Department of Psychiatry, University of Oxford, Oxford, UK.
Department of Psychiatry, University of Oxford, Oxford, UK.
Lancet Child Adolesc Health. 2019 Dec;3(12):899-916. doi: 10.1016/S2352-4642(19)30267-6. Epub 2019 Oct 9.
Leading suicide theories and research in adults suggest that pain can exacerbate the suicidal risk of an individual. Although pain and suicidality (including suicidal ideation, behaviour, and death by suicide) both increase in prevalence during adolescence, the relationship between these factors remains unclear. We aimed to systematically review the empirical evidence for such an association in adolescence. We included 25 observational studies published between January 1961 and December 2018, exploring the potential association between pain and suicidality in adolescents aged 10-19 years. Across various samples and manifestations of pain and suicidality, we found that pain approximately doubles the suicidal risk in adolescents, with a few studies suggesting that pain can predict suicidality longitudinally. Although depression was an important factor, it did not fully explain the association between pain and suicidality. Evidence for associations between pain characteristics and suicidality is sparse and inconclusive, and potentially hides developmental differences between adolescents and adults. Identification of psychological mediators and moderators is required to develop interventions tailored to the needs of adolescents experiencing pain. This study is registered with the PROSPERO database, number CRD42018097226.
主要的自杀理论和成人研究表明，疼痛会加剧个体的自杀风险。尽管疼痛和自杀意念（包括自杀意念、行为和自杀死亡）在青少年时期的患病率都有所增加，但这些因素之间的关系仍不清楚。我们旨在系统地回顾青少年时期这两者之间关联的实证证据。我们纳入了 1961 年 1 月至 2018 年 12 月期间发表的 25 项观察性研究，探讨了 10-19 岁青少年疼痛与自杀意念之间的潜在关联。在各种疼痛和自杀意念的样本和表现中，我们发现疼痛使青少年的自杀风险增加近一倍，一些研究表明疼痛可以纵向预测自杀意念。尽管抑郁是一个重要因素，但它并没有完全解释疼痛和自杀意念之间的关联。疼痛特征与自杀意念之间关联的证据很少且不一致，并且可能掩盖了青少年和成年人之间的发展差异。需要确定心理中介和调节因素，以制定针对经历疼痛的青少年的需求的干预措施。本研究在 PROSPERO 数据库中注册，编号为 CRD42018097226。
