Suicidal Behaviour Research Laboratory, Institute of Health and Wellbeing, University of Glasgow.
Institute of Health and Wellbeing, University of Glasgow.
J Affect Disord. 2020 Sep 1;274:880-896. doi: 10.1016/j.jad.2020.05.004. Epub 2020 May 22.
Suicide and suicidal behaviour are global health concerns with complex aetiologies. Given the recent research and policy focus on loneliness, this systematic review aimed to determine the extent to which loneliness predicts suicidal ideation and/or behaviour (SIB) over time.
A keyword search of five major databases (CINHAL, Medline, PsychArticles, PsychInfo and Web of Knowledge) was conducted. Papers for inclusion were limited to those using a prospective longitudinal design, written in English and which measured loneliness at baseline and SIB at a later time-point.
After duplicates were removed, 947 original potential papers were identified, with 22 studies meeting the review criteria. Meta-analysis revealed loneliness was a significant predictor of both suicidal ideation and behaviour and there was evidence that depression acted as a mediator. Furthermore, studies which consisted of predominantly female participants were more likely to report a significant relationship, as were studies where participants were aged 16-20 or >55 years at baseline.
There was considerable variability in measures, samples and methodologies used across the studies. Middle-aged adults were under-represented, as were individuals from minority ethnic backgrounds. All studies were conducted in countries where self-reliance and independence (i.e. individualism) are the cultural norm.
Loneliness predicts later SIB in select populations. However, due to the heterogeneity of the studies further research is needed to draw more robust conclusions. Suicide death also needs to be included as an outcome measure. A focus on more collectivist countries is also required.
自杀和自杀行为是全球性的健康问题，具有复杂的病因。鉴于最近的研究和政策重点关注孤独，本系统综述旨在确定孤独感在多大程度上可以预测随时间推移的自杀意念和/或行为（SIB）。
对五个主要数据库（CINHAL、Medline、PsychArticles、PsychInfo 和 Web of Knowledge）进行了关键字搜索。纳入的论文仅限于使用前瞻性纵向设计、用英文撰写、并在基线时测量孤独感、在稍后时间点测量 SIB 的论文。
在去除重复项后，确定了 947 篇原始潜在论文，其中 22 项研究符合综述标准。荟萃分析表明，孤独感是自杀意念和行为的重要预测因素，并且有证据表明抑郁起中介作用。此外，主要由女性参与者组成的研究更有可能报告显著的关系，而基线时参与者年龄为 16-20 岁或>55 岁的研究也是如此。
研究中使用的测量、样本和方法存在相当大的差异。中年成年人代表性不足，少数族裔背景的个体也代表性不足。所有研究都是在以自力更生和独立（即个人主义）为文化规范的国家进行的。
孤独感可预测特定人群中随后的 SIB。然而，由于研究的异质性，需要进一步研究以得出更可靠的结论。自杀死亡也需要作为一个结果测量。还需要关注更加集体主义的国家。
