Risk and protective factors for self-harm and suicide in children and adolescents: a systematic review and meta-analysis protocol

doi:10.1136/bmjopen-2021-058297

. 2022 Nov 25;12(11):e058297.

doi: 10.1136/bmjopen-2021-058297.

Risk and protective factors for self-harm and suicide in children and adolescents: a systematic review and meta-analysis protocol

Dan Farbstein^#^{1

2}, Steve Lukito^#³, Isabel Yorke⁴, Emma Wilson^{5

6}, Holly Crudgington^{5

6}, Omar El-Aalem⁷, Charlotte Cliffe⁸, Nicol Bergou⁹, Lynn Itani¹⁰, Andy Owusu⁷, Rosemary Sedgwick⁷, Nidhita Singh⁷, Anna Tarasenko¹¹, Gavin Tucker⁷, Emma Woodhouse^{12

13}, Mimi Suzuki¹⁴, Anna Louise Myerscough¹⁴, Natalia Lopez Chemas¹⁴, Nadia Abdel-Halim¹⁴, Cinzia Del Giovane^{15

16}, Sophie Epstein^#¹⁷, Dennis Ougrin^#^{4

18}

Affiliations

¹ Child and Adolescent Psychiatry Unit, Psychiatric Division, Rambam Health Care Campus, Haifa, Israel.
² Technion Israel Institute of Technology, The Ruth and Bruce Rappaport Faculty of Medicine, Haifa, Israel.
³ Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK steve.lukito@kcl.ac.uk.
⁴ Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
⁵ Economic and Social Research Council (ESRC) Centre for Society and Mental Health, King's College London, London, UK.
⁶ Department of Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
⁷ South London and Maudsley NHS Foundation Trust, London, UK.
⁸ Department of Biostatistics & Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
⁹ Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
¹⁰ Emirates Health Services, Maudsley Health, Al Amal Psychiatric Hospital, Dubai, UAE.
¹¹ BrainPatch Ltd, London, UK.
¹² Compass Psychological Services Ltd, London, UK.
¹³ Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
¹⁴ Unit for Social and Community Psychiatry, Queen Mary University of London & East London NHS Foundation Trust, London, UK.
¹⁵ Department of Medical and Surgical Sciences for Children and Adults, University-Hospital of Modena and Reggio Emilia, Modena, Italy.
¹⁶ Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.
¹⁷ Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
¹⁸ Youth Resilience Research Unit, WHO Collaborating Centre for Mental Health Services Development, Queen Mary University of London, London, UK.

^# Contributed equally.

PMID: 36428021
PMCID: PMC9703327
DOI: 10.1136/bmjopen-2021-058297

Risk and protective factors for self-harm and suicide in children and adolescents: a systematic review and meta-analysis protocol

Dan Farbstein et al. BMJ Open. 2022.

. 2022 Nov 25;12(11):e058297.

doi: 10.1136/bmjopen-2021-058297.

Authors

Affiliations

¹ Child and Adolescent Psychiatry Unit, Psychiatric Division, Rambam Health Care Campus, Haifa, Israel.
² Technion Israel Institute of Technology, The Ruth and Bruce Rappaport Faculty of Medicine, Haifa, Israel.
³ Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK steve.lukito@kcl.ac.uk.
⁴ Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
⁵ Economic and Social Research Council (ESRC) Centre for Society and Mental Health, King's College London, London, UK.
⁶ Department of Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
⁷ South London and Maudsley NHS Foundation Trust, London, UK.
⁸ Department of Biostatistics & Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
⁹ Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
¹⁰ Emirates Health Services, Maudsley Health, Al Amal Psychiatric Hospital, Dubai, UAE.
¹¹ BrainPatch Ltd, London, UK.
¹² Compass Psychological Services Ltd, London, UK.
¹³ Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
¹⁴ Unit for Social and Community Psychiatry, Queen Mary University of London & East London NHS Foundation Trust, London, UK.
¹⁵ Department of Medical and Surgical Sciences for Children and Adults, University-Hospital of Modena and Reggio Emilia, Modena, Italy.
¹⁶ Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.
¹⁷ Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
¹⁸ Youth Resilience Research Unit, WHO Collaborating Centre for Mental Health Services Development, Queen Mary University of London, London, UK.

^# Contributed equally.

PMID: 36428021
PMCID: PMC9703327
DOI: 10.1136/bmjopen-2021-058297

Abstract

Introduction: Self-harm and suicide are major public health concerns among children and adolescents. Many risk and protective factors for suicide and self-harm have been identified and reported in the literature. However, the capacity of these identified risk and protective factors to guide assessment and management is limited due to their great number. This protocol describes an ongoing systematic review and meta-analysis which aims to examine longitudinal studies of risk factors for self-harm and suicide in children and adolescents, to provide a comparison of the strengths of association of the various risk factors for self-harm and suicide and to shed light on those that require further investigation.

Methods and analysis: We perform a systematic search of the literature using the databases EMBASE, PsycINFO, Medline, CINAHL and HMIC from inception up to 28 October 2020, and the search will be updated before the systematic review publication. Additionally, we will contact experts in the field, including principal investigators whose peer-reviewed publications are included in our systematic review as well as investigators from our extensive research network, and we will search the reference lists of relevant reviews to retrieve any articles that were not identified in our search. We will extract relevant data and present a narrative synthesis and combine the results in meta-analyses where there are sufficient data. We will assess the risk of bias for each study using the Newcastle-Ottawa Scale and present a summary of the quantity and the quality of the evidence for each risk or protective factor.

Ethics and dissemination: Ethical approval will not be sought as this is a systematic review of the literature. Results will be published in mental health journals and presented at conferences focused on suicide prevention.

Prospero registration number: CRD42021228212.

Keywords: child & adolescent psychiatry; community child health; suicide & self-harm.

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Conflict of interest statement

Competing interests: None declared.

References

1. National Institute for Health and Care Excellence (NICE) . Self-harm [NICE Quality Standard No. 34], 2019.
1. Brunner R, Kaess M, Parzer P, et al. . Life-Time prevalence and psychosocial correlates of adolescent direct self-injurious behavior: a comparative study of findings in 11 European countries. J Child Psychol Psychiatry 2014;55:337–48. 10.1111/jcpp.12166 - DOI - PubMed
1. Hawton K, Saunders KEA, O'Connor RC. Self-Harm and suicide in adolescents. Lancet 2012;379:2373–82. 10.1016/S0140-6736(12)60322-5 - DOI - PubMed
1. Madge N, Hewitt A, Hawton K, et al. . Deliberate self-harm within an international community sample of young people: comparative findings from the Child & Adolescent Self-harm in Europe (CASE) Study. J Child Psychol Psychiatry 2008;49:667–77. 10.1111/j.1469-7610.2008.01879.x - DOI - PubMed
1. Nock MK, Green JG, Hwang I. Prevalence, correlates, and treatment of lifetime suicidal behavior among adolescents: results from the National comorbidity survey replication adolescent supplement. JAMA Psychiatry 2013;70:300–10. 10.1001/2013.jamapsychiatry.55 - DOI - PMC - PubMed

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[1] National Institute for Health and Care Excellence (NICE) . Self-harm [NICE Quality Standard No. 34], 2019.

[2] National Institute for Health and Care Excellence (NICE) . Self-harm [NICE Quality Standard No. 34], 2019.

[3] Brunner R, Kaess M, Parzer P, et al. . Life-Time prevalence and psychosocial correlates of adolescent direct self-injurious behavior: a comparative study of findings in 11 European countries. J Child Psychol Psychiatry 2014;55:337–48. 10.1111/jcpp.12166 - DOI - PubMed

[4] Brunner R, Kaess M, Parzer P, et al. . Life-Time prevalence and psychosocial correlates of adolescent direct self-injurious behavior: a comparative study of findings in 11 European countries. J Child Psychol Psychiatry 2014;55:337–48. 10.1111/jcpp.12166 - DOI - PubMed

[5] Hawton K, Saunders KEA, O'Connor RC. Self-Harm and suicide in adolescents. Lancet 2012;379:2373–82. 10.1016/S0140-6736(12)60322-5 - DOI - PubMed

[6] Hawton K, Saunders KEA, O'Connor RC. Self-Harm and suicide in adolescents. Lancet 2012;379:2373–82. 10.1016/S0140-6736(12)60322-5 - DOI - PubMed

[7] Madge N, Hewitt A, Hawton K, et al. . Deliberate self-harm within an international community sample of young people: comparative findings from the Child & Adolescent Self-harm in Europe (CASE) Study. J Child Psychol Psychiatry 2008;49:667–77. 10.1111/j.1469-7610.2008.01879.x - DOI - PubMed

[8] Madge N, Hewitt A, Hawton K, et al. . Deliberate self-harm within an international community sample of young people: comparative findings from the Child & Adolescent Self-harm in Europe (CASE) Study. J Child Psychol Psychiatry 2008;49:667–77. 10.1111/j.1469-7610.2008.01879.x - DOI - PubMed

[9] Nock MK, Green JG, Hwang I. Prevalence, correlates, and treatment of lifetime suicidal behavior among adolescents: results from the National comorbidity survey replication adolescent supplement. JAMA Psychiatry 2013;70:300–10. 10.1001/2013.jamapsychiatry.55 - DOI - PMC - PubMed

[10] Nock MK, Green JG, Hwang I. Prevalence, correlates, and treatment of lifetime suicidal behavior among adolescents: results from the National comorbidity survey replication adolescent supplement. JAMA Psychiatry 2013;70:300–10. 10.1001/2013.jamapsychiatry.55 - DOI - PMC - PubMed

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Risk and protective factors for self-harm and suicide in children and adolescents: a systematic review and meta-analysis protocol

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Risk and protective factors for self-harm and suicide in children and adolescents: a systematic review and meta-analysis protocol

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