Patients with depressive disorders are especially prone to suicide risk. Among the clinical predictors of suicidality, those specifically related to depressive disorders have not been accurately detailed. Our aim was to conduct a systematic review and meta-analysis of studies reporting longitudinal predictors of suicidal ideation, suicide attempts and suicide death within depression, including diagnostic subtypes, symptoms, clinical course, and assessment scales. A systematic search of the literature between 2001 and 2022 identified 4422 references, among which 19 studies providing 45 different predictors of suicidality met the inclusion criteria. Random effects meta-analyses were performed for 22 predictors, three for suicidal ideation, eleven for suicide attempts and eight for suicide death. Heterogeneity and publication bias were inspected through I² tests and Egger’s tests respectively. Meta-analysis results showed that severity of hopelessness predicted suicidal ideation and suicide attempts. History of suicide attempts, suicidal ideation, severe depression, and psychotic symptoms predicted subsequent suicide attempts and suicide death. Time to full remission and sleep disturbances were also found as relevant predictors of future suicide behaviours. This review specifies which predictors of suicidality within the clinical features of depression will help clinicians and policy makers to better prevent suicide risk in patients with depressive disorders. Further longitudinal studies are needed to reliably assess the predictive ability of our results and to analyse other possible clinical predictors to prevent suicidality, especially with regard to suicidal ideation.

患有抑郁症的患者特别容易有自杀风险。在自杀倾向的临床预测因子中，那些与抑郁症特别相关的预测因子尚未得到准确详细说明。我们的目的是对报告抑郁症中自杀意念、自杀未遂和自杀死亡的纵向预测因素的研究进行系统评价和荟萃分析，包括诊断亚型、症状、临床病程和评估量表。对 2001 年至 2022 年间的文献进行系统检索，确定了 4422 篇参考文献，其中 19 项研究提供了 45 种不同的自杀倾向预测因子，符合纳入标准。对 22 个预测因子进行了随机效应荟萃分析，其中 3 个预测因子用于自杀意念，11 个预测因子用于自杀未遂，8 个预测因子用于自杀死亡。异质性和发表偏倚分别通过 I² 检验和 Egger 检验进行检查。荟萃分析结果显示，绝望的严重程度可预测自杀意念和自杀未遂。自杀未遂史、自杀意念、严重抑郁和精神病症状可预测随后的自杀未遂和自杀死亡。完全缓解的时间和睡眠障碍也被发现是未来自杀行为的相关预测因子。本综述具体说明了抑郁症临床特征中哪些自杀倾向的预测因素将帮助临床医生和政策制定者更好地预防抑郁症患者的自杀风险。需要进一步的纵向研究来可靠地评估我们结果的预测能力，并分析其他可能的临床预测因素，以防止自杀倾向，特别是在自杀意念方面。