青少年期的焦虑将会增加未来自杀行为的发生风险：一项系统综述和荟萃分析的重要发现

Anxiety in adolescents and subsequent risk of suicidal behavior: A systematic review and meta-analysis

青少年的焦虑和随后的自杀行为风险:系统回顾和荟萃分析

Author: Lulu Fang, Yingying Tong, Min Li, Cong Wang, Yonghan Li, Mengyuan Yuan, Xueying Zhang, Gengfu Wang, Jun Wang, Puyu Su

Source: Journal Affective Disorders

Doi: 10.1016/j.jad.2024.05.005

Abstract

Background: Suicide is a major public health concern, and anxiety is a prevalent developmental challenge in adolescents closely linked to suicidal behavior. This study aimed to assess the association between anxiety in adolescents and subsequent risk of suicidal behavior through a meta-analysis, offering crucial insights for suicide prevention.

Methods: Six bibliographic databases were comprehensively searched to clarify the association between adolescents anxiety and subsequent risk of suicidal behavior. We used a fixed-effects model to determine the total pooled effect size estimate and reported odds ratios and the corresponding 95 % confidence intervals. Subgroup analysis, sensitivity analysis and publication bias analysis were conducted with Stata version 15.1.

Results: The findings revealed a significant association between anxiety in adolescents and subsequent suicidal behavior (OR = 2.33, 95 % CI [2.00, 2.71]). Subgroup analyses indicated differences in mean effect size estimates based on clinical diagnoses and self-reported measures used to assess anxiety. The correlation strength between adolescent anxiety and subsequent suicidal behavior increased with a longer follow-up period. Furthermore, adolescents anxiety was associated with increased risk of subsequent suicidal ideation (OR = 1.97, 95 % CI [1.72, 2.25]) and attempts (OR = 3.56, 95 % CI [2.49, 5.07]). Finally, boys (OR = 2.41, 95 % CI [1.67, 3.47]) with anxiety had a greater risk of subsequent suicidal behavior than girls (OR = 2.02, 95 % CI [1.47, 2.78]).

Conclusion: This study revealed that adolescents anxiety increases the risk of suicidal behavior, including suicidal ideation and attempts. Consequently, there is a critical need for timely interventions tailored to adolescents with anxiety to prevent future instances of suicide.

摘要

背景 自杀是一个重要的公共卫生问题，焦虑与自杀行为密切相关，是青少年普遍面临的发展挑战。本研究旨在通过荟萃分析评估青少年焦虑与随后自杀行为风险之间的关系，为自杀预防提供重要见解。

方法 全面检索了六个文献数据库，以阐明青少年焦虑与随后的自杀行为风险之间的关系。我们使用固定效应模型来确定总合并效应大小估计值和报告的优势比以及相应的95%置信区间。采用Stata 15.1版本进行亚组分析、敏感性分析和发表偏倚分析。

结果 研究结果显示，青少年焦虑与随后的自杀行为之间存在显著关联(OR = 2.33, 95% CI[2.00, 2.71])。亚组分析表明，基于临床诊断和用于评估焦虑的自我报告所测量的平均效应大小估计存在差异。青少年焦虑与随后的自杀行为之间的相关强度随着随访时间的延长而增加。此外，青少年焦虑与随后的自杀意念(OR = 1.97, 95% CI[1.72, 2.25])和企图自杀(OR = 3.56, 95% CI[2.49, 5.07])的风险增加有关。最后，焦虑的男孩(OR = 2.41, 95% CI[1.67, 3.47])比女孩有更高的自杀行为风险(OR = 2.02, 95% CI[1.47, 2.78])。

结论 本研究表明，青少年焦虑增加了自杀行为的风险，包括自杀意念和企图。因此，迫切需要针对有焦虑症的青少年及时采取干预措施，以防止未来发生自杀事件。