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Peripheral biological correlates of suicidality in children and adolescents: A systematic review and meta-analysis
Thomas K Pak1, Emine Rabia Ayvaci1,2, Thomas Carmody1,3
1Center for Depression Research and Clinical Care, Peter O'Donnell Jr. Brain Institute and Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Abstract:
A systematic review and meta-analysis were conducted to identify peripheral biological correlates of suicidality in children and adolescents. The review was pre-registered through PROSPERO (CRD42023417128) and included four databases (PubMed, Cochrane Library, Embase, and PsycINFO). From 27,977 non-duplicated articles, 102 full-text studies were selected. Studies investigated suicide attempts (n = 52), suicidal ideation (n = 42), or individuals with suicidal ideation or attempts grouped together (n = 22). Seropositive toxoplasmosis, cortisol, neutrophil, and neutrophil to lymphocyte ratio (NLR) exhibited significant effect size after Bonferroni correction. Effect sizes for biological correlates of suicidality were pooled using Cohen's d (effect size = -0.04, 95% confidence interval [CI]: -1.36 to 1.27) and odds ratio (effect size = -0.31, 95% CI: -1.06 to 0.42). Meta-regression analysis revealed that type of suicidality, type of control, means collected, and sample size significantly impacted the pooled effect size. Analysis showed significant publication bias and heterogeneity, as well as notable moderators and potential biomarkers for future research.
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