Suicide remains the second most common cause of death in young people aged 10–24 years and is a growing concern globally. The literature reports a vast number of factors that can predispose an adolescent to suicidality at an individual, relational, community, or societal level. There is limited high-level research identifying and understanding these risk and protective factors of adolescent suicidality. The present study used an umbrella review and meta-analysis to synthesize evidence from the review literature in the past 20 years on risk and protective factors of self-harm and suicidality (behavior and ideation) in adolescents. The umbrella review included 33 quantitative reviews with 1149 individual studies on suicidality and self-harm. Based on the data synthesis, it compared the public health impact of exposure on the population of the identified exposure. Bullying victimization was the most attributed environmental exposure for suicidality. The other identified significant school and individual factors were sleeping disturbance, school absenteeism, and exposure to antidepressants. Several significant vulnerable young populations were identified with significantly higher prevalence of suicidality, including lesbian, gay, bisexual, transgender, queer (or questioning) youth and those with mental health disorders, problem behaviors, previous suicidality, self-harm, and gender (female). A person-centered approach emphasizing connectedness and bully-free school environments should be a priority focus for schools, health professionals, and public health policymakers.

自杀仍然是 10-24 岁年轻人第二大常见死因，并且在全球范围内日益受到关注。文献报道了在个人、关系、社区或社会层面上导致青少年自杀倾向的大量因素。识别和理解青少年自杀的这些风险和保护因素的高水平研究有限。本研究采用总体综述和荟萃分析，综合了过去 20 年有关青少年自残和自杀（行为和意念）的风险和保护因素的综述文献中的证据。总体审查包括 33 项定量审查，涉及 1149 项关于自杀和自残的个人研究。根据数据综合，它比较了暴露对已识别暴露人群的公共卫生影响。欺凌受害是导致自杀的最主要原因。另一个确定的重要学校和个人因素是睡眠障碍、缺勤和接触抗抑郁药物。一些重要的弱势年轻人群体的自杀率明显较高，包括女同性恋、男同性恋、双性恋、跨性别者、酷儿（或有疑问的）青少年以及患有精神健康障碍、问题行为、有自杀倾向、自残和性别（女性）的青少年。 ）。强调连通性和无欺凌学校环境的以人为本的方法应该成为学校、卫生专业人员和公共卫生政策制定者的优先关注点。