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Association of suicidal behavior with exposure to suicide and suicide attempt: A systematic review and multilevel meta-analysis
Exposure to suicidal behavior may be associated with increased risk of suicide, suicide attempt, and suicidal ideation and is a significant public health problem. However, evidence to date has not reliably distinguished between exposure to suicide versus suicide attempt, nor whether the risk differs...
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Published in: | PLoS medicine 2020-03, Vol.17 (3), p.e1003074-e1003074 |
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description | Exposure to suicidal behavior may be associated with increased risk of suicide, suicide attempt, and suicidal ideation and is a significant public health problem. However, evidence to date has not reliably distinguished between exposure to suicide versus suicide attempt, nor whether the risk differs across suicide-related outcomes, which have markedly different public health implications. Our aim therefore was to quantitatively assess the independent risk associated with exposure to suicide and suicide attempt on suicide, suicide attempt, and suicidal ideation outcomes and to identify moderators of this risk using multilevel meta-analysis.
We systematically searched MEDLINE, Embase, PsycINFO, CINAHL, ASSIA, Sociological Abstracts, IBSS, and Social Services Abstracts from inception to 19 November 2019. Eligible studies included comparative data on prior exposure to suicide, suicide attempt, or suicidal behavior (composite measure-suicide or suicide attempt) and the outcomes of suicide, suicide attempt, and suicidal ideation in relatives, friends, and acquaintances. Dichotomous events or odds ratios (ORs) of suicide, suicide attempt, and suicidal ideation were analyzed using multilevel meta-analyses to accommodate the non-independence of effect sizes. We assessed study quality using the National Heart, Lung, and Blood Institute quality assessment tool for observational studies. Thirty-four independent studies that presented 71 effect sizes (exposure to suicide: k = 42, from 22 independent studies; exposure to suicide attempt: k = 19, from 13 independent studies; exposure to suicidal behavior (composite): k = 10, from 5 independent studies) encompassing 13,923,029 individuals were eligible. Exposure to suicide was associated with increased odds of suicide (11 studies, N = 13,464,582; OR = 3.23, 95% CI = 2.32 to 4.51, P < 0.001) and suicide attempt (10 studies, N = 121,836; OR = 2.91, 95% CI = 2.01 to 4.23, P < 0.001). However, no evidence of an association was observed for suicidal ideation outcomes (2 studies, N = 43,354; OR = 1.85, 95% CI = 0.97 to 3.51, P = 0.06). Exposure to suicide attempt was associated with increased odds of suicide attempt (10 studies, N = 341,793; OR = 3.53, 95% CI = 2.63 to 4.73, P < 0.001), but not suicide death (3 studies, N = 723; OR = 1.64, 95% CI = 0.90 to 2.98, P = 0.11). By contrast, exposure to suicidal behavior (composite) was associated with increased odds of suicide (4 studies, N = 1,479; OR = 3.83, 95% CI = 2.38 to 6.17, |
doi_str_mv | 10.1371/journal.pmed.1003074 |
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We systematically searched MEDLINE, Embase, PsycINFO, CINAHL, ASSIA, Sociological Abstracts, IBSS, and Social Services Abstracts from inception to 19 November 2019. Eligible studies included comparative data on prior exposure to suicide, suicide attempt, or suicidal behavior (composite measure-suicide or suicide attempt) and the outcomes of suicide, suicide attempt, and suicidal ideation in relatives, friends, and acquaintances. Dichotomous events or odds ratios (ORs) of suicide, suicide attempt, and suicidal ideation were analyzed using multilevel meta-analyses to accommodate the non-independence of effect sizes. We assessed study quality using the National Heart, Lung, and Blood Institute quality assessment tool for observational studies. Thirty-four independent studies that presented 71 effect sizes (exposure to suicide: k = 42, from 22 independent studies; exposure to suicide attempt: k = 19, from 13 independent studies; exposure to suicidal behavior (composite): k = 10, from 5 independent studies) encompassing 13,923,029 individuals were eligible. Exposure to suicide was associated with increased odds of suicide (11 studies, N = 13,464,582; OR = 3.23, 95% CI = 2.32 to 4.51, P < 0.001) and suicide attempt (10 studies, N = 121,836; OR = 2.91, 95% CI = 2.01 to 4.23, P < 0.001). However, no evidence of an association was observed for suicidal ideation outcomes (2 studies, N = 43,354; OR = 1.85, 95% CI = 0.97 to 3.51, P = 0.06). Exposure to suicide attempt was associated with increased odds of suicide attempt (10 studies, N = 341,793; OR = 3.53, 95% CI = 2.63 to 4.73, P < 0.001), but not suicide death (3 studies, N = 723; OR = 1.64, 95% CI = 0.90 to 2.98, P = 0.11). By contrast, exposure to suicidal behavior (composite) was associated with increased odds of suicide (4 studies, N = 1,479; OR = 3.83, 95% CI = 2.38 to 6.17, P < 0.001) but not suicide attempt (1 study, N = 666; OR = 1.10, 95% CI = 0.69 to 1.76, P = 0.90), a finding that was inconsistent with the separate analyses of exposure to suicide and suicide attempt. Key limitations of this study include fair study quality and the possibility of unmeasured confounders influencing the findings. The review has been prospectively registered with PROSPERO (CRD42018104629).
The findings of this systematic review and meta-analysis indicate that prior exposure to suicide and prior exposure to suicide attempt in the general population are associated with increased odds of subsequent suicidal behavior, but these exposures do not incur uniform risk across the full range of suicide-related outcomes. Therefore, future studies should refrain from combining these exposures into single composite measures of exposure to suicidal behavior. Finally, future studies should consider designing interventions that target suicide-related outcomes in those exposed to suicide and that include efforts to mitigate the adverse effects of exposure to suicide attempt on subsequent suicide attempt outcomes.</description><identifier>ISSN: 1549-1676</identifier><identifier>ISSN: 1549-1277</identifier><identifier>EISSN: 1549-1676</identifier><identifier>DOI: 10.1371/journal.pmed.1003074</identifier><identifier>PMID: 32231381</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Epidemiology ; Grief ; Investigations ; Medicine and Health Sciences ; Mental health ; Meta-analysis ; Physical Sciences ; Population ; Public health ; Quality control ; Research and Analysis Methods ; Reviews ; Social sciences ; Software ; Suicidal behavior ; Suicide ; Suicides & suicide attempts ; Supervision ; Systematic review</subject><ispartof>PLoS medicine, 2020-03, Vol.17 (3), p.e1003074-e1003074</ispartof><rights>2020 Hill et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2020 Hill et al 2020 Hill et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c526t-97cd5e60b32db5908d51ca8f5782e0712c266d4209906db5459cea81e83754623</citedby><cites>FETCH-LOGICAL-c526t-97cd5e60b32db5908d51ca8f5782e0712c266d4209906db5459cea81e83754623</cites><orcidid>0000-0003-1987-5299 ; 0000-0002-7033-6904 ; 0000-0001-5652-918X ; 0000-0003-0683-5386 ; 0000-0001-8860-6450 ; 0000-0001-6522-8397 ; 0000-0002-3107-1114 ; 0000-0003-2310-1894</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/2460795352/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2460795352?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,25753,27924,27925,37012,37013,44590,53791,53793,75126</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32231381$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Patel, Vikram</contributor><creatorcontrib>Hill, Nicole T M</creatorcontrib><creatorcontrib>Robinson, Jo</creatorcontrib><creatorcontrib>Pirkis, Jane</creatorcontrib><creatorcontrib>Andriessen, Karl</creatorcontrib><creatorcontrib>Krysinska, Karolina</creatorcontrib><creatorcontrib>Payne, Amber</creatorcontrib><creatorcontrib>Boland, Alexandra</creatorcontrib><creatorcontrib>Clarke, Alison</creatorcontrib><creatorcontrib>Milner, Allison</creatorcontrib><creatorcontrib>Witt, Katrina</creatorcontrib><creatorcontrib>Krohn, Stephan</creatorcontrib><creatorcontrib>Lampit, Amit</creatorcontrib><title>Association of suicidal behavior with exposure to suicide and suicide attempt: A systematic review and multilevel meta-analysis</title><title>PLoS medicine</title><addtitle>PLoS Med</addtitle><description>Exposure to suicidal behavior may be associated with increased risk of suicide, suicide attempt, and suicidal ideation and is a significant public health problem. However, evidence to date has not reliably distinguished between exposure to suicide versus suicide attempt, nor whether the risk differs across suicide-related outcomes, which have markedly different public health implications. Our aim therefore was to quantitatively assess the independent risk associated with exposure to suicide and suicide attempt on suicide, suicide attempt, and suicidal ideation outcomes and to identify moderators of this risk using multilevel meta-analysis.
We systematically searched MEDLINE, Embase, PsycINFO, CINAHL, ASSIA, Sociological Abstracts, IBSS, and Social Services Abstracts from inception to 19 November 2019. Eligible studies included comparative data on prior exposure to suicide, suicide attempt, or suicidal behavior (composite measure-suicide or suicide attempt) and the outcomes of suicide, suicide attempt, and suicidal ideation in relatives, friends, and acquaintances. Dichotomous events or odds ratios (ORs) of suicide, suicide attempt, and suicidal ideation were analyzed using multilevel meta-analyses to accommodate the non-independence of effect sizes. We assessed study quality using the National Heart, Lung, and Blood Institute quality assessment tool for observational studies. Thirty-four independent studies that presented 71 effect sizes (exposure to suicide: k = 42, from 22 independent studies; exposure to suicide attempt: k = 19, from 13 independent studies; exposure to suicidal behavior (composite): k = 10, from 5 independent studies) encompassing 13,923,029 individuals were eligible. Exposure to suicide was associated with increased odds of suicide (11 studies, N = 13,464,582; OR = 3.23, 95% CI = 2.32 to 4.51, P < 0.001) and suicide attempt (10 studies, N = 121,836; OR = 2.91, 95% CI = 2.01 to 4.23, P < 0.001). However, no evidence of an association was observed for suicidal ideation outcomes (2 studies, N = 43,354; OR = 1.85, 95% CI = 0.97 to 3.51, P = 0.06). Exposure to suicide attempt was associated with increased odds of suicide attempt (10 studies, N = 341,793; OR = 3.53, 95% CI = 2.63 to 4.73, P < 0.001), but not suicide death (3 studies, N = 723; OR = 1.64, 95% CI = 0.90 to 2.98, P = 0.11). By contrast, exposure to suicidal behavior (composite) was associated with increased odds of suicide (4 studies, N = 1,479; OR = 3.83, 95% CI = 2.38 to 6.17, P < 0.001) but not suicide attempt (1 study, N = 666; OR = 1.10, 95% CI = 0.69 to 1.76, P = 0.90), a finding that was inconsistent with the separate analyses of exposure to suicide and suicide attempt. Key limitations of this study include fair study quality and the possibility of unmeasured confounders influencing the findings. The review has been prospectively registered with PROSPERO (CRD42018104629).
The findings of this systematic review and meta-analysis indicate that prior exposure to suicide and prior exposure to suicide attempt in the general population are associated with increased odds of subsequent suicidal behavior, but these exposures do not incur uniform risk across the full range of suicide-related outcomes. Therefore, future studies should refrain from combining these exposures into single composite measures of exposure to suicidal behavior. Finally, future studies should consider designing interventions that target suicide-related outcomes in those exposed to suicide and that include efforts to mitigate the adverse effects of exposure to suicide attempt on subsequent suicide attempt outcomes.</description><subject>Epidemiology</subject><subject>Grief</subject><subject>Investigations</subject><subject>Medicine and Health Sciences</subject><subject>Mental health</subject><subject>Meta-analysis</subject><subject>Physical Sciences</subject><subject>Population</subject><subject>Public health</subject><subject>Quality control</subject><subject>Research and Analysis Methods</subject><subject>Reviews</subject><subject>Social sciences</subject><subject>Software</subject><subject>Suicidal behavior</subject><subject>Suicide</subject><subject>Suicides & suicide attempts</subject><subject>Supervision</subject><subject>Systematic review</subject><issn>1549-1676</issn><issn>1549-1277</issn><issn>1549-1676</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>PIMPY</sourceid><sourceid>DOA</sourceid><recordid>eNptkktvEzEUhUcIREvgHyAYiU03CX4_WFSKqgKVKrGBteXx3DSOPONge1Ky4q8zaaalRax8ZX_3-Fz7VNVbjBaYSvxxE4fU27DYdtAuMEIUSfasOsWc6TkWUjx_VJ9Ur3LeIEQ00uhldUIJoZgqfFr9XuYcnbfFx76OqzoP3vnWhrqBtd35mOpbX9Y1_NrGPCSoS5wQqG3f_q1LgW5bPtXLOu_zWI-Crk6w83B7B3ZDKD7ADkLdQbFzO1rfZ59fVy9WNmR4M62z6sfny-8XX-fX375cXSyv544TUeZaupaDQA0lbcM1Ui3HzqoVl4oAkpg4IkTLCNIaiZFgXDuwCoOikjNB6Kx6f9TdhpjN9HbZECaQ1JzyA3F1JNpoN2abfGfT3kTrzd1GTDfGpnGqAAZJxBRlK9k4xmjTKt0KBVoLxhvlcDNqnU-3Dc34PQ76kmx4Ivr0pPdrcxN3RmKkxOhnVp1NAin-HCAX0_nsIATbQxxG31RxIjnHB98f_kH_Px07Ui7FnBOsHsxgZA55uu8yhzyZKU9j27vHgzw03QeI_gEcP8pS</recordid><startdate>20200301</startdate><enddate>20200301</enddate><creator>Hill, Nicole T M</creator><creator>Robinson, Jo</creator><creator>Pirkis, Jane</creator><creator>Andriessen, Karl</creator><creator>Krysinska, Karolina</creator><creator>Payne, Amber</creator><creator>Boland, Alexandra</creator><creator>Clarke, Alison</creator><creator>Milner, Allison</creator><creator>Witt, Katrina</creator><creator>Krohn, Stephan</creator><creator>Lampit, Amit</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><scope>CZK</scope><orcidid>https://orcid.org/0000-0003-1987-5299</orcidid><orcidid>https://orcid.org/0000-0002-7033-6904</orcidid><orcidid>https://orcid.org/0000-0001-5652-918X</orcidid><orcidid>https://orcid.org/0000-0003-0683-5386</orcidid><orcidid>https://orcid.org/0000-0001-8860-6450</orcidid><orcidid>https://orcid.org/0000-0001-6522-8397</orcidid><orcidid>https://orcid.org/0000-0002-3107-1114</orcidid><orcidid>https://orcid.org/0000-0003-2310-1894</orcidid></search><sort><creationdate>20200301</creationdate><title>Association of suicidal behavior with exposure to suicide and suicide attempt: A systematic review and multilevel meta-analysis</title><author>Hill, Nicole T M ; Robinson, Jo ; Pirkis, Jane ; Andriessen, Karl ; Krysinska, Karolina ; Payne, Amber ; Boland, Alexandra ; Clarke, Alison ; Milner, Allison ; Witt, Katrina ; Krohn, Stephan ; Lampit, Amit</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c526t-97cd5e60b32db5908d51ca8f5782e0712c266d4209906db5459cea81e83754623</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Epidemiology</topic><topic>Grief</topic><topic>Investigations</topic><topic>Medicine and Health Sciences</topic><topic>Mental health</topic><topic>Meta-analysis</topic><topic>Physical Sciences</topic><topic>Population</topic><topic>Public health</topic><topic>Quality control</topic><topic>Research and Analysis Methods</topic><topic>Reviews</topic><topic>Social sciences</topic><topic>Software</topic><topic>Suicidal behavior</topic><topic>Suicide</topic><topic>Suicides & suicide attempts</topic><topic>Supervision</topic><topic>Systematic review</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hill, Nicole T M</creatorcontrib><creatorcontrib>Robinson, Jo</creatorcontrib><creatorcontrib>Pirkis, Jane</creatorcontrib><creatorcontrib>Andriessen, Karl</creatorcontrib><creatorcontrib>Krysinska, Karolina</creatorcontrib><creatorcontrib>Payne, Amber</creatorcontrib><creatorcontrib>Boland, Alexandra</creatorcontrib><creatorcontrib>Clarke, Alison</creatorcontrib><creatorcontrib>Milner, Allison</creatorcontrib><creatorcontrib>Witt, Katrina</creatorcontrib><creatorcontrib>Krohn, Stephan</creatorcontrib><creatorcontrib>Lampit, Amit</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Complete (ProQuest Database)</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>ProQuest Publicly Available Content database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>Directory of Open Access Journals at publisher websites</collection><collection>PLoS Medicine</collection><jtitle>PLoS medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hill, Nicole T M</au><au>Robinson, Jo</au><au>Pirkis, Jane</au><au>Andriessen, Karl</au><au>Krysinska, Karolina</au><au>Payne, Amber</au><au>Boland, Alexandra</au><au>Clarke, Alison</au><au>Milner, Allison</au><au>Witt, Katrina</au><au>Krohn, Stephan</au><au>Lampit, Amit</au><au>Patel, Vikram</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Association of suicidal behavior with exposure to suicide and suicide attempt: A systematic review and multilevel meta-analysis</atitle><jtitle>PLoS medicine</jtitle><addtitle>PLoS Med</addtitle><date>2020-03-01</date><risdate>2020</risdate><volume>17</volume><issue>3</issue><spage>e1003074</spage><epage>e1003074</epage><pages>e1003074-e1003074</pages><issn>1549-1676</issn><issn>1549-1277</issn><eissn>1549-1676</eissn><abstract>Exposure to suicidal behavior may be associated with increased risk of suicide, suicide attempt, and suicidal ideation and is a significant public health problem. However, evidence to date has not reliably distinguished between exposure to suicide versus suicide attempt, nor whether the risk differs across suicide-related outcomes, which have markedly different public health implications. Our aim therefore was to quantitatively assess the independent risk associated with exposure to suicide and suicide attempt on suicide, suicide attempt, and suicidal ideation outcomes and to identify moderators of this risk using multilevel meta-analysis.
We systematically searched MEDLINE, Embase, PsycINFO, CINAHL, ASSIA, Sociological Abstracts, IBSS, and Social Services Abstracts from inception to 19 November 2019. Eligible studies included comparative data on prior exposure to suicide, suicide attempt, or suicidal behavior (composite measure-suicide or suicide attempt) and the outcomes of suicide, suicide attempt, and suicidal ideation in relatives, friends, and acquaintances. Dichotomous events or odds ratios (ORs) of suicide, suicide attempt, and suicidal ideation were analyzed using multilevel meta-analyses to accommodate the non-independence of effect sizes. We assessed study quality using the National Heart, Lung, and Blood Institute quality assessment tool for observational studies. Thirty-four independent studies that presented 71 effect sizes (exposure to suicide: k = 42, from 22 independent studies; exposure to suicide attempt: k = 19, from 13 independent studies; exposure to suicidal behavior (composite): k = 10, from 5 independent studies) encompassing 13,923,029 individuals were eligible. Exposure to suicide was associated with increased odds of suicide (11 studies, N = 13,464,582; OR = 3.23, 95% CI = 2.32 to 4.51, P < 0.001) and suicide attempt (10 studies, N = 121,836; OR = 2.91, 95% CI = 2.01 to 4.23, P < 0.001). However, no evidence of an association was observed for suicidal ideation outcomes (2 studies, N = 43,354; OR = 1.85, 95% CI = 0.97 to 3.51, P = 0.06). Exposure to suicide attempt was associated with increased odds of suicide attempt (10 studies, N = 341,793; OR = 3.53, 95% CI = 2.63 to 4.73, P < 0.001), but not suicide death (3 studies, N = 723; OR = 1.64, 95% CI = 0.90 to 2.98, P = 0.11). By contrast, exposure to suicidal behavior (composite) was associated with increased odds of suicide (4 studies, N = 1,479; OR = 3.83, 95% CI = 2.38 to 6.17, P < 0.001) but not suicide attempt (1 study, N = 666; OR = 1.10, 95% CI = 0.69 to 1.76, P = 0.90), a finding that was inconsistent with the separate analyses of exposure to suicide and suicide attempt. Key limitations of this study include fair study quality and the possibility of unmeasured confounders influencing the findings. The review has been prospectively registered with PROSPERO (CRD42018104629).
The findings of this systematic review and meta-analysis indicate that prior exposure to suicide and prior exposure to suicide attempt in the general population are associated with increased odds of subsequent suicidal behavior, but these exposures do not incur uniform risk across the full range of suicide-related outcomes. Therefore, future studies should refrain from combining these exposures into single composite measures of exposure to suicidal behavior. Finally, future studies should consider designing interventions that target suicide-related outcomes in those exposed to suicide and that include efforts to mitigate the adverse effects of exposure to suicide attempt on subsequent suicide attempt outcomes.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>32231381</pmid><doi>10.1371/journal.pmed.1003074</doi><orcidid>https://orcid.org/0000-0003-1987-5299</orcidid><orcidid>https://orcid.org/0000-0002-7033-6904</orcidid><orcidid>https://orcid.org/0000-0001-5652-918X</orcidid><orcidid>https://orcid.org/0000-0003-0683-5386</orcidid><orcidid>https://orcid.org/0000-0001-8860-6450</orcidid><orcidid>https://orcid.org/0000-0001-6522-8397</orcidid><orcidid>https://orcid.org/0000-0002-3107-1114</orcidid><orcidid>https://orcid.org/0000-0003-2310-1894</orcidid><oa>free_for_read</oa></addata></record> |
fulltext | fulltext |
identifier | ISSN: 1549-1676 |
ispartof | PLoS medicine, 2020-03, Vol.17 (3), p.e1003074-e1003074 |
issn | 1549-1676 1549-1277 1549-1676 |
language | eng |
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source | PubMed Central database; ProQuest Publicly Available Content database |
subjects | Epidemiology Grief Investigations Medicine and Health Sciences Mental health Meta-analysis Physical Sciences Population Public health Quality control Research and Analysis Methods Reviews Social sciences Software Suicidal behavior Suicide Suicides & suicide attempts Supervision Systematic review |
title | Association of suicidal behavior with exposure to suicide and suicide attempt: A systematic review and multilevel meta-analysis |
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