Department of Psychology,Florida State University,Tallahassee,Florida.
Department of Psychology,Harvard University,Cambridge,Massachusetts.
Br J Psychiatry. 2018 May;212(5):279-286. doi: 10.1192/bjp.2018.27. Epub 2018 Mar 28.
Many studies have documented robust relationships between depression and hopelessness and subsequent suicidal thoughts and behaviours; however, much weaker and non-significant effects have also been reported. These inconsistencies raise questions about whether and to what degree these factors confer risk for suicidal thoughts and behaviours.AimsThis study aimed to evaluate the magnitude and clinical utility of depression and hopelessness as risk factors for suicide ideation, attempts and death.
We conducted a meta-analysis of published studies from 1971 to 31 December 2014 that included at least one longitudinal analysis predicting suicide ideation, attempt or death using any depression or hopelessness variable.
Overall prediction was weaker than anticipated, with weighted mean odds ratios of 1.96 (1.81-2.13) for ideation, 1.63 (1.55-1.72) for attempt and 1.33 (1.18-1.49) for death. Adjusting for publication bias further reduced estimates. Effects generally persisted regardless of sample severity, sample age or follow-up length.
Several methodological constraints were prominent across studies; addressing these issues would likely be fruitful moving forward.Declaration of interestNone.
许多研究记录了抑郁和绝望与随后的自杀念头和行为之间的强烈关系；然而，也有报道称这些关系的影响较弱且不显著。这些不一致性引发了关于这些因素是否以及在多大程度上会导致自杀念头和行为的风险的问题。
本研究旨在评估抑郁和绝望作为自杀意念、自杀企图和自杀死亡的风险因素的程度和临床实用性。
我们对 1971 年至 2014 年 12 月 31 日发表的研究进行了荟萃分析，这些研究至少包括一项使用任何抑郁或绝望变量预测自杀意念、自杀企图或自杀死亡的纵向分析。
总体预测结果比预期的要弱，意念的加权平均优势比为 1.96（1.81-2.13），企图的优势比为 1.63（1.55-1.72），死亡的优势比为 1.33（1.18-1.49）。调整发表偏倚后进一步降低了估计值。无论样本严重程度、样本年龄或随访时间如何，效果通常都持续存在。
几项方法学限制在研究中普遍存在；解决这些问题可能会对未来的研究产生积极影响。
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