Suicides in men outnumber women in almost every country in the world (Naghavi, 2019), with the exception of the 15-19 year age group. In Scotland males accounted for almost 75% of all suicide deaths in 2019 (ScotPHO, 2020). Each life lost to suicide is a preventable tragedy and more needs to be done to understand the risk factors in individuals who take their own life.
A well-known theory in this field is the Gender Paradox of Suicide (Canetto & Sakinofsky, 1998) where women are more likely to attempt suicide, but men are more likely to die by suicide. Due to this increased risk in men we need to understand which risk factors are particularly relevant in this group. Recent reviews (Franklin et al., 2017; O’Connor & Nock, 2014; Turecki & Brent, 2016; Turecki et al., 2019) have highlighted advances in our understanding of risk factors for suicide in men and women, yet our ability to predict suicide remains no better than chance.
Suicide in men is a complex issue encompassing a wide range of risk factors across the lifespan, from early childhood experiences to mental illness, masculinity, social context and negative life events. Despite this, there has not been a comprehensive systematic review of risk factors for suicidal behaviour in men. It is also known that the time taken to transition from thinking about suicide to acting on these suicidal thoughts can be shorter in men (Schrijvers, Bollen, & Sabbe, 2012), highlighting the need to further understand the factors that affect this transition. Therefore, we conducted such a review to determine the extent and nature of the risk factors that predicted suicidal behaviour in men over time.
In this study there were 105 eligible studies (62 prospective and 43 retrospective) identified. Overall, the risk factors with the strongest evidence predicting suicidal behaviour in men were alcohol and/or drug use/dependence; being unmarried, single, divorced or widowed; and having a diagnosis of depression.
This systematic review has highlighted the wide range of risk factors for suicidal behaviour in men. There are many factors that can interact and change in relevance throughout an individual’s life. This review has identified important gaps in the literature, including the need for more research in women’s suicidal behaviour and gender differences to determine the extent to which risk factors are “gender specific”. There is also a lack of research on psychological factors, such as impulsivity, which may have an influence. Furthermore, many of the studies assessed risk factors in different ways which made collating this information difficult. Although many factors are relevant for all genders, by identifying risk factors in men it provides a step forward towards understanding why men are more likely to die by suicide than women.
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Canetto, S. S., & Sakinofsky, I. (1998). The gender paradox in suicide. Suicide and Life‐Threatening Behavior, 28(1), 1-23.
Chandler, A. (2019). Boys don’t cry? Critical phenomenology, self-harm and suicide. The Sociological Review, 0038026119854863.
Franklin, J. C., Ribeiro, J. D., Fox, K. R., Bentley, K. H., Kleiman, E. M., Huang, X., . . . Nock, M. K. (2017). Risk factors for suicidal thoughts and behaviors: a meta-analysis of 50 years of research. Psychological Bulletin, 143(2), 187.
Mościcki, E. K. (1994). Gender differences in completed and attempted suicides. Annals of epidemiology, 4(2), 152-158.
Naghavi, M. (2019). Global burden of disease self-harm collaborators: global, regional, and national burden of suicide mortality 1990 to 2016: systematic analysis for the global burden of disease study 2016. BMJ, 364(l94).
O’Connor, R. C., & Nock, M. K. (2014). The psychology of suicidal behaviour. The Lancet Psychiatry, 1(1), 73-85.
ScotPHO. (2020). Suicide: Scottish Trends. url: https://www.scotpho.org.uk/health-wellbeing-and-disease/suicide/data/scottish-trends/
Schrijvers, D. L., Bollen, J., & Sabbe, B. G. C. (2012). The gender paradox in suicidal behavior and its impact on the suicidal process. Journal of affective disorders, 138(1), 19-26.
Turecki, G., & Brent, D. A. (2016). Suicide and suicidal behaviour. The Lancet, 387(10024), 1227-1239.
Turecki, G., Brent, D. A., Gunnell, D., O’Connor, R. C., Oquendo, M. A., Pirkis, J., & Stanley, B. H. (2019). Suicide and suicide risk. Nature reviews Disease primers, 5(1), 1-22.