The communication of suicidal intentions: a meta-analysis

Psychological Medicine - Tập 46 Số 11 - Trang 2239-2253 - 2016
Maurizio Pompili1, Martino Belvederi Murri2, Sara Patti2, Marco Innamorati3, David Lester4, Paolo Girardi1, Mario Amore2
1Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Italy
2Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genova, Italy
3Department of Human Sciences, European University of Rome, Italy
4Stockton University, New Jersey, USA

Tóm tắt

BackgroundAmong the myths that are often cited about suicide is that ‘people who talk about killing themselves rarely die by suicide’, but the evidence seems to contradict this statement. The aim of this study was to conduct a meta-analysis of studies reporting a prevalence of suicide communication (SC), and to examine the diagnostic accuracy of SC towards suicide in case-control reports.MethodEligible studies had to examine data relative to completed suicides and report the prevalence of SC. Data relative to sample characteristics, study definition, modality and recipient of the SC were coded.ResultsWe included 36 studies, conducted on a total of 14 601 completed suicides. The overall proportion of SC was 44.5% [95% confidence interval (CI) 35.4–53.8], with large heterogeneity (I2= 98.8%) and significant publication bias. The prevalence of SC was negatively associated with the detection of verbal communication as the sole means of SC and, positively, with study methodological quality. Based on seven case-control studies, SC was associated with an odds ratio of 4.66 for suicide (95% CI 3.00–7.25) and was characterized by sufficient diagnostic accuracy only if studies on adolescents were removed.ConclusionAvailable data suggest that SC occurs in nearly half of subjects who go on to die by suicide, but this figure is likely to be an underestimate given the operational definitions of SC. At present, SC seems associated with overall insufficient accuracy towards subsequent suicide, although further rigorous studies are warranted to draw definite conclusions on this issue.

Từ khóa


Tài liệu tham khảo

10.1007/s00127-012-0488-7

10.1016/S0379-0738(02)00188-3

10.1016/j.adolescence.2008.10.007

Isometsa, 1994, Suicide in bipolar disorder in Finland, American Journal of Psychiatry, 151, 1020, 10.1176/ajp.151.7.1020

10.1097/00005053-196601000-00006

Shneidman, 1996, The Suicidal Mind, 10.1093/oso/9780195103663.001.0001

Marttunen, 1998, Completed suicide among adolescents with no diagnosable psychiatric disorder, Adolescence, 33, 669

10.1186/1752-4458-1-6

Bernstein, 1978, The communication of suicidal intent by completed suicides, Omega, 9, 1978

10.1001/archpsyc.1988.01800300079011

10.1192/bjp.154.2.247

10.1037/h0030492

10.1080/07481180701603394

10.1186/2049-3258-72-39

10.1111/j.1600-0447.1999.tb00977.x

Isometsa, 1994, Suicide in major depression, American Journal of Psychiatry, 151, 530, 10.1176/ajp.151.4.530

Maltsberger, 1989, Suicide: Understanding and Responding, 285

10.1002/1099-1166(200008)15:8<736::AID-GPS214>3.0.CO;2-K

Harbord, 2009, METANDI: Stata module to perform meta-analysis of diagnostic accuracy using hierarchical logistic regression, Stata Journal, 9, 211, 10.1177/1536867X0900900203

10.1192/bjp.170.5.447

Beisser, 1961, A study of suicides in a mental hospital, Diseases of the Nervous System, 22, 365

10.1521/suli.2006.36.5.491

10.1007/s00127-005-0977-x

10.1111/j.1365-2125.2004.02252.x

10.1111/sltb.12041

10.1001/archpsyc.1960.01710060044008

10.1001/archpsyc.1976.01770070065006

10.1016/j.socscimed.2012.02.058

10.1177/000486740403800103

10.1016/S0140-6736(88)90017-7

10.1001/archpsyc.1988.01800300087012

10.1176/ajp.115.8.724

10.1177/0020764012461209

10.1016/S0022-3999(03)00372-6

10.1016/0165-0327(94)90028-0

10.1192/bjp.173.4.330

10.1192/bjp.125.4.355

10.1080/00223980.1976.9921330

10.1016/S0010-440X(60)80058-2

10.1001/jama.1992.03490170092032

Shafii, 1985, Psychological autopsy of completed suicide in children and adolescents, American Journal of Psychiatry, 142, 1061, 10.1176/ajp.142.9.1061

10.1016/0165-0327(79)90007-7

10.1097/00004583-199305000-00006

10.1016/j.genhosppsych.2011.10.009

10.1001/archpsyc.1993.01820140064007

10.1001/archpsyc.1986.01800100056008

Isometsa, 1996, Suicide among subjects with personality disorders, American Journal of Psychiatry, 153, 667, 10.1176/ajp.153.5.667

10.1016/0165-0327(90)90039-B

10.1016/0197-2456(86)90046-2

Isometsa, 1995, The last appointment before suicide: is suicide intent communicated?, American Journal of Psychiatry, 152, 919, 10.1176/ajp.152.6.919

Breier, 1984, Characterization of schizophrenic patients who commit suicide, American Journal of Psychiatry, 141, 206, 10.1176/ajp.141.2.206

Thông tin
Thông tin xuất bản

Psychological Medicine

Tập 46 Số 11

2239-2253

Thông tin tác giả