Risk and protective factors for self-harm and suicide in children and adolescents: a systematic review and meta-analysis protocol

BMJ Open. 2022 Nov 25;12(11):e058297. doi: 10.1136/bmjopen-2021-058297.


Introduction: Self-harm and suicide are major public health concerns among children and adolescents. Many risk and protective factors for suicide and self-harm have been identified and reported in the literature. However, the capacity of these identified risk and protective factors to guide assessment and management is limited due to their great number. This protocol describes an ongoing systematic review and meta-analysis which aims to examine longitudinal studies of risk factors for self-harm and suicide in children and adolescents, to provide a comparison of the strengths of association of the various risk factors for self-harm and suicide and to shed light on those that require further investigation.

Methods and analysis: We perform a systematic search of the literature using the databases EMBASE, PsycINFO, Medline, CINAHL and HMIC from inception up to 28 October 2020, and the search will be updated before the systematic review publication. Additionally, we will contact experts in the field, including principal investigators whose peer-reviewed publications are included in our systematic review as well as investigators from our extensive research network, and we will search the reference lists of relevant reviews to retrieve any articles that were not identified in our search. We will extract relevant data and present a narrative synthesis and combine the results in meta-analyses where there are sufficient data. We will assess the risk of bias for each study using the Newcastle-Ottawa Scale and present a summary of the quantity and the quality of the evidence for each risk or protective factor.

Ethics and dissemination: Ethical approval will not be sought as this is a systematic review of the literature. Results will be published in mental health journals and presented at conferences focused on suicide prevention.

Prospero registration number: CRD42021228212.

Keywords: child & adolescent psychiatry; community child health; suicide & self-harm.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Child
  • Humans
  • Meta-Analysis as Topic
  • Protective Factors
  • Public Health
  • Risk Factors
  • Self-Injurious Behavior* / epidemiology
  • Self-Injurious Behavior* / prevention & control
  • Suicide Prevention*
  • Systematic Reviews as Topic