Question Effective prevention of suicide requires a comprehensive understanding of risk factors. Study selection and analysis Five databases were systematically searched to identify psychological autopsy studies (published up to February 2022) that reported on risk factors for suicide mortality among adults in the general population. Effect sizes were pooled as odds ratios (ORs) using random-effects models for each risk factor examined in at least three independent samples. Findings A total of 37 case–control studies from 23 countries were included, providing data on 40 risk factors in 5633 cases and 7101 controls. The magnitude of effect sizes varied substantially both between and within risk factor domains. Clinical factors had the strongest associations with suicide, including any mental disorder (OR=13.1, 95% CI 9.9 to 17.4) and a history of self-harm (OR=10.1, 95% CI 6.6 to 15.6). By comparison, effect sizes were smaller for other domains relating to sociodemographic status, family history, and adverse life events (OR range 2–5). Conclusions A wide range of predisposing and precipitating factors are associated with suicide among adults in the general population, but with clear differences in their relative strength. PROSPERO registration number CRD42021232878. Data are available upon reasonable request.

中文翻译：

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成人自杀的危险因素：心理尸检研究的系统回顾和荟萃分析

问题 有效预防自杀需要全面了解危险因素。研究选择和分析系统地检索了五个数据库，以确定心理尸检研究（截至 2022 年 2 月发表），这些研究报告了一般人群中成年人自杀死亡的危险因素。使用随机效应模型，对至少三个独立样本中检查的每个风险因素，将效应大小汇总为比值比 (OR)。研究结果 总共纳入了来自 23 个国家的 37 项病例对照研究，提供了 5633 例病例和 7101 例对照中 40 个危险因素的数据。风险因素域之间和内部的效应大小差异很大。临床因素与自杀的关联最强，包括任何精神障碍（OR=13.1，95% CI 9.9至17.4）和自残史（OR=10.1，95% CI 6.6至15.6）。相比之下，与社会人口状况、家族史和不良生活事件相关的其他领域的效应较小（OR范围2-5）。结论 多种诱发因素和促发因素与一般人群中成年人的自杀相关，但其相对强度存在明显差异。PROSPERO 注册号 CRD42021232878。数据可根据合理要求提供。