Victoria Newell, Lucy Phillips, Chris Jones, Ellen Townsend, Caroline Richards, Sarah Cassidy
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引用次数: 6
Abstract
Background: Suicidality is highly prevalent in autistic people without co-occurring intellectual disabilities, and high autistic traits are found in adults who have attempted suicide. However, prevalence rates for both autistic and possibly autistic people have not been synthesised meta-analytically.
Aims: To (1) calculate pooled prevalence estimates of suicidality in autistic people and possibly autistic people without co-occurring intellectual disability; (2) evaluate the influence of participant and study level characteristics on heterogeneity; and (3) determine the quality of evidence.
Methods: Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines were followed. PsycINFO, Embase, MEDLINE and Web of Science were systematically searched from 1992 to January 25, 2022. Empirical quantitative studies reporting prevalence of suicidal ideation, suicide plans, or suicide attempts and behaviours were considered for inclusion. Random effects models were used to estimate pooled prevalence of each suicidality outcome with 95% confidence intervals. Heterogeneity was explored using sensitivity and moderator analyses.
Results: Data from 48,186 autistic and possibly autistic participants in 36 primary studies were meta-analysed. Pooled prevalence of suicidal ideation was 34.2% (95% CI 27.9-40.5), suicide plans 21.9% (13.4-30.4), and suicidal attempts and behaviours 24.3% (18.9-29.6). High levels of heterogeneity (I2 > 75) were observed in all three analyses. Estimates did not differ between autistic or possibly autistic samples. Geographical location (p = 0.005), transgender or gender non-conforming samples (p < 0.001) and type of report (p < 0.001) significantly moderated suicidal ideation, whereas age group (p = 0.001) and measure of suicidality (p = 0.001) significantly moderated suicide plans. There was a significant association between the proportion of male participants and prevalence of suicide plans, with a decrease in the proportion of males for every unit change of suicide plan prevalence (p = 0.013). No variables were found to moderate estimates of suicide attempts and behaviours.
Conclusions: The results confirm suicidality is highly prevalent in both autistic and possibly autistic people without co-occurring intellectual disability and highlights potential moderators. Possibly autistic individuals require more attention in clinical and research considerations going forward to further understand and prevent suicide in both groups.
背景:自杀倾向在没有智力障碍的自闭症患者中非常普遍,在试图自杀的成年人中发现了高度的自闭症特征。然而,自闭症和可能患有自闭症的人的患病率还没有综合分析。目的:(1)计算自闭症患者和可能患有自闭症但没有并发智力障碍的患者自杀率的汇总估计;(2)评价参与者和研究水平特征对异质性的影响;(3)确定证据的质量。方法:遵循系统评价和元分析指南的首选报告项目。系统检索了1992年至2022年1月25日期间的PsycINFO、Embase、MEDLINE和Web of Science。报告自杀意念、自杀计划或自杀企图和行为的流行程度的实证定量研究被纳入考虑。随机效应模型用于估计每个自杀结局的总患病率,置信区间为95%。采用敏感性和调节因子分析探讨异质性。结果:对36项主要研究中48186名自闭症和可能自闭症的参与者的数据进行了荟萃分析。自杀意念的总患病率为34.2% (95% CI 27.9-40.5),自杀计划的总患病率为21.9%(13.4-30.4),自杀企图和行为的总患病率为24.3%(18.9-29.6)。在所有三个分析中均观察到高度异质性(I2 > 75)。自闭或可能自闭的样本之间的估计没有差异。结论:研究结果证实,在没有并发智力残疾的自闭症和可能自闭症患者中,自杀行为都非常普遍,并突出了潜在的调节因素。可能自闭症患者需要在临床和研究方面给予更多的关注,以进一步了解和预防这两组人的自杀。
期刊介绍:
Molecular Autism is a peer-reviewed, open access journal that publishes high-quality basic, translational and clinical research that has relevance to the etiology, pathobiology, or treatment of autism and related neurodevelopmental conditions. Research that includes integration across levels is encouraged. Molecular Autism publishes empirical studies, reviews, and brief communications.