This comprehensive systematic review and meta-analysis aims to quantify the association between different types of childhood maltreatment and suicidality. We searched five bibliographic databases, including Medline, PsychINFO, Embase, Web of Science and CINAHL, until January 2018. Random-effects meta-analysis was employed followed by univariable and multivariable meta-regressions. Heterogeneity was quantified using theI2statistic and formal publication bias tests were undertaken. The methodological quality of the studies was critically appraised and accounted in the meta-regression analyses. Data from 68 studies based onn= 261.660 adults were pooled. All different types of childhood maltreatment including sexual abuse [odds ratio (OR) 3.17, 95% confidence interval (CI) 2.76–3.64], physical abuse (OR 2.52, 95% CI 2.09–3.04) and emotional abuse (OR 2.49, 95% CI 1.64–3.77) were associated with two- to three-fold increased risk for suicide attempts. Similar results were found for the association between childhood maltreatment and suicidal ideation. Complex childhood abuse was associated with a particularly high risk for suicide attempts in adults (OR 5.18, 95% CI 2.52–10.63). Variations across the studies in terms of demographic and clinical characteristics of the participants and other core methodological factors did not affect the findings of the main analyses. We conclude that there is solid evidence that childhood maltreatment is associated with increased odds for suicidality in adults. The main outstanding challenge is to better understand the mechanisms which underpin the development of suicidality in people exposed to childhood maltreatment because current evidence is scarce.

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This systematic review and meta-analysis assesses the association between experiences of childhood maltreatment and suicide behaviors in children and young adults.

Although a considerable number of studies have indicated that the rates of suicidal thoughts and behaviors in Body Dysmorphic Disorder (BDD) are high, no systematic review has been undertaken to explore the strength and patterns of the relationship between suicidality and BDD. This is the first systematic review and meta-analysis which aimed to examine the association between BDD and suicidality and the mechanisms underlying suicidality in BDD. Searches of five bibliographic databases including Medline, PsychINFO, Embase, Web of Science and CINAHL, were conducted from inception to June 2015. Seventeen studies were included in the review. Meta-analyses were performed using random effect models to account for the high levels of heterogeneity in the data. A positive and statistically significant association was found between BDD and suicidality (OR=3.63, 95% CI=2.62 to 4.63). Subgroup analyses showed that BDD was associated with increased odds for both, suicide attempts (OR=3.30, 95% CI=2.18 to 4.43) and suicidal ideation (OR=2.57, 95% CI=1.44 to 3.69). The evidence concerning suicide deaths in BDD was scarce. BDD-specific factors and comorbid diagnoses of Axis I disorders were likely to worsen suicidality in BDD. However, the modest number, and the low methodological quality, of the studies included in this review suggest caution the interpretation of these findings.

In the past decade, the links between core types of childhood maltreatment and suicidal acts have become an increasingly important area of investigation. However, no meta-analytic review has examined this relationship in prisoners. We undertook the first systematic meta-analytic review examining the link between childhood maltreatment and suicide attempts in prisoners to redress this important gap. We searched Medline, PsychINFO, Embase, Web of Science and CINAHL from inception until August 2019. Meta-analyses using random effect models were applied, and heterogeneity was quantified using the I2 statistic. Publication bias and risk of bias across studies were assessed. We identified 24 studies comprising 16 586 prisoners. The rates of different types of childhood maltreatment ranged between 29% and 68% [95% confidence interval (CI) 18–81%]. The rate of suicide attempts in prisoners was 23% (95% CI 18–27%). Main results demonstrated that sexual abuse [odds ratio (OR) 2.68, 95% CI 1.86–3.86], physical abuse (OR 2.16, 95% CI 1.60–2.91), emotional abuse (OR 2.70, 95% CI 1.92–3.79), emotional neglect (OR 2.29, 95% CI 1.69–3.10), physical neglect (OR 1.57, 95% CI 1.27–1.94) and combined abuse (OR 3.09, 95% CI 2.14–4.45) were strongly associated with suicide attempts in prisoners. There was an indication of publication bias. Duval and Tweedie's trim-and-fill method was applied, which increased the odds for suicide attempts. Given the high rates of prison suicide deaths and suicide attempts, our findings suggest an urgent need for targeted suicide prevention priorities for prisoners, with a particular focus on ameliorating the effects of childhood traumatic experiences on suicidal prisoners.

Inconsistent findings have been reported by previous cross-sectional studies regarding the association between specific posttraumatic stress disorder (PTSD) symptom clusters and suicidality. To advance the understanding of the role of specific PTSD symptoms in the development of suicidality, the primary aim of this study was to investigate the predictive effects of the three specific PTSD symptom clusters on suicidal ideation prospectively. Fifty-six individuals diagnosed with PTSD completed a two-stage research design, at baseline and 13–15 months follow-up. The clinician administered PTSD scale (CAPS) was used to assess the severity of the PTSD symptom clusters and validated self-report measures were used to assess suicidal ideation, severity of depressive symptoms and perceptions of defeat entrapment. The results showed that only the hyperarousal symptom cluster significantly predicted suicidal ideation at follow-up after controlling for baseline suicidal ideation, severity of depressive symptoms and perceptions of defeat and entrapment. These findings suggest that both disorder-specific and transdiagnostic factors are implicated in the development of suicidal ideation in PTSD. Important clinical implications are discussed in terms of predicting and treating suicidality in those with PTSD.

Objective Obsessive–compulsive disorder (OCD) is a disabling mental health problem that affects a significant proportion of the general population. Experiential avoidance appears to account for the development of anxiety and depressive symptoms. However, its relationship with OCD has yielded contradictory results. Furthermore, although OCD‐specific thoughts and behaviors, including obsessing, checking, washing, and ordering, have been suggested to significantly predict suicidal ideation and behaviors, this line of research has received scant empirical attention. The overarching aim of this study was to explore the relationship between OCD, OCD‐specific behaviors, experiential avoidance, and suicidal experiences. Methods Overall, 1,046 adults from the community who completed self‐report scales participated. Results Strong links between overall OCD severity, obsessing, experiential avoidance, and suicidal experiences were established. Results from mediational analyses showed that overall OCD severity and individual obsessive–compulsive thoughts and behaviors were both directly and indirectly linked with suicidal experiences, via experiential avoidance. Obsessing was among the critical obsessive–compulsive symptoms leading to suicidal experiences. Conclusions These findings are important because they identify experiential avoidance as a potential key explanatory construct in accounting for the development of OCD and suicidal experiences. However, future research using longitudinal and/or experimental designs is needed to infer causality.

Mindfulness interventions (MIs) emphasize living in the present moment without being judgmental of one's feelings and sensations. We aimed to evaluate the effectiveness of MIs, including both mindfulness-based and mindfulness-informed interventions, in reducing overall obsessive-compulsive and related disorders (OCRDs) severity and comorbid depression at post-treatment and in the long-term. The potential contribution of methodological variables moderating the effectiveness of MIs was examined. Five databases (Medline, PsychInfo, Embase, Web of Science, Cochrane Register of Controlled Trials) were searched until May 2022. The pooled standardized mean difference was calculated using random effect models. Twenty-six studies with 1,281 participants were included. We found moderate to large reductions in overall OCRDs severity in favor of MIs at post-treatment (SMD ranging between −0.62 and −1.52, 95% CI: −2.02 to −0.22). MIs were associated with small reductions of depression in people with OCD (SMD = −0.30 and −0.52, 95% CI: −0.68 to −0.09) and obsessions (SMD = −0.32, 95% CI: −0.65 to −0.01) at post-treatment but these effects were not sustained at follow-up. Meta-regression analyses showed that Acceptance and Commitment Therapy (ACT) and Mindfulness-Based Cognitive Therapy (MBCT) appeared to be effective in treating OCD and/or depressive symptoms in these patients. Lower income countries contributed larger effect sizes. Our findings provide first evidence of the effectiveness of MIs in reducing OCRDs severity which require further exploration from high quality RCT studies with embedded qualitative research. Public Health Significance StatementExposure-based psychological interventions are the gold standard for treating obsessive-compulsive and related disorders. However, dropout rates remain one of their biggest limitations. This meta-analytic review showed that mindfulness interventions, which can be both acceptable and have low attrition rates, can be effective in treating these disorders.