Posttraumatic stress disorder and risk of suicidal behavior: A systematic review and meta‐analysis

Introduction This study conducted a systematic review and meta‐analysis of the association between posttraumatic stress disorder (PTSD) and (i) death by suicide, (ii) attempted suicide (AS), and (iii) suicidal ideation (SI). Methods The systematic review identified seven studies on PTSD and suicide,...

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Bibliographic Details
Published in:Suicide & life-threatening behavior 2023-02, Vol.53 (1), p.163-184
Main Authors: Akbar, Rahat, Arya, Vikas, Conroy, Elizabeth, Wilcox, Holly C., Page, Andrew
Format: Article
Language:English
Subjects:
attempted suicide
Humans
Meta-analysis
Post traumatic stress disorder
Posttraumatic Stress Disorder
Psychiatry
Risk
Stress Disorders, Post-Traumatic - psychology
Suicidal behavior
Suicidal Ideation
Suicide
Suicide prevention
Suicide, Attempted - psychology
Suicides & suicide attempts
Systematic review
Veterans - psychology
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Summary:Introduction This study conducted a systematic review and meta‐analysis of the association between posttraumatic stress disorder (PTSD) and (i) death by suicide, (ii) attempted suicide (AS), and (iii) suicidal ideation (SI). Methods The systematic review identified seven studies on PTSD and suicide, 33 studies for AS, and 20 studies for SI. A series of stratified meta‐analyses were conducted to estimate pooled effects, in addition to meta‐regression to investigate sources of heterogeneity. Results A higher relative risk of suicide was evident among those diagnosed with PTSD (RR = 2.09 [95% confidence interval (CI): 1.11–3.94]), with strongest associations among combat veterans (RR = 3.97, 95% CI 2.22–7.10). A lower relative risk of suicide among those with PTSD and co‐morbid psychiatric conditions was evident (RR = 0.74, 95% CI 0.63–0.86). A strong association between PTSD and attempted suicide (RR = 4.05, 95% CI 3.14–5.23) and suicidal ideation (RR = 2.91, 95% CI 2.22–3.82) was also found, with a consistently strong association among those with co‐morbid psychiatric conditions and non‐clinical cohorts. Conclusion This review found a strong association between PTSD and death by suicide, attempted suicide, and suicidal ideation, and also suicide among veteran populations. Early identification and treatment of PTSD across both clinical and non‐clinical cohorts should be a priority for suicide prevention.
ISSN:0363-0234
1943-278X
DOI:10.1111/sltb.12931