title: Suicide risk in type 1 diabetes mellitus: A systematic review.
abstract: BACKGROUND
  Research has shown that suicide risk is often present in patients suffering from type 1 diabetes mellitus (DM-1).
  
  
  OBJECTIVE
  The aim of the present paper was to investigate whether there was a relationship between DM-1 and suicidal behavior and to determine whether or not people affected by DM-1 are at an increased risk of completed suicide, attempted suicide, and suicidal ideation.
  
  
  METHODS
  We performed a careful MedLine, ExcerptaMedica, PsycLit, PsycInfo and Index Medicus search to identify all papers on the topic for the period 1970 to 2013 written in English. The following search terms were used: (suicide OR suicide attempt OR ideation) AND (diabetes mellitus). Where a title or abstract seems to describe a study eligible for inclusion, the full article was examined.
  
  
  METHODS
  We included only original articles published in English peer-reviewed journals. We excluded meta-analyses and systematic reviews, studies that were not clear about follow-up times, the method of statistical analysis, diagnostic criteria or the number of patients included, and studies only on patients affected by type 2 diabetes mellitus (DM-2).
  
  
  RESULTS
  The research reviewed indicated that patients with DM-1 are at an increased risk for suicide, although no clear consensus exists regarding the level of the increased risk.
  
  
  CONCLUSIONS
  The studies used different measurement techniques and different outcomes, and they assessed patients at different time points.
  
  
  CONCLUSIONS
  Our findings support the recommendation that a suicide risk assessment of patients with DM-1 should be part of the routine clinical assessment. The assessment of patients at risk should consist of the evaluation of current and previous suicidal behaviors (both suicidal ideation and attempted suicide).
authors.affiliation: Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Italy. Electronic address: maurizio.pompili@uniroma1.it.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Pompili
authors.affiliation: Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Forte
authors.affiliation: The Richard Stockton College of New Jersey, USA.
authors.forename: David
authors.initials: D
authors.lastname: Lester
authors.affiliation: Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Italy.
authors.forename: Denise
authors.initials: D
authors.lastname: Erbuto
authors.affiliation: Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Italy.
authors.forename: Fabiana
authors.initials: F
authors.lastname: Rovedi
authors.affiliation: Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Innamorati
authors.affiliation: Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genova, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Amore
authors.affiliation: Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Girardi
mesh_terms: D000328:Adult; D003922:Diabetes Mellitus, Type 1 / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D012306:Risk; D016728:Self-Injurious Behavior / Q000453:epidemiology; D059020:Suicidal Ideation; D013405:Suicide / Q000706:statistics & numerical data*; D013406:Suicide, Attempted / Q000706:statistics & numerical data; D000092864:Suicide Prevention
keywords: Diabetes type I; Prevention; Suicide