title: Suicide risk and sexual orientation: a critical review.
abstract: Many studies have reported higher rates of suicide attempts among sexual minority individuals compared with their heterosexual counterparts. For suicides, however, it has been argued that there is no sexual orientation risk difference, based on the results of psychological autopsy studies. The purpose of this article was to clarify the reasons for the seemingly discrepant findings for suicide attempts and suicides. First, we reviewed studies that investigated if the increased suicide attempt risk of sexual minorities resulted from biased self-reports or less rigorous assessments of suicide attempts. Second, we reanalyzed the only two available case-control autopsy studies and challenge their original "no difference" conclusion by pointing out problems with the interpretation of significance tests and by applying Bayesian statistics and meta-analytical procedures. Third, we reviewed register based and clinical studies on the association of suicides and sexual orientation. We conclude that studies of both suicide attempts and suicides do, in fact, point to an increased suicide risk among sexual minorities, thus solving the discrepancy. We also discuss methodological challenges inherent in research on sexual minorities and potential ethical issues. The arguments in this article are necessary to judge the weight of the evidence and how the evidence might be translated into practice.
authors: Suicide Prevention Research Program, Institute of Public Health, Paracelsus Private Medical University, Salzburg, Austria.m.ploederl@salk.at
authors: Martin
authors: M
authors: Plöderl
authors: Eric-Jan
authors: EJ
authors: Wagenmakers
authors: Pierre
authors: P
authors: Tremblay
authors: Richard
authors: R
authors: Ramsay
authors: Karl
authors: K
authors: Kralovec
authors: Clemens
authors: C
authors: Fartacek
authors: Reinhold
authors: R
authors: Fartacek
mesh_terms: D001499:Bayes Theorem; D005260:Female; D006801:Humans; D008297:Male; D012306:Risk; D012307:Risk Factors; D019529:Sexuality / Q000523:psychology / Q000706:statistics & numerical data*; D013405:Suicide / Q000523:psychology / Q000706:statistics & numerical data; D013406:Suicide, Attempted / Q000523:psychology / Q000706:statistics & numerical data*