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The epidemiology of suicidal behaviors among the countries of the South Asia: A systematic review and meta analysis

N. Imran,A. Waqas,S. Tahir,Roop Kiran Khan,M. Ayub,Hareem Arshad,Bariah Rafiq,Sadiq Naveed

Published 2025 in Pakistan Journal of Medical Sciences

ABSTRACT

SUMMARY Despite the alarming suicide burden, South Asia lacks sufficient literature and research. The objective of this systematic review and meta-analysis was to appraise the current evidence and estimate the prevalence of suicidal behaviors (ideation, plan, attempts, completed suicide and non-suicidal self-injury (NSSI)) among countries in South Asia. We systematically searched PubMed, PsycINFO, Web of Science, Scopus, and CINAHL for observational and longitudinal studies involving statistical analysis of suicidal behaviors in south Asian countries as per the PRISMA guidelines, without any limitations concerning age, gender, language, or year of publication. A random-effects model was used to synthesize prevalence data, and mixed-effects regression models were employed for subgroup analyses. Main outcome was lifetime, period and point prevalence of completed suicide, suicidal ideation, plan, and Non suicidal behaviors. A total of 27 studies representing data pertaining to suicidality and related behaviors in South Asian countries were included. The point prevalence of suicidal ideation was 16.7% (95% CI: 11.5% to 23.5%), suicidal plan was 13.6% (13.0% to 14.2%) and attempted suicide was 5.6% (95% CI: 3.5% - 9.0%). The 12-month period prevalence for suicidal ideation was noted to be 11.8% (95% CI: 5.5% to 23.6%), plan 3.6% (95% CI: 2.1% to 6.0%). Suicidal attempts 3.0% (95% CI: 1.6% to 5.5%), completed suicides 0.1% (95% CI: 0% to 0.8%) and non-suicidal behaviors 6.5% (95% CI: 0.7% to 39.5%). Lifetime prevalence ranged from suicidal thoughts 15.9% (95% CI:15.0% to 16.8%), suicidal plan 7.9% (95% CI: 6.2% to 10.1%), attempts 3.1% (95% CI: 1.2% to 7.8%) and non-suicidal behaviors 44.8% (95% CI: 41.2% to 48.4%). We found evidence of significant heterogeneity for suicidal behaviors in the studies included. The epidemiological burden of suicidal behaviors among countries in South Asia appears to be very high. Knowledge about the epidemiology of such behaviors is important for policymaking and to inform context specific interventions to reduce loss of lives caused by suicidal behaviors.

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