@article{ref1,
title="Association of mental disorders with firearm suicides: a systematic review with meta-analyses of observational studies in the United States",
journal="Journal of affective disorders",
year="2021",
author="Zuriaga, Ana and Kaplan, Mark S. and Choi, Namkee G. and Hodkinson, Alexander and Storman, Dawid and Brudasca, Nicoleta I. and Hirani, Shashivadan P. and Brini, Stefano",
volume="291",
number="",
pages="384-399",
abstract="In the United States (US), 61% of all suicide cases may involve firearms, and some evidence suggests that mental disorders may play a role in suicide by firearm. We performed the first systematic review and meta-analyses to investigate: (i) whether mental disorders are associated with suicide by firearm, and (ii) whether the risk of using a firearm compared with alternative means is associated with higher levels of suicide in individuals with a mental disorder METHODS AND FINDINGS: We searched twelve databases from inception to the 24th of May 2020. We retrieved 22 observational studies conducted in the US. Random-effects meta-analyses showed individuals who had a diagnosis of a mental disorder had lower odds (odds ratios (OR)= 0.50, 95% CI: 0.36 to 0.69; I(2)=100 (95% CI: 87 to 100%), of dying by suicide with a firearm than those who did not have a diagnosis of a mental disorder. Secondary analysis showed that decedents who had a mental health diagnosis resulted in lower odds of dying by suicide by using firearms than using other means LIMITATIONS: Risk of bias revealed a heterogeneous and poor definition of mental disorders as well as lack of control for potential demographic confounding factors. In the meta-analyses, studies were combined in the same analytic sample as 77% of these studies did not specify the type of mental disorder CONCLUSION: While our results seem to suggest that having a mental disorder may not be consistently associated with the odds of dying by suicide using a firearm, the presence of substantial heterogeneity and high risk of bias precludes any firm conclusions.<p /> <p>Language: en</p>",
language="en",
issn="0165-0327",
doi="10.1016/j.jad.2021.05.005",
url="http://dx.doi.org/10.1016/j.jad.2021.05.005"
}