Abstract
BackgroundGuidelines to encourage responsible reporting of suicide in news media are a key component of suicide prevention strategies. Recent guidelines have been developed on portrayal of suicide in entertainment media although the relationship between these portrayals and subsequent suicidal behaviour has received considerably less attention in research.MethodsWe conducted a systematic review and meta-analysis to examine the association between portrayals of suicide and suicide attempt in entertainment media and suicidal behaviour in the population. We searched PubMed, Scopus, Embase, PsycInfo, Web of Science and Google Scholar until April 20, 2021. We included studies adopting interrupted time series or single/multiple arm pre-post designs. Separate analyses were undertaken for studies of suicide and suicide attempts. We synthesized studies at moderate risk of bias and included studies at serious risk in a sensitivity analysis. Using a random-effects meta-analysis, we synthesized studies at moderate risk of bias and included studies at serious risk in a sensitivity analysis. Study registration: PROSPERO (CRD42020221333).FindingsTwelve studies met our inclusion criteria. Six studies were about suicide. Two of these were at moderate risk of bias and both examined the effects of the Netflix series 13 Reasons Why. The pooled rate ratio (RR) for these studies was 1·18 (95% CI 1·09 to 1·27, p<0·001). Heterogeneity was low (I2 = 29%). Six studies focused on suicide attempts, and two of them were at moderate risk of bias. The pooled RR for these two studies was 1·33 (95% CI 0·84 to 2·09, p = 0·22). Heterogeneity was high (I2 = 92%). Enhanced funnel plots indicated likely publication bias for studies of suicide and possible bias for studies of attempted suicide.InterpretationPortrayals of suicide in entertainment media may increase suicides and attempted suicide in the population. More studies that limit the potential sources of bias are needed to fully understand the circumstances under which fictional portrayals may influence suicidal behaviour.FundingNone.
Highlights
Our recent meta-analysis about suicide portrayals in news and information media and its association with subsequent suicides showed that media reporting about celebrity suicide was associated
This study provides important evidence supporting the use of recommendations for how to portray suicide and suicide attempt in entertainment media in a way that is appropriate, sensitive and minimises the risk of harm
The reasons for exclusion were because the outcome was not suicide or attempted suicide (3 studies), the media intervention was a non-fictional portrayal (2 studies), the article was a review study (6 studies) or a case study (2 studies), the study was descriptive only without sufficient data for abstraction (3 studies), no data was presented (1 study), data was collected annually and not fine-grained enough for our analysis (1 study), the study had strong overlap with data presented in another study (11 studies), the portrayal targeted a specific population subgroup (2 studies) or data was collected from only a subgroup of a specific method (1 study)
Summary
Our recent meta-analysis about suicide portrayals in news and information media and its association with subsequent suicides showed that media reporting about celebrity suicide was associated We undertook a systematic search of five databases (PubMed/ Medline, Embase, PsychInfo, Scopus, Web of Science) up to April 20, 2021 and searched the reference list of all relevant primary studies for studies reporting on portrayals of suicide in entertainment media. The individual studies showed differing results À some showed no association between portrayals of suicide and suicide attempt in entertainment media and subsequent suicidal behaviour, whereas others showed a harmful effect, especially for the recent Netflix show 13 Reasons Why. Guidelines to encourage responsible reporting of suicide in news media are a key component of suicide prevention strategies. Methods: We conducted a systematic review and meta-analysis to examine the association between portrayals of suicide and suicide attempt in entertainment media and suicidal behaviour in the population.
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