TY - JOUR
T1 - Childhood maltreatment and adult suicidality: A comprehensive systematic review with meta-analysis
AU - Angelakis, Ioannis
AU - Gillespie, Emma Louise
AU - Panagioti, Maria
PY - 2019/5
Y1 - 2019/5
N2 - This comprehensive systematic review and meta-analysis aimed to quantify the association between different types of childhood maltreatment and suicidality. We searched five bibliographic databases, including Medline, PsychINFO, Embase, Web of Science and CINAHL, until January 2018. Random-effects meta-analysis was employed followed by univariable and multivariable meta-regressions. Heterogeneity was quantified using the I2 statistic and formal publication bias tests were undertaken. The methodological quality of the studies was critically appraised and accounted in the meta-regression analyses. Data from sixty-eight studies based on n = 261.660 adults were pooled. All different types of childhood maltreatment including sexual abuse (OR = 3.17, 95% CI = 2.76 to 3.64), physical abuse (OR = 2.52, 95% CI = 2.09 to 3.04) and emotional abuse (OR = 2.49, 95% CI = 1.64 to 3.77) were associated with 2 to 3-fold increased risk for suicide attempts. Similar results were found for the association between childhood maltreatment and suicidal ideation. Complex childhood abuse was associated with a particularly high risk for suicide attempts in adults (OR= 5.18, 95% CI = 2.52 to 10.63). Variations across the studies in terms of demographic and clinical characteristics of the participants and other core methodological factors did not affect the findings of the main analyses. We conclude that there is solid evidence that childhood maltreatment is associated with increased odds for suicidality in adults. The main outstanding challenge is to better understand the mechanisms which underpin the development of suicidality in people exposed to childhood maltreatment because current evidence is scarce.
AB - This comprehensive systematic review and meta-analysis aimed to quantify the association between different types of childhood maltreatment and suicidality. We searched five bibliographic databases, including Medline, PsychINFO, Embase, Web of Science and CINAHL, until January 2018. Random-effects meta-analysis was employed followed by univariable and multivariable meta-regressions. Heterogeneity was quantified using the I2 statistic and formal publication bias tests were undertaken. The methodological quality of the studies was critically appraised and accounted in the meta-regression analyses. Data from sixty-eight studies based on n = 261.660 adults were pooled. All different types of childhood maltreatment including sexual abuse (OR = 3.17, 95% CI = 2.76 to 3.64), physical abuse (OR = 2.52, 95% CI = 2.09 to 3.04) and emotional abuse (OR = 2.49, 95% CI = 1.64 to 3.77) were associated with 2 to 3-fold increased risk for suicide attempts. Similar results were found for the association between childhood maltreatment and suicidal ideation. Complex childhood abuse was associated with a particularly high risk for suicide attempts in adults (OR= 5.18, 95% CI = 2.52 to 10.63). Variations across the studies in terms of demographic and clinical characteristics of the participants and other core methodological factors did not affect the findings of the main analyses. We conclude that there is solid evidence that childhood maltreatment is associated with increased odds for suicidality in adults. The main outstanding challenge is to better understand the mechanisms which underpin the development of suicidality in people exposed to childhood maltreatment because current evidence is scarce.
KW - Abuse
KW - childhood maltreatment
KW - meta-analysis
KW - neglect
KW - suicidality
KW - systematic review
U2 - 10.1017/S0033291718003823
DO - 10.1017/S0033291718003823
M3 - Article
C2 - 30608046
SN - 1469-8978
VL - 49
SP - 1057
EP - 1078
JO - Psychological Medicine
JF - Psychological Medicine
IS - 7
ER -