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. 2021 Sep 16:12:690130.
doi: 10.3389/fpsyt.2021.690130. eCollection 2021.

Prevalence of Suicidality in Major Depressive Disorder: A Systematic Review and Meta-Analysis of Comparative Studies

Hong Cai  1   2   3 , Xiao-Meng Xie  4 , Qinge Zhang  4 , Xiling Cui  5 , Jing-Xia Lin  6 , Kang Sim  7 , Gabor S Ungvari  8   9 , Ling Zhang  4 , Yu-Tao Xiang  1   2   3
Affiliations

Prevalence of Suicidality in Major Depressive Disorder: A Systematic Review and Meta-Analysis of Comparative Studies

Hong Cai et al. Front Psychiatry. .

Abstract

Background: Suicidality is common in major depressive disorder (MDD), but there has been no systematic review published about all aspects of suicidality. This meta-analysis and systematic review compared the prevalence of the whole range of suicidality comprising suicidal ideation (SI), suicide plan (SP), suicide attempt (SA), and completed suicide (CS), between patients with MDD and non-MDD controls. Methods: Major international (PubMed, PsycINFO, Web of Science, EMBASE) and Chinese (Chinese Nation Knowledge Infrastructure and WANFANG) databases were systematically and independently searched from their inception until January 12, 2021. Results: Fifteen studies covering 85,768 patients (12,668 in the MDD group and 73,100 in the non-MDD group) were included in the analyses. Compared to non-MDD controls, the odds ratios (ORs) for lifetime, past month, past year, and 2-week prevalence of SI in MDD were 2.88 [95% confidence interval (CI) = 0.30-27.22, p = 0.36], 49.88 (95% CI = 2-8.63, p < 0.001), 13.97 (95% CI = 12.67-15.41, p < 0.001), and 24.81 (95% CI = 15.70-39.22, p < 0.001), respectively. Compared to non-MDD controls, the OR for lifetime SP in MDD was 9.51 (95% CI = 7.62-11.88, p < 0.001). Compared to non-MDD controls, the ORs of lifetime and past-year prevalence of SA were 3.45 (95% CI = 1.58-7.52, p = 0.002), and 7.34 (95% CI = 2.14-25.16, p = 0.002), respectively, in MDD patients. No difference in the prevalence of CS between MDD and controls was found (OR = 0.69, 95% CI = 0.23-2.02, p = 0.50). Conclusions: MDD patients are at a higher risk of suicidality, compared to non-MDD controls. Routine screening for a range of suicidality should be included in the management of MDD, followed by timely treatment for suicidal patients. Systematic Review Registration: Identifier [INPLASY202120078].

Keywords: comparative study; major depressive disorder; meta-analysis; suicidality; suicide attempt.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow chart of study selection.
Figure 2
Figure 2
Comparison of lifetime prevalence of suicide ideation between the MDD group and non-MDD groups.
Figure 3
Figure 3
Comparison of lifetime prevalence of suicide attempts between MDD and non-MDD groups.
Figure 4
Figure 4
Comparison of 1-year prevalence of suicide attempts between the MDD and non-MDD groups.
See this image and copyright information in PMC

References

    1. World Health Organization . Mental Health-Suicide. WHO (2021). Available online at: https://www.who.int/health~topics/suicide#tab=tab_1 (accessed March 30, 2021).
    1. Posner K, Oquendo MA, Gould M, Stanley B, Davies M. Columbia classification algorithm of suicide assessment (C-CASA): classification of suicidal events in the FDA's pediatric suicidal risk analysis of antidepressants. Am J Psychiatry. (2007) 164:1035–43. 10.1176/ajp.2007.164.7.1035 - DOI - PMC - PubMed
    1. Burke TA, Jacobucci R, Ammerman BA, Piccirillo M, McCloskey MS, Heimberg RG, et al. . Identifying the relative importance of non-suicidal self-injury features in classifying suicidal ideation, plans, and behavior using exploratory data mining. Psychiatry Res. (2018) 262:175–83. 10.1016/j.psychres.2018.01.045 - DOI - PMC - PubMed
    1. Nordentoft M, Mortensen PB, Pedersen CB. Absolute risk of suicide after first hospital contact in mental disorder. Arch Gen Psychiatry. (2011) 68:1058–64. 10.1001/archgenpsychiatry.2011.113 - DOI - PubMed
    1. Dong M, Wang SB, Li Y, Xu DD, Ungvari GS, Ng CH, et al. . Prevalence of suicidal behaviors in patients with major depressive disorder in China: a comprehensive meta-analysis. J Affect Disord. (2018) 225:32–9. 10.1016/j.jad.2017.07.043 - DOI - PubMed

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