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Title:	Internalizing and externalizing symptoms and suicidal behaviour in young people: a systematic review and meta-analysis of longitudinal studies
Author:	Soto-Sanz, Victoria; Castellví Obiols, Pere; Piqueras, José Antonio; Rodríguez-Marín, Jesús; Rodríguez Jimenez, Tiscar; Miranda-Mendizábal, Andrea; Parés Badell, Oleguer; Almenara, José; Alonso, Iciar; Blasco Cubedo, Maria Jesús; Cebrià, Ana Isabel; Gabilondo Cuéllar, Andrea; Gili, Margalida; Lagares, Carolina; Roca, Miquel; Alonso Caballero, Jordi
Notes:	Objective: To assess internalizing and externalizing symptoms as risk factors for suicidal behaviour and suicide among adolescents and young adults. Method: We conducted a systematic review of articles published until January 2017. We identified 26 883 potential papers; 1701 full-text articles were assessed for eligibility, of which 1479 were excluded because of methodological reasons. Diverse meta-analyses were performed for each group of symptoms. Odds ratios (ORs) and 95% confidence intervals (95% CI) or beta coefficients for categorical variables, and effect size (ES) were calculated for continuous variables. Results: Finally, 41 studies were included, involving participants aged 12-26 years for a systematic review, and 24 articles were included for meta-analysis. The meta-analysis showed that youths with any internalizing (ES = 0.93) or externalizing symptoms (ES = 0.76 and OR = 2.59) were more likely to attempt suicide in future. This effect was also seen in depression symptoms (OR = 6.58 and ES = 1.00), legal problems (OR = 3.36), and anxiety (ES = 0.65). Conclusion: Reported internalizing and externalizing symptoms are predictors of suicide behaviour in young people; therefore, the detection and management of these symptoms in young populations could be a crucial strategy for preventing suicidality in this group.
Subject(s):	-Símptomes externalitzadors -Símptomes d’interiorització -Metaanàlisi -Comportament suïcida -Revisió sistemàtica -Joves -Síntomas externalizadores -Síntomas de interiorización -Metaanálisis -Comportamiento suicida -Revisión sistemática -Jóvenes -Outsourcing symptoms -Symptoms of internalization -Meta-analysis -Suicidal behavior -Systematic review -Teens -61 -616.89
Rights:	This is the pre-peer reviewed version of the following article: Soto-Sanz V, Castellví P, Piqueras JA, Rodríguez-Marín J, Rodríguez-Jiménez T, Miranda-Mendizábal A. et al. Internalizing and externalizing symptoms and suicidal behaviour in young people: a systematic review and meta-analysis of longitudinal studies. Acta Psychiatr Scand. 2019 Jul;140(1):5-19, which has been published in final form at http://dx.doi.org/10.1111/acps.13036. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.
Document type:	Article Article - Accepted version
Published by:	Wiley-Blackwell
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