013). No variables were found to moderate estimates of suicide attempts and behaviours. Conclusions: The results confirm suicidality is highly prevalent in both autistic and possibly autistic people without co-occurring intellectual disability and highlights potential moderators. Possibly autistic individuals require more attention in clinical and research considerations going forward to further understand and prevent suicide in both groups.

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Cited by

Sorted by citations

Authors
Newell, V., Phillips, L., Jones, C., Townsend, E., Richards, C., & Cassidy, S.
Affiliations
  • University of Nottingham (GB)
  • Loughborough University (GB)
  • University of Birmingham (GB)
Corresponding author
Newell, Victoria
ORCID
Venue
Molecular Autism
Publisher
Springer Science and Business Media LLC
Published
2023-03-15
Volume
14
Issue
1
Pages
12-12
ISSN
2040-2392 (ISSN-L)
DOI
10.1186/s13229-023-00544-7
PMC
PMC10018918
OpenAlex
W4324354182
Cited by
143
References
38
Citations by year
2026: 44 · 2025: 54 · 2024: 37 · 2023: 8
FWCI
7.25
Type
journal article
Language
en
Open access
Licence
Locations
  • Molecular Autism (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Repository@Nottingham (University of Nottingham) (publishedVersion, other-oa)
  • Repository@Nottingham (University of Nottingham) (submittedVersion, cc-by)
  • University of Birmingham Research Portal (University of Birmingham) (submittedVersion, cc-by)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
Economic and Social Research Council (ES/P000711/1)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Down syndrome and intellectual disability research
Keywords
suicidality, autism spectrum disorder, autistic traits, suicide attempts, suicide planning, suicidal ideation, suicide prevention, prevalence, intellectual disability, sex differences
MeSH terms
Adult, Autistic Disorder, Humans, Male, Intellectual Disability, Suicide, Suicide, Attempted, Suicidal Ideation

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