Social Psychiatry and Psychiatric Epidemiology

, Volume 54, Issue 12, pp 1459–1470 | Cite as

Suicide risk around the world: a meta-analysis of longitudinal studies

  • E. M. Guzmán
  • C. B. ChaEmail author
  • J. D. Ribeiro
  • J. C. Franklin



Suicidal thoughts and behaviors (STBs) have been a persistent problem worldwide. Identifying risk factors for STBs across distinct areas of the world may help predict who or where requires the greatest attention. However, risk factors for STBs are infrequently explored cross-nationally. The present study examined whether psychopathology prospectively predicts STBs across different areas of the world, and whether certain country-level factors moderate the degree of risk conferred.


We conducted a meta-analysis of 71 longitudinal studies from 30 different countries that featured psychopathology-related variables predicting STB outcomes. Meta-regression was used to evaluate whether the following country-level factors modified risk: geographic region, income level, and degree of mental health structural stigma.


Over 90% of studies had been conducted in North America and Europe. When assessed by country income level, it was found that only one longitudinal study on psychopathology and STB was conducted outside of a high-income country. Moreover, less than 10% of studies were conducted in high structural stigma contexts. Meta-regression findings revealed that the variation in risk effect sizes across studies was not explained by models including country-level factors.


Our findings show critical underrepresentation of low- and middle-income countries, which account for a large proportion of global suicide deaths. This reveals a need to broaden the scope of longitudinal research on STB risk, such that countries across more regions, income levels, and degrees of structural stigma are fully accounted for. Such lines of research will improve generalizability of findings, and more precisely inform prevention efforts worldwide.


Suicide Risk factors Mental illness stigma Prospective study 



We thank May Yuan, M.A., Vidal Yook, M.A., Liliana Anjali Varman, M.A., Heeyewon Jeong, M.A., and Irene Zhang, M.A. for their contributions coding articles.


This work was supported by the Teachers College Dean’s Faculty Diversity Research Awards Program (C.B.C., E.M.G.), the Military Suicide Research Consortium (MSRC), an effort supported by the Office of the Assistant Secretary of Defense for Health Affairs (C.B.C., J.C.F, J.D.R, M.K.N., Grant number W81XWH-10- 2-0181). Opinions, interpretations, conclusions, and recommendations are those of the authors and are not necessarily endorsed by the MSRC or the Department of Defense. Additional support was provided via the National Institute of Mental Health (J.D.R, Grant number T32MH18921) and via the John D. and Catherine T. MacArthur Foundation (M.K.N).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical standards

The manuscript does not contain clinical studies or patient data.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Counseling and Clinical Psychology, Teachers CollegeColumbia UniversityNew YorkUSA
  2. 2.Department of PsychologyFlorida State UniversityTallahaseeUSA

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