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The Association between Mental Disorders and Suicide: A Systematic Review and Meta-Analysis of Record Linkage Studies

38 Pages Posted: 5 Sep 2018

See all articles by Lay San Too

Lay San Too

University of Melbourne - Centre for Mental Health

Matthew J. Spittal

University of Melbourne

Lyndal Bugeja

Monash University

Lennart Reifels

University of Melbourne - Centre for Mental Health

Jane Pirkis

University of Melbourne - Melbourne School of Population and Global Health

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Abstract

Background:  There has long been debate about the extent to which mental disorders contribute to suicide. We aimed to examine the evidence on the contribution of mental disorders to suicide among record linkage studies. Methods: We performed a systematic search using eight major health databases for English-language studies published between 1 January 2000 and 11 June 2018 that linked routinely collected data on mental disorders and suicide. We then conducted a meta-analysis to assess risk of suicide conferred by mental disorders. Outcomes: Our search identified 22 articles representing 14 unique studies. The overall pooled rate ratio (RRpooled) for mental disorders was 6∙14 (95% CI 5∙17−7∙30) in the general population. The highest pooled RR was observed in psychotic disorders (RRpooled = 13∙18, 95% CI 8∙55−20∙30) and the lowest RR in anxiety disorders (RRpooled = 3∙86; 95% CI 2∙38−6∙23). Mood, personality, and substance use disorders also showed a strong pooled RR (RRpooled = 12∙33, 95% CI 8∙89−17∙10; RRpooled = 8∙09, 95% CI 4∙62−14∙17; RRpooled = 4∙11, 95% CI 2∙73−6∙20; respectively). The pooled RR for 'any mental disorder' was 3∙90 (95% CI 1∙99−7∙66). The population attributable risk of mental disorders was up to 21%. Interpretation: Our findings underline the important role of mental disorders in suicide. This suggests that ongoing efforts are required to improve access to and quality of mental health care to prevent suicide by people with mental disorders. Funding Statement: Australian Government Department of Health and a National Health and Medical Research Council Senior Research Fellowship.

Declaration of Interests: We declare no competing interests.

Ethics Approval Statement: Ethics approval is not required for this systematic review and meta-analysis.

Keywords: Mental Disorders, Suicide, Systematic Review, Meta-Analysis, Record Linkage

Suggested Citation

Too, Lay San and Spittal, Matthew J. and Bugeja, Lyndal and Reifels, Lennart and Pirkis, Jane, The Association between Mental Disorders and Suicide: A Systematic Review and Meta-Analysis of Record Linkage Studies (November 7, 2018). Available at SSRN: https://ssrn.com/abstract=3212359

Lay San Too (Contact Author)

University of Melbourne - Centre for Mental Health ( email )

185 Pelham Street
Carlton, Victoria 3053
Australia

Matthew J. Spittal

University of Melbourne ( email )

185 Pelham Street
Carlton, Victoria 3053
Australia

Lyndal Bugeja

Monash University

23 Innovation Walk
Wellington Road
Clayton, Victoria 3800
Australia

Lennart Reifels

University of Melbourne - Centre for Mental Health

185 Pelham Street
Carlton, Victoria 3053
Australia

Jane Pirkis

University of Melbourne - Melbourne School of Population and Global Health ( email )

4/207 Bouverie Street
Parkville, Victoria
Australia

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