Zortea Tiago C, Kõlves Kairi, Russell Kirsten, Mathieu Sharna, Platt Stephen
Emergency Department Psychiatric Service, Oxford Health NHS Foundation Trust, John Radcliffe Hospital, Headley Way, Headington, Oxford OX3 9DU, United Kingdom; The Oxford Institute of Clinical Psychology Training & Research, Department of Experimental Psychology, University of Oxford, Isis Education Centre, Warneford Hospital, Oxford OX3 7J, United Kingdom; Suicidal Behaviour Research Laboratory, Institute of Health and Wellbeing, University of Glasgow, Pears Building, Clarice, Glasgow G12 8TB, Scotland, United Kingdom.
Australian Institute for Suicide Research and Prevention, WHO Collaborating Centre for Research and Training in Suicide Prevention, School of Applied Psychology, Griffith University, Messines Ridge Rd, Mount Gravatt, QLD 4122, Australia.
J Affect Disord. 2025 Apr 15;375:256-292. doi: 10.1016/j.jad.2025.01.114. Epub 2025 Jan 23.
This systematic review aims to update and extend the findings of an earlier review on the suicidogenic impact of natural disasters.
A systematic search of research published in 17 bibliographic databases was conducted (PROSPERO CRD42020216722). The review following PRISMA checklist identified 64 primary studies, published between 2012 and 2022, investigating the association between natural disasters and suicidal behaviour and ideation.
The majority of studies related to natural disasters in Japan, China, USA, India and Australia. Over half the studies (n = 39) investigated the impact of earthquakes. Other disasters included hurricanes, floods, tsunamis, droughts, wildfires, tornadoes and multiple disasters. Concerning suicide mortality (the most studied suicide-related outcome), there was variability in the suicidogenic impact of earthquakes depending on location, age, sex and time elapsed since the event. While suicide mortality appeared to increase following drought, investigations of hurricanes/tornadoes and floods found no evidence of a similar association. Findings relating to other suicide-related outcomes are more consistent, suggesting that exposure to droughts, hurricanes, tsunamis, floods, and other natural disasters is associated with increased risk of suicidal ideation and non-fatal suicidal behaviour. This association, however, is dependent on other factors, including the level of structural adversity in the exposed population (e.g., unemployment, poverty, food insecurity), individual vulnerabilities (e.g., physical and mental health), local resources, and availability of support.
Publications in languages other than English, French, Spanish, Italian and Portuguese may have been missed. The heterogeneity and methodological weakness of primary studies limited our ability to provide definitive responses to our research questions.
The considerable inconsistency in the findings reported across these studies, particularly relating to suicide mortality, is noteworthy. While this may be an artefact of methodological limitations, it is possible that there are substantive ('real') differences in the impact of natural disasters on suicidal behaviour linked to the type of disaster, the socioeconomic and sociocultural context, the type of suicidal behaviour, or other explanatory factors.
本系统评价旨在更新和扩展早期关于自然灾害自杀性影响的综述结果。
对17个文献数据库中发表的研究进行系统检索（PROSPERO CRD42020216722）。遵循PRISMA清单的综述确定了64项2012年至2022年间发表的主要研究，这些研究调查了自然灾害与自杀行为及自杀意念之间的关联。
大多数研究涉及日本、中国、美国、印度和澳大利亚的自然灾害。超过一半的研究（n = 39）调查了地震的影响。其他灾害包括飓风、洪水、海啸、干旱、野火、龙卷风以及多种灾害并发。关于自杀死亡率（研究最多的与自杀相关的结果），地震的自杀性影响因地点、年龄、性别以及事件发生后的时间而有所不同。虽然干旱后自杀死亡率似乎有所上升，但对飓风/龙卷风以及洪水的调查未发现类似关联的证据。与其他自杀相关结果的研究发现更为一致，表明遭受干旱、飓风、海啸、洪水及其他自然灾害与自杀意念及非致命自杀行为风险增加有关。然而，这种关联取决于其他因素,包括受灾人群的结构性逆境水平（如失业、贫困、粮食不安全）、个体脆弱性（如身心健康状况）、当地资源以及支持的可获得性。
可能遗漏了非英语、法语、西班牙语、意大利语和葡萄牙语的出版物。主要研究的异质性和方法学弱点限制了我们对研究问题给出确定性回答的能力。
这些研究报告结果存在相当大的不一致性，尤其是与自杀死亡率相关的结果，这一点值得注意。虽然这可能是方法学局限性造成的假象，但自然灾害对自杀行为的影响可能因灾害类型、社会经济和社会文化背景、自杀行为类型或其他解释因素而存在实质性（“真实”）差异。
