Premium
Body Mass Index Is an Important Predictor for Suicide: Results from a Systematic Review and Meta‐Analysis
Author(s) -
Perera Stefan,
Eisen Rebecca B.,
Dennis Brittany B.,
Bawor Monica,
Bhatt Meha,
Bhatnagar Neera,
Thabane Lehana,
Souza Russell,
Samaan Zainab
Publication year - 2016
Publication title -
suicide and life‐threatening behavior
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.544
H-Index - 90
eISSN - 1943-278X
pISSN - 0363-0234
DOI - 10.1111/sltb.12244
Subject(s) - body mass index , cinahl , medicine , overweight , underweight , meta analysis , suicidal ideation , confounding , obesity , observational study , suicide attempt , poison control , systematic review , suicide prevention , medline , psychiatry , environmental health , psychological intervention , political science , law
Public health concerns for the independent management of obesity and suicidal behavior are rising. Emerging evidence suggests body weight plays an important role in quantifying the risk of suicide. In light of these findings, we aimed to clarify the association between body mass index ( BMI ) and suicidal behavior by systematically reviewing and evaluating the literature. Studies were identified by searching MEDLINE , EMBASE , Psyc INFO , and CINAHL from inception to January 2015, supplemented by hand and grey literature searches. Study screening, data extraction, and risk of bias assessment were conducted in duplicate. We included 38 observational studies. Meta‐analyses supported an inverse association between BMI and completed suicide. Pooled summary estimates demonstrated that underweight was significantly associated with an increased risk of completed suicide ( HR = 1.21, 95% CI 1.07 to 1.36, p = .002), and obesity ( HR = 0.71, 95% CI 0.56 to 0.89, p = .003) and overweight ( HR = 0.78, 95% CI 0.75 to 0.82, p < .0001) were significantly associated with a decreased risk of completed suicide relative to normal weight. A qualitative summary of the literature demonstrated conflicting evidence regarding the association between BMI and attempted suicide and revealed no association between BMI and suicidal ideation. BMI may be used to aid the assessment of suicide risk, especially that of completed suicide. However, unmeasured confounders and systematic biases of individual studies limit the quality of evidence.