Review Article

Prevalence of Suicidal Ideation and Suicide Attempts after Disaster and Mass Causality Incidents in the World: A Systematic Review and Meta-analysis


Objective: After accidents and disasters, people suffer from mental disorders due to physical, economic and social injuries. These include anxiety, stress, depression, suicidal ideation, and suicide attempts. Due to the fact that some of these measures can endanger a person’s life, as a result, it is important to pay attention to these psychological factors. Accordingly, the present study was conducted to investigate the prevalence of suicidal ideation and suicide attempt after disaster in the world.

Methods: The present study was a systematic review and meta-analysis of the prevalence of suicidal ideation and suicide attempt after disaster in the world. Accordingly, all English-language articles published from the beginning of 2000 to the end of 2019 were extracted through searches in the databases of Scopus, Web of Science, PubMed, Cochrane Library, Science Direct and Google scholar and then evaluated. Statistical analysis of data was performed using fixed and random effects model in meta-analysis, Cochran test and meta-regression.

Results: A total of 33 studies with a sample size of 61,180 people entered the meta-analysis process. Accordingly, the prevalence of suicidal ideation was estimated at 12.9% (CI95%: 10.3% -15.5%) in the whole population, 5.2% (CI95%: 2.9% - 7.4%) in male and 15.8% (CI95%: 10.0% - 21.6%) in female. Moreover, the prevalence of suicide attempt after disasters was estimated at 8.8% (CI95%: 6.6% - 11.0%).

Conclusion: Based on the findings of the present study, the prevalence of ​​ suicidal ideation and suicide attempt after disaster is high. Due to the fact that many people in the world are exposed to disasters every year, relatively many people deal with suicidal ideation or suicide attempts.

1. Guha-Sapir D, Hoyois P, Below R. Annual Disaster Statistical Review 2011: the numbers and trends. 2012. Centre for REsearch on the Epidemiology of Disasters (CRED), Institute of Health and Society (IRSS) and Universite catholoque de Louvain: Louvain-la-neuve, Belgium. 2014.
2. Djalali A, Della Corte F, Foletti M, Ragazzoni L, Ripoll Gallardo A, Lupescu O, et al. Art of disaster preparedness in European union: a survey on the health systems. PLoS Curr. 2014;6.
3. Furr JM, Comer JS, Edmunds JM, Kendall PC. Disasters and youth: a meta-analytic examination of posttraumatic stress. J Consult Clin Psychol. 2010;78(6):765-80.
4. North CS, Pfefferbaum B. Mental health response to community disasters: a systematic review. Jama. 2013;310(5):507-18.
5. Bonanno GA, Brewin CR, Kaniasty K, Greca AM. Weighing the Costs of Disaster: Consequences, Risks, and Resilience in Individuals, Families, and Communities. Psychol Sci Public Interest. 2010;11(1):1-49.
6. Adeagbo A, Daramola A, Carim-Sanni A, Akujobi C, Ukpong C. Effects of natural disasters on social and economic well being: A study in Nigeria. IJDRR. 2016;17:1-12.
7. Bonde JP, Utzon-Frank N, Bertelsen M, Borritz M, Eller N, Nordentoft M, et al. Risk of depressive disorder following disasters and military deployment: systematic review with meta-analysis. Br J Psychiatry. 2016;208(4) :330-6.
8. Nagata S, Matsunaga A, Teramoto C. Follow-up study of the general and mental health of people living in temporary housing at 10 and 20 months after the Great East Japan Earthquake. Jpn J Nurs Sci. 2015;12(2):162-5.
9. Maeda M, Oe M. Mental Health Consequences and Social Issues After the Fukushima Disaster. Asia Pac J Public Health. 2017;29(2_suppl):36s-46s.
10. Suzuki Y, Kim Y. The great east Japan earthquake in 2011; toward sustainable mental health care system. Epidemiol Psychiatr Sci. 2012;21(1):7-11.
11. Aoki A, Aoki Y, Harima H. The impact of the Great East Japan earthquake on mandatory psychiatric emergency hospitalizations in Tokyo: a retrospective observational study. Transl Psychiatry. 2012;2(10):e168.
12. Vins H, Bell J, Saha S, Hess JJ. The Mental Health Outcomes of Drought: A Systematic Review and Causal Process Diagram. Int J Environ Res Public Health. 2015;12(10):13251-75.
13. Aoki Y, Okada M, Inokuchi R, Matsumoto A, Kumada Y, Yokoyama H, et al. Time-related changes in suicide attempts after the nuclear accident in Fukushima. Soc Psychiatry Psychiatr Epidemiol. 2014;49(12):1911-8.
14. Amaddeo F, Tansella M. Mental health, natural and human-made disasters: lessons learnt and future needs. Epidemiol Psychiatr Sci. 2012;21(1):1-5.
15. Kõlves K, Kõlves KE, De Leo D. Natural disasters and suicidal behaviours: a systematic literature review. J Affect Disord. 2013;146(1):1-14.
16. Fujiwara T, Yagi J, Homma H, Mashiko H, Nagao K, Okuyama M. Suicide risk among young children after the Great East Japan Earthquake: A follow-up study. Psychiatry Res. 2017;253:318-24.
17. Lai BS, Auslander BA, Fitzpatrick SL, Podkowirow V. Disasters and Depressive Symptoms in Children: A Review. Child Youth Care Forum. 2014;43(4):489-504.
18. Cerel J, Maple M, Aldrich R, van de Venne J. Exposure to suicide and identification as survivor. Results from a random-digit dial survey. Crisis. 2013;34(6):413-9.
19. Cobham VE, McDermott B, Haslam D, Sanders MR. The Role of Parents, Parenting and the Family Environment in Children's Post-Disaster Mental Health. Curr Psychiatry Rep. 2016;18(6):53.
20. Atay IM, Eren I, Gündoğar D. The prevalence of death ideation and attempted suicide and the associated risk factors in Isparta, Turkey. Turk Psikiyatri Derg. 2012;23(2):89-98.
21. Torres AR, Ramos-Cerqueira AT, Ferrão YA, Fontenelle LF, Do Rosário MC, Miguel EC. Suicidality in obsessive-compulsive disorder:prevalence and relation to symptom dimensions and comorbid conditions. J Clin Psychiatry. 2011;72(1):1-6.
22. Jeon HJ, Lee JY, Lee YM, Hong JP, Won SH, Cho SJ, et al. Lifetime prevalence and correlates of suicidal ideation, plan, and single and multiple attempts in a Korean nationwide study. J Nerv Ment Dis. 2010;198(9):643-6.
23. Hu J, Dong Y, Chen X, Liu Y, Ma D, Liu X, et al. Prevalence of suicide attempts among Chinese adolescents: A meta-analysis of cross-sectional studies. Compr Psychiatry. 2015;61:78-89.
24. Valdez-Santiago R, Solórzano EH, Iñiguez MM, Burgos L, Gómez Hernández H, Martínez González Á. Attempted suicide among adolescents in Mexico: prevalence and associated factors at the national level. Inj Prev. 2018;24(4):256-61.
25. Graham H, White P, Cotton J, McManus S. Flood- and Weather-Damaged Homes and Mental Health: An Analysis Using England's Mental Health Survey. Int J Environ Res Public Health. 2019;16(18).
26. Xu Q, Fukasawa M, Kawakami N, Baba T, Sakata K, Suzuki R, et al. Cumulative incidence of suicidal ideation and associated factors among adults living in temporary housing during the three years after the Great East Japan Earthquake. J Affect Disord. 2018;232:1-8.
27. Tang W, Zhao J, Lu Y, Zha Y, Liu H, Sun Y, et al. Suicidality, posttraumatic stress, and depressive reactions after earthquake and maltreatment: A cross-sectional survey of a random sample of 6132 chinese children and adolescents. J Affect Disord. 2018;232:363-9.
28. Han B, Compton WM, Gfroerer J, McKeon R. Prevalence and correlates of past 12-month suicide attempt among adults with past-year suicidal ideation in the United States. J Clin Psychiatry. 2015;76(3):295-302.
29. Moher D, Shamseer L, Clarke M, Ghersi D, Liberati A, Petticrew M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev. 2015;4(1):1.
30. Von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP, et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: guidelines for reporting observational studies. IJS. 2014;12(12):1495-9.
31. Bazyar J, Safarpour H, Daliri S, Karimi A, Safi Keykaleh M, Bazyar M. The prevalence of sexual violence during pregnancy in Iran and the world: a systematic review and meta-analysis. J Inj Violence Res. 2018;10(2):63-74.
32. Guo J, He H, Fu M, Han Z, Qu Z, Wang X, et al. Suicidality associated with PTSD, depression, and disaster recovery status among adult survivors 8 years after the 2008 Wenchuan earthquake in China. Psychiatry Res. 2017;253:383-90.
33. Bromet EJ. Mental health consequences of the Chernobyl disaster. J Radiol 2012;32(1):N71-5.
34. Tanaka E, Tsutsumi A, Kawakami N, Kameoka S, Kato H, You Y. Long-term psychological consequences among adolescent survivors of the Wenchuan earthquake in China: A cross-sectional survey six years after the disaster. J Affect Disord. 2016;204:255-61.
35. Tang B, Liu X, Liu Y, Xue C, Zhang L. A meta-analysis of risk factors for depression in adults and children after natural disasters. BMC Public Health. 2014;14:623.
36. Loganovsky K, Havenaar JM, Tintle NL, Guey LT, Kotov R, Bromet EJ. The mental health of clean-up workers 18 years after the Chernobyl accident. Psychol Med. 2008;38(4):481-8.
37. Chan HL, Liu CY, Chau YL, Chang CM. Prevalence and association of suicide ideation among Taiwanese elderly--a population-based cross-sectional study. Chang Gung Med J. 2011;34(2):197-204.
38. Lee S, Fung SC, Tsang A, Liu ZR, Huang YQ, He YL, et al. Lifetime prevalence of suicide ideation, plan, and attempt in metropolitan China. Acta Psychiatr Scand. 2007;116(6):429-37.
39. Park E, Choi SJ. Prevalence of suicidal ideation and related risk factors among Korean adults. JKAPMHN. 2013;22(2):88-96.
40. Forkmann T, Brähler E, Gauggel S, Glaesmer H. Prevalence of suicidal ideation and related risk factors in the German general population. J Nerv Ment Dis. 2012;200(5):401-5.
41. Malakouti SK, Davoudi F, Khalid S, Ahmadzad Asl M, Moosa Khan M, Alirezaei N, et al. The Epidemiology of Suicide Behaviors among the Countries of the Eastern Mediterranean Region of WHO: a Systematic Review. Acta Med Iran. 2015;53(5):257-65.
42. Stratta P, Capanna C, Carmassi C, Patriarca S, Di Emidio G, Riccardi I, et al. The adolescent emotional coping after an earthquake: a risk factor for suicidal ideation. J Adolesc. 2014;37(5):605-11.
43. Adebäck P, Schulman A, Nilsson D. Children exposed to a natural disaster: psychological consequences eight years after 2004 tsunami. Nord J Psychiatry. 2018;72(1):75-81.
44. Bell TR, Langhinrichsen-Rohling J, Selwyn CN. Conservation of resources and suicide proneness after oilrig disaster. Death Stud. 2020;44(1):48-57.
45. Contis G, Foley TP, Jr. Depression, suicide ideation, and thyroid tumors among ukrainian adolescents exposed as children to chernobyl radiation. J Clin Med Res. 2015;7(5):332-8.
46. Wu CY, Lee MB, Lin CH, Kao SC, Tu CC, Chang CM. A longitudinal study on psychological reactions and resilience among young survivors of a burn disaster in Taiwan 2015-2018. J Adv Nurs. 2020;76(2):514-25.
47. Kessler RC, Galea S, Jones RT, Parker HA. Mental illness and suicidality after Hurricane Katrina. Bull World Health Organ. 2006;84(12):930-9.
48. Brown LA, Fernandez CA, Kohn R, Saldivia S, Vicente B. Pre-disaster PTSD as a moderator of the relationship between natural disaster and suicidal ideation over time. J Affect Disord. 2018;230:7-14.
49. Tang W, Xu D, Li B, Lu Y, Xu J. The relationship between the frequency of suicidal ideation and sleep disturbance factors among adolescent earthquake victims in China. Gen Hosp Psychiatry. 2018;55:90-7.
50. Ran MS, Zhang Z, Fan M, Li RH, Li YH, Ou GJ, et al. Risk factors of suicidal ideation among adolescents after Wenchuan earthquake in China. Asian J Psychiatr. 2015;13:66-71.
51. Zuromski KL, Resnick H, Price M, Galea S, Kilpatrick DG, Ruggiero K. Suicidal ideation among adolescents following natural disaster: The role of prior interpersonal violence. Psychol Trauma. 2019;11(2):184-8.
52. Stratta P, Capanna C, Riccardi I, Carmassi C, Piccinni A, Dell'Osso L, et al. Suicidal intention and negative spiritual coping one year after the earthquake of L'Aquila (Italy). J Affect Disord. 2012;136(3):1227-31.
53. Guo J, Liu C, Kong D, Solomon P, Fu M. The relationship between PTSD and suicidality among Wenchuan earthquake survivors: The role of PTG and social support. J Affect Disord. 2018;235:90-5.
54. Kar N. Suicidality following a natural disaster. Am J Disaster Med. 2010;5(6):361-8.
55. Vehid HE, Alyanak B, Eksi A. Suicide ideation after the 1999 earthquake in Marmara, Turkey. Tohoku J Exp Med. 2006;208(1):19-24.
56. Tang TC, Yen CF, Cheng CP, Yang P, Chen CS, Yang RC, et al. Suicide risk and its correlate in adolescents who experienced typhoon-induced mudslides: a structural equation model. Depress Anxiety. 2010;27(12):1143-8.
57. Kessler RC, Galea S, Gruber MJ, Sampson NA, Ursano RJ, Wessely S. Trends in mental illness and suicidality after Hurricane Katrina. Mol Psychiatry. 2008;13(4):374-84.
58. Conejo-Galindo J, Medina O, Fraguas D, Terán S, Sainz-Cortón E, Arango C. Psychopathological sequelae of the 11 March terrorist attacks in Madrid : an epidemiological study of victims treated in a hospital. Eur Arch Psychiatry Clin Neurosci. 2008;258(1):28-34.
59. Fergusson DM, Horwood LJ, Boden JM, Mulder RT. Impact of a major disaster on the mental health of a well-studied cohort. JAMA Psychiatry. 2014;71(9):1025-31.
60. Reifels L, Spittal MJ, Dückers MLA, Mills K, Pirkis J. Suicidality Risk and (Repeat) Disaster Exposure: Findings From a Nationally Representative Population Survey. Psychiatry. 2018;81(2):158-72.
61. Yang HJ, Cheong HK, Choi BY, Shin MH, Yim HW, Kim DH, et al. Community mental health status six months after the Sewol ferry disaster in Ansan, Korea. Epidemiol Health. 2015;37:e2015046.
62. Amstadter AB, Koenen KC, Ruggiero KJ, Acierno R, Galea S, Kilpatrick DG, et al. Variation in RGS2 is associated with suicidal ideation in an epidemiological study of adults exposed to the 2004 Florida hurricanes. Arch Suicide Res. 2009;13(4):349-57.
63. Ying L, Chen C, Lin C, Greenberger E, Wu X, Jiang L. The relationship between posttraumatic stress symptoms and suicide ideation among child survivors following the Wenchuan earthquake. Suicide Life Threat Behav. 2015;45(2):230-42.
64. Caldera T, Palma L, Penayo U, Kullgren G. Psychological impact of the hurricane Mitch in Nicaragua in a one-year perspective. Soc Psychiatry Psychiatr Epidemiol. 2001;36(3):108-14.
65. Chou FH, Wu HC, Chou P, Su CY, Tsai KY, Chao SS, et al. Epidemiologic psychiatric studies on post-disaster impact among Chi-Chi earthquake survivors in Yu-Chi, Taiwan. Psychiatry Clin Neurosci. 2007;61(4):370-8.
66. Pietrzak RH, Tracy M, Galea S, Kilpatrick DG, Ruggiero KJ, Hamblen JL, et al. Resilience in the face of disaster: prevalence and longitudinal course of mental disorders following hurricane Ike. PLoS One. 2012;7(6):e38964.
67. Kane JC, Luitel NP, Jordans MJD, Kohrt BA, Weissbecker I, Tol WA. Mental health and psychosocial problems in the aftermath of the Nepal earthquakes: findings from a representative cluster sample survey. Epidemiol Psychiatr Sci. 2018;27(3):301-10.
68. Morali D, Jehel L, Paterniti S. [The August 2003 heat wave in France: effects on psychiatric disorders and suicidal behavior]. Presse Med. 2008;37(2 Pt 1):224-8.
IssueVol 17 No 1 (2022) QRcode
SectionReview Article(s)
Suicidal Ideation Suicide Attempt Disasters Mass Casualty Incidents Systematic Review Meta-analysis

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Karimi A, Bazyar J, Malekyan L, Daliri S. Prevalence of Suicidal Ideation and Suicide Attempts after Disaster and Mass Causality Incidents in the World: A Systematic Review and Meta-analysis. Iran J Psychiatry. 2021;17(1):99-109.