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Link to original content: https://pubmed.ncbi.nlm.nih.gov/36962383
Suicide and self-harm in low- and middle- income countries during the COVID-19 pandemic: A systematic review - PubMed Skip to main page content
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. 2022 Jun 1;2(6):e0000282.
doi: 10.1371/journal.pgph.0000282. eCollection 2022.

Suicide and self-harm in low- and middle- income countries during the COVID-19 pandemic: A systematic review

Duleeka Knipe  1   2 , Ann John  3 , Prianka Padmanathan  1 , Emily Eyles  1 , Dana Dekel  3 , Julian P T Higgins  1   4 , Jason Bantjes  5   6 , Rakhi Dandona  7   8 , Catherine Macleod-Hall  1 , Luke A McGuinness  1 , Lena Schmidt  1   9 , Roger T Webb  10   11 , David Gunnell  1   4
Affiliations

Suicide and self-harm in low- and middle- income countries during the COVID-19 pandemic: A systematic review

Duleeka Knipe et al. PLOS Glob Public Health. .

Abstract

There is widespread concern over the potential impact of the COVID-19 pandemic on suicide and self-harm globally, particularly in low- and middle-income countries (LMIC) where the burden of these behaviours is greatest. We synthesised the evidence from the published literature on the impact of the pandemic on suicide and self-harm in LMIC. This review is nested within a living systematic review (PROSPERO ID CRD42020183326) that continuously identifies published evidence (all languages) through a comprehensive automated search of multiple databases (PubMed; Scopus; medRxiv, PsyArXiv; SocArXiv; bioRxiv; the WHO COVID-19 database; and the COVID-19 Open Research Dataset by Semantic Scholar (up to 11/2020), including data from Microsoft Academic, Elsevier, arXiv and PubMed Central.) All articles identified by the 4th August 2021 were screened. Papers reporting on data from a LMIC and presenting evidence on the impact of the pandemic on suicide or self-harm were included. Methodological quality was assessed using an appropriate tool, and a narrative synthesis presented. A total of 22 studies from LMIC were identified representing data from 12 countries. There was an absence of data from Africa, the Pacific, and the Caribbean. The reviewed studies mostly report on the early months of COVID-19 and were generally methodologically poor. Few studies directly assessed the impact of the pandemic. The most robust evidence, from time-series studies, indicate either a reduction or no change in suicide and self-harm behaviour. As LMIC continue to experience repeated waves of the virus and increased associated mortality, against a backdrop of vaccine inaccessibility and limited welfare support, continued efforts are needed to track the indirect impact of the pandemic on suicide and self-harm in these countries.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. PRISMA 2020 flow diagram of study selection.
Fig 2
Fig 2. Distribution of evidence from low- and middle-income countries on the impact of COVID-19 on suicidal behaviour.
The base map layer used to construct the map was obtained from Esri (https://hub.arcgis.com/datasets/esri::world-countries-generalized/about). High income countries are not represented in the map.
Fig 3
Fig 3. Forest plot of study estimates* assessing the impact of the pandemic on suicide deaths and self-harm from before and after or time-series studies.
* An estimate of below 1 is indicative of a reduction in suicide or self harm. rRR–reported rate ratio; cRR–calculate rate ratio; OR–Odds ratio.
See this image and copyright information in PMC

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