Gender differences in suicidal behavior in adolescents and young adults: systematic review and meta-analysis of longitudinal studies

Int J Public Health. 2019 Mar;64(2):265-283. doi: 10.1007/s00038-018-1196-1. Epub 2019 Jan 12.

Abstract

Objectives: To assess the association between gender and suicide attempt/death and identify gender-specific risk/protective factors in adolescents/young adults.

Methods: Systematic review (5 databases until January 2017). Population-based longitudinal studies considering non-clinical populations, aged 12-26 years, assessing associations between gender and suicide attempts/death, or evaluating their gender risk/protective factors, were included. Random effect meta-analyses were performed.

Results: Sixty-seven studies were included. Females presented higher risk of suicide attempt (OR 1.96, 95% CI 1.54-2.50), and males for suicide death (HR 2.50, 95% CI 1.8-3.6). Common risk factors of suicidal behaviors for both genders are previous mental or substance abuse disorder and exposure to interpersonal violence. Female-specific risk factors for suicide attempts are eating disorder, posttraumatic stress disorder, bipolar disorder, being victim of dating violence, depressive symptoms, interpersonal problems and previous abortion. Male-specific risk factors for suicide attempt are disruptive behavior/conduct problems, hopelessness, parental separation/divorce, friend's suicidal behavior, and access to means. Male-specific risk factors for suicide death are drug abuse, externalizing disorders, and access to means. For females, no risk factors for suicide death were studied.

Conclusions: More evidence about female-specific risk/protective factors of suicide death, for adolescent/young adults, is needed.

Keywords: Adolescents; Gender; Risk factors; Suicide; Suicide attempt; Young adults.

Publication types

  • Comparative Study
  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Adolescent
  • Adolescent Behavior / psychology*
  • Adult
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Protective Factors
  • Risk Factors
  • Sex Factors
  • Substance-Related Disorders / psychology*
  • Suicidal Ideation*
  • Suicide, Attempted / psychology*
  • Suicide, Attempted / statistics & numerical data
  • Violence / psychology*
  • Young Adult