Table 4.
Summary of data extraction of the selected articles (1990–2018)
| Author (year) | Setting | Method | Time spent (after the disaster) | Identified risk factors for suicide | Findings |
|---|---|---|---|---|---|
| Chen et al. (19) | Taiwan | Time series | 9 years | Age | Earthquake resulted in a significant decrease in standardised suicide mortality ratios. Gender was not a risk factor for suicide. |
| Ohto et al. (20) | Japan | Time series | 3 years | Unemployment, having a serious psychological illness | Suicide prevalence decreased during the first 2 years and then increased. |
| Tang et al. (21) | China | Empirical study | 3 years | Age, gender, depression, PTSD | Suicidality is independently associated with emotional abuse, neglect, depression and PTSD symptoms in this disaster-exposed young population. Physical neglect or abuse were not related to suicidality. |
| Fujiwara et al. (23) | Japan | Follow-up study | 3 years | Gender, having a serious psychological illness, injuries of individual or their relatives | Trauma experience before the earthquake, behaviour problems at baseline, subjective socioeconomic status, maternal mental health, and parenting practice at baseline were not associated with suicide risk in the crude model. |
| Guo et al. (23) | China | Cross- sectional | 8 years | PTSD, depression, gender, perceived non-recovery, low social support, low education | Targeted, long-term suicide prevention programmes for adult survivors should be further developed. |
| Ran et al. (24) | China | Follow-up study | 6, 12 and 18 months | PTSD, depression, gender, low social support, loss of relatives | Depression symptoms were the strongest predictor of suicidal ideation after earthquake. An increased rate of suicidal ideation after the earthquake may be mainly due to depression but not to PTSD symptoms. There was no significant differences of rates of suicidal ideation between adolescents who lost their family members and those who did not lose their family members. Evidence indicates that earthquakes, by themselves, do not cause suicides. |
| Matsubayashi et al. (25) | Japan | Panel data | 29 years | Age, gender, number of disaster victims | Areas affected by natural disasters experienced a temporary increase in suicide rates in the same year, but the rates decreased over the next two years. Subsequently, however, the suicide rates in the areas increased again in the third and fourth year after the disaster. Five years after the disaster, the overall suicide rate was not associated with the size of the damages. |
| Chou et al. (12) | Taiwan | Cohort study | 2–15 months | Age, gender, pre- disaster physical disability status, having a serious psychological illness | The risk of suicide increased with age. Women had a 50% lower risk of suicide than men. |
| Aoki et al. (26) | Japan | Time series | 1 year | Economic conditions | The risk of non-fatal suicide attempts using high mortality methods was significantly higher for four months, by three to four times after a series of disasters, and then decreased. The total number of death by suicide reported by the police decreased in the first year after the disasters. |
| Brown et al. (27) | Chile | Follow-up study | 1 year | PTSD | Groups with pre-disaster PTSD should be prioritised for receipt of mental health resources following a natural disaster. Pre-disaster panic disorder is not associated with elevated thoughts of death or suicide following a natural disaster. |
| Nishio et al. (28) | Japan | Time series | 5 years | Age | Suicide rates in Kobe significantly decreased in the two years after the earthquake. An influence on suicide rate after the disaster clearly appeared in the middle-aged men. |
| Yang et al. (14) | Taiwan | Time series | 2 years | Number of disaster victims | Higher suicide rates were observed over a 10-month period following the disaster. |
| Krug et al. (10) | USA | Time series | 4 years | Age, gender, depression, having a serious psychological illness | Suicide rates increased in the four years after floods in the two years after hurricanes and in the first year after earthquakes. The suicide rates did not change significantly after tornadoes or severe storms. Strong social support is a protective factor against suicide. |
| Shoaf et al. (29) | USA | Time series | 3 years | Gender, ethnicity | The rates of suicide are lower in the three years following the earthquake than those in the three years prior to the earthquake. |
| Vehid et al. (30) | Turkey | Cross- sectional | 2 months | Gender, depression, damage to home or property, loss of relatives, injuries of individual or their relatives | - |
| Suzuki et al. (31) | Japan | Cross- sectional | 3 years | Gender | - |
| Hyodo et al. (32) | Japan | Time series | 3 years | Gender | Suicide rate decreased in men after earthquake. |
| Akbiyik et al. (33) | Turkey | Cross- sectional | 3 years | Loss of relatives, having a serious psychological illness, low social support | Temporary symptoms are more common than long-term reactions. Earthquake experience was not a risk factor in suicidal ideation. |
| Castellanos et al. (34) | USA | Time series | 16 months | - | Suicide rates did not increase after hurricane. |
| Chen et al. (54) | Taiwan | Time series | First month | Injuries of individual or their relatives, damage to home or property | It showed that there were no significant associations between occurrence of suicidal ideation and gender, age, and obsessional personality. |
| Rodrigo et al. (36) | Sri Lanka | Time series | 1 year | - | No significant differences were found between the number of suicides before and following the disaster or between areas affected and unaffected by the tsunami. |
| Kar (59) | India | Qualitative longitudinal observational study | 3 years | - | Suicidal ideation, plans, and attempts are common after cyclone. The status of post-disaster morbidity and higher vulnerability of these communities suggested the need to improve disaster. Preparedness and management along with focused attention to psychosocial sequelae. |
| Lau et al. (38) | China | Cross- sectional | 1 month | Gender, low education, PTSD, having a serious psychological illness, loss of relatives | Protective factors included perceived social support, frequent exposure to news contents that are touching, and perceived sense of security obtained from teachers. |
| Kessler et al. (39) | USA | Follow up study | 1 year | Age, economic conditions | The prevalence of suicidality, finally, was significantly higher in the follow-up than baseline survey both with regard to suicidal ideation. Suicidality was found to be unrelated to sex, race/ethnicity, education, and health insurance status. |
| Gordon et al. (17) | USA | Cross- sectional | - | Low social support | Communities pulling together during a natural disaster can reduce interpersonal risk factors associated with the desire for suicide. |
| Caldera et al. (40) | Nicaragua | Time series | 1 year | Having a serious psychological illness | - |
| Shioiri et al. (41) | Japan | Time series | 2 years | - | Suicide decreased among survivors especially for men. |
| Stratta et al. (42) | Italy | Cross- sectional | 1 year | PTSD, gender | Religious involvement was found to be related to better coping with stress and less depression, suicide, anxiety, and substance abuse. |
| Kar (59) | India | Cross- sectional | 1 year | Having a serious psychological illness, low social support | Awareness of increased suicidality, attention to associated risk factors, and support may help in the prevention of suicide following disasters. |
| Warheit et al. (57) | USA | Time series | - | Having a serious psychological illness, gender, depression, low social support | - |