Suicidality is highly prevalent in autistic people without co-occurring intellectual disabilities, and high autistic traits are found in adults who have attempted suicide. However, prevalence rates for both autistic and possibly autistic people have not been synthesised meta-analytically. To (1) calculate pooled prevalence estimates of suicidality in autistic people and possibly autistic people without co-occurring intellectual disability; (2) evaluate the influence of participant and study level characteristics on heterogeneity; and (3) determine the quality of evidence. Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines were followed. PsycINFO, Embase, MEDLINE and Web of Science were systematically searched from 1992 to January 25, 2022. Empirical quantitative studies reporting prevalence of suicidal ideation, suicide plans, or suicide attempts and behaviours were considered for inclusion. Random effects models were used to estimate pooled prevalence of each suicidality outcome with 95% confidence intervals. Heterogeneity was explored using sensitivity and moderator analyses. Data from 48,186 autistic and possibly autistic participants in 36 primary studies were meta-analysed. Pooled prevalence of suicidal ideation was 34.2% (95% CI 27.9–40.5), suicide plans 21.9% (13.4–30.4), and suicidal attempts and behaviours 24.3% (18.9–29.6). High levels of heterogeneity (I2 > 75) were observed in all three analyses. Estimates did not differ between autistic or possibly autistic samples. Geographical location (p = 0.005), transgender or gender non-conforming samples (p < 0.001) and type of report (p < 0.001) significantly moderated suicidal ideation, whereas age group (p = 0.001) and measure of suicidality (p = 0.001) significantly moderated suicide plans. There was a significant association between the proportion of male participants and prevalence of suicide plans, with a decrease in the proportion of males for every unit change of suicide plan prevalence (p = 0.013). No variables were found to moderate estimates of suicide attempts and behaviours. The results confirm suicidality is highly prevalent in both autistic and possibly autistic people without co-occurring intellectual disability and highlights potential moderators. Possibly autistic individuals require more attention in clinical and research considerations going forward to further understand and prevent suicide in both groups.

中文翻译：

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对自闭症和可能患有自闭症但没有同时出现智力障碍的人的自杀倾向的系统回顾和荟萃分析

自杀倾向在没有同时发生智力障碍的自闭症患者中非常普遍，并且在试图自杀的成年人中发现了高度自闭症特征。然而，自闭症和可能患有自闭症的人的患病率尚未通过荟萃分析进行综合。(1) 计算自闭症患者和可能没有同时出现智力障碍的自闭症患者自杀倾向的合并流行率估计值；(2) 评估参与者和研究水平特征对异质性的影响；(3) 确定证据的质量。遵循系统评价和荟萃分析指南的首选报告项目。从 1992 年到 2022 年 1 月 25 日，系统地搜索了 PsycINFO、Embase、MEDLINE 和 Web of Science。实证定量研究报告了自杀意念的流行程度，自杀计划或自杀企图和行为被考虑纳入。随机效应模型用于估计每个自杀结局的合并流行率和 95% 置信区间。使用敏感性和调节剂分析探索异质性。对来自 36 项主要研究的 48,186 名自闭症和可能患有自闭症的参与者的数据进行了荟萃分析。自杀意念的合并流行率为 34.2%（95% CI 27.9-40.5），自杀计划为 21.9%（13.4-30.4），自杀企图和行为为 24.3%（18.9-29.6）。在所有三项分析中均观察到高水平的异质性 (I2 > 75)。自闭症或可能患有自闭症的样本之间的估计值没有差异。地理位置 (p = 0.005)、跨性别或性别不合格样本 (p < 0.001) 和报告类型 (p < 0.001) 显着缓和自杀意念，而年龄组 (p = 0.001) 和自杀倾向 (p = 0.001) 显着缓和自杀计划。男性参与者的比例与自杀计划流行率之间存在显着关联，自杀计划流行率每发生一个单位变化，男性比例就会下降 (p = 0.013)。没有发现任何变量可以调节对自杀未遂和行为的估计。结果证实，自杀在自闭症和可能患有自闭症但没有同时发生智力障碍的人中非常普遍，并突出了潜在的调节因素。可能自闭症患者在临床和研究方面需要更多关注，以进一步了解和预防这两个群体的自杀。男性参与者的比例与自杀计划流行率之间存在显着关联，自杀计划流行率每发生一个单位变化，男性比例就会下降 (p = 0.013)。没有发现任何变量可以调节对自杀未遂和行为的估计。结果证实，自杀在自闭症和可能患有自闭症但没有同时发生智力障碍的人中非常普遍，并突出了潜在的调节因素。可能自闭症患者在临床和研究方面需要更多关注，以进一步了解和预防这两个群体的自杀。男性参与者的比例与自杀计划流行率之间存在显着关联，自杀计划流行率每发生一个单位变化，男性比例就会下降 (p = 0.013)。没有发现任何变量可以调节对自杀未遂和行为的估计。结果证实，自杀在自闭症和可能患有自闭症但没有同时发生智力障碍的人中非常普遍，并突出了潜在的调节因素。可能自闭症患者在临床和研究方面需要更多关注，以进一步了解和预防这两个群体的自杀。没有发现任何变量可以调节对自杀未遂和行为的估计。结果证实，自杀在自闭症和可能患有自闭症但没有同时发生智力障碍的人中非常普遍，并突出了潜在的调节因素。可能自闭症患者在临床和研究方面需要更多关注，以进一步了解和预防这两个群体的自杀。没有发现任何变量可以调节对自杀未遂和行为的估计。结果证实，自杀在自闭症和可能患有自闭症但没有同时发生智力障碍的人中非常普遍，并突出了潜在的调节因素。可能自闭症患者在临床和研究方面需要更多关注，以进一步了解和预防这两个群体的自杀。