SynthesisPloS one2021
Substance use disorders and suicidality in youth: A systematic review and meta-analysis with a focus on the direction of the association.
Synthesis in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
29 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Substance Use Disorders in Adolescents: A Qualitative Systematic Review.Journal of advanced nursing · 2026Pooled it
- Suicidality risk after using cannabis and cannabinoids: An umbrella review.Dialogues in clinical neuroscience · 2023Pooled it
- eHealth Interventions to Treat Substance Use in Pregnancy: A Systematic Review and Meta-Analysis.International journal of environmental research and public health · 2021Pooled it
- Trial
- Adolescent suicidal distress and adult mental health: findings from a 25-year population based cohort.European child & adolescent psychiatry · 2026Article
- Trends in Associations Between Substance Use and Suicidality and Patterns of Current Substance Use in U.S. Adolescents: A Repeated Cross-Sectional Study.American journal of preventive medicine · 2026Article
- Cross-Sectional Differences in Self-Harm Methods Across Childhood and Adolescence.JAMA network open · 2026Article
- Developmental variation in basal ganglia tissue iron, neurocognitive functioning, and impulsivity is associated with substance use trajectories in youth.Nature communications · 2026Article
- Clinical and demographic characteristics of adolescents, emerging adults, and young adults presenting to an emergency department following a suicide attempt.JCPP advances · 2026Article
- Psychotic symptoms and suicidality: combined findings from a high-risk and a clinical cohort of adolescents.European child & adolescent psychiatry · 2026Article
- Article
- Profiles of Quality of Outpatient Care Received Among Adolescents and Young Adults with Health Mental Disorders.The Psychiatric quarterly · 2026Article
- Developmental variation in dopamine neurobiology, neurocognitive functioning, and impulsivity shape substance use trajectories in youth.bioRxiv : the preprint server for biology · 2025Article
- Suicidal Ideation and Substance Use Among Middle and High School Students in Morocco.Healthcare (Basel, Switzerland) · 2025Article
- Substance Use Problems and Death of Despair in a 32-Year Follow-Up Study of Suicide Attempters Examined at a Medical Emergency Inpatient Unit.International journal of environmental research and public health · 2025Article
- Physical activity and risk behaviors among adolescents: the mediating roles of diet, sleep, mental health, and substance use.Frontiers in public health · 2025Article
- Intersection of adverse childhood experiences, suicide and overdose prevention.Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention · 2024Review
- The InterSECT Framework: a proposed model for explaining population-level trends in substance use and emotional concerns.American journal of epidemiology · 2024Article
- Suicidal thoughts and behaviors among untreated illicit substance users: a population-based study.Harm reduction journal · 2024Article
- Predictors and Prevalence of Alcohol and Cannabis Co-use Among Filipino Adolescents: Evidence From a School-based Student Health Survey.Journal of preventive medicine and public health = Yebang Uihakhoe chi · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
Abstract
backgroundReviews and meta-analyses suggest that substance use and suicidality (i.e., suicidal ideations and attempts) are associated in youth, but the direction of this association remains unclear. Theoretically, the secondary psychiatric disorder hypothesis (SPDH) posits that substance use leads to suicidality, while the secondary substance use disorder hypothesis (SSUDH) posits that suicidality leads to substance use. To clarify these associations, this meta-analysis systematically reviewed studies that examined the prospective associations between SUDs and suicidality in youth (age 25 and younger) and compared results according to the direction of the association.
methodsWeb of Science, Embase, PsycINFO, PubMed, Medline and ProQuest Dissertations & Theses Global were searched from inception to March 8, 2020, and 55 effect sizes from 23 samples were included and analyzed using a three-level meta-analysis.
resultsSUDs significantly predicted subsequent suicidality (OR = 2.16, 95%CI 1.57-2.97), suicidality significantly predicted subsequent SUDs (OR = 2.16, 95%CI 1.53-3.04), and these effect sizes did not differ (p = 0.49).
conclusionsConsidering that 65% of reviewed studies only examined the SPDH, this review highlights that more attention should be given to the SSUDH, and that studies should examine bidirectional associations between SUDs and suicidality across time. Clinically, because SUDs and suicidality were found to influence each other, results suggest that mental health and SUDs should ideally be detected and treated early, and that co-occurring disorders should be assessed and treated concomitantly.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.