Geographical and temporal variations in the prevalence of mental disorders in suicide: systematic review and meta-analysis
Abstract
Background In contrast to the previous studies reporting that most suicides occur among people with mental disorders, recent studies have reported various rates of mental disorders in suicide in different geographical regions. We aimed to comprehensively investigate the factors influencing the variation in the prevalence of mental disorders reported among suicide victims.Method The authors searched Embase, Medline, Web of Science, and the Cochrane Library to identify psychological autopsy studies reporting the prevalence of any mental disorders among suicide victims. A meta-regression analysis was conducted to identify the potential effects of geographical regions, the year of publication, measurements of personality disorder, measurements of comorbidity, and the ratio of females on the prevalence of mental disorders in addition to examining the heterogeneity across studies.Results From 4475 potentially relevant studies, 48 studies met eligibility criteria, with 6626 suicide victims. The studies from East Asia had a significantly lower mean prevalence (69.6% [95% CI=56.8 to 80.0]) than those in North America (88.2% [95% CI=79.7-93.5]) and South Asia (90.4% [95% CI=71.8-97.2]). The prevalence of any mental disorder decreased according to the year of publication (coefficients=-0.0715, p<0.001).Limitations Substantial heterogeneities were identified within all subgroup analyses.Conclusions The prevalence of mental disorders among suicide cases seemed relatively low in the East Asia region, and recently published studies tended to report a lower prevalence of mental disorders. The link between the risk factors and suicide in the absence of a mental disorder should be examined in different geographical and sociocultural contexts.
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Previous reviews of psychological autopsy studies have been limited in scope (primarily focusing on mental disorders) and samples (including selected populations such as psychiatric patients).
“To our knowledge, five previous reviews have quantitatively summarised findings from psychological autopsy studies,5–9 but these have been limited in scope (primarily focusing on mental disorders) and samples (including selected populations such as psychiatric patients).”
From Risk factors for suicide in adults: systematic review and meta-analysis of psychological autopsy studies (2022) · cites this paper as [8]
The inclusion of studies with controls who died by causes other than suicide is consistent with previous reviews of psychological autopsy studies.
“The inclusion of studies with controls who died by causes other than suicide is consistent with previous reviews of psychological autopsy studies.5–9”
From Risk factors for suicide in adults: systematic review and meta-analysis of psychological autopsy studies (2022) · cites this paper as [8]
Bibliographical searches were complemented by manual searches of reference lists of included studies and previous systematic reviews.
“Bibliographical searches were complemented by manual searches of reference lists of included studies and previous systematic reviews.5–9”
From Risk factors for suicide in adults: systematic review and meta-analysis of psychological autopsy studies (2022) · cites this paper as [8]
Previous reviews of psychological autopsy studies have not captured the breadth of individual-level risk factors for suicide and mainly focused on the contribution of mental disorders to suicide risk.
“First, previous reviews of psychological autopsy studies5–9 have not captured the breadth of individual-level risk factors for suicide, and instead mainly focused on the contribution of mental disorders to suicide risk.”
From Risk factors for suicide in adults: systematic review and meta-analysis of psychological autopsy studies (2022) · cites this paper as [8]
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- Authors
- Cho, S.-E., Na, K.-S., Cho, S.-J., Im, J.-S., & Kang, S.-G.
- Affiliations
- Gachon University Gil Medical Center (KR)
- Corresponding author
- Na, Kyoung-Sae
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2016-01
- Volume
- 190
- Pages
- 704-713
- ISSN
- 0165-0327 (ISSN-L)
- OpenAlex
- W2189883719
- Cited by
- 133
- References
- 91
- Citations by year
- 2026: 5 · 2025: 10 · 2024: 10 · 2023: 29 · 2022: 19 · 2021: 14 · 2020: 12 · 2019: 7 · 2018: 13 · 2017: 9 · 2016: 4
- FWCI
- 1.25
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Affective Disorders (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Centers for Disease Control and Prevention
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Social Sciences › Sociology and Political Science › Homicide, Infanticide, and Child Abuse
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- suicide, mental illness, prevalence, psychological autopsy, regional variation, temporal trends, personality disorders, comorbidities, sex ratio, East Asia, North America, South Asia
- MeSH terms
- Asia, Mental Disorders, Female, Humans, Male, Mental Health, North America, Personality Disorders, Psychotic Disorders, Risk Factors, Suicide, Global Health, Comorbidity, Prevalence
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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