Association of mental disorders with firearm suicides: A systematic review with meta-analyses of observational studies in the United States

JOURNAL OF AFFECTIVE DISORDERS

卷:291

Review

Zuriaga, Ana¹  Kaplan, Mark S.²  Choi, Namkee G.³  Hodkinson, Alexander⁴  Storman, Dawid^5,6  Brudasca, Nicoleta I.¹  Hirani, Shashivadan P.¹  Brini, Stefano¹ 

[1] City Univ London, Sch Hlth Sci, Div Hlth Serv Res & Management, London, England

[2] Univ Calif Los Angeles, Luskin Sch Publ Affairs, Los Angeles, CA USA

[3] Univ Texas Austin, Steve Hicks Sch Social Work, Austin, TX 78712 USA

[4] Univ Manchester, Natl Inst Hlth Res, Sch Primary Care Res, Manchester Acad Hlth Sci Ctr, Manchester, Lancs, England

[5] Jagiellonian Univ Med Coll, Chair Epidemiol & Prevent Med, Dept Hyg & Dietet, Fac Med, Krakow, Poland

[6] Jagiellonian Univ Med Coll, Systemat Reviews Unit, Krakow, Poland

关键词: Mental health;    Depression;    Suicide;    Firearms;    Systematic review;    Meta-analysis;   

DOI  :  10.1016/j.jad.2021.05.005

来源: Elsevier

【 摘 要 】

Background: In the United States (US), 61% of all suicide cases may involve firearms, and some evidence suggests that mental disorders may play a role in suicide by firearm. We performed the first systematic review and metaanalyses to investigate: (i) whether mental disorders are associated with suicide by firearm, and (ii) whether the risk of using a firearm compared with alternative means is associated with higher levels of suicide in individuals with a mental disorder Methods and findings: We searched twelve databases from inception to the 24th of May 2020. We retrieved 22 observational studies conducted in the US. Random-effects meta-analyses showed individuals who had a diagnosis of a mental disorder had lower odds (odds ratios (OR)= 0.50, 95% CI: 0.36 to 0.69; I2=100 (95% CI: 87 to 100%), of dying by suicide with a firearm than those who did not have a diagnosis of a mental disorder. Secondary analysis showed that decedents who had a mental health diagnosis resulted in lower odds of dying by suicide by using firearms than using other means Limitations: Risk of bias revealed a heterogeneous and poor definition of mental disorders as well as lack of control for potential demographic confounding factors. In the meta-analyses, studies were combined in the same analytic sample as 77% of these studies did not specify the type of mental disorder Conclusion: While our results seem to suggest that having a mental disorder may not be consistently associated with the odds of dying by suicide using a firearm, the presence of substantial heterogeneity and high risk of bias precludes any firm conclusions.

【 授权许可】

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