Risk factors for suicide in individuals with depression: A systematic review

Keith Hawton, Carolina Casanas i Comabella, Camilla Haw, Kate Saunders

Research output: Contribution to journalArticle

Abstract

Background
Depression is the most common psychiatric disorder in people who die by suicide. Awareness of risk factors for suicide in depression is important for clinicians.

Methods
In a systematic review of the international literature we identified cohort and case-control studies of people with depression in which suicide was an outcome, and conducted meta-analyses of potential risk factors.

Results
Nineteen studies (28 publications) were included. Factors significantly associated with suicide were: male gender (OR=1.76, 95% CI=1.08–2.86), family history of psychiatric disorder (OR=1.41, 95% CI=1.00–1.97), previous attempted suicide (OR=4.84, 95% CI=3.26–7.20), more severe depression (OR=2.20, 95% CI=1.05–4.60), hopelessness (OR=2.20, 95% CI=1.49–3.23) and comorbid disorders, including anxiety (OR=1.59, 95% CI=1.03–2.45) and misuse of alcohol and drugs (OR=2.17, 95% CI=1.77–2.66).

Limitations
There were fewer studies than suspected. Interdependence between risk factors could not be examined.

Conclusions
The factors identified should be included in clinical assessment of risk in depressed patients. Further large-scale studies are required to identify other relevant factors.
Original languageEnglish
Pages (from-to)17-28
Number of pages11
JournalJournal of Affective Disorders
Volume147
Issue number1-3
DOIs
Publication statusPublished - May 2013
Externally publishedYes

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Suicide
Depression
Psychiatry
Attempted Suicide
Anxiety Disorders
Publications
Meta-Analysis
Case-Control Studies
Alcohols
Pharmaceutical Preparations

Cite this

Hawton, Keith ; Casanas i Comabella, Carolina ; Haw, Camilla ; Saunders, Kate. / Risk factors for suicide in individuals with depression: A systematic review. In: Journal of Affective Disorders. 2013 ; Vol. 147, No. 1-3. pp. 17-28.
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abstract = "BackgroundDepression is the most common psychiatric disorder in people who die by suicide. Awareness of risk factors for suicide in depression is important for clinicians.MethodsIn a systematic review of the international literature we identified cohort and case-control studies of people with depression in which suicide was an outcome, and conducted meta-analyses of potential risk factors.ResultsNineteen studies (28 publications) were included. Factors significantly associated with suicide were: male gender (OR=1.76, 95{\%} CI=1.08–2.86), family history of psychiatric disorder (OR=1.41, 95{\%} CI=1.00–1.97), previous attempted suicide (OR=4.84, 95{\%} CI=3.26–7.20), more severe depression (OR=2.20, 95{\%} CI=1.05–4.60), hopelessness (OR=2.20, 95{\%} CI=1.49–3.23) and comorbid disorders, including anxiety (OR=1.59, 95{\%} CI=1.03–2.45) and misuse of alcohol and drugs (OR=2.17, 95{\%} CI=1.77–2.66).LimitationsThere were fewer studies than suspected. Interdependence between risk factors could not be examined.ConclusionsThe factors identified should be included in clinical assessment of risk in depressed patients. Further large-scale studies are required to identify other relevant factors.",
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Hawton, K, Casanas i Comabella, C, Haw, C & Saunders, K 2013, 'Risk factors for suicide in individuals with depression: A systematic review', Journal of Affective Disorders, vol. 147, no. 1-3, pp. 17-28. https://doi.org/10.1016/j.jad.2013.01.004

Risk factors for suicide in individuals with depression: A systematic review. / Hawton, Keith; Casanas i Comabella, Carolina; Haw, Camilla; Saunders, Kate.

In: Journal of Affective Disorders, Vol. 147, No. 1-3, 05.2013, p. 17-28.

Research output: Contribution to journalArticle

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AU - Hawton, Keith

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N2 - BackgroundDepression is the most common psychiatric disorder in people who die by suicide. Awareness of risk factors for suicide in depression is important for clinicians.MethodsIn a systematic review of the international literature we identified cohort and case-control studies of people with depression in which suicide was an outcome, and conducted meta-analyses of potential risk factors.ResultsNineteen studies (28 publications) were included. Factors significantly associated with suicide were: male gender (OR=1.76, 95% CI=1.08–2.86), family history of psychiatric disorder (OR=1.41, 95% CI=1.00–1.97), previous attempted suicide (OR=4.84, 95% CI=3.26–7.20), more severe depression (OR=2.20, 95% CI=1.05–4.60), hopelessness (OR=2.20, 95% CI=1.49–3.23) and comorbid disorders, including anxiety (OR=1.59, 95% CI=1.03–2.45) and misuse of alcohol and drugs (OR=2.17, 95% CI=1.77–2.66).LimitationsThere were fewer studies than suspected. Interdependence between risk factors could not be examined.ConclusionsThe factors identified should be included in clinical assessment of risk in depressed patients. Further large-scale studies are required to identify other relevant factors.

AB - BackgroundDepression is the most common psychiatric disorder in people who die by suicide. Awareness of risk factors for suicide in depression is important for clinicians.MethodsIn a systematic review of the international literature we identified cohort and case-control studies of people with depression in which suicide was an outcome, and conducted meta-analyses of potential risk factors.ResultsNineteen studies (28 publications) were included. Factors significantly associated with suicide were: male gender (OR=1.76, 95% CI=1.08–2.86), family history of psychiatric disorder (OR=1.41, 95% CI=1.00–1.97), previous attempted suicide (OR=4.84, 95% CI=3.26–7.20), more severe depression (OR=2.20, 95% CI=1.05–4.60), hopelessness (OR=2.20, 95% CI=1.49–3.23) and comorbid disorders, including anxiety (OR=1.59, 95% CI=1.03–2.45) and misuse of alcohol and drugs (OR=2.17, 95% CI=1.77–2.66).LimitationsThere were fewer studies than suspected. Interdependence between risk factors could not be examined.ConclusionsThe factors identified should be included in clinical assessment of risk in depressed patients. Further large-scale studies are required to identify other relevant factors.

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