title: Do reasons for living protect against suicidal thoughts and behaviors? A systematic review of the literature.
abstract: BACKGROUND
  Few studies have investigated protective factors against suicide.
  
  
  OBJECTIVE
  To identify whether reasons for living (RFL), measured with the Reasons for Living Inventory (RFLI), protect against suicidal ideation (SI), attempts (SA) and suicide death.
  
  
  METHODS
  This systematic review followed the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analysis) statement guidelines. PubMed database was searched for studies published until October 2015. Studies were eligible if they used RFLI or one of its versions. All eligible studies were included, regardless of study design, quality indicators, and target populations. No publication year limit was imposed. We included 39 studies.
  
  
  RESULTS
  RFL may protect against SI and SA and yield a predictive value. The role of two specific reasons for living (Moral Objections to Suicide and Survival and Coping Beliefs) was particularly emphasized. No study investigating suicide death was found.
  
  
  CONCLUSIONS
  RFL may moderate suicide risk factors and correlate with resilience factors. Moreover, RFL may depend on and interact with numerous factors such as DSM-IV Axis I disorders, personality disorders and features, coping abilities and social support. Clinicians could develop therapeutic strategies aimed at enhancing RFL, like Dialectical Behavior Therapy and Cognitive Behavioral Therapies, to prevent suicidal thoughts and behaviors and improve the care management of suicidal patients.
authors.affiliation: Department of Emergency Psychiatry & Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France; Psychiatric Unit, CHU Casablanca, Hassan II University, Casablanca, Morocco; INSERM U1061, La Colombière Hospital, University of Montpellier UM1, Montpellier, France. Electronic address: camelia.laglaoui@gmail.com.
authors.forename: Camélia Laglaoui
authors.initials: CL
authors.lastname: Bakhiyi
authors.affiliation: INSERM U1061, La Colombière Hospital, University of Montpellier UM1, Montpellier, France; FondaMental Foundation, France.
authors.forename: Raffaella
authors.initials: R
authors.lastname: Calati
authors.affiliation: Department of Emergency Psychiatry & Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France; INSERM U1061, La Colombière Hospital, University of Montpellier UM1, Montpellier, France; FondaMental Foundation, France.
authors.forename: Sébastien
authors.initials: S
authors.lastname: Guillaume
authors.affiliation: Department of Emergency Psychiatry & Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France; INSERM U1061, La Colombière Hospital, University of Montpellier UM1, Montpellier, France; FondaMental Foundation, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Courtet
mesh_terms: D006801:Humans; D012649:Self Concept; D013405:Suicide / Q000523:psychology*; D013850:Thinking
keywords: Clinical aspects; Cognition; Reasons for living; Suicide; Systematic review of literature; Treatment