Prevalence of suicidal ideation and planning in patients with major depressive disorder: A meta-analysis of observation studies

Hong Cai; Yu Jin; Shou Liu; Qinge Zhang; Ling Zhang; Teris Cheung; Lloyd Balbuena; Yu-Tao Xiang

doi:10.1016/j.jad.2021.05.115

Prevalence of suicidal ideation and planning in patients with major depressive disorder: A meta-analysis of observation studies

J Affect Disord. 2021 Oct 1:293:148-158. doi: 10.1016/j.jad.2021.05.115. Epub 2021 Jun 27.

Authors

Hong Cai¹, Yu Jin², Shou Liu³, Qinge Zhang⁴, Ling Zhang⁴, Teris Cheung⁵, Lloyd Balbuena⁶, Yu-Tao Xiang⁷

Affiliations

¹ Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China; Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China; Institute of Advanced Studies in Humanities and Social Sciences, University of Macau, Macao SAR, China.
² College of Education for the Future, Beijing Normal University, China.
³ Department of Public Health, Medical College, Qinghai University, Xining, Qinghai province, China.
⁴ The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.
⁵ School of Nursing, Hong Kong Polytechnic University, Hong Kong SAR, China.
⁶ Department of Psychiatry, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
⁷ Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China; Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China; Institute of Advanced Studies in Humanities and Social Sciences, University of Macau, Macao SAR, China. Electronic address: xyutly@gmail.com.

PMID: 34192629
DOI: 10.1016/j.jad.2021.05.115

Abstract

Background: Suicidal ideation (SI) and suicide planning (SP) are associated with an increased risk of future suicide. We performed a meta-analysis of observational studies to estimate the prevalence of SI and SP in patients with major depressive disorder (MDD) and its associated factors.

Methods: A systematic literature search was conducted in PubMed, EMBASE, PsycINFO and Web of Science from their commencement date until 7 October 2020. Original studies containing data on the prevalence of SI and SP in individuals with MDD were analyzed.

Results: Forty-six articles covering 53,598 patients were included in the meta-analysis. The overall prevalence of SI was 37.7% (95% confidence interval (CI): 32.3-43.4%) and the pooled prevalence of SP was 15.1% (95% CI: 8.0--26.8%). Subgroup analyses revealed that the timeframe over which SI was assessed, source of patients, study design, and diagnostic criteria were significantly associated with the pooled prevalence of SI. Meta-regression analyses revealed that the Hamilton Depression Rating Scale (HAMD) score and percentage of male participants were positively associated with the pooled prevalence of SI. Study quality and mean age were negatively associated with the pooled prevalence of SI. In contrast, survey year and study quality were negatively associated with pooled prevalence of SP LIMITATION: SI and SP were self-reported and subject to recall bias and impression management.

Conclusions: SI and SP are common in patients with MDD, especially among inpatients. Preventive measures and treatments focusing on factors associated with SI and SP may reduce the risk of suicide in patients with MDD.

Keywords: Major depressive disorder; Meta-analysis; Suicidal ideation; Suicide planning.

Publication types

Meta-Analysis
Research Support, Non-U.S. Gov't
Review

MeSH terms

Depressive Disorder, Major* / epidemiology
Humans
Male
Prevalence
Self Report
Suicidal Ideation
Suicide*