Worldwide prevalence of suicidal ideation and suicide plan among people with schizophrenia: a meta-analysis and systematic review of epidemiological surveys

W Bai,Y T Xiang,Q E Zhang,B J Hall,W W Rao,Y Y Jiang,T Cheung,Z H Liu

doi:10.1038/s41398-021-01671-6

Abstract

Schizophrenia is a severe psychiatric disorder with high premature mortality rates. This is a meta-analysis and systematic review of the prevalence of suicidal ideation (SI) and suicide plan (SP) among people with schizophrenia. PubMed, Web of Science, Embase, and PsycINFO were systematically searched from their respective inception to October 10, 2020. Data on prevalence of SI and/or SP were synthesized using the random effects model. Twenty-six studies covering 5079 people with schizophrenia were included for meta-analysis. The lifetime and point prevalence of SI were 34.5% (95% CI: 28.2−40.9%), and 29.9% (95% CI: 24.2−35.6%), respectively. The lifetime prevalence of SP was 44.3% and the point prevalence of SP ranged between 6.4 and 13%. Subgroup and meta-regression analyses revealed that source of patients, survey countries, and sample size were significantly associated with the point prevalence of SI, while male proportion and quality assessment scores were significantly associated with the lifetime and point prevalence of SI. Survey time and mean age were significantly associated with lifetime prevalence of SI. Both SI and SP are common in people living with schizophrenia, especially in males and inpatients. Routine screening and effective interventions for SI and SP should be implemented in this population.

Highlights

Schizophrenia is a severe psychiatric disorder characterized by cognitive impairment and behavioral dysfunction [1]
Effective interventions targeting patients with schizophrenia who are at high risk of suicidal ideation (SI) and suicide plan (SP) are a priority for reducing the likelihood of future suicide [40]
To the best of our knowledge, this was the first study that examined the prevalence of SI and SP among people living with schizophrenia globally

Summary

Introduction

Schizophrenia is a severe psychiatric disorder characterized by cognitive impairment and behavioral dysfunction [1]. A meta-analysis of 19 studies on the prevalence of suicide-related behaviors in schizophrenia in China [15] found that the pooled lifetime prevalence of SI and SA were 25.8% (95% CI: 14.7−41.1%) and 14.6% (95% CI: 9.1−22.8%), respectively [15]. Another meta-analysis of 81 studies [16] on the risk of subsequent completed suicide found that people living with schizophrenia who reported SI had a 5.8-fold higher risk of future suicide than those without SI

Methods

Results

Conclusion