Imran Nazish, Waqas Ahmed, Tahir Sania Mumtaz, Khan Roop Kiran, Ayub Maryam, Arshad Hareem, Rafiq Bariah, Naveed Sadiq
Nazish Imran, FRCPsych, MRCPsych, MHPE, PhD. Professor, Head Department of Child & Family Psychiatry, King Edward Medical University, Lahore, Pakistan.
Ahmed Waqas, PhD. Institute of Population Health, University of Liverpool, Liverpool, UK.
Pak J Med Sci. 2025 Jun;41(6):1799-1808. doi: 10.12669/pjms.41.6.12041.
Despite the alarming suicide burden, South Asia lacks sufficient literature and research. The objective of this systematic review and meta-analysis was to appraise the current evidence and estimate the prevalence of suicidal behaviors (ideation, plan, attempts, completed suicide and non-suicidal self-injury (NSSI)) among countries in South Asia. We systematically searched PubMed, PsycINFO, Web of Science, Scopus, and CINAHL for observational and longitudinal studies involving statistical analysis of suicidal behaviors in south Asian countries as per the PRISMA guidelines, without any limitations concerning age, gender, language, or year of publication. A random-effects model was used to synthesize prevalence data, and mixed-effects regression models were employed for subgroup analyses. Main outcome was lifetime, period and point prevalence of completed suicide, suicidal ideation, plan, and Non suicidal behaviors. A total of 27 studies representing data pertaining to suicidality and related behaviors in South Asian countries were included. The point prevalence of suicidal ideation was 16.7% (95% CI: 11.5% to 23.5%), suicidal plan was 13.6% (13.0% to 14.2%) and attempted suicide was 5.6% (95% CI: 3.5% - 9.0%). The 12-month period prevalence for suicidal ideation was noted to be 11.8% (95% CI: 5.5% to 23.6%), plan 3.6% (95% CI: 2.1% to 6.0%). Suicidal attempts 3.0% (95% CI: 1.6% to 5.5%), completed suicides 0.1% (95% CI: 0% to 0.8%) and non-suicidal behaviors 6.5% (95% CI: 0.7% to 39.5%). Lifetime prevalence ranged from suicidal thoughts 15.9% (95% CI:15.0% to 16.8%), suicidal plan 7.9% (95% CI: 6.2% to 10.1%), attempts 3.1% (95% CI: 1.2% to 7.8%) and non-suicidal behaviors 44.8% (95% CI: 41.2% to 48.4%). We found evidence of significant heterogeneity for suicidal behaviors in the studies included. The epidemiological burden of suicidal behaviors among countries in South Asia appears to be very high. Knowledge about the epidemiology of such behaviors is important for policymaking and to inform context specific interventions to reduce loss of lives caused by suicidal behaviors.
尽管自杀负担令人担忧,但南亚地区缺乏足够的文献和研究。本系统评价和荟萃分析的目的是评估现有证据,并估计南亚各国自杀行为(自杀意念、自杀计划、自杀未遂、自杀死亡和非自杀性自伤)的患病率。我们按照PRISMA指南,系统检索了PubMed、PsycINFO、科学网、Scopus和CINAHL数据库,以查找涉及南亚国家自杀行为统计分析的观察性和纵向研究,对年龄、性别、语言或出版年份没有任何限制。采用随机效应模型综合患病率数据,并使用混合效应回归模型进行亚组分析。主要结局是自杀死亡、自杀意念、自杀计划和非自杀行为的终生患病率、期间患病率和时点患病率。共纳入27项代表南亚国家自杀及相关行为数据的研究。自杀意念的时点患病率为16.7%(95%CI:11.5%至23.5%),自杀计划为13.6%(13.0%至14.2%),自杀未遂为5.6%(95%CI:3.5%至9.0%)。自杀意念的12个月期间患病率为11.8%(95%CI:5.5%至23.6%),自杀计划为3.6%(95%CI:2.1%至6.0%)。自杀未遂为3.0%(95%CI:1.6%至5.5%),自杀死亡为0.1%(95%CI:0%至0.8%),非自杀行为为6.5%(95%CI:0.7%至39.5%)。终生患病率范围为自杀意念15.9%(95%CI:15.0%至16.8%),自杀计划7.9%(95%CI:6.2%至10.1%),自杀未遂3.1%(95%CI:1.2%至7.8%),非自杀行为44.8%(95%CI:41.2%至48.4%)。我们发现纳入研究中的自杀行为存在显著异质性证据。南亚各国自杀行为的流行病学负担似乎非常高。了解此类行为的流行病学对于制定政策以及为减少自杀行为导致的生命损失提供针对具体情况的干预措施至关重要。