Internalizing and externalizing symptoms and suicidal behaviour in young people: a systematic review and meta‐analysis of longitudinal studies

Abstract

Internalizing and externalizing symptoms and suicidal behaviour in young people: a systematic review and meta-analysis of longitudinal studies.Objective: To assess internalizing and externalizing symptoms as risk factors for suicidal behaviour and suicide among adolescents and young adults. Method: We conducted a systematic review of articles published until January 2017. We identified 26 883 potential papers; 1701 full-text articles were assessed for eligibility, of which 1479 were excluded because of methodological reasons. Diverse meta-analyses were performed for each group of symptoms. Odds ratios (ORs) and 95% confidence intervals (95% CI) or beta coefficients for categorical variables, and effect size (ES) were calculated for continuous variables. Results: Finally, 41 studies were included, involving participants aged 12-26 years for a systematic review, and 24 articles were included for meta-analysis. The meta-analysis showed that youths with any internalizing (ES = 0.93) or externalizing symptoms (ES = 0.76 and OR = 2.59) were more likely to attempt suicide in future. This effect was also seen in depression symptoms (OR = 6.58 and ES = 1.00), legal problems (OR = 3.36), and anxiety (ES = 0.65). Conclusion: Reported internalizing and externalizing symptoms are predictors of suicide behaviour in young people; therefore, the detection and management of these symptoms in young populations could be a crucial strategy for preventing suicidality in this group.

Socio-emotional Strengths Against Psychopathology and Suicidal Ideation in Fear of Covid-19

“…However, it has been found that anxious-depressive symptoms mediate between COVID-19 fear and life satisfaction (Satici, Gocet-Tekin, Deniz & Satici, 2020a) and that positive factors may protect against suicidal ideation (Chang et al, 2017;Sánchez-Alvarez et al, 2020). As regards the relationship between anxious-depressive symptoms and suicide ideation, previous studies have shown this to be a positive relationship (Blasco et al, 2018;Soto-Sanz et al, 2019). Fear of COVID-19 has previously been associated with depression and anxiety symptoms as a statistically significant variable (Fitzpatrick et al, 2020;Harper et al, 2020;Satici et al, 2020a).…”

“…This increase in anxious-depressive symptoms can cause serious repercussions. In previous studies, the occurrence of anxiety and depressive disorders, or the presence of symptoms, has been associated with suicidal behavior (Gili et al, 2019;Gilmour, 2016;Sareen et al, 2005;Soto-Sanz et al, 2019).…”

“…Data analyzed in a study in Spain on young university students reflected that the absence of covitality explained 23% of the presence of internalizing symptoms (anxiety and depression) and externalizing symptoms (behavioral problems). In addition, vitality was shown to moderate the relationship between suicidal behaviors (ideation and attempt) and internalizing symptoms, explaining 15% of the variance in suicidal behaviors (Soto-Sanz et al, 2019).…”

Suicide research and prevention: we need new, innovative approaches

“…Three thought‐stimulating research reports are published in this issue of ‘Acta Psychiatrica Scandinavica’ (). These three papers demonstrate innovative approaches to the studies of suicidal behavior.…”

“…Soto‐Sanz et al. performed a systematic review and meta‐analysis of longitudinal studies of a relation between internalizing and externalizing symptoms and suicidal behavior in young (12–26 y.o.) people.…”