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SYSTEMATIC REVIEW article
Front. Psychol.
Sec. Psychopathology
Volume 15 - 2024 |
doi: 10.3389/fpsyg.2024.1369669
Smoking behavior is associated with suicidality in individuals with psychosis and bipolar disorder: A systematic quantitative review and meta-analysis
Provisionally accepted- University of Vienna, Vienna, Austria
Smoking behavior has been well-established to be more prevalent in individuals with psychosis and bipolar disorder compared to the general population. However, reports about higher suicide attempt prevalence of smoking compared to non-smoking patients suggest that smoking behavior may contribute to identifying at-risk groups of patients in a comparatively easy manner. In the present systematic quantitative review, we provide meta-analytical evidence on the smoking and suicide attempt link in 22 studies (k = 27 independent samples; N = 11,452) of patients with psychosis and bipolar disorder. We observed a small meaningful effect of smoking on suicide attempts (OR = 1.70; 95% CI [1.48; 1.95]), indicating that smokers have 1.70 the odds of having reported a suicide attempt compared to non-smokers. This effect generalized across diagnosis type (i.e., schizophrenia vs. bipolar spectrum disorder), sample type (i.e., in-vs. outpatients), and participant sex. However, the observed summary effect appeared somewhat inflated due to publication process-related mechanisms, showing some evidence for effect-inflating publication bias and a decline effect. In all, the presently observed smoking and suicide attempt link appears to be small but meaningful and robust, thus suggesting smoking status represents a useful variable for the identification of at-risk populations for suicide attempts.
Keywords: Smoking, Suicide, Meta-analysis, psychosis, Quantitative review, Bipolar Disorder
Received: 15 Jan 2024; Accepted: 03 Sep 2024.
Copyright: © 2024 Pietschnig, Oberleiter and Köhler. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Jakob Pietschnig, University of Vienna, Vienna, Austria
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