Biological risk factors for suicidal behaviors: a meta-analysis.
Prior studies have proposed a wide range of potential biological risk factors for future suicidal behaviors. Although strong evidence exists for biological correlates of suicidal behaviors, it remains unclear if these correlates are also risk factors for suicidal behaviors. We performed a meta-analysis to integrate the existing literature on biological risk factors for suicidal behaviors and to determine their statistical significance. We conducted a systematic search of PubMed, PsycInfo and Google Scholar for studies that used a biological factor to predict either suicide attempt or death by suicide. Inclusion criteria included studies with at least one longitudinal analysis using a biological factor to predict either of these outcomes in any population through 2015. From an initial screen of 2541 studies we identified 94 cases. Random effects models were used for both meta-analyses and meta-regression. The combined effect of biological factors produced statistically significant but relatively weak prediction of suicide attempts (weighted mean odds ratio (wOR)=1.41; CI: 1.09-1.81) and suicide death (wOR=1.28; CI: 1.13-1.45). After accounting for publication bias, prediction was nonsignificant for both suicide attempts and suicide death. Only two factors remained significant after accounting for publication bias-cytokines (wOR=2.87; CI: 1.40-5.93) and low levels of fish oil nutrients (wOR=1.09; CI: 1.01-1.19). Our meta-analysis revealed that currently known biological factors are weak predictors of future suicidal behaviors. This conclusion should be interpreted within the context of the limitations of the existing literature, including long follow-up intervals and a lack of tests of interactions with other risk factors. Future studies addressing these limitations may more effectively test for potential biological risk factors.
Department of Emergency Medicine, Columbia University Medical Center, New York, NY, USA.
B P
BP
Chang
Department of Psychology, Vanderbilt University, Nashville, TN, USA.|Department of Psychology, Harvard University, Cambridge, MA, USA.
J C
JC
Franklin
Department of Psychology, Vanderbilt University, Nashville, TN, USA.|Department of Psychology, Harvard University, Cambridge, MA, USA.
J D
JD
Ribeiro
Department of Psychology, Harvard University, Cambridge, MA, USA.
K R
KR
Fox
Department of Psychology, Boston University, Boston, MA, USA.
K H
KH
Bentley
Department of Psychology, Harvard University, Cambridge, MA, USA.
E M
EM
Kleiman
Department of Psychology, Harvard University, Cambridge, MA, USA.
M K
MK
Nock
D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D002784:Cholesterol / Q000097:blood; D004041:Dietary Fats; D005227:Fatty Acids / Q000378:metabolism; D006801:Humans; D018377:Neurotransmitter Agents / Q000134:cerebrospinal fluid; D010121:Oxytocin / Q000097:blood / Q000134:cerebrospinal fluid; D011985:Receptors, Serotonin / Q000235:genetics; D012307:Risk Factors; D050486:Serotonin Plasma Membrane Transport Proteins / Q000235:genetics; D013405:Suicide / Q000706:statistics & numerical data*; D013406:Suicide, Attempted / Q000706:statistics & numerical data; D014365:Tryptophan Hydroxylase / Q000235:genetics; D014797:Vital Capacity
D001786:Blood Glucose; D004041:Dietary Fats; D005227:Fatty Acids; D018377:Neurotransmitter Agents; D011985:Receptors, Serotonin; D050486:Serotonin Plasma Membrane Transport Proteins; D010121:Oxytocin; D002784:Cholesterol; D014365:Tryptophan Hydroxylase