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. 2024 Mar 13;29(1):290–308. doi: 10.1080/13811118.2024.2322144

Are we Using the Right Evidence to Inform Suicide Prevention in Low- and Middle-Income Countries? An Umbrella Review

Ivie Itua, Kamal Shah, Patrick Galway, Faiza Chaudhry, Tatiana Georgiadi, Juhi Rastogi, Shameer Naleer, Duleeka Knipe ✉
PMCID: PMC11809771  PMID: 38480516

Abstract

Objective

Suicide disproportionately affects low- and middle-income countries and evidence regarding prevention approaches developed in high income countries may not be applicable in these settings. We conducted an umbrella review to assess whether the conclusions of suicide prevention systematic reviews accurately reflect the studies contained within those reviews in terms of setting generalizability.

Methods

We conducted database searches in PubMed/Medline, Embase, PsycInfo, PsychExtra, OVID global health, and LILACS/BECS. We included systematic reviews with the outcome of suicide, including bereavement studies where suicide death was also the exposure.

Results

Out of the 147 reviews assessed, we found that over 80% of systematic reviews on suicide deaths do not provide an accurate summary of review findings with relation to geographic relevance and ultimately generalizability.

Conclusion

Systematic reviews are often the resource used by practitioners and policymakers to guide services. Misleading reviews can detrimentally impact suicide prevention efforts in LMICs. We call for systematic reviewers to be responsible when generalizing the findings of their reviews particularly in the abstracts.

Keywords: Global mental health, self-harm, suicide

Suicide is a major global issue with 800,000 people dying every year − 77% of these deaths occurring in low- and middle-income countries (LMICs) (World Health Organisation, 2021). We know relatively little about this behavior in these contexts. A recent review has shown that whilst there has been a steady increase in the number of academic publications in suicide research, there are few papers originating from LMICs (Cai et al., 2020).

Suicidal behavior is complex. No single factor will increase the risk of suicide, rather it is the complex interplay of multiple factors. Given the significant variability in cultural, economic, and medical care between countries, the findings in one might not be applicable to another. This is particularly likely to be the case for research that is purely conducted in high-income countries (HIC). Despite the sparse evidence base regarding suicide in LMICs, the available evidence in terms of both the epidemiology and risk factors suggests that suicidal behavior in these contexts is likely to be different to that of HIC (Knipe et al., 2022).

With the growing body of research evidence, policy makers and practitioners often turn to systematic reviews to provide them with a summary of the most up to date evidence. Against the backdrop of suicide research primarily originating from HIC, it would be reasonable to assume that the findings from these systematic reviews would only be applicable to high-income settings. However, often these reviews will make recommendations without the caveat that the results of the review are only applicable to a high-income setting (Knipe & Jewkes, 2022). Ultimately these important reviews might be quite misleading.

We conducted an umbrella review of systematic reviews to assess whether the current systematic review evidence base informing suicide prevention globally provides an accurate summary of the studies contained within those reviews.

METHODS

We registered the umbrella review protocol with PROSPERO (registration ID: CRD42020198194). Umbrella reviews are essentially a systematic review of systematic reviews.

Search Strategy

We conducted database searches in PubMed/Medline, Embase, PsycInfo, PsychExtra, OVID global health, and LILACS/BECS. We used the search terms suicide (suicid*) AND review. No date restrictions were applied and searches were conducted on 23 July 2020. The full text versions of studies that potentially fit the inclusion criteria were reviewed by two independent screeners after the titles and abstracts of the articles were screened for relevance (two independent reviewers).

Inclusion and Exclusion Criteria

Inclusion and exclusion criteria are summarized in Table 1. We included studies with the outcome of suicide, including bereavement studies where suicide death was also the exposure. We included studies which were systematic reviews, and excluded all other reviews (e.g., scoping reviews). We also excluded records related to conference abstracts and protocols where the research had not been completed and/or published. Due to the vast nature of this topic, we focussed on reviews on death by suicide and excluded reviews that studied other suicidal behavior, intent, and ideation. Some reviews looked at multiple related outcomes including death by suicide but did not distinguish between the outcomes and thus were excluded. We excluded reviews that did not look at death by suicide as a main outcome, i.e., reviews that have less than five original studies examining death by suicide. We excluded reviews that examined medically assisted suicide, and those focused on clinical or specific subgroups of the population because the findings might not be representative of the general population. Although we excluded studies that examine suicide of people living with mental health conditions, some reviews examined suicide and mental health conditions as separate entities and thus were included. Where the full text of the article couldn’t be found, the authors were contacted to provide the full text where possible. Full text articles that were in different languages, were analyzed after being translated to English using Google translate. When this was not possible, at least 3 attempts were made to contact authors to provide translation and/or further information.

TABLE 1.

Inclusion and exclusion criteria.

Inclusion criteria Exclusion criteria
All ages and genders Broader mental health interventions
All populations in all countries Studies that examine attitudes toward
Reviews studying general population Examining suicidal ideation or self-injury or suicide attempts
Death by suicide Other types of reviews (e.g. scoping reviews)
Systematic reviews or meta-analyses Studies specific population that does not represent general population
English text/translations available Medically assisted suicide
Peer reviewed journal  
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Unlike typical umbrella reviews which are focused on summarizing the strength of the evidence of for example a particular exposure to a condition, or an intervention effect, our umbrella review’s objective focused on how systematic review authors present their findings. For this reason, we included all eligible systematic reviews even if the underlying studies within the reviews overlap.

Data Extraction

We extracted data in a pre-piloted form and classified the included studies by income using the 2020 World Bank classification (World Bank, n.d.). When a review examined suicide death as an exposure and outcome, we extracted data for both (Hill et al., 2020).

All papers were screened, and data extracted, by two independent reviewers. Discrepancies were resolved through team meetings or decided by the senior author (DK). We did not formally assess risk of bias of the included systematic reviews. Risk of bias in umbrella reviews is designed to assess whether the review has been designed, conducted, analyzed and/or reported in such a way as to introduce systemic deviations from the truth (Pollock M et al., 2023). The reason to do this is so that there is a way of assessing whether the strength of the evidence is likely to be impacted by bias—i.e., internal validity. As our objective was not to assess the strength of the association, but to assess the quality of the review in terms of the recommendations that are put forward (i.e., external validity), we decided that a risk of bias assessment would not be needed. The results of a risk of bias assessment would not have been used to either present or interpret the findings of this review.

Analysis

We calculated the proportion of included studies in each review that were based in HICs, low income, lower-middle income, and upper-middle income countries. We then evaluated how the conclusions (as presented in the abstract and discussion) of each review accurately reflect the generalizability of the review in terms of country/income data. We did not conduct a formal statistical synthesis as this would have not been appropriate for the objectives of this study.

RESULTS

The electronic searches generated 10117 de-duplicated records, with 147 systematic reviews meeting the inclusion criteria (Figure 1).

FIGURE 1.

FIGURE 1.

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PRISMA Flow diagram of included studies.

Less than 1 in 5 of the systematic reviews were led (i.e., first author) by researchers in middle-income countries and none were led by researchers in low-income countries. The details of included studies can be found in Table 2. There were 4595 included studies combined from 147 reviews, but only 2758 of those studies investigated suicide deaths. Of the 2758 studies included within the reviews, 68% were conducted in HICs, 8% from upper middle-income countries, 6% from low middle income countries and only 1 study was from a low-income country. 30 of the studies were from a mixture of countries and the country was unknown for 17% of the 2758 included studies.

TABLE 2.

Characteristics of included studies*.

Review No. of primary studies included that examine suicide death No. of studies by World Bank Income Status Does the review conclusions reflect the generalizability of the study?
Ahmed et al. (2017) 8 HIC:0 UMIC:0 LMIC:8 LIC:0 NK:0 Yes
Aho et al. (2017) 12 HIC:0 UMIC:0 LMIC:0 LIC:0 NK:12 ?
Amiri and Behnezhad (2018) 9 HIC:9 UMIC:0 LMIC:0 LIC:0 NK:0 No
Amiri and Behnezhad (2020) 17 HIC:17 UMIC:0 LMIC:0 LIC:0 NK:0 No
Andriessen et al. (2016) 56 HIC:54 UMIC:1 LMIC:1 LIC:0 NK:0 No
Andriessen et al. (2018) 11 HIC:10 UMIC:0 LMIC:0 LIC:1 NK:0 No
Andriessen, Krysinska, Hill, et al. (2019) 12 HIC:12 UMIC:0 LMIC:0 LIC:0 NK:0 No
Andriessen, Krysinska, Kolves, et al. (2019) 8 HIC:8 UMIC:0 LMIC:0 LIC:0 NK:0 No
Anglemyer et al. (2014) 14 HIC:14 UMIC:0 LMIC:0 LIC:0 NK:0 No
Anguelova et al. (2003) 11 HIC:11 UMIC:0 LMIC:0 LIC:0 NK:0 No
Antypa et al. (2013) 20 HIC:15 UMIC:4 LMIC:1 LIC:0 NK:0 Yes
Arsenault-Lapierre et al. (2004) 27 HIC:25 UMIC:1 LMIC:1 LIC:0 NK:0 No
Barjasteh-Askari et al. (2020) 14 HIC:14 UMIC:0 LMIC:0 LIC:0 NK:0 No
Barker et al. (2017) 9 HIC:9 UMIC:0 LMIC:0 LIC:0 NK:0 No
Barry et al. (2020) 36 HIC:36 UMIC:0 LMIC:0 LIC:0 NK:0 No
Belsher et al. (2019) 11 HIC:10 UMIC:0 LMIC:1 LIC:0 NK:0 No
Ben Alaya et al. (2018) 6 HIC:0 UMIC:0 LMIC:6 LIC:0 NK:0 Yes
Blacker et al. (2019) 12 HIC:10 UMIC:1 LMIC:1 LIC:0 NK:0 Yes
Brezo et al. (2006) 11 HIC:0 UMIC:0 LMIC:0 LIC:0 NK:11 ?
Brown et al. (2017) 8 HIC:2 UMIC:5 LMIC:0 LIC:0 NK:0 M:1 Yes
Cairns et al. (2017) 20 HIC:19 UMIC:0 LMIC:0 LIC:0 NK:0 M:1 Yes
Calati et al. (2015) 8 HIC:4 UMIC:0 LMIC:1 LIC:0 NK:3 No
Cano-Montalbán and Quevedo-Blasco (2018) 30 HIC:20 UMIC:9 LMIC:0 LIC:0 NK:0 M:1 No
Causer et al. (2019) 12 HIC:10 UMIC:2 LMIC:0 LIC:0 NK:0 No
Cavanagh et al. (2003) 76 HIC:0 UMIC:0 LMIC:0 LIC:0 NK:76 ?
Cenderadewi et al. (2020) 10 HIC:10 UMIC:0 LMIC:0 LIC:0 NK:0 Yes
Cho et al. (2016) 48 HIC:36 UMIC:7 LMIC:5 LIC:0 NK:0 Yes
Colucci and Martin (2007) 10 HIC:5 UMIC:1 LMIC:0 LIC:0 NK:0 M:4 No
Cordner et al. (2020) 31 HIC:25 UMIC:5 LMIC:0 LIC:0 NK:1 No
Cox et al. (2013) 14 HIC:14 UMIC:0 LMIC:0 LIC:0 NK:0 No
De la Cruz-Cano (2017) 7 HIC:7 UMIC:0 LMIC:0 LIC:0 NK:0 No
de Souza et al. (2020) 9 HIC:0 UMIC:9 LMIC:0 LIC:0 NK:0 Yes
Dickson et al. (2019) 11 HIC:11 UMIC:0 LMIC:0 LIC:0 NK:0 Yes
Dong et al. (2015) 20 HIC:0 UMIC:0 LMIC:0 LIC:0 NK:20 Yes
Duarte et al. (2020) 9 HIC:8 UMIC:1 LMIC:0 LIC:0 NK:0 No
Dutheil et al. (2019) 52 HIC:0 UMIC:0 LMIC:0 LIC:0 NK:52 ?
El-Sayed et al. (2012) 12 HIC:12 UMIC:0 LMIC:0 LIC:0 NK:0 No
Freire and Koifman (2013) 14 HIC:9 UMIC:5 LMIC:0 LIC:0 NK:0 No
Fung and Chan (2011) 17 HIC:16 UMIC:1 LMIC:0 LIC:0 NK:0 No
Galvão et al. (2018) 50 HIC:38 UMIC:9 LMIC:1 LIC:0 NK:0 M:2 Yes
Gao et al. (2019) 16 HIC:12 UMIC:4 LMIC:0 LIC:0 NK:0 Yes
Glenn et al. (2020) 45 HIC:37 UMIC:6 LMIC:2 LIC:0 NK:0 Yes
González-Castro et al. (2017) 5 HIC:5 UMIC:0 LMIC:0 LIC:0 NK:0 No
Goodday et al. (2019) 5 HIC:5 UMIC:0 LMIC:0 LIC:0 NK:0 No
Gorton et al. (2016) 11 HIC:11 UMIC:0 LMIC:0 LIC:0 NK:0 No
Gramaglia et al. (2019) 6 HIC:6 UMIC:0 LMIC:0 LIC:0 NK:0 No
Grandclerc et al. (2016) 5 HIC:5 UMIC:0 LMIC:0 LIC:0 NK:0 No
Grek (2007) 26 HIC:0 UMIC:0 LMIC:0 LIC:0 NK:26 ?
Gunnell et al. (2005) 15 HIC:14 UMIC:0 LMIC:1 LIC:0 NK:0 No
Gunnell et al. (2017) 27 HIC:18 UMIC:2 LMIC:7 LIC:0 NK:0 Yes
Hahn et al. (2014) 7 HIC:7 UMIC:0 LMIC:0 LIC:0 NK:0 No
Havârneanu et al. (2015) 9 HIC:9 UMIC:0 LMIC:0 LIC:0 NK:0 No
Haw and Hawton (2016) 20 HIC:19 UMIC:0 LMIC:1 LIC:0 NK:0 Yes
Hill et al. (2020) 27 HIC:20 UMIC:4 LMIC:3 LIC:0 NK:0 No
Hofstra et al. (2020) 9 HIC:7 UMIC:0 LMIC:2 LIC:0 NK:0 No
Holmes et al. (2012) 10 HIC:2 UMIC:8 LMIC:0 LIC:0 NK:0 No
Honkaniemi et al. (2017) 16 HIC:16 UMIC:0 LMIC:0 LIC:0 NK:0 Yes
Hua et al. (2019) 26 HIC:21 UMIC:1 LMIC:0 LIC:0 NK:2 M:2 No
Hunt et al. (2017) 6 HIC:6 UMIC:0 LMIC:0 LIC:0 NK:0 No
Ide et al. (2010) 8 HIC:8 UMIC:0 LMIC:0 LIC:0 NK:0 No
Iemmi et al. (2016) 17 HIC:1 UMIC:6 LMIC:9 LIC:0 NK:0 M:1 Yes
Jafari et al. (2020) 12 HIC:10 UMIC:1 LMIC:1 LIC:0 NK:0 No
Jang and Elfenbein (2019) 5 HIC:0 UMIC:0 LMIC:0 LIC:0 NK:5 ?
Kenedi et al. (2016) 11 HIC:0 UMIC:0 LMIC:0 LIC:0 NK:11 ?
Kleck (2019) 29 HIC:29 UMIC:0 LMIC:0 LIC:0 NK:0 No
Klingelschmidt et al. (2018) 32 HIC:32 UMIC:0 LMIC:0 LIC:0 NK:0 No
Klinitzke et al. (2013) 12 HIC:11 UMIC:0 LMIC:0 LIC:0 NK:0 M:1 No
Knipe et al. (2019) 22 HIC:0 UMIC:13 LMIC:9 LIC:0 NK:0 Yes
Knipe et al. (2015) 5 HIC:0 UMIC:1 LMIC:4 LIC:0 NK:0 Yes
Kõlves et al. (2013) 19 HIC:11 UMIC:7 LMIC:1 LIC:0 NK:0 No
Kuramoto et al. (2009) 9 HIC:9 UMIC:0 LMIC:0 LIC:0 NK:0 No
Large et al. (2009) 49 HIC:48 UMIC:1 LMIC:0 LIC:0 NK:0 Yes
Li and Katikireddi (2019) 24 HIC:0 UMIC:24 LMIC:0 LIC:0 NK:0 Yes
Li et al. (2012) 5 HIC:0 UMIC:5 LMIC:0 LIC:0 NK:0 Yes
Linde et al. (2017) 7 HIC:0 UMIC:0 LMIC:0 LIC:0 NK:7 ?
Lindeman et al. (1996) 14 HIC:13 UMIC:1 LMIC:0 LIC:0 NK:0 No
Liotta et al. (2015) 9 HIC:7 UMIC:1 LMIC:1 LIC:0 NK:0 No
Liu et al. (2021) 10 HIC:8 UMIC:2 LMIC:0 LIC:0 NK:0 No
Liu and Miller (2014) 20 HIC:10 UMIC:4 LMIC:5 LIC:0 NK:1 No
Malakouti et al. (2015) 12 HIC:2 UMIC:1 LMIC:9 LIC:0 NK:0 Yes
Maple et al. (2017) 27 HIC:21 UMIC:2 LMIC:4 LIC:0 NK:0 No
McDaid et al. (2008) 8 HIC:0 UMIC:0 LMIC:0 LIC:0 NK:8 ?
Memon et al. (2020) 15 HIC:15 UMIC:0 LMIC:0 LIC:0 NK:0 No
Mew et al. (2017) 6 HIC:0 UMIC:0 LMIC:0 LIC:0 NK:6 ?
Milner, Page, et al. (2013) 10 HIC:9 UMIC:0 LMIC:0 LIC:0 NK:0 M:1 No
Milner et al. (2014) 5 HIC:5 UMIC:0 LMIC:0 LIC:0 NK:0 No
Milner, Spittal, et al. (2013) 34 HIC:34 UMIC:0 LMIC:0 LIC:0 NK:0 No
Milner, Sveticic, et al. (2013) 29 HIC:17 UMIC:9 LMIC:3 LIC:0 NK:0 Yes
Milner et al. (2018) 6 HIC:6 UMIC:0 LMIC:0 LIC:0 NK:0 No
Milner et al. (2017) 9 HIC:8 UMIC:0 LMIC:1 LIC:0 NK:0 No
Milner et al. (2015) 5 HIC:5 UMIC:0 LMIC:0 LIC:0 NK:0 No
Miranda-Mendizabal et al. (2019) 8 HIC:7 UMIC:1 LMIC:0 LIC:0 NK:0 No
Mishara and Bardon (2016) 55 HIC:19 UMIC:1 LMIC:0 LIC:0 NK:35 ?
Morovatdar et al. (2013) 19 HIC:3 UMIC:2 LMIC:14 LIC:0 NK:0 Yes
Nazarzadeh et al. (2013) 7 HIC:0 UMIC:0 LMIC:7 LIC:0 NK:0 Yes
Niederkrotenthaler et al. (2020) 31 HIC:31 UMIC:0 LMIC:0 LIC:0 NK:0 No
Niedzwiedz et al. (2014) 82 HIC:68 UMIC:2 LMIC:1 LIC:0 NK:4 M:7 ?
Okolie et al. (2017) 11 HIC:11 UMIC:0 LMIC:0 LIC:0 NK:0 No
Okolie et al. (2020) 14 HIC:14 UMIC:0 LMIC:0 LIC:0 NK:0 No
Owens et al. (2002) 26 HIC:26 UMIC:0 LMIC:0 LIC:0 NK:0 No
Oyama et al. (2008) 5 HIC:5 UMIC:0 LMIC:0 LIC:0 NK:0 Yes
Oyesanya et al. (2015) 38 HIC:19 UMIC:2 LMIC:0 LIC:0 NK:13 M:4 ?
Panczak et al. (2013) 27 HIC:26 UMIC:1 LMIC:0 LIC:0 NK:0 Yes
Perera et al. (2016) 21 HIC:20 UMIC:0 LMIC:0 LIC:0 NK:0 M:1 No
Pigeon et al. (2016) 5 HIC:2 UMIC:1 LMIC:0 LIC:0 NK:2 No
Pirkis and Burgess (1998) 24 HIC:24 UMIC:0 LMIC:0 LIC:0 NK:0 No
Pirkis et al. (2015) 18 HIC:18 UMIC:0 LMIC:0 LIC:0 NK:0 No
Platt et al. (2010) 19 HIC:19 UMIC:0 LMIC:0 LIC:0 NK:0 Yes
Plöderl and Tremblay (2015) 7 HIC:2 UMIC:0 LMIC:0 LIC:0 NK:5 No
Pollock et al. (2018) 99 HIC:70 UMIC:17 LMIC:12 LIC:0 NK:0 Yes
Ragguett et al. (2017) 11 HIC:10 UMIC:1 LMIC:0 LIC:0 NK:0 No
Rane and Nadkarni (2014) 36 HIC:0 UMIC:0 LMIC:36 LIC:0 NK:0 Yes
Rehkopf and Buka (2006) 86 HIC:0 UMIC:0 LMIC:0 LIC:0 NK:86 ?
Rice and Sher (2016) ? HIC:? UMIC:? LMIC:? LIC:? NK:? ?
Robinson et al. (2018) 12 HIC:10 UMIC:0 LMIC:2 LIC:0 NK:0 No
Rowell et al. (2008) 9 HIC:9 UMIC:0 LMIC:0 LIC:0 NK:0 Yes
Runeson et al. (2017) 10 HIC:0 UMIC:0 LMIC:0 LIC:0 NK:10 ?
Sales et al. (2019) 14 HIC:6 UMIC:0 LMIC:0 LIC:0 NK:8 No
Sargeant et al. (2018) 8 HIC:8 UMIC:0 LMIC:0 LIC:0 NK:0 Yes
Serafini et al. (2013) 6 HIC:0 UMIC:0 LMIC:0 LIC:0 NK:6 ?
Shahid and Hyder (2008) 9 HIC:0 UMIC:0 LMIC:9 LIC:0 NK:0 Yes
Shields et al. (2017) 11 HIC:11 UMIC:0 LMIC:0 LIC:0 NK:0 No
Silva et al. (2014) 12 HIC:0 UMIC:0 LMIC:0 LIC:0 NK:12 ?
Simon et al. (2013) 35 HIC:13 UMIC:22 LMIC:0 LIC:0 NK:0 Yes
Sisask and Värnik (2012) 48 HIC:48 UMIC:0 LMIC:0 LIC:0 NK:0 No
Skinner and Farrington (2020) 15 HIC:15 UMIC:0 LMIC:0 LIC:0 NK:0 No
Soole et al. (2015) 15 HIC:14 UMIC:0 LMIC:0 LIC:0 NK:0 M:2 No
Spallek et al. (2015) 24 HIC:24 UMIC:0 LMIC:0 LIC:0 NK:0 Yes
Spillane et al. (2017) 27 HIC:26 UMIC:1 LMIC:0 LIC:0 NK:0 No
Stanley et al. (2016) 43 HIC:39 UMIC:0 LMIC:0 LIC:0 NK:3 M:1 No
Stene-Larsen and Reneflot (2019) 44 HIC:44 UMIC:0 LMIC:0 LIC:0 NK:0 No
Sveen and Walby (2008) 41 HIC:0 UMIC:0 LMIC:0 LIC:0 NK:41 ?
Szücs et al. (2018) 12 HIC:12 UMIC:0 LMIC:0 LIC:0 NK:0 No
Thompson et al. (2018) 17 HIC:13 UMIC:4 LMIC:0 LIC:0 NK:0 No
Tøllefsen et al. (2012) 31 HIC:30 UMIC:0 LMIC:1 LIC:0 NK:0 Yes
Too et al. (2014) 11 HIC:11 UMIC:0 LMIC:0 LIC:0 NK:0 No
Torok et al. (2017) 7 HIC:7 UMIC:0 LMIC:0 LIC:0 NK:0 No
Troya et al. (2019) 16 HIC:14 UMIC:0 LMIC:1 LIC:0 NK:0 M:1 No
Wagner et al. (2021) 6 HIC:6 UMIC:0 LMIC:0 LIC:0 NK:0 No
Walby et al. (2018) 35 HIC:35 UMIC:0 LMIC:0 LIC:0 NK:0 Yes
Wilson et al. (2020) 7 HIC:0 UMIC:0 LMIC:0 LIC:0 NK:7 ?
Witt et al. (2019) 11 HIC:11 UMIC:0 LMIC:0 LIC:0 NK:0 No
Witt et al. (2017) 7 HIC:5 UMIC:2 LMIC:0 LIC:0 NK:0 No
Wu et al. (2016) 6 HIC:0 UMIC:0 LMIC:0 LIC:0 NK:6 ?
Yoshimasu et al. (2008) 24 HIC:20 UMIC:2 LMIC:2 LIC:0 NK:0 No
Zhang et al. (2013) 10 HIC:9 UMIC:0 LMIC:0 LIC:0 NK:0 M:1 Yes
Zhao et al. (2018) 5 HIC:5 UMIC:0 LMIC:0 LIC:0 NK:0 Yes
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*

HIC: High income country; UMIC: Upper middle income country; LMIC: Lower middle income country; LIC: Lower income country; NK: Country income status not reported/known; M: Multicounty data presented and income status unable to be assessed. ; ? : indicates where the study has not provided sufficient details regarding the income of the countries included in their review to assess whether the conclusions are supported by the included studies.

One review did not have any data on included studies (i.e., did not provide information on included studies) and thus was unable to be analyzed (Rice & Sher, 2016).

Of all the reviews, 17% (25/147) were focused on a specific region of the world (e.g., LMIC), whereas most reviews aimed to review the global literature. Of the 122 reviews that did not focus on a specific region, the median number of papers included in these reviews that were from LMIC were 0 (range: 0–17). Of note, we were unable to assess whether 21 of the reviews included data that would make the conclusions appropriate (i.e., generalizable) because the authors did not provide sufficient country data for all included studies). Despite the weight of evidence in favor of HICs, the majority of reviewers presented the conclusions of their review as if the evidence base was generalizable to a global population (83/101 (82%)).

DISCUSSION

The findings of this umbrella review highlight that over 80% of systematic reviews on suicide deaths do not provide an accurate summary of review findings with relation to geographic relevance and ultimately generalizability. The reviews had conclusions and abstracts that made generalizations to the global population, whereas their included studies did not reflect a global population and were instead mostly reflective of HICs with less than 10% of the included studies in the reviews being from LMICs.

The findings of this review of reviews is in keeping with normative, although inappropriate, practices in academic publishing, where findings from HICs are reported as if they are applicable to all (Knipe & Jewkes, 2022). Systematic review authors in the field of suicide prevention are misrepresenting the findings of their reviews, which ultimately will misguide the users of their research. Our review has shown that 4-in-5 systematic reviews informing suicide prevention globally does not provide an accurate summary of the studies contained within those reviews. Whether systematic review authors believe that their work can indeed be generalized, or whether this is even a consideration is unknown. The majority of systematic reviews included in this review of reviews were led by researchers in HICs and therefore are more likely to see the studies included in their studies as “normal”—they might fail to see the absence of data from LMICs. However, the extrapolation of findings from a select number of “WEIRD” (Western, educated, industrialized, rich, democratic) countries to the rest of the world is likely to be inappropriate in the context of suicide prevention. The contextual differences between HICs and LMICs, and also within the vast grouping of LMICs needs to be appropriately recognized. Considering other contexts, cultures, socioeconomic settings should be kept in mind throughout the research process, when data are being presented and when it is being published.

If research has been done in a particular setting, i.e., HICs, then that should be reflected in the conclusions of the reviews and made clear in the abstracts. The importance of generalizability has been shown in research where interventions researched in one setting has been applied to another setting and not had the desired effect (in this instance the reduction of repeat self-harm behavior (Husain et al., 2014)). Critical evaluations of the evidence’s local applicability prior to adapting it to a different health setting are essential to maximizing its utility. Generalizability being highlighted in systematic reviews that are used to inform changes would help in making these evaluations. More scrutinization should be done during the drafting of manuscripts as well as in the peer-review and publishing process to avoid the use of irrelevant research in policy making (Knipe & Jewkes, 2022).

STRENGTHS AND LIMITATIONS

This is the first review of reviews to consider the importance of context in the presentation of review findings. We employed robust systematic review processes; however, the findings of this review need to be considered in light of its limitations. First, although effort was made to search a variety of search engines, the ones that were used may not index as many non-English journals. Thus, we may have not identified important systematic reviews especially from LMICs where English may not the predominant language. However, the search engines used are some of the most used for systematic reviews. One can argue that a paper that cannot be easily found is less likely to be used to inform policy thus the systematic reviews presented in this review are of high importance when considering suicide prevention policy making. Secondly, one of the included systematic reviews investigated suicide in LMICs however it included studies from countries that are high income and did not include any studies from LICs. It is possible that the income status has changed from when the systematic review was completed to when this current systematic review is being completed. This highlights a possible limitation of this study as it is assessing research based on current income status and not previously. However, this review is being used to highlights the need for more research to be conducted in current LMICs and for researchers to be more aware of the way they present the generalizability of their research. This point still stands with the current review outcome.

CONCLUSION

The findings of research in one context should not be assumed to be applicable to another setting. Countries which have similar characteristics and systems may share commonalities in terms of suicide prevention, but when these characteristics are vastly different, as is the case between many HICs and LMICs, caution needs to be employed in the presentation of result. As systematic reviews are key sources of information for policy makers, it is crucial that these reviews are representing the data within them correctly. Inadequate representation may lead to economically resource poor countries investing in prevention approaches which might be ineffective. The long-term consequences of this might lead to despondency by policy makers and the public, which is likely to be detrimental for suicide prevention. To avoid this there needs to be a concerted effort by researchers, peer-reviewers, and editors to ensure findings are accurately reported.

ACKNOWLEDGEMENTS

The authors would like to thank Pik Hampton for her administrative support.

Biographies

Ivie Itua, UCL Medical School, University College London, London, UK. Polygeia Global Health Think Tank, London, England.

Kamal Shah, Polygeia Global Health Think Tank, London, England, Imperial College Medical School, Imperial College London, London, UK.

Patrick Galway, Bristol Medical School, University of Bristol, Bristol, UK.

Faiza Chaudhry, Polygeia Global Health Think Tank, London, England, Imperial College Medical School, Imperial College London, London, UK.

Tatiana Georgiadi, Polygeia Global Health Think Tank, London, England, Imperial College Medical School, Imperial College London, London, UK.

Juhi Rastogi, UCL Medical School, University College London, London, UK.

Shameer Naleer, UCL Medical School, University College London, London, UK, and Duleeka Knipe, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK, South Asian Clinical Toxicology Research Collaboration, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka.

Correction Statement

This article has been corrected with minor changes. These changes do not impact the academic content of the article.

Funding Statement

DK was supported by the Wellcome Trust (grant number 204813/Z/16/Z) through an Institutional Strategic Support Fund Award to the University of Bristol [204813] and the Elizabeth Blackwell Institute for Health Research University of Bristol. The work was also supported by the NIHR Biomedical Research Center at University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol.

AUTHOR CONTRIBUTIONS

DK conceptualized the study and designed it. II developed the database searches, coordinated the study, and wrote the first draft under the supervision of DK. II, KS, PG, FC, TG, SN and TS, screened all included abstracts. II, KS, PG, and JS contributed to full text screening and data extraction, with additional support from SN for full text screening. All authors contributed to critical revision of the manuscript. All authors had access to and verified all the data and accept responsibility for the decision to submit for publication.

DISCLOSURE STATEMENT

No potential conflict of interest was reported by the author(s).

REFERENCES

  1. Ahmed, H. U., Hossain, M. D., Aftab, A., Soron, T. R., Alam, M. T., Chowdhury, M. W. A., & Uddin, A. (2017). Suicide and depression in the World Health Organization South-East Asia Region: A systematic review. WHO South-East Asia Journal of Public Health, 6(1), 60–66. 10.4103/2224-3151.206167 [DOI] [PubMed] [Google Scholar]
  2. Aho, A. L., Remahl, A., & Paavilainen, E. (2017). Homicide in the western family and background factors of a perpetrator. Scandinavian Journal of Public Health, 45(5), 555–568. 10.1177/1403494817705587 [DOI] [PubMed] [Google Scholar]
  3. Amiri, S., & Behnezhad, S. (2018). Body mass index and risk of suicide: A systematic review and meta-analysis. Journal of Affective Disorders, 238, 615–625. 10.1016/j.jad.2018.05.028 [DOI] [PubMed] [Google Scholar]
  4. Amiri, S., & Behnezhad, S. (2020). Alcohol use and risk of suicide: A systematic review and Meta-analysis. Journal of Addictive Diseases, 38(2), 200–213. 10.1080/10550887.2020.1736757 [DOI] [PubMed] [Google Scholar]
  5. Andriessen, K., Draper, B., Dudley, M., & Mitchell, P. B. (2016). Pre- and postloss features of adolescent suicide bereavement: A systematic review. Death Studies, 40(4), 229–246. 10.1080/07481187.2015.1128497 [DOI] [PubMed] [Google Scholar]
  6. Andriessen, K., Krysinska, K., Draper, B., Dudley, M., & Mitchell, P. B. (2018). Harmful or helpful? A systematic review of how those bereaved through suicide experience research participation. Crisis, 39(5), 364–376. 10.1027/0227-5910/a000515 [DOI] [PubMed] [Google Scholar]
  7. Andriessen, K., Krysinska, K., Hill, N. T. M., Reifels, L., Robinson, J., Reavley, N., & Pirkis, J. (2019). Effectiveness of interventions for people bereaved through suicide: A systematic review of controlled studies of grief, psychosocial and suicide-related outcomes. BMC Psychiatry, 19(1), 49. 10.1186/s12888-019-2020-z [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Andriessen, K., Krysinska, K., Kõlves, K., & Reavley, N. (2019). Suicide Postvention Service Models and Guidelines 2014–2019: A Systematic Review. Frontiers in Psychology, 10, 2677. 10.3389/fpsyg.2019.02677 [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Anglemyer, A., Horvath, T., & Rutherford, G. (2014). The accessibility of firearms and risk for suicide and homicide victimization among household members: A systematic review and meta-analysis. Annals of Internal Medicine, 160(2), 101–110. 10.7326/m13-1301 [DOI] [PubMed] [Google Scholar]
  10. Anguelova, M., Benkelfat, C., & Turecki, G. (2003). A systematic review of association studies investigating genes coding for serotonin receptors and the serotonin transporter: I. Affective disorders. Molecular Psychiatry, 8(6), 574–591. 10.1038/sj.mp.4001328 [DOI] [PubMed] [Google Scholar]
  11. Antypa, N., Serretti, A., & Rujescu, D. (2013). Serotonergic genes and suicide: A systematic review. European Neuropsychopharmacology, 23(10), 1125–1142. 10.1016/j.euroneuro.2013.03.013 [DOI] [PubMed] [Google Scholar]
  12. Arsenault-Lapierre, G., Kim, C., & Turecki, G. (2004). Psychiatric diagnoses in 3275 suicides: A meta-analysis. BMC Psychiatry, 4(1), 37. 10.1186/1471-244X-4-37 [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Barjasteh-Askari, F., Davoudi, M., Amini, H., Ghorbani, M., Yaseri, M., Yunesian, M., Mahvi, A. H., & Lester, D. (2020). Relationship between suicide mortality and lithium in drinking water: A systematic review and meta-analysis. Journal of Affective Disorders, 264, 234–241. 10.1016/j.jad.2019.12.027 [DOI] [PubMed] [Google Scholar]
  14. Barker, E., Kolves, K., & De Leo, D. (2017). Rail-suicide prevention: Systematic literature review of evidence-based activities. Asia-Pacific Psychiatry, 9(3), 246. 10.1111/appy.12246 [DOI] [PubMed] [Google Scholar]
  15. Barry, R., Rehm, J., de Oliveira, C., Gozdyra, P., & Kurdyak, P. (2020). Rurality and risk of suicide attempts and death by suicide among people living in four english-speaking high-income countries: A systematic review and meta-analysis. Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie, 65(7), 441–447. 10.1177/0706743720902655 [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Belsher, B. E., Smolenski, D. J., Pruitt, L. D., Bush, N. E., Beech, E. H., Workman, D. E., Morgan, R. L., Evatt, D. P., Tucker, J., & Skopp, N. A. (2019). Prediction models for suicide attempts and deaths: A systematic review and simulation. JAMA Psychiatry, 76(6), 642–651. 10.1001/jamapsychiatry.2019.0174 [DOI] [PubMed] [Google Scholar]
  17. Ben Alaya, M., Ben Youssef, S., & Ben Abdelaziz, A. (2018). Specificities of mental health problems in the countries of the Maghreb region, through scientific publications on the theme of suicide. A systematic review. La Tunisie Medicale, 96(10–11), 719–730. [PubMed] [Google Scholar]
  18. Blacker, C. J., Lewis, C. P., Swintak, C. C., Bostwick, J. M., & Rackley, S. J. (2019). Medical student suicide rates: A systematic review of the historical and international literature. Academic Medicine, 94(2), 274–280. 10.1097/ACM.0000000000002430 [DOI] [PubMed] [Google Scholar]
  19. Brezo, J., Paris, J., & Turecki, G. (2006). Personality traits as correlates of suicidal ideation, suicide attempts, and suicide completions: A systematic review. Acta Psychiatrica Scandinavica, 113(3), 180–206. 10.1111/j.1600-0447.2005.00702.x [DOI] [PubMed] [Google Scholar]
  20. Brown, C. R., Hambleton, I. R., Sobers-Grannum, N., Hercules, S. M., Unwin, N., Nigel Harris, E., Wilks, R., MacLeish, M., Sullivan, L., … Murphy, M. M. (2017). Social determinants of depression and suicidal behaviour in the Caribbean: A systematic review. BMC Public Health, 17(1), 577. 10.1186/s12889-017-4371-z [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Cai, Z., Chang, Q., & Yip, P. S. F. (2020). A scientometric analysis of suicide research: 1990–2018. Journal of Affective Disorders, 266, 356–365. 10.1016/j.jad.2020.01.121 [DOI] [PubMed] [Google Scholar]
  22. Cairns, J. M., Graham, E., & Bambra, C. (2017). Area-level socioeconomic disadvantage and suicidal behaviour in Europe: A systematic review. Social Science & Medicine, 192, 102–111. 10.1016/j.socscimed.2017.09.034 [DOI] [PubMed] [Google Scholar]
  23. Calati, R., Laglaoui Bakhiyi, C., Artero, S., Ilgen, M., & Courtet, P. (2015). The impact of physical pain on suicidal thoughts and behaviors: Meta-analyses. Journal of Psychiatric Research, 71, 16–32. 10.1016/j.jpsychires.2015.09.004 [DOI] [PubMed] [Google Scholar]
  24. Cano-Montalbán, I., & Quevedo-Blasco, R. (2018). Sociodemographic variables most associated with suicidal behaviour and suicide methods in Europe and America. A systematic review. The European Journal of Psychology Applied to Legal Context, 10(1), 15–25. http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1889-18612018000100015&nrm=iso 10.5093/ejpalc2018a2 [DOI] [Google Scholar]
  25. Causer, H., Muse, K., Smith, J., & Bradley, E. (2019). What is the experience of practitioners in health, education or social care roles following a death by suicide? A qualitative research synthesis. International Journal of Environmental Research and Public Health, 16(18), 3293. 10.3390/ijerph16183293 [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Cavanagh, J. T., Carson, A. J., Sharpe, M., & Lawrie, S. M. (2003). Psychological autopsy studies of suicide: A systematic review. Psychological Medicine, 33(3), 395–405. http://www.ncbi.nlm.nih.gov/pubmed/12701661 10.1017/s0033291702006943 [DOI] [PubMed] [Google Scholar]
  27. Cenderadewi, M., Franklin, R. C., Peden, A. E., & Devine, S. (2020). Fatal intentional drowning in Australia: A systematic literature review of rates and risk factors. PLoS One, 15(5), e0231861. 10.1371/journal.pone.0231861 [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Cho, S. E., Na, K. S., Cho, S. J., Im, J. S., & Kang, S. G. (2016). Geographical and temporal variations in the prevalence of mental disorders in suicide: Systematic review and meta-analysis. Journal of Affective Disorders, 190, 704–713. 10.1016/j.jad.2015.11.008 [DOI] [PubMed] [Google Scholar]
  29. Colucci, E., & Martin, G. (2007). Ethnocultural aspects of suicide in young people: A systematic literature review part 1: Rates and methods of youth suicide. Suicide & Life-Threatening Behavior, 37(2), 197–221. 10.1521/suli.2007.37.2.197 [DOI] [PubMed] [Google Scholar]
  30. Cordner, S., Clay, F. J., Bassed, R., & Thomsen, A. H. (2020). Suicidal ligature strangulation: A systematic review of the published literature. Forensic Science, Medicine, and Pathology, 16(1), 123–133. 10.1007/s12024-019-00187-2 [DOI] [PubMed] [Google Scholar]
  31. Cox, G. R., Owens, C., Robinson, J., Nicholas, A., Lockley, A., Williamson, M., Cheung, Y. T. D., & Pirkis, J. (2013). Interventions to reduce suicides at suicide hotspots: A systematic review. BMC Public Health, 13(1), 214. 10.1186/1471-2458-13-214 [DOI] [PMC free article] [PubMed] [Google Scholar]
  32. De la Cruz-Cano, E. (2017). Association between FKBP5 and CRHR1 genes with suicidal behavior: A systematic review. Behavioural Brain Research, 317, 46–61. 10.1016/j.bbr.2016.09.032 [DOI] [PubMed] [Google Scholar]
  33. de Souza, R. S. B., de Oliveira, J. C., Alvares-Teodoro, J., & Teodoro, M. L. M. (2020). [Suicide and indigenous populations in Brazil: Systematic reviewEl suicidio y los pueblos indígenas brasileños: Revisión sistemática]. Rev Panam Salud Publica, 44, e58. 10.26633/rpsp.2020.58(Suicídio e povos indígenas brasileiros: Revisão sistemática.) [DOI] [PMC free article] [PubMed] [Google Scholar]
  34. Dickson, J. M., Cruise, K., McCall, C. A., & Taylor, P. J. (2019). A systematic review of the antecedents and prevalence of suicide, self-harm and suicide ideation in Australian Aboriginal and Torres Strait Islander Youth. International Journal of Environmental Research and Public Health, 16(17), 3154. 10.3390/ijerph16173154 [DOI] [PMC free article] [PubMed] [Google Scholar]
  35. Dong, X., Chang, E. S., Zeng, P., & Simon, M. A. (2015). Suicide in the global Chinese aging population: A review of risk and protective factors, consequences, and interventions. Aging and Disease, 6(2), 121–130. 10.14336/AD.2014.0223 [DOI] [PMC free article] [PubMed] [Google Scholar]
  36. Duarte, D., El-Hagrassy, M. M., Couto, T. C. E., Gurgel, W., Fregni, F., & Correa, H. (2020). Male and female physician suicidality: A systematic review and meta-analysis. JAMA Psychiatry, 77(6), 587–597. 10.1001/jamapsychiatry.2020.0011 [DOI] [PMC free article] [PubMed] [Google Scholar]
  37. Dutheil, F., Aubert, C., Pereira, B., Dambrun, M., Moustafa, F., Mermillod, M., Baker, J. S., Trousselard, M., Lesage, F.-X., & Navel, V. (2019). Suicide among physicians and health-care workers: A systematic review and meta-analysis. PLoS One, 14(12), e0226361. 10.1371/journal.pone.0226361 [DOI] [PMC free article] [PubMed] [Google Scholar]
  38. El-Sayed, A. M., Haloossim, M. R., Galea, S., & Koenen, K. C. (2012). Epigenetic modifications associated with suicide and common mood and anxiety disorders: A systematic review of the literature. Biology of Mood & Anxiety Disorders, 2(1), 10. 10.1186/2045-5380-2-10 [DOI] [PMC free article] [PubMed] [Google Scholar]
  39. Freire, C., & Koifman, S. (2013). Pesticides, depression and suicide: A systematic review of the epidemiological evidence. International Journal of Hygiene and Environmental Health, 216(4), 445–460. 10.1016/j.ijheh.2012.12.003 [DOI] [PubMed] [Google Scholar]
  40. Fung, Y. L., & Chan, Z. C. (2011). A systematic review of suicidal behaviour in old age: A gender perspective. Journal of Clinical Nursing, 20(15–16), 2109–2124. 10.1111/j.1365-2702.2010.03649.x [DOI] [PubMed] [Google Scholar]
  41. Galvão, P. V. M., Silva, H. R. S. E., & Silva, C. M. F. P. d (2018). Temporal distribution of suicide mortality: A systematic review. Journal of Affective Disorders, 228, 132–142. 10.1016/j.jad.2017.12.008 [DOI] [PubMed] [Google Scholar]
  42. Gao, J., Cheng, Q., Duan, J., Xu, Z., Bai, L., Zhang, Y., Zhang, H., Wang, S., Zhang, Z., & Su, H. (2019). Ambient temperature, sunlight duration, and suicide: A systematic review and meta-analysis. The Science of the Total Environment, 646, 1021–1029. 10.1016/j.scitotenv.2018.07.098 [DOI] [PubMed] [Google Scholar]
  43. Glenn, C. R., Kleiman, E. M., Kellerman, J., Pollak, O., Cha, C. B., Esposito, E. C., Porter, A. C., Wyman, P. A., & Boatman, A. E. (2020). Annual research review: A meta-analytic review of worldwide suicide rates in adolescents. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 61(3), 294–308. 10.1111/jcpp.13106 [DOI] [PubMed] [Google Scholar]
  44. González-Castro, T. B., Hernandez-Diaz, Y., Juárez-Rojop, I. E., López-Narváez, L., Tovilla-Zárate, C. A., Rodriguez-Perez, J. M., & Sánchez-de la Cruz, J. P. (2017). The role of the Cys23Ser (rs6318) polymorphism of the HTR2C gene in suicidal behavior: Systematic review and meta-analysis. Psychiatric Genetics, 27(6), 199–209. 10.1097/YPG.0000000000000184 [DOI] [PubMed] [Google Scholar]
  45. Goodday, S. M., Shuldiner, J., Bondy, S., & Rhodes, A. E. (2019). Exposure to parental psychopathology and offspring’s risk of suicide-related thoughts and behaviours: A systematic review. Epidemiology and Psychiatric Sciences, 28(2), 179–190. 10.1017/S2045796017000397 [DOI] [PMC free article] [PubMed] [Google Scholar]
  46. Gorton, H. C., Webb, R. T., Kapur, N., & Ashcroft, D. M. (2016). Non-psychotropic medication and risk of suicide or attempted suicide: A systematic review. BMJ Open, 6(1), e009074. 10.1136/bmjopen-2015-009074 [DOI] [PMC free article] [PubMed] [Google Scholar]
  47. Gramaglia, C., Calati, R., & Zeppegno, P. (2019). Rational suicide in late life: A systematic review of the literature. Medicina, 55(10), 656. 10.3390/medicina55100656 [DOI] [PMC free article] [PubMed] [Google Scholar]
  48. Grandclerc, S., De Labrouhe, D., Spodenkiewicz, M., Lachal, J., & Moro, M. R. (2016). Relations between nonsuicidal self-injury and suicidal behavior in adolescence: A systematic review. PLoS One, 11(4), e0153760. http://www.plosone.org/article/fetchObject.action?uri=info: 10.1371/journal.pone.0153760 http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=reference&D=emed17&NEWS=N&AN=611092504 [DOI] [PMC free article] [PubMed] [Google Scholar]
  49. Grek, A. (2007). Clinical management of suicidality in the elderly: An opportunity for involvement in the lives of older patients. The Canadian Journal of Psychiatry, 52(6 Suppl 1), 47S–57S. https://www.ncbi.nlm.nih.gov/pubmed/17824352 [PubMed] [Google Scholar]
  50. Gunnell, D., Bennewith, O., Hawton, K., Simkin, S., & Kapur, N. (2005). The epidemiology and prevention of suicide by hanging: A systematic review. International Journal of Epidemiology, 34(2), 433–442. 10.1093/ije/dyh398 [DOI] [PubMed] [Google Scholar]
  51. Gunnell, D., Knipe, D., Chang, S. S., Pearson, M., Konradsen, F., Lee, W. J., & Eddleston, M. (2017). Prevention of suicide with regulations aimed at restricting access to highly hazardous pesticides: A systematic review of the international evidence. The Lancet Global Health, 5(10), e1026–e1037. 10.1016/s2214-109x(17)30299-1 [DOI] [PubMed] [Google Scholar]
  52. Hahn, A. P., Jochai, D., Caufield-Noll, C. P., Hunt, C. A., Allen, L. E., Rios, R., & Cordts, G. A. (2014). Self-inflicted burns: A systematic review of the literature. Journal of Burn Care & Research, 35(1), 102–119. 10.1097/BCR.0b013e31828b0a46 [DOI] [PubMed] [Google Scholar]
  53. Havârneanu, G. M., Burkhardt, J.-M., & Paran, F. (2015). A systematic review of the literature on safety measures to prevent railway suicides and trespassing accidents. Accident, Analysis and Prevention, 81, 30–50. 10.1016/j.aap.2015.04.012 [DOI] [PubMed] [Google Scholar]
  54. Haw, C., & Hawton, K. (2016). Suicide and self-harm by drowning: A review of the literature. Archives of Suicide Research, 20(2), 95–112. 10.1080/13811118.2015.1025120 [DOI] [PubMed] [Google Scholar]
  55. Hill, N. T. M., Robinson, J., Pirkis, J., Andriessen, K., Krysinska, K., Payne, A., Boland, A., Clarke, A., Milner, A., Witt, K., Krohn, S., & Lampit, A. (2020). Association of suicidal behavior with exposure to suicide and suicide attempt: A systematic review and multilevel meta-analysis. PLoS Medicine, 17(3), e1003074. 10.1371/journal.pmed.1003074 [DOI] [PMC free article] [PubMed] [Google Scholar]
  56. Hofstra, E., van Nieuwenhuizen, C., Bakker, M., Özgül, D., Elfeddali, I., de Jong, S. J., & van der Feltz-Cornelis, C. M. (2020). Effectiveness of suicide prevention interventions: A systematic review and meta-analysis. General Hospital Psychiatry, 63, 127–140. 10.1016/j.genhosppsych.2019.04.011 [DOI] [PubMed] [Google Scholar]
  57. Holmes, J., Meier, P. S., Booth, A., Guo, Y., & Brennan, A. (2012). The temporal relationship between per capita alcohol consumption and harm: A systematic review of time lag specifications in aggregate time series analyses. Drug and Alcohol Dependence, 123(1–3), 7–14. 10.1016/j.drugalcdep.2011.12.005 [DOI] [PubMed] [Google Scholar]
  58. Honkaniemi, H., Bacchus-Hertzman, J., Fritzell, J., & Rostila, M. (2017). Mortality by country of birth in the Nordic countries – A systematic review of the literature. BMC Public Health, 17(1), 511. 10.1186/s12889-017-4447-9 [DOI] [PMC free article] [PubMed] [Google Scholar]
  59. Hua, P., Bugeja, L., & Maple, M. (2019). A systematic review on the relationship between childhood exposure to external cause parental death, including suicide, on subsequent suicidal behaviour. Journal of Affective Disorders, 257, 723–734. 10.1016/j.jad.2019.07.082 [DOI] [PubMed] [Google Scholar]
  60. Hunt, T., Wilson, C. J., Caputi, P., Woodward, A., & Wilson, I. (2017). Signs of current suicidality in men: A systematic review. PLoS One, 12(3), e0174675. 10.1371/journal.pone.0174675 [DOI] [PMC free article] [PubMed] [Google Scholar]
  61. Husain, N., Afsar, S., Ara, J., Fayyaz, H., Rahman, R. U., Tomenson, B., Hamirani, M., Chaudhry, N., Fatima, B., Husain, M., Naeem, F., & Chaudhry, I. B. (2014). Brief psychological intervention after self-harm: Randomised controlled trial from Pakistan. The British Journal of Psychiatry, 204(6), 462–470. 10.1192/bjp.bp.113.138370 [DOI] [PubMed] [Google Scholar]
  62. Ide, N., Wyder, M., Kolves, K., & De Leo, D. (2010). Separation as an important risk factor for suicide: A systematic review. Journal of Family Issues, 31(12), 1689–1716. http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=reference&D=psyc7&NEWS=N&AN=2010-23005-007 10.1177/0192513X10365317 [DOI] [Google Scholar]
  63. Iemmi, V., Bantjes, J., Coast, E., Channer, K., Leone, T., McDaid, D., Palfreyman, A., Stephens, B., & Lund, C. (2016). Suicide and poverty in low-income and middle-income countries: A systematic review. The Lancet, 3(8), 774–783. 10.1016/S2215-0366(16)30066-9 [DOI] [PubMed] [Google Scholar]
  64. Jafari, H., Heidari, M., Heidari, S., & Sayfouri, N. (2020). Risk factors for suicidal behaviours after natural disasters: A systematic review. The Malaysian Journal of Medical Sciences, 27(3), 20–33. 10.21315/mjms2020.27.3.3 [DOI] [PMC free article] [PubMed] [Google Scholar]
  65. Jang, D., & Elfenbein, H. A. (2019). Menstrual cycle effects on mental health outcomes: A meta-analysis. Archives of Suicide Research, 23(2), 312–332. 10.1080/13811118.2018.1430638 [DOI] [PubMed] [Google Scholar]
  66. Kenedi, C., Friedman, S. H., Watson, D., & Preitner, C. (2016). Suicide and murder-suicide involving aircraft. Aerospace Medicine and Human Performance, 87(4), 388–396. 10.3357/AMHP.4474.2016 [DOI] [PubMed] [Google Scholar]
  67. Kleck, G. (2019). Macro-level research on the effect of firearms prevalence on suicide rates: A systematic review and new evidence. Social Science Quarterly, 100(3), 936–950. http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=reference&D=psyc16&NEWS=N&AN=2019-06786-001 10.1111/ssqu.12602 [DOI] [Google Scholar]
  68. Klingelschmidt, J., Milner, A., Khireddine-Medouni, I., Witt, K., Alexopoulos, E. C., Toivanen, S., LaMontagne, A. D., Chastang, J.-F., & Niedhammer, I. (2018). Suicide among agricultural, forestry, and fishery workers: A systematic literature review and meta-analysis. Scandinavian Journal of Work, Environment & Health, 44(1), 3–15. 10.5271/sjweh.3682 [DOI] [PubMed] [Google Scholar]
  69. Klinitzke, G., Steinig, J., Blüher, M., Kersting, A., & Wagner, B. (2013). Obesity and suicide risk in adults – A systematic review. Journal of Affective Disorders, 145(3), 277–284. 10.1016/j.jad.2012.07.010 [DOI] [PubMed] [Google Scholar]
  70. Knipe, D., & Jewkes, R. (2022). Equity in reporting settings of studies. European Science Editing, 48, e87545. 10.3897/ese.2022.e87545 [DOI] [Google Scholar]
  71. Knipe, D., Padmanathan, P., Newton-Howes, G., Chan, L. F., & Kapur, N. (2022). Suicide and self-harm. Lancet, 399(10338), 1903–1916. 10.1016/S0140-6736(22)00173-8 [DOI] [PubMed] [Google Scholar]
  72. Knipe, D., Williams, A. J., Hannam-Swain, S., Upton, S., Brown, K., Bandara, P., Chang, S.-S., & Kapur, N. (2019). Psychiatric morbidity and suicidal behaviour in low- and middle-income countries: A systematic review and meta-analysis. PLoS Medicine, 16(10), e1002905. 10.1371/journal.pmed.1002905 [DOI] [PMC free article] [PubMed] [Google Scholar]
  73. Knipe, D. W., Carroll, R., Thomas, K. H., Pease, A., Gunnell, D., & Metcalfe, C. (2015). Association of socio-economic position and suicide/attempted suicide in low and middle income countries in South and South-East Asia – A systematic review. BMC Public Health, 15(1), 1055. 10.1186/s12889-015-2301-5 [DOI] [PMC free article] [PubMed] [Google Scholar]
  74. Kõlves, K., Kõlves, K. E., & De Leo, D. (2013). Natural disasters and suicidal behaviours: A systematic literature review. Journal of Affective Disorders, 146(1), 1–14. 10.1016/j.jad.2012.07.037 [DOI] [PubMed] [Google Scholar]
  75. Kuramoto, J. S., Brent, D. A., & Wilcox, H. C. (2009). The impact of parental suicide on child and adolescent offspring. Suicide & Life-Threatening Behavior, 39(2), 137–151. 10.1521/suli.2009.39.2.137 [DOI] [PubMed] [Google Scholar]
  76. Large, M., Smith, G., & Nielssen, O. (2009). The epidemiology of homicide followed by suicide: A systematic and quantitative review. Suicide & Life-Threatening Behavior, 39(3), 294–306. 10.1521/suli.2009.39.3.294 [DOI] [PubMed] [Google Scholar]
  77. Li, M., & Katikireddi, S. V. (2019). Urban-rural inequalities in suicide among elderly people in China: A systematic review and meta-analysis. International Journal for Equity in Health, 18(1), 2. 10.1186/s12939-018-0881-2 [DOI] [PMC free article] [PubMed] [Google Scholar]
  78. Li, Y., Li, Y., & Cao, J. (2012). Factors associated with suicidal behaviors in mainland China: A meta-analysis. BMC Public Health, 12(1), 524. 10.1186/1471-2458-12-524 [DOI] [PMC free article] [PubMed] [Google Scholar]
  79. Linde, K., Treml, J., Steinig, J., Nagl, M., & Kersting, A. (2017). Grief interventions for people bereaved by suicide: A systematic review. PLoS One, 12(6), e0179496. 10.1371/journal.pone.0179496 [DOI] [PMC free article] [PubMed] [Google Scholar]
  80. Lindeman, S., Laara, E., Hakko, H., & Lonnqvist, J. (1996). A systematic review on gender-specific suicide mortality in medical doctors. The British Journal of Psychiatry, 168(3), 274–279. 10.1192/bjp.168.3.274 [DOI] [PubMed] [Google Scholar]
  81. Liotta, M., Mento, C., & Settineri, S. (2015). Seriousness and lethality of attempted suicide: A systematic review. Aggression and Violent Behavior, 21, 97–109. http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=reference&D=psyc12&NEWS=N&AN=2015-10447-012 10.1016/j.avb.2014.12.013 [DOI] [Google Scholar]
  82. Liu, Q., Wang, W., Gu, X., Deng, F., Wang, X., Lin, H., Guo, X., & Wu, S. (2021). Association between particulate matter air pollution and risk of depression and suicide: A systematic review and meta-analysis. Environmental Science and Pollution Research International, 28(8), 9029–9049. 10.1007/s11356-021-12357-3 [DOI] [PubMed] [Google Scholar]
  83. Liu, R. T., & Miller, I. (2014). Life events and suicidal ideation and behavior: A systematic review. Clinical Psychology Review, 34(3), 181–192. 10.1016/j.cpr.2014.01.006 [DOI] [PubMed] [Google Scholar]
  84. Malakouti, S. K., Davoudi, F., Khalid, S., Ahmadzad Asl, M., Moosa Khan, M., Alirezaei, N., & DeLeo, D. (2015). The epidemiology of suicide behaviors among the Countries of the Eastern Mediterranean Region of WHO: A Systematic Review. Acta Med Iran, 53(5), 257–265. https://acta.tums.ac.ir/index.php/acta/article/download/4895/4451 [PubMed] [Google Scholar]
  85. Maple, M., Cerel, J., Sanford, R., Pearce, T., & Jordan, J. (2017). Is exposure to suicide beyond kin associated with risk for suicidal behavior? A systematic review of the evidence. Suicide & Life-Threatening Behavior, 47(4), 461–474. 10.1111/sltb.12308 [DOI] [PubMed] [Google Scholar]
  86. McDaid, C., Trowman, R., Golder, S., Hawton, K., & Sowden, A. (2008). Interventions for people bereaved through suicide: Systematic review. The British Journal of Psychiatry, 193(6), 438–443. 10.1192/bjp.bp.107.040824 [DOI] [PubMed] [Google Scholar]
  87. Memon, A., Rogers, I., Fitzsimmons, S., Carter, B., Strawbridge, R., Hidalgo-Mazzei, D., & Young, A. H. (2020). Association between naturally occurring lithium in drinking water and suicide rates: Systematic review and meta-analysis of ecological studies. The British Journal of Psychiatry, 217(6), 667–678. 10.1192/bjp.2020.128 [DOI] [PubMed] [Google Scholar]
  88. Mew, E. J., Padmanathan, P., Konradsen, F., Eddleston, M., Chang, S. S., Phillips, M. R., & Gunnell, D. (2017). The global burden of fatal self-poisoning with pesticides 2006–15: Systematic review. Journal of Affective Disorders, 219, 93–104. 10.1016/j.jad.2017.05.002 [DOI] [PubMed] [Google Scholar]
  89. Milner, A., Page, A., & LaMontagne, A. D. (2013). Long-term unemployment and suicide: A systematic review and meta-analysis. PLoS One, 8(1), e51333. 10.1371/journal.pone.0051333 [DOI] [PMC free article] [PubMed] [Google Scholar]
  90. Milner, A., Page, A., & LaMontagne, A. D. (2014). Cause and effect in studies on unemployment, mental health and suicide: A meta-analytic and conceptual review. Psychological Medicine, 44(5), 909–917. 10.1017/S0033291713001621 [DOI] [PubMed] [Google Scholar]
  91. Milner, A., Spittal, M. J., Pirkis, J., & LaMontagne, A. D. (2013). Suicide by occupation: Systematic review and meta-analysis. The British Journal of Psychiatry, 203(6), 409–416. 10.1192/bjp.bp.113.128405 [DOI] [PubMed] [Google Scholar]
  92. Milner, A., Sveticic, J., & De Leo, D. (2013). Suicide in the absence of mental disorder? A review of psychological autopsy studies across countries. The International Journal of Social Psychiatry, 59(6), 545–554. 10.1177/0020764012444259 [DOI] [PubMed] [Google Scholar]
  93. Milner, A., Witt, K., LaMontagne, A. D., & Niedhammer, I. (2018). Psychosocial job stressors and suicidality: A meta-analysis and systematic review. Occupational and Environmental Medicine, 75(4), 245–253. 10.1136/oemed-2017-104531 [DOI] [PubMed] [Google Scholar]
  94. Milner, A., Witt, K., Pirkis, J., Hetrick, S., Robinson, J., Currier, D., Spittal, M. J., Page, A., & Carter, G. L. (2017). The effectiveness of suicide prevention delivered by GPs: A systematic review and meta-analysis. Journal of Affective Disorders, 210, 294–302. 10.1016/j.jad.2016.12.035 [DOI] [PubMed] [Google Scholar]
  95. Milner, A. J., Carter, G., Pirkis, J., Robinson, J., & Spittal, M. J. (2015). Letters, green cards, telephone calls and postcards: Systematic and meta-analytic review of brief contact interventions for reducing self-harm, suicide attempts and suicide. The British Journal of Psychiatry, 206(3), 184–190. 10.1192/bjp.bp.114.147819 [DOI] [PubMed] [Google Scholar]
  96. Miranda-Mendizabal, A., Castellví, P., Parés-Badell, O., Alayo, I., Almenara, J., Alonso, I., Blasco, M. J., Cebrià, A., Gabilondo, A., Gili, M., Lagares, C., Piqueras, J. A., Rodríguez-Jiménez, T., Rodríguez-Marín, J., Roca, M., Soto-Sanz, V., Vilagut, G., & Alonso, J. (2019). Gender differences in suicidal behavior in adolescents and young adults: Systematic review and meta-analysis of longitudinal studies. International Journal of Public Health, 64(2), 265–283. 10.1007/s00038-018-1196-1 [DOI] [PMC free article] [PubMed] [Google Scholar]
  97. Mishara, B. L., & Bardon, C. (2016). Systematic review of research on railway and urban transit system suicides. Journal of Affective Disorders, 193, 215–226. 10.1016/j.jad.2015.12.042 [DOI] [PubMed] [Google Scholar]
  98. Morovatdar, N., Moradi-Lakeh, M., Malakouti, S. K., & Nojomi, M. (2013). Most common methods of suicide in Eastern Mediterranean Region of WHO: A systematic review and meta-analysis. Archives of Suicide Research, 17(4), 335–344. 10.1080/13811118.2013.801811 [DOI] [PubMed] [Google Scholar]
  99. Nazarzadeh, M., Bidel, Z., Ayubi, E., Asadollahi, K., Carson, K. V., & Sayehmiri, K. (2013). Determination of the social related factors of suicide in Iran: A systematic review and meta-analysis. BMC Public Health, 13(1), 4. 10.1186/1471-2458-13-4 [DOI] [PMC free article] [PubMed] [Google Scholar]
  100. Niederkrotenthaler, T., Braun, M., Pirkis, J., Till, B., Stack, S., Sinyor, M., Tran, U. S., Voracek, M., Cheng, Q., Arendt, F., Scherr, S., Yip, P. S. F., & Spittal, M. J. (2020). Association between suicide reporting in the media and suicide: Systematic review and meta-analysis. BMJ, 368, m575. 10.1136/bmj.m575 [DOI] [PMC free article] [PubMed] [Google Scholar]
  101. Niedzwiedz, C., Haw, C., Hawton, K., & Platt, S. (2014). The definition and epidemiology of clusters of suicidal behavior: A systematic review. Suicide & Life-Threatening Behavior, 44(5), 569–581. 10.1111/sltb.12091 [DOI] [PubMed] [Google Scholar]
  102. Okolie, C., Dennis, M., Simon Thomas, E., & John, A. (2017). A systematic review of interventions to prevent suicidal behaviors and reduce suicidal ideation in older people. International Psychogeriatrics, 29(11), 1801–1824. 10.1017/S1041610217001430 [DOI] [PubMed] [Google Scholar]
  103. Okolie, C., Wood, S., Hawton, K., Kandalama, U., Glendenning, A. C., Dennis, M., Price, S. F., Lloyd, K., & John, A. (2020). Means restriction for the prevention of suicide by jumping. The Cochrane Database of Systematic Reviews, 2(2), CD013543. 10.1002/14651858.CD013543 [DOI] [PMC free article] [PubMed] [Google Scholar]
  104. Owens, D., Horrocks, J., & House, A. (2002). Fatal and non-fatal repetition of self-harm. Systematic review. The British Journal of Psychiatry, 181(3), 193–199. 10.1192/bjp.181.3.193 [DOI] [PubMed] [Google Scholar]
  105. Oyama, H., Sakashita, T., Ono, Y., Goto, M., Fujita, M., & Koida, J. (2008). Effect of community-based intervention using depression screening on elderly suicide risk: A meta-analysis of the evidence from Japan. Community Mental Health Journal, 44(5), 311–320. 10.1007/s10597-008-9132-0 [DOI] [PubMed] [Google Scholar]
  106. Oyesanya, M., Lopez-Morinigo, J., & Dutta, R. (2015). Systematic review of suicide in economic recession. World Journal of Psychiatry, 5(2), 243–254. 10.5498/wjp.v5.i2.243 [DOI] [PMC free article] [PubMed] [Google Scholar]
  107. Panczak, R., Geissbühler, M., Zwahlen, M., Killias, M., Tal, K., & Egger, M. (2013). Homicide-suicides compared to homicides and suicides: Systematic review and meta-analysis. Forensic Science International, 233(1–3), 28–36. 10.1016/j.forsciint.2013.08.017 [DOI] [PubMed] [Google Scholar]
  108. Perera, S., Eisen, R. B., Dennis, B. B., Bawor, M., Bhatt, M., Bhatnagar, N., Thabane, L., de Souza, R., & Samaan, Z. (2016). Body mass index is an important predictor for suicide: Results from a systematic review and meta-analysis. Suicide & Life-Threatening Behavior, 46(6), 697–736. 10.1111/sltb.12244 [DOI] [PubMed] [Google Scholar]
  109. Pigeon, W. R., Bishop, T. M., & Titus, C. E. (2016). The relationship between sleep disturbance, suicidal ideation, suicide attempts, and suicide among adults: A systematic review. Psychiatric Annals, 46(3), 177–186. http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=reference&D=psyc13&NEWS=N&AN=2016-57996-007 10.3928/00485713-20160128-01 [DOI] [Google Scholar]
  110. Pirkis, J., & Burgess, P. (1998). Suicide and recency of health care contacts. A systematic review. The British Journal of Psychiatry, 173(6), 462–474. 10.1192/bjp.173.6.462 [DOI] [PubMed] [Google Scholar]
  111. Pirkis, J., Too, L. S., Spittal, M. J., Krysinska, K., Robinson, J., & Cheung, Y. T. (2015). Interventions to reduce suicides at suicide hotspots: A systematic review and meta-analysis. The Lancet, 2(11), 994–1001. 10.1016/s2215-0366(15)00266-7 [DOI] [PubMed] [Google Scholar]
  112. Platt, B., Hawton, K., Simkin, S., & Mellanby, R. J. (2010). Systematic review of the prevalence of suicide in veterinary surgeons. Occupational Medicine, 60(6), 436–446. 10.1093/occmed/kqq044 [DOI] [PubMed] [Google Scholar]
  113. Plöderl, M., & Tremblay, P. (2015). Mental health of sexual minorities. A systematic review. International Review of Psychiatry, 27(5), 367–385. 10.3109/09540261.2015.1083949 [DOI] [PubMed] [Google Scholar]
  114. Pollock, M., Fernandes, R. M., Becker, L. A., Pieper, D., & Hartling, L. (2023). Chapter V: Overviews of reviews. In Higgins J. P. T., Thomas J., Chandler J., Cumpston M., Li T., Page M. J., & VA W. (Eds.), Cochrane handbook for systematic reviews of interventions (version 6.4 ed.). Cochrane. www.training.cochrane.org/handbook [Google Scholar]
  115. Pollock, N. J., Naicker, K., Loro, A., Mulay, S., & Colman, I. (2018). Global incidence of suicide among Indigenous peoples: A systematic review. BMC Medicine, 16(1), 145. 10.1186/s12916-018-1115-6 [DOI] [PMC free article] [PubMed] [Google Scholar]
  116. Ragguett, R.-M., Cha, D. S., Subramaniapillai, M., Carmona, N. E., Lee, Y., Yuan, D., Rong, C., & McIntyre, R. S. (2017). Air pollution, aeroallergens and suicidality: A review of the effects of air pollution and aeroallergens on suicidal behavior and an exploration of possible mechanisms. Reviews on Environmental Health, 32(4), 343–359. 10.1515/reveh-2017-0011 [DOI] [PubMed] [Google Scholar]
  117. Rane, A., & Nadkarni, A. (2014). Suicide in India: A systematic review. Shanghai Arch Psychiatry, 26(2), 69–80. 10.3969/j.issn.1002-0829.2014.02.003 [DOI] [PMC free article] [PubMed] [Google Scholar]
  118. Rehkopf, D. H., & Buka, S. L. (2006). The association between suicide and the socio-economic characteristics of geographical areas: A systematic review. Psychological Medicine, 36(2), 145–157. 10.1017/S003329170500588x [DOI] [PubMed] [Google Scholar]
  119. Rice, T. R., & Sher, L. (2016). Preventing plane-assisted suicides through the lessons of research on homicide and suicide-homicide. Acta Neuropsychiatrica, 28(4), 195–198. 10.1017/neu.2015.67 [DOI] [PubMed] [Google Scholar]
  120. Robinson, J., Bailey, E., Witt, K., Stefanac, N., Milner, A., Currier, D., Pirkis, J., Condron, P., & Hetrick, S. (2018). What works in youth suicide prevention? A systematic review and meta-analysis. EClinicalMedicine, 4-5, 52–91. 10.1016/j.eclinm.2018.10.004 [DOI] [PMC free article] [PubMed] [Google Scholar]
  121. Rowell, K. L., Green, B. L., Guidry, J., & Eddy, J. (2008). Factors associated with suicide among African American adult men: A systematic review of the literature. Journal of Men’s Health, 5(4), 274–281. http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=reference&D=psyc6&NEWS=N&AN=2008-17467-004 10.1016/j.jomh.2008.09.013 [DOI] [Google Scholar]
  122. Runeson, B., Odeberg, J., Pettersson, A., Edbom, T., Jildevik Adamsson, I., & Waern, M. (2017). Instruments for the assessment of suicide risk: A systematic review evaluating the certainty of the evidence. PLoS One, 12(7), e0180292. 10.1371/journal.pone.0180292 [DOI] [PMC free article] [PubMed] [Google Scholar]
  123. Sales, A. P., Santana da Silva, T. P., Sougey, E. B., & Saraiva Câmara Filho, J. W. (2019). Psychopathological and psychosocial repercussions of suicide in the family. Current Psychiatry Research and Reviews, 15(1), 3–10. 10.2174/1573400515666190114155014 [DOI] [Google Scholar]
  124. Sargeant, H., Forsyth, R., & Pitman, A. (2018). The epidemiology of suicide in young men in Greenland: A systematic review. International Journal of Environmental Research and Public Health, 15(11), 2442. 10.3390/ijerph15112442 [DOI] [PMC free article] [PubMed] [Google Scholar]
  125. Serafini, G., Pompili, M., Lindqvist, D., Dwivedi, Y., & Girardi, P. (2013). The role of neuropeptides in suicidal behavior: A systematic review. BioMed Research International, 2013, 687575–687522. 10.1155/2013/687575 [DOI] [PMC free article] [PubMed] [Google Scholar]
  126. Shahid, M., & Hyder, A. A. (2008). Deliberate self-harm and suicide: A review from Pakistan. International Journal of Injury Control and Safety Promotion, 15(4), 233–241. 10.1080/17457300802149811 [DOI] [PubMed] [Google Scholar]
  127. Shields, C., Kavanagh, M., & Russo, K. (2017). A qualitative systematic review of the bereavement process following suicide. Omega, 74(4), 426–454. 10.1177/0030222815612281 [DOI] [PubMed] [Google Scholar]
  128. Silva, A. C., de Oliveira Ribeiro, N. P., de Mello Schier, A. R., Pereira, V. M., Vilarim, M. M., Pessoa, T. M., Arias-Carrión, O., Machado, S., & Nardi, A. E. (2014). Caffeine and suicide: A systematic review. CNS & Neurological Disorders Drug Targets, 13(6), 937–944. 10.2174/1871527313666140612123656 [DOI] [PubMed] [Google Scholar]
  129. Simon, M., Chang, E. S., Zeng, P., & Dong, X. (2013). Prevalence of suicidal ideation, attempts, and completed suicide rate in Chinese aging populations: A systematic review. Archives of Gerontology and Geriatrics, 57(3), 250–256. 10.1016/j.archger.2013.05.006 [DOI] [PMC free article] [PubMed] [Google Scholar]
  130. Sisask, M., & Värnik, A. (2012). Media roles in suicide prevention: A systematic review. International Journal of Environmental Research and Public Health, 9(1), 123–138. 10.3390/ijerph9010123 [DOI] [PMC free article] [PubMed] [Google Scholar]
  131. Skinner, G. C. M., & Farrington, D. P. (2020). A systematic review and meta-analysis of offending versus suicide in community (non-psychiatric and non-prison) samples. Aggression and Violent Behavior, 52, 101421. 10.1016/j.avb.2020.101421 [DOI] [Google Scholar]
  132. Soole, R., Kõlves, K., & De Leo, D. (2015). Suicide in children: A systematic review. Archives of Suicide Research, 19(3), 285–304. 10.1080/13811118.2014.996694 [DOI] [PubMed] [Google Scholar]
  133. Spallek, J., Reeske, A., Norredam, M., Nielsen, S. S., Lehnhardt, J., & Razum, O. (2015). Suicide among immigrants in Europe–a systematic literature review. European Journal of Public Health, 25(1), 63–71. 10.1093/eurpub/cku121 [DOI] [PubMed] [Google Scholar]
  134. Spillane, A., Larkin, C., Corcoran, P., Matvienko-Sikar, K., Riordan, F., & Arensman, E. (2017). Physical and psychosomatic health outcomes in people bereaved by suicide compared to people bereaved by other modes of death: A systematic review. BMC Public Health, 17(1), 939. http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med14&AN=29228916 https://bris.on.worldcat.org/atoztitles/link?sid = OVID:Medline&id = pmid:29228916&id = =1471-2458&isbn=&volume=17&issue=1&spage=939&pages=939&date=2017&title = BMC + Public + Health&atitle = Physical + and + psychosomatic + health + outcomes + in + people + bereaved + by + suicide + compared + to + people + bereaved + by + other + modes + of + death%3A + a+systematic + review.&aulast = Spillane&pid=%3Cauthor%3ESpillane + A%3C%2Fauthor%3E%3CAN%3E29228916%3C%2FAN%3E%3CDT%3EJournal + Article%3C%2FDT%3E 10.1186/s12889-017-4930-3 [DOI] [PMC free article] [PubMed] [Google Scholar]
  135. Stanley, I. H., Hom, M. A., & Joiner, T. E. (2016). A systematic review of suicidal thoughts and behaviors among police officers, firefighters, EMTs, and paramedics. Clinical Psychology Review, 44, 25–44. 10.1016/j.cpr.2015.12.002 [DOI] [PubMed] [Google Scholar]
  136. Stene-Larsen, K., & Reneflot, A. (2019). Contact with primary and mental health care prior to suicide: A systematic review of the literature from 2000 to 2017. Scandinavian Journal of Public Health, 47(1), 9–17. 10.1177/1403494817746274 [DOI] [PubMed] [Google Scholar]
  137. Sveen, C. A., & Walby, F. A. (2008). Suicide survivors’ mental health and grief reactions: A systematic review of controlled studies. Suicide & Life-Threatening Behavior, 38(1), 13–29. 10.1521/suli.2008.38.1.13 [DOI] [PubMed] [Google Scholar]
  138. Szücs, A., Szanto, K., Aubry, J.-M., & Dombrovski, A. Y. (2018). Personality and suicidal behavior in old age: A systematic literature review. Frontiers in Psychiatry, 9, 128. 10.3389/fpsyt.2018.00128 [DOI] [PMC free article] [PubMed] [Google Scholar]
  139. Thompson, R., Hornigold, R., Page, L., & Waite, T. (2018). Associations between high ambient temperatures and heat waves with mental health outcomes: A systematic review. Public Health, 161, 171–191. http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=reference&D=med15&NEWS=N&AN=30007545 10.1016/j.puhe.2018.06.008 [DOI] [PubMed] [Google Scholar]
  140. Tøllefsen, I. M., Hem, E., & Ekeberg, Ø. (2012). The reliability of suicide statistics: A systematic review. BMC Psychiatry, 12(1), 9. 10.1186/1471-244X-12-9 [DOI] [PMC free article] [PubMed] [Google Scholar]
  141. Too, L. S., Milner, A., Bugeja, L., & McClure, R. (2014). The socio-environmental determinants of railway suicide: A systematic review. BMC Public Health, 14(1), 20. 10.1186/1471-2458-14-20 [DOI] [PMC free article] [PubMed] [Google Scholar]
  142. Torok, M., Calear, A., Shand, F., & Christensen, H. (2017). A systematic review of Mass Media campaigns for suicide prevention: Understanding their efficacy and the mechanisms needed for successful behavioral and literacy change. Suicide & Life-Threatening Behavior, 47(6), 672–687. 10.1111/sltb.12324 [DOI] [PubMed] [Google Scholar]
  143. Troya, M. I., Babatunde, O., Polidano, K., Bartlam, B., McCloskey, E., Dikomitis, L., & Chew-Graham, C. A. (2019). Self-harm in older adults: Systematic review. The British Journal of Psychiatry, 214(4), 186–200. 10.1192/bjp.2019.11 [DOI] [PubMed] [Google Scholar]
  144. Wagner, B., Hofmann, L., & Grafiadeli, R. (2021). Psychological interventions for people bereaved by suicide: A systematic review. Psychiatrische Praxis, 48(1), 9–18. 10.1055/a-1182-2821 [DOI] [PubMed] [Google Scholar]
  145. Walby, F. A., Myhre, M. O., & Kildahl, A. T. (2018). Contact with mental health services prior to suicide: A Systematic Review and Meta-Analysis. Psychiatric Services, 69(7), 751–759. 10.1176/appi.ps.201700475 [DOI] [PubMed] [Google Scholar]
  146. Wilson, M. P., Moutier, C., Wolf, L., Nordstrom, K., Schulz, T., & Betz, M. E. (2020). ED recommendations for suicide prevention in adults: The ICAR(2)E mnemonic and a systematic review of the literature. The American Journal of Emergency Medicine, 38(3), 571–581. 10.1016/j.ajem.2019.06.031 [DOI] [PubMed] [Google Scholar]
  147. Witt, K., Daly, C., Arensman, E., Pirkis, J., & Lubman, D. (2019). Patterns of self-harm methods over time and the association with methods used at repeat episodes of non-fatal self-harm and suicide: A systematic review. Journal of Affective Disorders, 245, 250–264. 10.1016/j.jad.2018.11.001 [DOI] [PubMed] [Google Scholar]
  148. Witt, K., Milner, A., Allisey, A., Davenport, L., & LaMontagne, A. D. (2017). Effectiveness of suicide prevention programs for emergency and protective services employees: A systematic review and meta-analysis. American Journal of Industrial Medicine, 60(4), 394–407. 10.1002/ajim.22676 [DOI] [PubMed] [Google Scholar]
  149. World Bank . (n.d.). World Bank Country and Lending Groups. Retrieved January, 11, 2021, from https://datahelpdesk.worldbank.org/knowledgebase/articles/906519-world-bank-country-and-lending-groups.
  150. World Health Organisation . (2021). Suicide worldwide in 2019: Global health estimates. W. H. Organization. https://apps.who.int/iris/rest/bitstreams/1350975/retrieve. [Google Scholar]
  151. Wu, S., Ding, Y., Wu, F., Xie, G., Hou, J., & Mao, P. (2016). Serum lipid levels and suicidality: A meta-analysis of 65 epidemiological studies. Journal of Psychiatry & Neuroscience, 41(1), 56–69. 10.1503/jpn.150079 [DOI] [PMC free article] [PubMed] [Google Scholar]
  152. Yoshimasu, K., Kiyohara, C., & Miyashita, K. (2008). Suicidal risk factors and completed suicide: Meta-analyses based on psychological autopsy studies. Environmental Health and Preventive Medicine, 13(5), 243–256. 10.1007/s12199-008-0037-x [DOI] [PMC free article] [PubMed] [Google Scholar]
  153. Zhang, J., Yan, F., Li, Y., & McKeown, R. E. (2013). Body mass index and suicidal behaviors: A critical review of epidemiological evidence. Journal of Affective Disorders, 148(2–3), 147–160. 10.1016/j.jad.2012.05.048 [DOI] [PubMed] [Google Scholar]
  154. Zhao, T., Markevych, I., Romanos, M., Nowak, D., & Heinrich, J. (2018). Ambient ozone exposure and mental health: A systematic review of epidemiological studies. Environmental Research, 165, 459–472. 10.1016/j.envres.2018.04.015 [DOI] [PubMed] [Google Scholar]

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