Suicide and depression in the World Health Organization South-East Asia Region: a systematic review

Abstract

Background Depression is the most common comorbid psychiatric disorder in people who die by suicideand 39% of global suicides occur in the World Health Organization (‎WHO)‎ South-East Asia Region. The aimof this systematic review was to identify, for countries of this region, first the prevalence of depression amongpeople who (‎i)‎ die by, or (‎ii)‎ attempt, suicide, and second, the proportion of people with depression whoattempt or die by suicide.Methods PubMed, PsycINFO, EMBASE and Google Scholar were searched, together with five availablenational databases, for quantitative research papers published in English between 1956 and 4 September2016 from the 11 countries of the WHO South-East Asia Region.Results The 19 articles that met the predefined eligibility criteria were from five countries: Bangladesh (‎1)‎,India (‎12)‎, Indonesia (‎1)‎, Sri Lanka (‎3)‎ and Thailand (‎2)‎; no eligible papers from the remaining countriesof the region were retrieved. Eight studies, from Bangladesh, India, Indonesia and Sri Lanka, reported theprevalence of depression among people who had died by suicide. The study settings varied, as did theproportion of depression recorded (‎6.9–51.7%)‎, and the study sample sizes ranged from 27 to 372. Eightstudies from India and one from Sri Lanka investigated depression among people who had attempted suicide.Using a range of screening and diagnostic tools, the reported prevalence of depression ranged between22.0% and 59.7%. The study sample sizes ranged from 56 to 949. Only two articles were found, both fromThailand, that reported on suicide in people with depression.Conclusion Despite the high burden of mortality of suicide in the WHO South-East Asia Region, evidenceon the relation between suicide and depression is scarce. There is a need to understand this phenomenonbetter, in order to inform suicide-prevention strategies in the region.