School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada.
Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway.
Pediatrics. 2023 Mar 1;151(3). doi: 10.1542/peds.2022-058113.
Suicide is one of the leading causes of death among adolescents worldwide. Adolescents who present with suicidality may be at an increased risk for future mental illness and suicidality in young adulthood.
The objective of this study was to systematically assess the relationship between adolescent suicidal ideation and suicide attempts (suicidality) and young adult psychopathological outcomes.
Medline, Embase, and PsychInfo (OVID Interface) were searched for articles published before August 2021.
Included articles were prospective cohort studies that compared young adult (19-30 years) psychopathological outcomes between suicidal and nonsuicidal adolescents.
We extracted data related to suicidality in adolescence, mental health outcomes in young adulthood, and covariates. Outcomes were analyzed via random-effect meta-analyses and reported using odds ratios.
Of 9401 references screened, we included 12 articles comprising over 25 000 adolescents. Four outcomes were meta-analyzed: depression, anxiety, suicidal ideation, and suicide attempt. Adjusted meta-analyses showed that adolescent suicidal ideation was associated with young adult suicide attempt (odds ratio [OR] = 2.75, 95% confidence interval [CI]:1.70-4.44), depressive disorders (OR = 1.58, 95% CI: 1.20-2.08), and anxiety disorders (OR = 1.41, 95% CI: 1.01-1.96), whereas adolescent suicide attempts were associated with young adult suicide attempt (OR = 5.71, 95% CI: 2.40-13.61), and young adult anxiety disorders (OR = 1.54, 95% CI: 1.01-2.34). Results for young adult substance use disorders were mixed.
Significant heterogeneity between studies was observed because of differences in timing, method of assessments, and covariate adjustment.
Adolescents experiencing suicidal ideation or with a history of suicide attempt may have increased odds of further suicidality or mental disorders in young adulthood.
自杀是全球青少年死亡的主要原因之一。有自杀意念的青少年未来可能会面临更高的精神疾病和成年早期自杀的风险。
本研究旨在系统评估青少年自杀意念和自杀企图（自杀行为）与年轻成人精神病理结果之间的关系。
在 2021 年 8 月之前，检索了 Medline、Embase 和 PsychInfo（OVID 界面）中的文章。
纳入的文章为比较自杀和非自杀青少年的年轻成人（19-30 岁）精神病理结果的前瞻性队列研究。
我们提取了与青少年时期自杀行为、成年早期心理健康结果和协变量相关的数据。使用比值比进行了随机效应荟萃分析，并报告了结果。
在筛选出的 9401 篇参考文献中，我们纳入了包含超过 25000 名青少年的 12 篇文章。对 4 项结果进行了荟萃分析：抑郁、焦虑、自杀意念和自杀企图。调整后的荟萃分析显示，青少年自杀意念与年轻成人自杀企图（比值比[OR] = 2.75，95%置信区间[CI]：1.70-4.44）、抑郁障碍（OR = 1.58，95% CI：1.20-2.08）和焦虑障碍（OR = 1.41，95% CI：1.01-1.96）相关，而青少年自杀企图与年轻成人自杀企图（OR = 5.71，95% CI：2.40-13.61）和年轻成人焦虑障碍（OR = 1.54，95% CI：1.01-2.34）相关。年轻成人物质使用障碍的结果不一。
由于研究在时间、评估方法和协变量调整方面存在差异，观察到研究之间存在显著的异质性。
有自杀意念或有自杀企图病史的青少年在成年早期可能有更高的自杀或精神障碍的几率。
