Predisposing and protective factors influencing suicide ideation, attempt, and death in patients accessing substance use treatment: a systematic review and meta-analysis protocol.
Protective factor
Risk factor
Substance use
Suicidality
Treatment
Journal
Systematic reviews
ISSN: 2046-4053
Titre abrégé: Syst Rev
Pays: England
ID NLM: 101580575
Informations de publication
Date de publication:
15 05 2019
15 05 2019
Historique:
received:
27
02
2018
accepted:
15
04
2019
entrez:
17
5
2019
pubmed:
17
5
2019
medline:
20
8
2020
Statut:
epublish
Résumé
The lifetime risk of suicide in patients with substance use disorder is five to ten times the risk in the general population. Critically, up to 19% of patients continue to think about and attempt suicide even after accessing treatment. Therefore, suicidality represents a significant clinical concern in patients struggling with substance use that warrants careful investigation of the factors involved. While most previous research has relied on limited cross-sectional designs, a growing number of prospective studies are improving our understanding of the factors involved. However, a systematic study of these factors has not yet been conducted. The primary objective of this review and possible meta-analysis will be to identify key risk and protective factors for suicide ideation, attempt, and death in patients accessing substance use treatment, guided by current models of suicide. Secondary and tertiary objectives will be to obtain pooled effect sizes for the factors identified and to disaggregate factors for suicidality before and after treatment, and for suicidal thought versus action. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we will conduct an electronic search of the literature using the databases Embase, Medline, PsycINFO, and Web of Science. Two authors will independently screen studies based on pre-specified inclusion and exclusion criteria, extract relevant data, and assess study quality. Observational and randomized-controlled studies will be included, whereas case-studies and reviews will be excluded. We will extract data on risk and protective factors associated with suicide ideation, attempt (odds or risk ratios), and death (hazard ratio). Given sufficient data (> 5 studies), we will calculate pooled effects using comprehensive meta-analysis. This systematic review will contribute to our knowledge of risk and protective factors for suicidality in patients before and after treatment. Understanding these factors will help define areas of research for further investigation to ultimately inform risk assessment and prevention strategies. PROSPERO (reference number: CRD42018076260).
Sections du résumé
BACKGROUND
The lifetime risk of suicide in patients with substance use disorder is five to ten times the risk in the general population. Critically, up to 19% of patients continue to think about and attempt suicide even after accessing treatment. Therefore, suicidality represents a significant clinical concern in patients struggling with substance use that warrants careful investigation of the factors involved. While most previous research has relied on limited cross-sectional designs, a growing number of prospective studies are improving our understanding of the factors involved. However, a systematic study of these factors has not yet been conducted.
METHODS
The primary objective of this review and possible meta-analysis will be to identify key risk and protective factors for suicide ideation, attempt, and death in patients accessing substance use treatment, guided by current models of suicide. Secondary and tertiary objectives will be to obtain pooled effect sizes for the factors identified and to disaggregate factors for suicidality before and after treatment, and for suicidal thought versus action. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we will conduct an electronic search of the literature using the databases Embase, Medline, PsycINFO, and Web of Science. Two authors will independently screen studies based on pre-specified inclusion and exclusion criteria, extract relevant data, and assess study quality. Observational and randomized-controlled studies will be included, whereas case-studies and reviews will be excluded. We will extract data on risk and protective factors associated with suicide ideation, attempt (odds or risk ratios), and death (hazard ratio). Given sufficient data (> 5 studies), we will calculate pooled effects using comprehensive meta-analysis.
DISCUSSION
This systematic review will contribute to our knowledge of risk and protective factors for suicidality in patients before and after treatment. Understanding these factors will help define areas of research for further investigation to ultimately inform risk assessment and prevention strategies.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO (reference number: CRD42018076260).
Identifiants
pubmed: 31092292
doi: 10.1186/s13643-019-1028-2
pii: 10.1186/s13643-019-1028-2
pmc: PMC6518617
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
115Références
Alcohol Clin Exp Res. 2007 Apr;31(4):635-42
pubmed: 17374043
PLoS One. 2016 Jul 08;11(7):e0156348
pubmed: 27391330
Drug Alcohol Depend. 2004 Dec 7;76 Suppl:S21-9
pubmed: 15555813
Drug Alcohol Depend. 2008 Oct 1;97(3):268-75
pubmed: 18556146
Drug Alcohol Depend. 2004 Dec 7;76 Suppl:S11-9
pubmed: 15555812
Alcohol Clin Exp Res. 2004 May;28(5 Suppl):6S-17S
pubmed: 15166632
Alcohol Clin Exp Res. 2006 Jun;30(6):998-1005
pubmed: 16737458
Drug Alcohol Depend. 2011 Dec 1;119(1-2):106-12
pubmed: 21715108
ACP J Club. 1995 Nov-Dec;123(3):A12-3
pubmed: 7582737
PLoS One. 2015 May 20;10(5):e0126870
pubmed: 25993344
Syst Rev. 2015 Jan 01;4:1
pubmed: 25554246
Suicide Life Threat Behav. 2010 Feb;40(1):14-21
pubmed: 20170258
Clin Pract Epidemiol Ment Health. 2007 Oct 10;3:20
pubmed: 17927822
Drug Alcohol Depend. 2005 May 9;78(2):177-86
pubmed: 15845321
Addiction. 2002 Nov;97(11):1383-94
pubmed: 12410779
Suicide Life Threat Behav. 2014 Feb;44(1):1-5
pubmed: 24313594
Am J Epidemiol. 2000 Apr 15;151(8):781-9
pubmed: 10965975
J Urban Health. 2004 Sep;81(3):505-15
pubmed: 15273272
Subst Use Misuse. 2011;46(12):1553-9
pubmed: 21463204
Ment Health Subst Use. 2014;7(1):59-72
pubmed: 24729792
Psychiatry Res. 2015 Jun 30;227(2-3):166-70
pubmed: 25908265