Prevalence of suicide attempts in individuals with schizophrenia: a meta-analysis of observational studies

Abstract Aims Suicide attempt is an important indicator of suicide and potential future mortality. However, the prevalence of suicide attempts has been inconsistent across studies. This meta-analysis aimed to examine the prevalence of suicide attempts in individuals with schizophrenia and associated correlates. Methods Relevant publications in Embase, PsycINFO, PubMed, Web of science and Cochrane were systematically searched. Data on the prevalence of suicide attempts in individuals with schizophrenia were pooled using a random-effects model. Results Thirty-five studies with 16 747 individuals with schizophrenia were included. The pooled lifetime prevalence of suicide attempts was 26.8% (95% CI 22.1–31.9%; I 2 = 97.0%), while the 1-year prevalence, 1-month prevalence and the prevalence of suicide attempts from illness onset were 3.0% (95% CI 2.3–3.7%; I 2 = 95.6%), 2.7% (95% CI 2.1–3.4%; I 2 = 78.5%) and 45.9% (95% CI 42.1–49.9%; I 2 = 0), respectively. Earlier age of onset ( Q = 4.38, p = 0.04), high-income countries ( Q = 53.29, p < 0.001), North America and Europe and Central Asia ( Q = 32.83, p < 0.001) were significantly associated with a higher prevalence of suicide attempts. Conclusions Suicide attempts are common in individuals with schizophrenia, especially those with an early age of onset and living in high-income countries and regions. Regular screening and effective preventive measures should be implemented as part of the clinical care.