Prevalence of suicidal behaviors in patients with major depressive disorder in China: A comprehensive meta-analysis

Background: Suicidal behaviors are common in major depressive disorder (MDD) and contribute significantly to premature death. The objective of this meta-analysis is to estimate the pooled prevalence of suicidal behaviors in patients with MDD in China. Methods: The relevant databases in English (PubMed, Embase, PsycINFO and Cochrane Library) and Chinese (Chinese National Knowledge Infrastructure, Wanfang and Chinese Biological Medical Literature) were systematically and independently searched from their inceptions until January 23, 2017. Original studies that reported the prevalence of suicidal behaviors including suicidal ideation (SI), suicide plan (SP), suicide attempt (SA) and completed suicide (CS) were included. Results: Thirty three articles that met the inclusion criteria were analyzed. The pooled lifetime prevalence of SI, SP and SA were 53.1% (95% CI: 42.4-63.4%), 17.5% (95% CI: 5.8-42.3%) and 23.7% (95% CI: 19.9-28.0%), respectively. One-month prevalence of SI and SA were 27.7% (95% CI: 15.4-44.5%) and 20.3% (95% CI: 12.1-32.2%), respectively. The pooled prevalence of SA during hospitalization and after onset of MDD were 17.3% (95% CI: 12.4-23.7%) and 42.1% (95% CI: 26.1-60.0%), respectively. Subgroup analyses revealed significant differences in both lifetime prevalence of SI and SA between genders, and between outpatients and inpatients with MDD. Conclusion: Suicidal behaviors are common in MDD patients in China. Regular screening and effective intervention for suicidal behavior in MDD patients are warranted.