Psychological factors associated with suicide attempt and suicide death in Scotland: A systematic review

Background The identification of modifiable psychological factors associated with suicide attempt and suicide death is required for the development of effective preventive interventions. The aim of this systematic review was to identify studies which explored psychological factors in relation to suicidal behaviour in the Scottish population. Methods Search terms relating to (i) suicide, (ii) associated psychological factors, and (iii) Scotland were searched in five bibliographic databases. Of the 1,479 papers identified, eight were eligible for, and seven included in, this review. Results Fourteen psychological factors were found to be significantly associated with suicide attempt and suicide death, after controlling for possible confounders. These factors were grouped into the following headings: connectivity, mental health and internal factors. Limitations: Only a small number of papers were eligible for this review, of which only a subset used a prospective design. Conclusions Many of the factors associated with suicide attempt and death were consistent with key concepts highlighted in the Integrated Motivational-Volitional (IMV) Model, in particular all major drivers of suicide (defeat, entrapment and suicidal ideation) and several volitional factors, including connectivity with others. Further investigation of the psychological factors addressed in this review, using prospective designs and clarifying the intended outcome of self-injurious action, is encouraged.