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Suicide rates among people with serious mental illness: a systematic review and meta-analysis

Published online by Cambridge University Press:  06 May 2021

Xue-Lei Fu
Affiliation:
School of Medicine, Nantong University, Nantong, Jiangsu, 226001PR China
Yan Qian
Affiliation:
Affiliated Hospital of Nantong University, Nantong, Jiangsu, 226001PR China
Xiao-Hong Jin
Affiliation:
Affiliated Hospital of Nantong University, Nantong, Jiangsu, 226001PR China
Hai-Rong Yu
Affiliation:
Affiliated Hospital of Nantong University, Nantong, Jiangsu, 226001PR China
Hua Wu
Affiliation:
School of Medicine, Nantong University, Nantong, Jiangsu, 226001PR China
Lin Du
Affiliation:
School of Medicine, Nantong University, Nantong, Jiangsu, 226001PR China
Hong-Lin Chen*
Affiliation:
School of Public Health, Nantong University, Nantong, Jiangsu, 226019PR China
Ya-Qin Shi*
Affiliation:
School of Medicine, Nantong University, Nantong, Jiangsu, 226001PR China
*
Author for correspondence: Hong-Lin Chen, E-mail: honglinyjs@126.com; Ya-Qin Shi, E-mail: shiyaqin@ntu.edu.cn
Author for correspondence: Hong-Lin Chen, E-mail: honglinyjs@126.com; Ya-Qin Shi, E-mail: shiyaqin@ntu.edu.cn

Abstract

Background

People with serious mental illness are at great risk of suicide, but little is known about the suicide rates among this population. We aimed to quantify the suicide rates among people with serious mental illness (bipolar disorder, major depression, or schizophrenia).

Methods

PubMed and Web of Science were searched to identify studies published from 1 January 1975 to 10 December 2020. We assessed English-language studies for the suicide rates among people with serious mental illness. Random-effects meta-analysis was used. Changes in follow-up time and the suicide rates were presented by a locally weighted scatter-plot smoothing (LOESS) curve. Suicide rate ratio was estimated for assessments of difference in suicide rate by sex.

Results

Of 5014 identified studies, 41 were included in this analysis. The pooled suicide rate was 312.8 per 100 000 person-years (95% CI 230.3–406.8). Europe was reported to have the highest pooled suicide rate of 335.2 per 100 000 person-years (95% CI 261.5–417.6). Major depression had the highest suicide rate of 534.3 per 100 000 person-years (95% CI 30.4–1448.7). There is a downward trend in suicide rate estimates over follow-up time. Excess risk of suicide in males was found [1.90 (95% CI 1.60–2.25)]. The most common suicide method was poisoning [21.9 per 100 000 person-years (95% CI 3.7–50.4)].

Conclusions

The suicide rates among people with serious mental illness were high, highlighting the requirements for increasing psychological assessment and monitoring. Further study should focus on region and age differences in suicide among this population.

Type
Original Article
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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