Suicide-related behaviours in schizophrenia in China: a comprehensive meta-analysis
Open accessAbstract
Aims.: Suicide-related behaviours are common in schizophrenia and are significantly associated with premature death. The objective of this meta-analysis study was to estimate the pooled prevalence of suicide-related behaviours in schizophrenia patients in China. Methods.: The relevant literature was searched systematically via the relevant electronic databases (PubMed, Embase, PsycINFO, Chinese National Knowledge Infrastructure, Wanfang Databases and Chinese Biological Medical Literature Database) from their inception until 14 September 2016. Only original studies that reported the prevalence of suicide-related behaviours including suicidal ideation (SI), suicide plan, suicide attempt (SA) and completed suicide were selected. Results.: Nineteen articles met the inclusion criteria and were analysed. 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. The 1-month prevalence of SI was 22.0% (95% CI 18.2–26.4%). Subgroup analyses of lifetime SI and SA showed that gender, sample size, survey year, study location and source of patients have no significant mediating effects on the results. Conclusions.: Suicide-related behaviours are common in Chinese schizophrenia patients. Due to the high mortality risk, regular screening and effective suicide prevention programmes are warranted.
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The vast majority of attempted and completed suicides occur in people with mental disorders, with mood disorders being the most frequently associated with suicidal behavior.
“epidemiological studies indicate that the vast majority of attempted and completed suicides occur in people with mental disorders with mood disorders being the most frequently associated with SB [2, 3].”
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Cites
Measuring inconsistency in meta-analyses
Higgins, J. P. T., Thompson, S. G., Deeks, J. J., & Altman, D. G. (2003) · BMJ · doi:10.1136/bmj.327.7414.557 · Cited by 63,139 · see citing works
Bias in meta-analysis detected by a simple, graphical test
Egger, M., Smith, G. D., Schneider, M., & Minder, C. (1997) · BMJ · doi:10.1136/bmj.315.7109.629 · Cited by 56,722 · see citing works
Dermyshi, E., Wang, Y., Yan, C., Hong, W., Qiu, G., Gong, X., & Zhang, T. (2017) · Neonatology · doi:10.1159/000454668 · Cited by 24,577 · see citing works
von Elm, E., Altman, D. G., Egger, M., Pocock, S. J., Gøtzsche, P. C., Vandenbroucke, J. P., & Initiative, F. T. S. (2007) · PLoS Medicine · doi:10.1371/journal.pmed.0040296 · Cited by 23,020 · see citing works
von Elm, E., Altman, D. G., Egger, M., Pocock, S. J., Gøtzsche, P. C., & Vandenbroucke, J. P. (2007) · The Lancet · doi:10.1016/s0140-6736(07)61602-x · Cited by 21,320 · see citing works
Stroup, D. F. (2000) · JAMA · doi:10.1001/jama.283.15.2008 · Cited by 20,623 · see citing works
Cross-national prevalence and risk factors for suicidal ideation, plans and attempts
Nock, M. K., Borges, G., Bromet, E. J., Alonso, J., Angermeyer, M., Beautrais, A., Bruffaerts, R., Chiu, W. T., de Girolamo, G., Gluzman, S., et al. (2008) · British Journal of Psychiatry · doi:10.1192/bjp.bp.107.040113 · Cited by 2,654 · see citing works
Prevalence of and Risk Factors for Lifetime Suicide Attempts in the National Comorbidity Survey
Kessler, R. C., Borges, G., & Walters, E. E. (1999) · Archives of General Psychiatry · doi:10.1001/archpsyc.56.7.617 · Cited by 2,514 · see citing works
van Os, J., & Kapur, S. (2009) · The Lancet · doi:10.1016/s0140-6736(09)60995-8 · Cited by 1,971 · see citing works
Kessler, R. C. (2005) · JAMA · doi:10.1001/jama.293.20.2487 · Cited by 1,071 · see citing works
Phillips, M. R., Zhang, J., Shi, Q., Song, Z., Ding, Z., Pang, S., Li, X., Zhang, Y., & Wang, Z. (2009) · The Lancet · doi:10.1016/s0140-6736(09)60660-7 · Cited by 1,063 · see citing works
The Lifetime Risk of Suicide in Schizophrenia: A Reexamination
Palmer, B. A., Pankratz, V. S., & Bostwick, J. M. (2005) · Archives of General Psychiatry · doi:10.1001/archpsyc.62.3.247 · Cited by 1,026 · see citing works
Review: Suicide and schizophrenia: a systematic review of rates and risk factors
Hor, K., & Taylor, M. (2010) · Journal of Psychopharmacology · doi:10.1177/1359786810385490 · Cited by 853 · see citing works
Suicide rates in China, 1995–99
Phillips, M. R., Li, X., & Zhang, Y. (2002) · The Lancet · doi:10.1016/s0140-6736(02)07954-0 · Cited by 800 · see citing works
Schizophrenia and suicide: Systematic review of risk factors
Hawton, K. E., Sutton, L., Haw, C., Sinclair, J., & Deeks, J. J. (2005) · The British Journal of Psychiatry · doi:10.1192/bjp.187.1.9 · Cited by 777 · see citing works
Completed Suicide After a Suicide Attempt: A 37-Year Follow-Up Study
Suominen, K. H., Isometsä, E. T., Suokas, J. T., Haukka, J. K., Achté, K., & Lönnqvist, J. K. (2004) · American Journal of Psychiatry · doi:10.1176/appi.ajp.161.3.562 · Cited by 636 · see citing works
Lifetime risk of suicide for affective disorder, alcoholism and schizophrenia
Inskip, H., Harris, C., & Barraclough, B. (1998) · British Journal of Psychiatry · doi:10.1192/bjp.172.1.35 · Cited by 579 · see citing works
Schizophrenics Kill Themselves Too: A Review of Risk Factors for Suicide
Caldwell, C. B., & Gottesman, I. I. (1990) · Schizophrenia Bulletin · doi:10.1093/schbul/16.4.571 · Cited by 511 · see citing works
CONDITIONS PREDISPOSING TO SUICIDE: A REVIEW
MILES, C. P. (1977) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-197704000-00002 · Cited by 504 · see citing works
Phillips, M. R., Li, X., Zhang, Y., & Eddleston, M. (2002) · The Lancet · doi:10.1016/s0140-6736(02)09269-3 · Cited by 382 · see citing works
Suicide risk in schizophrenia: learning from the past to change the future
Pompili, M., AMADOR, X. F., Girardi, P., Harkavy‐Friedman, J., Harrow, M., Kaplan, K. J., Krausz, M. R., Lester, D., Meltzer, H. Y., Modestin, J., et al. (2007) · Annals of General Psychiatry · doi:10.1186/1744-859x-6-10 · Cited by 363 · see citing works
Crisp, A. H., Gelder, M., Goddard, E., & Meltzer, H. (2005) · PubMed Central · Cited by 357 · see citing works
Symptoms, subtype, and suicidality in patients with schizophrenia spectrum disorders
Fenton, W. S., McGlashan, T. H., Victor, B. J., & Blyler, C. R. (1997) · American Journal of Psychiatry · doi:10.1176/ajp.154.2.199 · Cited by 325 · see citing works
Suicide rates in China from 2002 to 2011: an update
Wang, C.-W., Chan, C. L. W., & Yip, P. S. F. (2014) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-013-0789-5 · Cited by 279 · see citing works
Leo, D. D., Cerin, E., Spathonis, K., & Burgis, S. (2005) · Journal of Affective Disorders · doi:10.1016/j.jad.2005.02.001 · Cited by 252 · see citing works
Risk factors for suicide in young people suffering from schizophrenia: a long-term follow-up study
Binder, M. D., McKenzie, K. J., & Peuskens, J. (2001) · Schizophrenia Research · doi:10.1016/s0920-9964(00)00003-7 · Cited by 245 · see citing works
Suicide among schizophrenics: A review
Drake, R. E., Whitaker, A., Gates, C., & Cotton, P. G. (1985) · Comprehensive Psychiatry · doi:10.1016/0010-440x(85)90053-7 · Cited by 240 · see citing works
Harkavy‐Friedman, J., Restifo, K., Malaspina, D., Kaufmann, C. A., AMADOR, X. F., Yale, S. A., & Gorman, J. M. (1999) · American Journal of Psychiatry · doi:10.1176/ajp.156.8.1276 · Cited by 195 · see citing works
Risk factors for suicide in schizophrenia: systematic review and clinical recommendations
Popović, D., Benabarre, A., Crespo, J. M., Goikolea, J. M., González-Pinto, A. M., Gutiérrez-Rojas, L., Montes, J. M. G., & Vieta, E. (2014) · Acta Psychiatrica Scandinavica · doi:10.1111/acps.12332 · Cited by 177 · see citing works
Lifetime prevalence of suicide ideation, plan, and attempt in metropolitan China
Lee, S., Fung, S. C., Tsang, A., Liu, Z. R., Huang, Y., He, Y. L., Zhang, M. Y., Shen, Y., Nock, M. K., & Kessler, R. C. (2007) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.2007.01064.x · Cited by 177 · see citing works
Prevalence of suicidal ideation and suicide attempts in the general population of China
Cao, X., Zhong, B., Xiang, Y., Ungvari, G. S., Lai, K. Y. C., Chiu, H. F., & Caine, E. D. (2015) · The International Journal of Psychiatry in Medicine · doi:10.1177/0091217415589306 · Cited by 172 · see citing works
Self-citationCarlborg, A., Winnerbäck, K., Jönsson, E. G., Jokinen, J., & Nordström, P. (2010) · Expert Review of Neurotherapeutics · doi:10.1586/ern.10.82 · Cited by 154 · see citing works
Phillips, M. R., Yang, G., Li, S., & Li, Y. (2004) · The Lancet · doi:10.1016/s0140-6736(04)17061-x · Cited by 147 · see citing works
Calati, R., Porcelli, S., Giegling, I., Hartmann, A. M., Möller, H., Ronchi, D. D., Serretti, A., & Rujescu, D. (2010) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2010.07.004 · Cited by 146 · see citing works
Rates and characteristics of elderly suicide in China, 2013–14
Zhong, B., Chiu, H. F. K., & Conwell, Y. (2016) · Journal of Affective Disorders · doi:10.1016/j.jad.2016.09.003 · Cited by 144 · see citing works
Completed suicide in schizophrenia: Evidence from a case-control study
Pompili, M., Lester, D., Grispini, A., Innamorati, M., Calandro, F., Iliceto, P., Pisa, E. D., Tatarelli, R., & Girardi, P. (2009) · Psychiatry Research · doi:10.1016/j.psychres.2008.03.018 · Cited by 138 · see citing works
The prevalence of schizophrenia in mainland C hina: evidence from epidemiological surveys
Long, J., Huang, G., Liang, W., Liang, B., Chen, Q., Xie, J., Jiang, J., & Su, L. (2014) · Acta Psychiatrica Scandinavica · doi:10.1111/acps.12296 · Cited by 137 · see citing works
Suicide in China: Unique demographic patterns and relationship to depressive disorder
Law, S., & Liu, P. (2008) · Current Psychiatry Reports · doi:10.1007/s11920-008-0014-5 · Cited by 120 · see citing works
Prevalence of suicide ideation, plans, and attempts and related risk factors in Italy:
Scocco, P., de Girolamo, G., Vilagut, G., & Alonso, J. (2007) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2007.08.004 · Cited by 108 · see citing works
Winsper, C., Ganapathy, R., Marwaha, S., Large, M. M. B., Birchwood, M. J., & Singh, S. P. (2013) · Acta Psychiatrica Scandinavica · doi:10.1111/acps.12113 · Cited by 108 · see citing works
Ma, X., Xiang, Y., Cai, Z., Li, S., Xiang, Y., Guo, H.-L., Hou, Y., Li, Z.-B., Li, Z.-J., Tao, Y., et al. (2009) · Australian & New Zealand Journal of Psychiatry · doi:10.1080/00048670802607170 · Cited by 90 · see citing works
Self-citationPrevalence of schizophrenia in China between 1990 and 2010.
Chan, K. Y., Zhao, F.-F., Meng, S., Demaio, S., Reed, C., Τheodoratou, E., Campbell, H. J., Wang, W., & Rudan, I. (2015) · PubMed Central · doi:10.7189/jogh.05.010410 · Cited by 87 · see citing works
Meta‐analyses suggest association between COMT, but not HTR1B, alleles, and suicidal behavior
Kia-Keating, B. M., Glatt, S. J., & Tsuang, M. T. (2007) · American Journal of Medical Genetics Part B Neuropsychiatric Genetics · doi:10.1002/ajmg.b.30551 · Cited by 86 · see citing works
Suicide in schizophrenia: findings from a national clinical survey
HUNT, I. M., KAPUR, N., WINDFUHR, K., ROBINSON, J., BICKLEY, H., FLYNN, S., PARSONS, R., BURNS, J., SHAW, J., & APPLEBY, L. (2006) · Journal of Psychiatric Practice · doi:10.1097/00131746-200605000-00002 · Cited by 84 · see citing works
Mortality in people with schizophrenia in rural China
Ran, M., Chen, E. Y. H., Conwell, Y., Chan, C., YIP, P. S. F., Xiang, M., & Caine, E. D. (2007) · The British Journal of Psychiatry · doi:10.1192/bjp.bp.106.025155 · Cited by 75 · see citing works
Yan, F., Xiang, Y., Hou, Y., Ungvari, G. S., Dixon, L. B., Chan, S. S. M., Lee, E. H. M., Li, W.-Y., Li, W., Zhu, Y.-L., et al. (2012) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-012-0555-0 · Cited by 67 · see citing works
Self-citationNeurocognitive functioning and suicidality in schizophrenia spectrum disorders
Barrett, E. A., Sundet, K. S., Simonsen, C., Agartz, I., Lorentzen, S., Mehlum, L. I., Mork, E., Andreassen, O. A., & Melle, I. S. (2010) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2010.06.001 · Cited by 62 · see citing works
Prevalence of autism spectrum disorders among children in China: a systematic review.
Wan, Y., Hu, Q., Li, T., Jiang, L., Du, Y., Feng, L., Wong, J. C. M., & Li, C. (2013) · PubMed Central · doi:10.3969/j.issn.1002-0829.2013.02.003 · Cited by 61 · see citing works
Xiang, Y., Weng, Y., Leung, C. M., et al. (2007) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2007.06.001 · Cited by 55 · see citing works
Self-citationAssociation of the 5HTR2A gene with suicidal behavior: CASE-control study and updated meta-analysis
González‐Castro, T. B., Tovilla‐Zárate, C. A., Juárez‐Rojop, I. E., García, S. P., Velázquez-Sánchez, M. P., Genis, A. D., Nicolini, H., & López‐Narváez, M. L. (2013) · BMC Psychiatry · doi:10.1186/1471-244x-13-25 · Cited by 49 · see citing works
Characteristics of Suicide Attempters and Nonattempters with Schizophrenia in a Rural Community
Ran, M., Xiang, M., Mao, W., Hou, Z., Tang, M., Chen, E. Y. H., Chan, C., YIP, P. S. F., & Conwell, Y. (2005) · Suicide and Life-Threatening Behavior · doi:10.1521/suli.2005.35.6.694 · Cited by 48 · see citing works
Predictors of Suicide in First-Episode Affective and Nonaffective Psychotic Inpatients
González-Pinto, A. M., Aldama, A., González, C., Mosquera, F., Arrasate, M., & Vieta, E. (2007) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v68n0209 · Cited by 47 · see citing works
Triptish Bhatia, A., Thomas, P., Semwal, P., Thelma, B. K., Nimgaonkar, V. L., & Deshpande, S. N. (2006) · Schizophrenia Research · doi:10.1016/j.schres.2006.04.015 · Cited by 45 · see citing works
Yin, H., Xu, L., Shao, Y., Li, L., & Wan, C. (2016) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s116148 · Cited by 40 · see citing works
Subjective quality of life and suicidal behavior among Taiwanese schizophrenia patients
Kao, Y., Liu, Y., Cheng, T.-H., & Chou, M.-K. (2011) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-011-0361-0 · Cited by 35 · see citing works
Schizophrene Psychosen und Kliniksuizid
Krupinski, M., Fischer, A., Grohmann, R., Engel, R. R., Hollweg, M., & Möller, H. ‐. (2000) · Der Nervenarzt · doi:10.1007/s001150050682 · Cited by 25 · see citing works
Suicidal Behavior Among Inpatients with Schizophrenia and Mood Disorders in Chengdu, China
Ran, M., Wu, Q., Conwell, Y., Chen, E. Y. H., & Chan, C. (2004) · Suicide and Life-Threatening Behavior · doi:10.1521/suli.34.3.311.42784 · Cited by 20 · see citing works
Schizophrene Psychosen und Kliniksuizid Risikofaktoren, psychopharmakologische Behandlung
Krupinski, M., Fischer, A., Grohmann, R., Engel, R. R., Hollweg, M., & Möller, H. (2000) · Der Nervenarzt · Cited by 19 · see citing works
Flagged first, then by citations
Research works printed but not linked: 9
- Deng ZH (2000). The related factors of suicide in schizophrenia (in Chinese). Health Psychology Journal 13, 688-689.
- Jiang SA, Gao BL, Liu PZ, Su LY (1998). Clinical features of suicidal behavior in inpatients with schizophrenia or depression (in Chinese). Chinese Journal of Clinical Psychology 6, 28-31.
- Wang CW, Shi JF, Yuan HD (2006). Risk factors of suicide in outpatients with schizophrenia (in Chinese). Chinese Journal of Public Health 22, 99-100.
- Winsper C, Ganapathy R, Marwaha S, Large M, Birchwood M, Singh SP (2013). A systematic review and meta-regression analysis of aggression during the first episode of psychosis. Acta Psychiatrica Scandinavica 128, 413-421.
- Xue HY (2010). Suicidal behavior in patients with depression and schizophrenia (in Chinese). Chinese Journal of Health Psychology 18, 516-518.
- Zhang HS, Xiao SY (2002). Suicide behavior of inpatients with schizophrenia (in Chinese). Chinese Mental Health Journal 16, 260-262.
- Zhang X (1998). A survey of psychological condition in male patients with schizophrenia (in Chinese). Health Psychology Journal 6, 297-298.
- Zhao GF, Ma DD, Wang GX, Guo CQ, Liu ZX (1992). Follow-up survey of death in schizophrenia patients after discharge (in Chinese). Chinese Mental Health Journal 6, 233-234.
- Zheng W, Tang LR, Weng YZ, Zhao XQ, Wang QJ, Ma X, Xiang YQ (2015). Quality of life and its associations with oral health and suicide attempts in hospitalized schizophrenia patients (in Chinese). Chinese Journal of Health Psychology 23, 324-328.
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Velasco, A., Lengvenyte, A., Rodriguez-Revuelta, J., Jimenez-Treviño, L., Courtet, P., Garcia-Portilla, M., Bobes, J., & Sáiz, P. (2024) · European Psychiatry · doi:10.1192/j.eurpsy.2023.18 · Cited by 34 · see citing works
- Authors
- Dong, M., Wang, S. B., Wang, F., Zhang, L., Ungvari, G. S., Ng, C. H., Meng, X., Yuan, Z., Wang, G., & Xiang, Y. T.
- Affiliations
- University of Macau (MO)
- Guangdong General Hospital (CN)
- Capital Medical University (CN)
- The University of Notre Dame Australia (AU)
- The University of Melbourne (AU)
- Douglas Mental Health University Institute (CA)
- Corresponding author
- Xiang, Y. T.
- Venue
- Epidemiology and Psychiatric Sciences
- Publisher
- Cambridge University Press (CUP)
- Published
- 2017-09-25
- Volume
- 28
- Issue
- 03
- Pages
- 290-299
- ISSN
- 2045-7960 (ISSN-L)
- 2045-7979
- PMC
- PMC6998905
- OpenAlex
- W2758348761
- Cited by
- 37
- References
- 58
- Citations by year
- 2026: 2 · 2025: 6 · 2024: 6 · 2023: 11 · 2022: 1 · 2021: 3 · 2020: 2 · 2019: 4 · 2018: 2
- FWCI
- 0.34
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Epidemiology and Psychiatric Sciences (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Universidade de Macau
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Sociology and Political Science › Homicide, Infanticide, and Child Abuse
- Keywords
- schizophrenia, suicidal ideation, suicide attempts, suicide planning, suicide mortality, prevalence, suicide prevention
- MeSH terms
- China, Humans, Schizophrenia, Schizophrenic Psychology, Suicide, Suicide, Attempted, Prevalence, Databases, Factual, Suicidal Ideation
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