青少年睡眠问题与自杀行为关系的meta分析

Meta-analysis of the association between sleep problems and suicide thoughts and behaviors in adolescents

目的:系统评价青少年睡眠问题与自杀行为的关系。方法:检索PubMed、Web of Science、Ovid PsysINFO、中国知网、万方数据知识服务平台、维普中文科技期刊数据库、中国生物医学文献服务系统数据库中截至2021年2月3日发表的青少年睡眠问题与自杀行为关系的观察性研究。采用Stata 16进行分析,计算合并OR(95%CI)值。结果:从检索的8287篇文献中纳入31篇文献,共包含619715名研究对象。Meta分析结果显示,在横断面研究中,青少年睡眠问题与自杀意念、自杀计划和自杀未遂呈正关联(合并OR=1.63、1.57、1.89);在队列研究中,青少年睡眠问题可以预测自杀意念、自杀计划和自杀未遂(合并OR=1.35、2.40、1.61)。在队列研究的亚组分析中显示,控制抑郁后青少年睡眠问题与自杀行为仍存在关联,且控制抑郁后睡眠问题预测效应更强(OR=2.30,95%CI:1.09~2.41,P<0.001)。此外,青少年睡眠问题预测自杀未遂的能力受随访时长的变化影响,随访时长≥2年的预测效应更强(合并OR=2.43 vs.1.19,P<0.01)。结论:睡眠问题可能会增加青少年自杀行为的危险性。

Objective:To systematically evaluate the relationship between sleep problem and suicide thoughts and behaviors.Methods:A search was conducted in PubMed,Web of Science,Ovid PsysINFO,CNKI,Wanfang,VIP and CBM to explore the relationship between sleep problem and suicide thoughts and behaviors.The databases were searched from inception to February 3,2021 and the included literatures wereobservational study.Meta analysis will be performed using Stata 16.0 softwareto calculate combined odds radio(OR)and 95%CI.Results:Thirty-one literatures of 8287 with a total of 619715 were included in the study.Results of the meta-analysis showed that in cross-sectional studies,sleep problems were positively associated with suicidal ideation,suicide plan,and suicide attempt(pooled ORs=1.63,1.57,and 1.89).In cohort studies,sleep problems could predict suicidal ideation,suicide plan,and suicide attempt(pooled ORs=1.35,2.40,and 1.61).Subgroup analysis in cohort study showed that controlled depression sleep problems were still associated with suicidebehaviors,and sleep problems had a stronger predictive effect(OR=2.30,95%CI:1.09-2.41,P<0.001).In addition,the ability of sleep problems to predict suicide attempt was affected by the change of follow-up duration,and the prediction effect of follow-up duration≥2 years was stronger(pooled ORs=2.43 vs.1.19,P<0.01).Conclusion:Sleep problems could increase the suicide risk in adolescents.