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The association between self-esteem and suicidal risk: a meta-analysis

Published online by Cambridge University Press:  01 September 2022

F. Lippo ,
F. Madeddu ,
M. Fornaro  and
R. Calati
F. Lippo*
Affiliation:
University of Milan-Bicocca , Department Of Psychology, Milan, Italy
F. Madeddu
Affiliation:
University of Milan-Bicocca , Department Of Psychology, Milan, Italy
M. Fornaro
Affiliation:
Federico II University of Naples, Department Of Psychiatry, Naples, Italy
R. Calati
Affiliation:
University of Milan-Bicocca , Department Of Psychology, Milan, Italy
*
*Corresponding author.

Abstract

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Introduction

Background: Existing evidence poses low self-esteem as a risk factor for both suicidal ideation (SI) and suicide attempts (SAs) in the general population.

Objectives

The present study assesses the relationship between self-esteem level and SI/SA, considering across the lifespan. Two separate meta-analyses, one for SI and the other for SA are herein reported since they substantially overlap in terms of eligibility procedures and search strategies.

Methods

Eligible studies documented at least one suicidal, and a non-suicidal group. Data were analyzed using the Cochrane Collaboration Review Manager Software (RevMan, version 5.4.1) under the random-effects models. Values were standardized owing to the anticipated heterogeneity of self-esteem rating tools. Sensitivity analyses were performed to control for heterogeneity.

Results

Out of 3,310 initial hits, 24 studies were deemed eligible for inclusion. The meta-analyses showed that individuals with lower levels of self-esteem, compared to those with higher levels, were more likely to endorse both SI and SA. SI reached a standardized mean difference of -0.43 (CI: -0.81, -0.05), while SA reduced by -0.89 (CI: -1.02, -0.76), overall. Limitations: The herein presented results rely on standardized mean differences rather than odds of either SI or SA since the original studies failed to systematically fetch rates of the events.

Conclusions

Lower levels of self-esteem represent a risk factor for both SI and SA across the lifespan. Forthcoming studies should systematically account for multiple moderators to allow meta-analytic synthesis including sub-group and meta-regression analyses assuming high-heterogeneity would still be concerned.

Disclosure

No significant relationships.

Keywords

Suicideself-esteemsuicidal riskmeta-analysis
Type
Abstract
Information
European Psychiatry , Volume 65 , Special Issue S1: Abstracts of the 30th European Congress of Psychiatry , June 2022 , pp. S835
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the European Psychiatric Association
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