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Journal Article


Soto-Sanz V, Castellví P, Piqueras JA, Rodríguez-Marín J, Rodríguez-Jiménez T, Miranda-Mendizábal A, Parés-Badell O, Almenara J, Alonso I, Blasco MJ, Cebria A, Gabilondo A, Gili M, Lagares C, Roca M, Alonso J. Acta Psychiatr. Scand. 2019; ePub(ePub): ePub.


Department of Experimental and Health Sciences, Pompeu Fabra University (UPF), Barcelona, Spain.


(Copyright © 2019, John Wiley and Sons)






OBJECTIVE: To assess internalizing and externalizing symptoms as risk factors for suicidal behavior and suicide among adolescents and young adults.

METHOD: We conducted a systematic review of articles published until January 2017. We identified 26883 potential papers; 1701 full text articles were assessed for eligibility, of which 1479 were excluded due to 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 behavior 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. This article is protected by copyright. All rights reserved.

This article is protected by copyright. All rights reserved.

Language: en


Internalizing symptoms; externalizing symptoms; meta-analysis; suicidal behavior; systematic review; youths


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