Global Lifetime and 12-Month Prevalence of Suicidal Behavior, Deliberate Self-Harm and Non-Suicidal Self-Injury in Children and Adolescents between 1989 and 2018: A Meta-Analysis

Kim-San Lim, Celine H Wong, Roger S McIntyre, Jiayun Wang, Zhisong Zhang, Bach X Tran, Wanqiu Tan, Cyrus S Ho, Roger C Ho, Kim-San Lim, Celine H Wong, Roger S McIntyre, Jiayun Wang, Zhisong Zhang, Bach X Tran, Wanqiu Tan, Cyrus S Ho, Roger C Ho

Abstract

Objective: This meta-analysis aimed to estimate the global lifetime and 12-month prevalence of suicidal behavior, deliberate self-harm and non-suicidal self-injury in children and adolescents.

Methods: A systematic search for relevant articles published between 1989 to 2018 was performed in multiple electronic databases. The aggregate 12-month and lifetime prevalence of suicidal behavior, deliberate self-harm, and non-suicidal self-injury were calculated based on the random-effects model. Subgroup analyses were performed to compare the prevalence according to school attendance and geographical regions. Results: A total of 686,672 children and adolescents were included. The aggregate lifetime and 12-month prevalence of suicide attempts was 6% (95% CI: 4.7-7.7%) and 4.5% (95% CI: 3.4-5.9%) respectively. The aggregate lifetime and 12-month prevalence of suicidal plan was 9.9% (95% CI: 5.5-17%) and 7.5% (95% CI: 4.5-12.1%) respectively. The aggregate lifetime and 12-month prevalence of suicidal ideation was 18% (95% CI: 14.2-22.7%) and 14.2% (95% CI: 11.6-17.3%) respectively. The aggregate lifetime and 12-month prevalence of non-suicidal self-injury was 22.1% (95% CI: 16.9-28.4%) and 19.5% (95% CI: 13.3-27.6%) respectively. The aggregate lifetime and 12-month prevalence of deliberate self-harm was 13.7% (95% CI: 11.0-17.0%) and 14.2% (95% CI: 10.1-19.5%) respectively. Subgroup analyses showed that full-time school attendance, non-Western countries, low and middle-income countries, and geographical locations might contribute to the higher aggregate prevalence of suicidal behaviors, deliberate self-harm, and non-suicidal self-injury. Conclusions: This meta-analysis found that non-suicidal self-injury, suicidal ideation, and deliberate self-harm were the three most common suicidal and self-harm behaviors in children and adolescents.

Keywords: adolescents; children; deliberate self-harm; meta-analysis; non-suicidal self-injury; suicide.

Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1
Figure 1
Process of systematic selection using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow chart.
Figure 2
Figure 2
Forest plot of the aggregate lifetime prevalence of suicide attempts.
Figure 3
Figure 3
Forest plot of the aggregate 12-month prevalence of suicide attempts.
Figure 4
Figure 4
Forest plot of the aggregate lifetime and 12-month prevalence of suicidal plans.
Figure 5
Figure 5
Forest plot of the lifetime aggregate prevalence of suicidal ideation.
Figure 6
Figure 6
Forest plot of the aggregate 12-month prevalence of suicidal ideation.
Figure 7
Figure 7
Forest plot of the aggregate lifetime and 12-month prevalence of non-suicidal self-injury.
Figure 8
Figure 8
Forest plot of the aggregate lifetime and 12-month prevalence of deliberate self-harm.

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