Parental Mental Health and Suicidal Behavior as Predictors of Adolescent Suicidal Ideation and Attempts: A Systematic Review and Meta-Analysis

Background/Objectives: The intergenerational transmission of suicidal risk is a major global health concern. Evidence on the role of parental psychopathology, including suicidal behavior, in predicting adolescent suicidality remains inconsistent. This systematic review and meta-analysis aimed to synthesize recent findings and quantify these associations. Methods: The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the Population, Intervention/Exposure, Comparator, Outcome (PICO) framework. Searches (2015–2025) identified observational studies on parental suicidal behavior, depression, or psychiatric disorders predicting adolescent suicidal ideation or attempts. Thirty-one studies met eligibility, including over 12 million adolescents. Random-effects meta-analyses estimated pooled associations. Study quality was rated with the Newcastle–Ottawa Scale (NOS), and evidence certainty with the Grading of Recommendations, Assessment, Development and Evaluation (GRADE). Results: Both parental suicidal behavior and psychiatric disorders were consistently linked to increased adolescent suicidality. The pooled odds ratio (OR) for any parental psychopathology was 2.77 (95% confidence interval, CI: 2.22–3.47), indicating nearly a threefold higher risk of suicidal ideation or attempts in exposed youth. Subgroup analyses showed comparable risks for parental suicidal behavior (OR = 2.69, 95% CI: 2.30–3.14) and parental psychiatric morbidity (OR = 2.72, 95% CI: 2.05–3.60). Conclusions: Parental psychopathology, whether manifesting as suicidal behavior or psychiatric disorder, is a strong and universal risk factor for adolescent suicidal ideation and attempts. These findings underscore the need for family-centered prevention, early identification, and targeted interventions to disrupt intergenerational transmission of suicide risk.