Risk Factors for Suicide in Individuals With Depression: A Systematic Review

J Affect Disord. 2013 May;147(1-3):17-28. doi: 10.1016/j.jad.2013.01.004. Epub 2013 Feb 12.

Abstract

Background: Depression is the most common psychiatric disorder in people who die by suicide. Awareness of risk factors for suicide in depression is important for clinicians.

Methods: In a systematic review of the international literature we identified cohort and case-control studies of people with depression in which suicide was an outcome, and conducted meta-analyses of potential risk factors.

Results: Nineteen studies (28 publications) were included. Factors significantly associated with suicide were: male gender (OR=1.76, 95% CI=1.08-2.86), family history of psychiatric disorder (OR=1.41, 95% CI=1.00-1.97), previous attempted suicide (OR=4.84, 95% CI=3.26-7.20), more severe depression (OR=2.20, 95% CI=1.05-4.60), hopelessness (OR=2.20, 95% CI=1.49-3.23) and comorbid disorders, including anxiety (OR=1.59, 95% CI=1.03-2.45) and misuse of alcohol and drugs (OR=2.17, 95% CI=1.77-2.66).

Limitations: There were fewer studies than suspected. Interdependence between risk factors could not be examined.

Conclusions: The factors identified should be included in clinical assessment of risk in depressed patients. Further large-scale studies are required to identify other relevant factors.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Adult
  • Anxiety Disorders / epidemiology*
  • Anxiety Disorders / psychology
  • Depression / epidemiology*
  • Depression / psychology
  • Depressive Disorder / epidemiology*
  • Depressive Disorder / psychology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Risk Factors
  • Suicide / psychology
  • Suicide / statistics & numerical data*