A systematic review of controlled studies of suicidal and self-harming behaviours in adolescents following bereavement by suicide

Background Research suggests that being exposed to the suicide of others increases risk subsequent suicidal or self-harming thoughts behaviours. What is less clear whether this applies adolescents, and if exceeds following other causes death, which has implications on prevention approaches. This study aimed systematically review evidence adolescent bereavement experiences by different address gap. Methods A comprehensive literature search using four databases (MEDLINE, PsycInfo, Web Science, Embase) identified 21 studies measured self-harm outcomes among bereaved adolescents aged between 12 18 years old. The was screened, data extracted pre-piloted forms, bias assessed versions Newcastle-Ottawa Scale; a proportion papers were double for bias. been registered with PROSPERO (CRD42016051125). Results narrative synthesis demonstrated divergent findings depending outcome measured. Suicide appears be strongly associated mortality parentally youth, while non-fatal attempts (either presenting hospital self-reported) showed mixed evidence. Suicidal ideation not uniquely bereavement. An exploration circumstances surrounding characteristics person who died, young across each measure suggested earlier loss, shorter timeframes maternal death are particularly elevated outcomes. Conclusions Findings suggest loss suicide, may self-harm. detailed account protective factors people crucial understand pathways through behaviours develop. Researchers, policy makers practitioners an interest in will benefit from clarity around needs individuals.