Estimating the Risk of Attempted Suicide Among Sexual Minority Youths A Systematic Review and Meta-analysis

被引:167
作者
di Giacomo, Ester [1 ,2 ,3 ]
Krausz, Micheal [4 ]
Colmegna, Fabrizia [2 ]
Aspesi, Flora [2 ]
Clerici, Massimo [1 ,2 ]
机构
[1] Univ Milano Bicocca, Sch Med & Surg, Monza, Italy
[2] Azienda Socio Sanit Terr Monza, Dept Psychiat, Monza, Italy
[3] Univ Milano Bicocca, Doctorate Sch, Dept Neurosci, Via Cadore 48, I-20090 Monza, MB, Italy
[4] Univ British Columbia, Inst Mental Hlth, Vancouver, BC, Canada
关键词
PUBLICATION BIAS; MENTAL-HEALTH; HETEROSEXUAL IDENTITY; HOMOSEXUAL IDENTITY; ORIENTATION; IDEATION; BEHAVIOR; GAY; ADOLESCENTS; ATTRACTION;
D O I
10.1001/jamapediatrics.2018.2731
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
IMPORTANCE Suicide is the second-leading cause of death among adolescents. Sexual minority individuals are at a higher risk of suicide and attempted suicide, but a precise and systematic evaluation of this risk among sexual minority youths has not been documented to our knowledge. OBJECTIVE To examine the risk of attempted suicide among sexual minority adolescents, differentiating for each sexual minority group. DATA SOURCES Electronic databases (PubMed, Embase, and PsycINFO) were searched for articles published through April 30, 2017, with the following search terms: heterosexual, homosexual, bisexual, transgender, adolescents, teens, and attempted suicide. STUDY SELECTION Studies that reported attempted suicide in sexual minority adolescents compared with heterosexual peers were included. Thirty-five studies satisfied criteria for inclusion of 764 records identified. DATA EXTRACTION AND SYNTHESIS Pooled analyses were based on odds ratios (ORs), with relevant 95% Cls, weighting each study with inverse variance models with random effects. Risk of publication bias and analysis of heterogeneity through univariable and multivariable meta-regressions were also rated. MAIN OUTCOMES AND MEASURES The evaluation of increased odds of attempted suicide among sexual minority youths compared with heterosexual peers. RESULTS Thirty-five studies reported in 22 articles that involved a total of 2 378 987 heterosexual and 113 468 sexual minority adolescents (age range, 12-20 years) were included in the analysis. Sexual minority youths were generally at higher risk of attempted suicide (OR, 3.50; 95% Cl, 2.98-4.12; c(2) = 3074.01; P < .001; I-2 = 99%). If estimated in each sexual minority group, the OR was 3.71 in the homosexual group (95% Cl, 3.15-4.37; c(2) = 825.20; P < .001; I-2 = 97%) and 4.87 in the bisexual group (95% Cl, 4.76-4.98; c(2) = 980.02; P <.001; I-2 = 98%); transgender youths were described as an individual group in only 1 study, which reported an OR of 5.87 (95% Cl, 3.51-9.82). Meta-regressions weighted for the study weight highlighted that the presence of young participants (12 years old) was associated with heterogeneity in the bisexual group, whereas the year of sampling was associated with heterogeneity in the whole group when combined with other covariates. CONCLUSIONS AND RELEVANCE Our findings suggest that youths with nonheterosexual identity have a significantly higher risk of life-threatening behavior compared with their heterosexual peers. Public awareness is important, and a careful evaluation of supportive strategies (eg, support programs, counseling, and destigmatizing efforts) should be part of education and public health planning.
引用
收藏
页码:1145 / 1152
页数:8
相关论文
共 49 条
[1]  
Alavi N, 2017, J CAN ACAD CHILD ADO, V26, P70
[2]  
American Psychiatric Association, 2013, Diagnostic and Statistical Manual of Mental Disorders: DSM5, V5th, DOI DOI 10.1176/APPI.BOOKS.9780890425596
[3]   Suicidal risk and sexual orientation in adolescence: A population-based study in Iceland [J].
Arnarsson, Arsaell ;
Sveinbjornsdottir, Sigrun ;
Thorsteinsson, Einar B. ;
Bjarnason, Thoroddur .
SCANDINAVIAN JOURNAL OF PUBLIC HEALTH, 2015, 43 (05) :497-505
[4]  
Bagley C, 2000, Crisis, V21, P111, DOI 10.1027//0227-5910.21.3.111
[5]   Mental Health and Suicidality Among Racially/Ethnically Diverse Sexual Minority Youths [J].
Bostwick, Wendy B. ;
Meyer, Ilan ;
Aranda, Frances ;
Russell, Stephen ;
Hughes, Tonda ;
Birkett, Michelle ;
Mustanski, Brian .
AMERICAN JOURNAL OF PUBLIC HEALTH, 2014, 104 (06) :1129-1136
[6]  
CASS VC, 1983, J HOMOSEXUAL, V9, P105
[7]   The Health and Well-Being of Transgender High School Students: Results From the New Zealand Adolescent Health Survey (Youth'12) [J].
Clark, Terryann C. ;
Lucassen, Mathijs F. G. ;
Bullen, Pat ;
Denny, Simon J. ;
Fleming, Theresa M. ;
Robinson, Elizabeth M. ;
Rossen, Fiona V. .
JOURNAL OF ADOLESCENT HEALTH, 2014, 55 (01) :93-99
[8]  
Cotter P, 2014, Ir Med J, V107, P310
[9]   Predicting the suicide attempts of lesbian, gay, and bisexual youth [J].
D'Augelli, AR ;
Grossman, AH ;
Salter, NP ;
Vasey, JJ ;
Starks, MT ;
Sinclair, KO .
SUICIDE AND LIFE-THREATENING BEHAVIOR, 2005, 35 (06) :646-660
[10]   How Gay-Straight Alliance Groups Mitigate the Relationship Between Gay-Bias Victimization and Adolescent Suicide Attempts [J].
Davis, Brennan ;
Stafford, Marla B. Royne ;
Pullig, Chris .
JOURNAL OF THE AMERICAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY, 2014, 53 (12) :1271-1278