Suicidality in autistic youth is a major public health issue. This study aimed to determine global prevalence of, and risk/protective factors for suicidality in autistic youth via systematic review and meta-analysis. We systematically searched Embase, PubMed, PsycINFO, Web of Science, and the Cochrane library for studies from inception to November 22nd, 2021. We selected empirical studies reporting on suicide outcomes (i.e., ideation, behaviors, attempts and deaths) in autistic youth (≤25 years). Random effects models were used to estimate the pooled prevalence of suicide outcomes with 95% confidence interval (CI). Heterogeneity was investigated with potential moderators using meta-regression analyses. The final selection included 47 papers, 29 of which were included in meta-analyses and 37 were narratively synthesized (sociodemographic, psychiatric, psychological, other factors, and interventions). The pooled prevalence of suicidal ideation was 25.2% (95% CI 18.2–33.8; i.e., one in four), suicide attempts 8.3% (3.6–18.2), and suicide deaths 0.2% (0.05–0.52). Estimates in self-reports were higher than in parent-reports. Age was a significant but inconsistent moderator on suicide outcomes, but substantial heterogeneity remained. Adverse childhood experiences were strong risk factors for suicidality, while resilience was protective. Participatory suicide risk-assessment, early intervention, and resilience promotion should be primary clinical/research goals.

自闭症青少年的自杀是一个重大的公共卫生问题。本研究旨在通过系统评价和荟萃分析确定自闭症青少年自杀的全球流行率和风险/保护因素。我们系统地搜索了 Embase、PubMed、PsycINFO、Web of Science 和 Cochrane 图书馆从开始到 2021 年 11 月 22 日的研究。我们选择了报告自闭症青年自杀结果（即想法、行为、企图和死亡）的实证研究（ ≤25 年）。随机效应模型用于估计自杀结局的汇总患病率，具有 95% 置信区间 (CI)。使用元回归分析与潜在的调节剂一起研究异质性。最终选择包括 47 篇论文，其中 29 篇被纳入荟萃分析，37 篇是叙述性综合的（社会人口学、精神、心理、其他因素和干预措施）。自杀意念的综合患病率为 25.2%（95% CI 18.2-33.8；即四分之一），自杀未遂率为 8.3%（3.6-18.2），自杀死亡为 0.2%（0.05-0.52）。自我报告中的估计值高于父母报告中的估计值。年龄是自杀结果的显着但不一致的调节因素，但仍然存在很大的异质性。不良的童年经历是自杀的重要危险因素，而复原力具有保护作用。参与式自杀风险评估、早期干预和促进复原力应该是主要的临床/研究目标。自我报告中的估计值高于父母报告中的估计值。年龄是自杀结果的显着但不一致的调节因素，但仍然存在很大的异质性。不良的童年经历是自杀的重要危险因素，而复原力具有保护作用。参与式自杀风险评估、早期干预和促进复原力应该是主要的临床/研究目标。自我报告中的估计值高于父母报告中的估计值。年龄是自杀结果的显着但不一致的调节因素，但仍然存在很大的异质性。不良的童年经历是自杀的重要危险因素，而复原力具有保护作用。参与式自杀风险评估、早期干预和促进复原力应该是主要的临床/研究目标。