Childhood Maltreatment and Adult Suicidality: a Comprehensive Systematic Review with Meta-analysis

Overview

Journal Psychol Med

Publisher Cambridge University Press

Specialty Psychology

Date 2019 Jan 5

PMID 30608046

Citations 94

Authors

Ioannis Angelakis

Emma Louise Gillespie

Maria Panagioti

Affiliations

Soon will be listed here.

Abstract

This comprehensive systematic review and meta-analysis aims 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 68 studies based on n = 261.660 adults were pooled. All different types of childhood maltreatment including sexual abuse [odds ratio (OR) 3.17, 95% confidence interval (CI) 2.76-3.64], physical abuse (OR 2.52, 95% CI 2.09-3.04) and emotional abuse (OR 2.49, 95% CI 1.64-3.77) were associated with two- to three-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 2.52-10.63). 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.

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References

Bryan C, McNaugton-Cassill M, Osman A, Hernandez A . The associations of physical and sexual assault with suicide risk in nonclinical military and undergraduate samples. Suicide Life Threat Behav. 2013; 43(2):223-34. DOI: 10.1111/sltb.12011. View

Finkelhor D, Turner H, Shattuck A, Hamby S . Violence, crime, and abuse exposure in a national sample of children and youth: an update. JAMA Pediatr. 2013; 167(7):614-21. DOI: 10.1001/jamapediatrics.2013.42. View

Obikane E, Shinozaki T, Takagi D, Kawakami N . Impact of childhood abuse on suicide-related behavior: Analysis using marginal structural models. J Affect Disord. 2018; 234:224-230. DOI: 10.1016/j.jad.2018.02.034. View

Garno J, Goldberg J, Ramirez P, Ritzler B . Impact of childhood abuse on the clinical course of bipolar disorder. Br J Psychiatry. 2005; 186:121-5. DOI: 10.1192/bjp.186.2.121. View

Jeon H, Lee C, Fava M, Mischoulon D, Shim E, Heo J . Childhood trauma, parental death, and their co-occurrence in relation to current suicidality risk in adults: a nationwide community sample of Korea. J Nerv Ment Dis. 2014; 202(12):870-6. DOI: 10.1097/NMD.0000000000000217. View

Shinozaki G, Romanowicz M, Passov V, Rundell J, Mrazek D, Kung S . State dependent gene-environment interaction: serotonin transporter gene-child abuse interaction associated with suicide attempt history among depressed psychiatric inpatients. J Affect Disord. 2012; 147(1-3):373-8. DOI: 10.1016/j.jad.2012.11.043. View

Hassan A, Stuart E, De Luca V . Childhood maltreatment increases the risk of suicide attempt in schizophrenia. Schizophr Res. 2016; 176(2-3):572-577. DOI: 10.1016/j.schres.2016.05.012. View

Easton S, Renner L, OLeary P . Suicide attempts among men with histories of child sexual abuse: examining abuse severity, mental health, and masculine norms. Child Abuse Negl. 2013; 37(6):380-7. DOI: 10.1016/j.chiabu.2012.11.007. View

Martins C, Baes C, Tofoli S, Juruena M . Emotional abuse in childhood is a differential factor for the development of depression in adults. J Nerv Ment Dis. 2014; 202(11):774-82. DOI: 10.1097/NMD.0000000000000202. View

10.

Souza L, Molina M, da Silva R, Jansen K . History of childhood trauma as risk factors to suicide risk in major depression. Psychiatry Res. 2016; 246:612-616. DOI: 10.1016/j.psychres.2016.11.002. View

11.

Andover M, Zlotnick C, Miller I . Childhood physical and sexual abuse in depressed patients with single and multiple suicide attempts. Suicide Life Threat Behav. 2007; 37(4):467-74. DOI: 10.1521/suli.2007.37.4.467. View

12.

Kessler R, Sonnega A, Bromet E, Hughes M, Nelson C . Posttraumatic stress disorder in the National Comorbidity Survey. Arch Gen Psychiatry. 1995; 52(12):1048-60. DOI: 10.1001/archpsyc.1995.03950240066012. View

13.

Daray F, Rojas S, Bridges A, Badour C, Grendas L, Rodante D . The independent effects of child sexual abuse and impulsivity on lifetime suicide attempts among female patients. Child Abuse Negl. 2016; 58:91-8. DOI: 10.1016/j.chiabu.2016.06.011. View

14.

Enns M, Cox B, Afifi T, de Graaf R, Have M, Sareen J . Childhood adversities and risk for suicidal ideation and attempts: a longitudinal population-based study. Psychol Med. 2006; 36(12):1769-78. DOI: 10.1017/S0033291706008646. View

15.

Sfoggia A, Pacheco M, Grassi-Oliveira R . History of childhood abuse and neglect and suicidal behavior at hospital admission. Crisis. 2008; 29(3):154-8. DOI: 10.1027/0227-5910.29.3.154. View

16.

Moher D, Liberati A, Tetzlaff J, Altman D . Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009; 6(7):e1000097. PMC: 2707599. DOI: 10.1371/journal.pmed.1000097. View

17.

Pompili M, Innamorati M, Lamis D, Erbuto D, Venturini P, Ricci F . The associations among childhood maltreatment, "male depression" and suicide risk in psychiatric patients. Psychiatry Res. 2014; 220(1-2):571-8. DOI: 10.1016/j.psychres.2014.07.056. View

18.

Laglaoui Bakhiyi C, Jaussent I, Beziat S, Cohen R, Genty C, Kahn J . Positive and negative life events and reasons for living modulate suicidal ideation in a sample of patients with history of suicide attempts. J Psychiatr Res. 2017; 88:64-71. DOI: 10.1016/j.jpsychires.2016.12.022. View

19.

Siddaway A, Taylor P, Wood A, Schulz J . A meta-analysis of perceptions of defeat and entrapment in depression, anxiety problems, posttraumatic stress disorder, and suicidality. J Affect Disord. 2015; 184:149-59. DOI: 10.1016/j.jad.2015.05.046. View

20.

Bryant S, Range L . Type and severity of child abuse and college students' lifetime suicidality. Child Abuse Negl. 1998; 21(12):1169-76. DOI: 10.1016/s0145-2134(97)00092-6. View