Prevalence of Suicidal Behavior Among Students in South-East Asia: A Systematic Review and Meta-Analysis

Abstract

Objectives

Estimation of rates of suicidal behaviors (ideation, plan, and attempt) would help to understand the burden and prioritize prevention strategies. However, no attempt to assess suicidal behavior among students was identified in South-East Asia (SEA). We aimed to assess the prevalence of suicidal behavior (ideation, plan, and attempt) among students in SEA.

Methods

We followed PRISMA 2020 guidelines and registered the protocol in PROSPERO (CRD42022353438). We searched in Medline, Embase, and PsycINFO and performed meta-analyses to pool the lifetime, 1-year, and point prevalence rates for suicidal ideation, plans, and attempts. We considered the duration of a month for point prevalence.

Results

The search identified 40 separate populations from which 46 were included in the analyses, as some studies included samples from multiple countries. The pooled prevalence of suicidal ideation was 17.4% (confidence interval [95% CI], 12.4%–23.9%) for lifetime, 9.33% (95% CI, 7.2%–12%) for the past year, and 4.8% (95% CI, 3.6%–6.4%) for the present time. The pooled prevalence of suicide plans was 9% (95% CI, 6.2%–12.9%) for lifetime, 7.3% (95% CI, 5.1%–10.3%) for the past year, and 2.3% (95% CI, 0.8%–6.7%) for the present time. The pooled prevalence of suicide attempts was 5.2% (95% CI, 3.5%–7.8%) for lifetime and 4.5% (95% CI, 3.4%–5.8%) for the past year. Higher rates of suicide attempts in the lifetime were noted in Nepal (10%) and Bangladesh (9%), while lower rates were reported in India (4%) and Indonesia (5%).

Conclusions

Suicidal behaviors are a common phenomenon among students in the SEA region. These findings call for integrated, multisectoral efforts to prevent suicidal behaviors in this group.

Keywords:

• Prevalence
• South-East Asia
• students
• suicidal behavior
• suicide

AUTHOR CONTRIBUTIONS

Conceptualization: S. M. Yasir Arafat.

Data curation: S. M. Yasir Arafat, Pawan Sharma, Mila Nu Nu Htay, Hasina Akter, M. Marthoenis.

Formal analysis: Anuradha Baminiwatta, Vikas Menon.

Investigation: S. M. Yasir Arafat.

Methodology: S. M. Yasir Arafat.

Project administration: S. M. Yasir Arafat.

Supervision: S. M. Yasir Arafat.

Validation: S. M. Yasir Arafat.

Writing–original draft preparation: all authors.

Writing–review and editing: all authors.

All authors have read and approved the final version of the manuscript.

TRANSPARENCY STATEMENT

The lead author, S. M. Yasir Arafat, affirms that this manuscript is an honest, accurate, and transparent account of the study being reported; that no important aspects of the study have been omitted; and that any discrepancies from the study as planned have been explained.

DISCLOSURE STATEMENT

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

DATA AVAILABILITY STATEMENT

The data that support the findings of this study are available on request from the corresponding author.

Additional information

Notes on contributors

S. M. Yasir Arafat

S. M. Yasir Arafat, Department of Psychiatry, Enam Medical College and Hospital, Dhaka, Bangladesh.

Anuradha Baminiwatta

Anuradha Baminiwatta, Department of Psychiatry, Faculty of Medicine, University of Kelaniya, Sri Lanka.

Vikas Menon

Vikas Menon, Additional Professor Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.

Pawan Sharma

Pawan Sharma, Patan Academy of Health Sciences, Lalitpur, Nepal.

Mila Nu Nu Htay

Mila Nu Nu Htay, Department of Community Medicine, Manipal University College Malaysia, Melaka, Malaysia.

Hasina Akter

Hasina Akter, Department of Graduate Nursing, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.

M. Marthoenis

M. Marthoenis, Department of Psychiatry and Mental Health Nursing, Universitas Syiah Kuala, Banda Aceh, Indonesia.

Chencho Dorji

Chencho Dorji, Faculty of Post-Graduate Medicine, Khesar Gyalpo University of Medical Sciences of Bhutan, Thimphu.