Vidal-Ribas Pablo, Govender Theemeshni, Yu Jing, Livinski Alicia A, Haynie Denise L, Gilman Stephen E
Social and Behavioral Sciences Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA.
Office of Research Services, National Institutes of Health Library, OD, NIH, Bethesda, MD, USA.
Eur Child Adolesc Psychiatry. 2024 Jul;33(7):2083-2110. doi: 10.1007/s00787-022-02092-6. Epub 2022 Oct 7.
Suicide prevention efforts generally target acute precipitants of suicide, though accumulating evidence suggests that vulnerability to suicide is partly established early in life before acute precipitants can be identified. The aim of this systematic review was to synthesize evidence on early life vulnerability to suicide beginning in the prenatal period and extending through age 12. We searched PubMed, Embase, PsycNet, Web of Science, Scopus, Social Services Abstracts, and Sociological Abstracts for prospective studies published through January 2021 that investigated early life risk factors for suicide mortality. The search yielded 13,237 studies; 54 of these studies met our inclusion criteria. Evidence consistently supported the link between sociodemographic (e.g., young maternal age at birth, low parental education, and higher birth order), obstetric (e.g., low birth weight), parental (e.g., exposure to parental death by external causes), and child developmental factors (e.g., exposure to emotional adversity) and higher risk of suicide death. Among studies that also examined suicide attempt, there was a similar profile of risk factors. We discuss a range of potential pathways implicated in these associations and suggest that additional research be conducted to better understand how early life factors could interact with acute precipitants and increase vulnerability to suicide.
自杀预防工作通常针对自杀的急性诱发因素，不过越来越多的证据表明，自杀易感性部分在生命早期就已确立，此时急性诱发因素尚未能被识别。本系统评价的目的是综合从孕期开始直至12岁的生命早期自杀易感性的相关证据。我们检索了PubMed、Embase、PsycNet、Web of Science、Scopus、社会服务摘要数据库和社会学摘要数据库，查找截至2021年1月发表的关于自杀死亡早期生命危险因素的前瞻性研究。检索得到13237项研究；其中54项研究符合我们的纳入标准。证据一致支持社会人口学因素（如母亲生育时年龄小、父母教育程度低和出生顺序较高）、产科因素（如低出生体重）、父母因素（如遭受父母因外部原因死亡）以及儿童发育因素（如遭受情感逆境）与自杀死亡风险较高之间存在关联。在也研究了自杀未遂情况的研究中，危险因素情况类似。我们讨论了这些关联中涉及的一系列潜在途径，并建议开展更多研究，以更好地了解生命早期因素如何与急性诱发因素相互作用并增加自杀易感性。
