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Open Access 01-03-2019 | Suicide | Review

Gender differences in suicidal behavior in adolescents and young adults: systematic review and meta-analysis of longitudinal studies

Authors: Andrea Miranda-Mendizabal, Pere Castellví, Oleguer Parés-Badell, Itxaso Alayo, José Almenara, Iciar Alonso, Maria Jesús Blasco, Annabel Cebrià, Andrea Gabilondo, Margalida Gili, Carolina Lagares, José Antonio Piqueras, Tiscar Rodríguez-Jiménez, Jesús Rodríguez-Marín, Miquel Roca, Victoria Soto-Sanz, Gemma Vilagut, Jordi Alonso

Published in: International Journal of Public Health | Issue 2/2019

Abstract

Objectives

To assess the association between gender and suicide attempt/death and identify gender-specific risk/protective factors in adolescents/young adults.

Methods

Systematic review (5 databases until January 2017). Population-based longitudinal studies considering non-clinical populations, aged 12–26 years, assessing associations between gender and suicide attempts/death, or evaluating their gender risk/protective factors, were included. Random effect meta-analyses were performed.

Results

Sixty-seven studies were included. Females presented higher risk of suicide attempt (OR 1.96, 95% CI 1.54–2.50), and males for suicide death (HR 2.50, 95% CI 1.8–3.6). Common risk factors of suicidal behaviors for both genders are previous mental or substance abuse disorder and exposure to interpersonal violence. Female-specific risk factors for suicide attempts are eating disorder, posttraumatic stress disorder, bipolar disorder, being victim of dating violence, depressive symptoms, interpersonal problems and previous abortion. Male-specific risk factors for suicide attempt are disruptive behavior/conduct problems, hopelessness, parental separation/divorce, friend’s suicidal behavior, and access to means. Male-specific risk factors for suicide death are drug abuse, externalizing disorders, and access to means. For females, no risk factors for suicide death were studied.

Conclusions

More evidence about female-specific risk/protective factors of suicide death, for adolescent/young adults, is needed.

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Afifi TO, Cox BJ, Katz LY (2007) The associations between health risk behaviours and suicidal ideation and attempts in a nationally representative sample of young adolescents. Can J Psychiatry 52:666–674CrossRefPubMed

Beautrais AL (2002) Gender issues in youth suicide. Emerg Med Australas 14:35–42

Beautrais AL (2003) Suicide and serious suicide attempts in youth: a multiple-group comparison study. Am J Psychiatry 160:1093–1099. https://doi.org/10.1176/appi.ajp.160.6.1093 CrossRefPubMed

Beautrais L, Joyce PR, Mulder RT (1996) Risk factors for serious suicide attempts among youths aged 13 through 24 years. J Am Acad Child Adolesc Psychiatry 35:1174–1182. https://doi.org/10.1097/00004583-199609000-00015 CrossRefPubMed

Bellis MA, Hughes K, Leckenby N et al (2014) Adverse childhood experiences and associations with health-harming behaviours in young adults: surveys in eight eastern European countries. Bull World Health Organ 92:641–655BCrossRefPubMedPubMedCentral

Boeninger DK, Masyn KE, Feldman BJ, Conger PD (2010) Sex differences in developmental trends of suicide ideation, plans, and attempts among European American adolescents. Suicide Life Threat Behav 40:451–464. https://doi.org/10.1521/suli.2010.40.5.451.Sex CrossRefPubMedPubMedCentral

Bolger N, Downey G, Walker E, Steininger P (1989) The onset of suicidal ideation in childhood and adolescence. J Youth Adolesc 18:175–190. https://doi.org/10.1007/BF02138799 CrossRefPubMed

Borenstein M, Hedges L, Higgins J, Rothstein H (2009) Fixed-effect versus random-effects models. In: Introduction to meta-analysis. Wiley, Chichester

Borges G, Angst J, Nock MK et al (2008) Risk factors for the incidence and persistence of suicide-related outcomes: a 10-year follow-up study using the National Comorbidity Surveys. J Affect Disord 105:25–33CrossRefPubMed

Canetto SS (2008) Women and suicidal behavior: a cultural analysis. Am J Orthopsychiatry 78:259–266. https://doi.org/10.1037/a0013973 CrossRefPubMed

Canetto SS, Sakinofsky I (1998) The gender paradox in suicide. Suicide Life-Threat Behav 28:1–23PubMed

Cavanagh J, Carson A, Sharpe M, Lawrie S (2003) Psychological autopsy studies of suicide: a systematic review. Psychol Med 33:S0033291702006943. https://doi.org/10.1017/S0033291702006943 CrossRef

Chau K, Kabuth B, Chau N (2014) Gender and family disparities in suicide attempt and role of socioeconomic, school, and health-related difficulties in early adolescence. Biomed Res Int 2014:1–13. https://doi.org/10.1155/2014/314521 CrossRef

Coleman PK (2011) Abortion and mental health: quantitative synthesis and analysis of research published 1995–2009. Br J Psychiatry 199:180–186. https://doi.org/10.1192/bjp.bp.110.077230 CrossRefPubMed

Devries KM, Mak JY, Bacchus LJ et al (2013) Intimate partner violence and incident depressive symptoms and suicide attempts: a systematic review of longitudinal studies. PLoS Med 10:e1001439. https://doi.org/10.1371/journal.pmed.1001439 CrossRefPubMedPubMedCentral

Dieserud G, Gerhardsen RM, Van Weghe H, Corbett K (2015) Adolescent suicide attempts in Bærum, Norway, 1984–2006. Crisis 31:255–264CrossRef

Eaton D, Kann L, Jinchen S (2012) Youth risk behavior surveillance—United States, 2011. MMWR Surveill Summ 61:1–162PubMed

Ely GE, Nugent WR, Flaherty C (2009) The relationship between dating violence and psychosocial problems in a sample of adolescent pregnancy termination patients. Violence Vict 24:577–590. https://doi.org/10.1891/0886-6708.24.5.577 CrossRefPubMed

Evans E, Hawton K, Rodham K (2004) Factors associated with suicidal phenomena in adolescents: a systematic review of population-based studies. Clin Psychol Rev 24:957–979. https://doi.org/10.1016/j.cpr.2004.04.005 CrossRefPubMed

Evans E, Hawton K, Rodham K et al (2005) The prevalence of suicidal phenomena in adolescents: a systematic review of population-based studies. Suicide Life-Threat Behav 35:239–250. https://doi.org/10.1521/suli.2005.35.3.239 CrossRefPubMed

Fergusson DM, Lynskey M (1995) Childhood circumstances, adolescent adjustment, and suicide attempts in a New Zealand birth cohort. J Am Acad Child Adolesc Psychiatry 34:612–622CrossRefPubMed

Fergusson D, Horwood J, Lynskey M (1993) Prevalence and comorbidity of DSM-III-R diagnoses in a birth cohort of 15 year olds. J Am Acad Child Adolesc Psychiatry 32:1127–1134CrossRefPubMed

Fergusson DM, Horwood LJ, Ridder EM (2006) Abortion in young women and subsequent mental health. J Child Psychol Psychiatry Allied Discip 47:16–24. https://doi.org/10.1111/j.1469-7610.2005.01538.x CrossRef

Finkelstein Y, Macdonald EM, Hollands S et al (2015) Long-term outcomes following self-poisoning in adolescents: a population-based cohort study. Lancet Psychiatry 2:532–539. https://doi.org/10.1016/S2215-0366(15)00170-4 CrossRefPubMed

Fountoulakis KN, Gonda X, Rihmer Z (2011) Suicide prevention programs through community intervention. J Affect Disord 130:10–16. https://doi.org/10.1016/j.jad.2010.06.009 CrossRefPubMed

Gould M, Velting D, Kleinman M et al (2004) Teenagers’ attitudes about coping strategies and help-seeking behavior for suicidality. J Am Acad Child Adolesc Psychiatry 43:1124–1133CrossRefPubMed

Higgins J, Green S (2008) Cochrane handbook for systematic reviews of interventions. The Cochrane Collaboration

Higgins JPT, Thompson SG (2002) Quantifying heterogeneity in a meta-analysis. Stat Med 21:1539–1558. https://doi.org/10.1002/sim.1186 CrossRefPubMed

Kaess M, Parzer P, Haffner J et al (2011) Explaining gender differences in non-fatal suicidal behaviour among adolescents: a population-based study. BMC Public Health 11:597. https://doi.org/10.1186/1471-2458-11-597 CrossRefPubMedPubMedCentral

Kerr DCR, Preuss LJ, King CA (2006) Suicidal adolescents’ social support from family and peers: gender-specific associations with psychopathology. J Abnorm Child Psychol 34:103–114. https://doi.org/10.1007/s10802-005-9005-8 CrossRefPubMed

Kim HS, Kim HS (2008) Risk factors for suicide attempts among Korean adolescents. Child Psychiatry Hum Dev 39:221–235CrossRefPubMed

Kokkevi A, Rotsika V, Arapaki A, Richardson C (2012) Adolescents’ self-reported suicide attempts, self-harm thoughts and their correlates across 17 European countries. J Child Psychol Psychiatry Allied Discip 53:381–389. https://doi.org/10.1111/j.1469-7610.2011.02457.x CrossRef

Lewinsohn PM, Rohde P, Seeley JR, Baldwin CL (2001) Gender differences in suicide attempts from adolescence to young adulthood. J Am Acad Child Adolesc Psychiatry 40:427–434. https://doi.org/10.1097/00004583-200104000-00011 CrossRefPubMed

Löhönen J, Isohanni M, Nieminen P, Miettunen J (2010) Coverage of the bibliographic databases in mental health research. Nord J Psychiatry 64:181–188CrossRefPubMed

Mann JJ, Waternaux C, Haas GL, Malone KM (1999) Toward a clinical model of suicidal behavior in psychiatric patients. Am J Psychiatry 156:181–189. https://doi.org/10.1176/ajp.156.2.181 CrossRefPubMed

Marmorstein NR, Iacono WG (2005) Longitudinal follow-up of adolescents with late-onset antisocial behavior: a pathological yet overlooked group. J Am Acad Child Adolesc Psychiatry 44:1284–1291. https://doi.org/10.1097/01.chi.0000181039.75842.85 CrossRefPubMed

Mars B, Heron J, Crane C et al (2014) Differences in risk factors for self-harm with and without suicidal intent: findings from the ALSPAC cohort. J Affect Disord 168:407–414. https://doi.org/10.1016/j.jad.2014.07.009 CrossRefPubMedPubMedCentral

Maxwell L, Devries K, Zionts D et al (2015) Estimating the effect of intimate partner violence on women’s use of contraception: a systematic review and meta-analysis. PLoS ONE 10:e0118234. https://doi.org/10.1371/journal.pone.0118234 CrossRefPubMedPubMedCentral

Mergl R, Koburger N, Heinrichs K et al (2015) What are reasons for the large gender differences in the lethality of suicidal acts? An epidemiological analysis in four European countries. PLoS ONE 10:1–18. https://doi.org/10.1371/journal.pone.0129062 CrossRef

Miranda-Mendizábal A, Castellví P, Parés-Badell O et al (2017) Sexual orientation and suicidal behaviour in adolescents and young adults: systematic review and meta-analysis. Br J Psychiatry 211:77–87. https://doi.org/10.1192/bjp.bp.116.196345 CrossRefPubMed

Mota N, Burnett M, Sareen J (2010) Associations between abortion, mental disorders, and suicidal behaviour in a nationally representative sample. Can J Psychiatry 55:239–247CrossRefPubMed

Nock MK, Grief Green J, Hwang I et al (2013) Prevalence, correlates, and treatment of lifetime suicidal behavior among adolescents. JAMA Psychiatry 70:300. https://doi.org/10.1001/2013.jamapsychiatry.55 CrossRefPubMed

O´Brien BS, Sher L (2013) Child sexual abuse and the pathophysiology of suicide in adolescents and adults. Int J Adolesc Med Health 25:201–205

O’Connor RC, Smyth R, Williams JMG (2015) Intrapersonal positive future thinking predicts repeat suicide attempts in hospital-treated suicide attempters. J Consult Clin Psychol 83:169–176. https://doi.org/10.1037/a0037846 CrossRefPubMed

Peter T, Roberts LW (2010) “Bad” boys and “Sad” girls? Examining internalizing and externalizing effects on parasuicides among youth. J Youth Adolesc 39:495–503. https://doi.org/10.1007/s10964-009-9498-5 CrossRefPubMed

Prinstein MJ, Heilbron N, Guerry JD et al (2010) Peer influence and nonsuicidal self injury: longitudinal results in community and clinically-referred adolescent samples. J Abnorm Child Psychol 38:669–682. https://doi.org/10.1007/s10802-010-9423-0 CrossRefPubMedPubMedCentral

Randall JR, Nickel NC, Colman I (2015) Contagion from peer suicidal behavior in a representative sample of American adolescents. J Affect Disord 186:219–225CrossRefPubMed

Renaud J, Berlim MT, McGirr A et al (2008) Current psychiatric morbidity, aggression/impulsivity, and personality dimensions in child and adolescent suicide: a case-control study. J Affect Disord 105:221–228. https://doi.org/10.1016/j.jad.2007.05.013 CrossRefPubMed

Rhodes A (2013) Youth suicide in Canada: distinctions among boys and girls. Healthc Q 16:11–13CrossRefPubMed

Rhodes AE, Boyle MH, Bridge JA et al (2014a) Antecedents and sex/gender differences in youth suicidal behavior. World J Psychiatry 4:120–132. https://doi.org/10.5498/wjp.v4.i4.120 CrossRefPubMedPubMedCentral

Rhodes AE, Lu H, Skinner R (2014b) Time trends in medically serious suicide-related behaviours in boys and girls. Can J Psychiatry 59:556–560CrossRefPubMedPubMedCentral

Rickwood D, Deane FP, Wilson CJ, Ciarrochi JV (2005) Young people´s help-seeking for mental health problems. Aust e-J Adv Ment Health 4:218–251. https://doi.org/10.5172/jamh.4.3.218 CrossRef

Riner ME, Saywell RM (2002) Development of the social ecology model of adolescent interpersonal violence prevention (SEMAIVP). J Sch Health 72:65–70CrossRefPubMed

Sheikh MA (2018) Childhood physical maltreatment, perceived social isolation, and internalizing symptoms: a longitudinal, three-wave, population-based study. Eur Child Adolesc Psychiatry 27:481–491. https://doi.org/10.1007/s00787-017-1090-z CrossRefPubMed

Sheikh MA, Abelsen B, Olsen JA (2016) Clarifying associations between childhood adversity, social support, behavioral factors, and mental health, health, and well-being in adulthood: a population-based study. Front Psychol. https://doi.org/10.3389/fpsyg.2016.00727 CrossRefPubMedPubMedCentral

Solar O, Irwin A (2010) A conceptual framework for action on the social determinants of health. Geneva

Stroup D, Berlin J, Morton S (2000) Meta-analysis of observational studies in epidemiology: a proposal for reporting. JAMA 283:2008–2012CrossRefPubMed

Suokas J, Suominen K, Isometsä E et al (2001) Long-term risk factors for suicide mortality after attempted suicide–findings of a 14-year follow-up study. Acta Psychiatr Scand 104:117–121CrossRefPubMed

Temple J, Choi H, Elmquist J et al (2016) Psychological abuse, mental health, and acceptance of dating violence among adolescents. J Adolesc Heal 59:197–202CrossRef

Thompson MP, Light LS (2011) Examining gender differences in risk factors for suicide attempts made 1 and 7 years later in a nationally representative sample. J Adolesc Health 48:391–397. https://doi.org/10.1016/j.jadohealth.2010.07.018 CrossRefPubMed

Tseng FY, Yang HJ (2015) Internet use and web communication networks, sources of social support, and forms of suicidal and nonsuicidal self-injury among adolescents: Different patterns between genders. Suicide Life-Threat Behav 45:178–191. https://doi.org/10.1111/sltb.12124 CrossRefPubMed

Värnik A, Kõlves K, van der Feltz-Cornelis CM et al (2008) Suicide methods in Europe: a gender-specific analysis of countries participating in the “European Alliance Against Depression”. J Epidemiol Commun Health 62:545–551. https://doi.org/10.1136/jech.2007.065391 CrossRef

Wasserman D, Cheng Q, Jiang G-X (2005) Global suicide rates among young people aged 15–19. World Psychiatry 4:114–120PubMedPubMedCentral

Wasserman D, Carli V, Wasserman C et al (2010) Saving and Empowering Young Lives in Europe (SEYLE): a randomized controlled trial. BMC Public Health 10:1–14CrossRef

Wells G, Shea B, O’Connell D et al (2013) The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp

Wenzel A, Berchick ER, Tenhave T et al (2011) Predictors of suicide relative to other deaths in patients with suicide attempts and suicide ideation: a 30-year prospective study. J Affect Disord 132:375–382. https://doi.org/10.1016/j.jad.2011.03.006 CrossRefPubMed

Wilcox HC, Storr CL, Breslau N (2009) Posttraumatic stress disorder and suicide attempts in a community sample of urban American young adults. Arch Gen Psychiatry 66:305–311CrossRefPubMedPubMedCentral

Wilcox HC, Arria AM, Caldeira KM et al (2010) Prevalence and predictors of persistent suicide ideation, plans, and attempts during college. J Affect Disord 127:287–294CrossRefPubMedPubMedCentral

Wittchen H-U (1994) Reliability and validity studies of the WHO-Composite International Diagnostic Interview (CIDI): a critical review. J Psychiatr Res 28:57–84. https://doi.org/10.1016/0022-3956(94)90036-1 CrossRefPubMed

World Health Organization (2014) Preventing suicide, a global imperative. Geneva

World Health Organization (2016) Suicide data. http://www.who.int/mental_health/prevention/suicide/suicideprevent/en/

Wunderlich U, Bronisch T, Wittchen H-U, Carter R (2001) Gender differences in adolescents and young adults with suicidal behaviour. Acta Obstet Gynecol Scand 104:332–339

Zubrick SR, Hafekost J, Johnson SE et al (2016) Suicidal behaviours: prevalence estimates from the second Australian Child and Adolescent Survey of Mental Health and Wellbeing. Aust New Zeal J Psychiatry. https://doi.org/10.1177/0004867415622563 CrossRef

Title: Gender differences in suicidal behavior in adolescents and young adults: systematic review and meta-analysis of longitudinal studies
Authors: Andrea Miranda-Mendizabal
Pere Castellví
Oleguer Parés-Badell
Itxaso Alayo
José Almenara
Iciar Alonso
Maria Jesús Blasco
Annabel Cebrià
Andrea Gabilondo
Margalida Gili
Carolina Lagares
José Antonio Piqueras
Tiscar Rodríguez-Jiménez
Jesús Rodríguez-Marín
Miquel Roca
Victoria Soto-Sanz
Gemma Vilagut
Jordi Alonso
Publication date: 01-03-2019
Publisher: Springer International Publishing
Keywords: Suicide
Suicide
Published in: International Journal of Public Health / Issue 2/2019
Print ISSN: 1661-8556
Electronic ISSN: 1661-8564
DOI: https://doi.org/10.1007/s00038-018-1196-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Gender differences in suicidal behavior in adolescents and young adults: systematic review and meta-analysis of longitudinal studies

Abstract

Objectives

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

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