Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, CIBERSAM, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), School of Medicine, Universidad Complutense, Madrid, Spain.
Child and Adolescent Psychiatry and Psychology Department, 2014SGR489, Institute Clinic of Neurosciences, Hospital Clinic of Barcelona, CIBERSAM, Barcelona, Spain.
Eur Child Adolesc Psychiatry. 2020 Jun;29(6):759-776. doi: 10.1007/s00787-018-01270-9. Epub 2019 Jan 25.
Suicidality in childhood and adolescence is of increasing concern. The aim of this paper was to review the published literature identifying key psychosocial risk factors for suicidality in the paediatric population. A systematic two-step search was carried out following the PRISMA statement guidelines, using the terms 'suicidality, suicide, and self-harm' combined with terms 'infant, child, adolescent' according to the US National Library of Medicine and the National Institutes of Health classification of ages. Forty-four studies were included in the qualitative synthesis. The review identified three main factors that appear to increase the risk of suicidality: psychological factors (depression, anxiety, previous suicide attempt, drug and alcohol use, and other comorbid psychiatric disorders); stressful life events (family problems and peer conflicts); and personality traits (such as neuroticism and impulsivity). The evidence highlights the complexity of suicidality and points towards an interaction of factors contributing to suicidal behaviour. More information is needed to understand the complex relationship between risk factors for suicidality. Prospective studies with adequate sample sizes are needed to investigate these multiple variables of risk concurrently and over time.
儿童和青少年的自杀问题越来越受到关注。本文旨在回顾已发表的文献，确定儿科人群自杀行为的主要心理社会风险因素。按照美国国立医学图书馆和美国国立卫生研究院的年龄分类，我们遵循 PRISMA 声明指南，使用“自杀、自杀未遂和自伤”以及“婴儿、儿童和青少年”这两个术语，进行了系统的两步式搜索。共有 44 项研究纳入定性综合分析。综述确定了三个似乎会增加自杀风险的主要因素：心理因素（抑郁、焦虑、先前的自杀企图、药物和酒精使用以及其他共患精神障碍）；生活应激事件（家庭问题和同伴冲突）；以及人格特征（如神经质和冲动性）。证据强调了自杀行为的复杂性，并指出了导致自杀行为的多种因素的相互作用。需要更多的信息来了解自杀风险因素之间的复杂关系。需要有足够样本量的前瞻性研究，以便同时和随着时间的推移研究这些风险变量。
