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The prevalence of suicidal thoughts and behaviours among college students: a meta-analysis

Published online by Cambridge University Press:  14 August 2017

P. Mortier ,
P. Cuijpers ,
G. Kiekens ,
R. P. Auerbach ,
K. Demyttenaere ,
J. G. Green ,
R. C. Kessler ,
M. K. Nock  and
R. Bruffaerts
P. Mortier*
Affiliation:
Research Group Psychiatry, Department of Neurosciences, KU Leuven University, Leuven, Belgium
P. Cuijpers
Affiliation:
Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, the Netherlands
G. Kiekens
Affiliation:
Research Group Psychiatry, Department of Neurosciences, KU Leuven University, Leuven, Belgium
R. P. Auerbach
Affiliation:
Department of Psychiatry, Harvard Medical School, Boston, MA, USA Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA, USA
K. Demyttenaere
Affiliation:
Research Group Psychiatry, Department of Neurosciences, KU Leuven University, Leuven, Belgium
J. G. Green
Affiliation:
School of Education, Boston University, Boston, MA, USA
R. C. Kessler
Affiliation:
Department of Health Care Policy, Harvard Medical School, Harvard University, Boston, MA, USA
M. K. Nock
Affiliation:
Department of Psychology, Harvard University, Cambridge, MA, USA
R. Bruffaerts
Affiliation:
Research Group Psychiatry, Department of Neurosciences, KU Leuven University, Leuven, Belgium
*
*Address for correspondence: P. Mortier, M.D., Research Group Psychiatry, Department of Neurosciences, KU Leuven University, Herestraat 49, Leuven, Belgium. (Email: philippe.mortier@uzleuven.be)
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Abstract

Background

Adolescence and young adulthood carry risk for suicidal thoughts and behaviours (STB). An increasing subpopulation of young people consists of college students. STB prevalence estimates among college students vary widely, precluding a validated point of reference. In addition, little is known on predictors for between-study heterogeneity in STB prevalence.

Methods

A systematic literature search identified 36 college student samples that were assessed for STB outcomes, representing a total of 634 662 students [median sample size = 2082 (IQR 353–5200); median response rate = 74% (IQR 37–89%)]. We used random-effects meta-analyses to obtain pooled STB prevalence estimates, and multivariate meta-regression models to identify predictors of between-study heterogeneity.

Results

Pooled prevalence estimates of lifetime suicidal ideation, plans, and attempts were 22.3% [95% confidence interval (CI) 19.5–25.3%], 6.1% (95% CI 4.8–7.7%), and 3.2% (95% CI 2.2–4.5%), respectively. For 12-month prevalence, this was 10.6% (95% CI 9.1–12.3%), 3.0% (95% CI 2.1–4.0%), and 1.2% (95% CI 0.8–1.6%), respectively. Measures of heterogeneity were high for all outcomes (I 2 = 93.2–99.9%), indicating substantial between-study heterogeneity not due to sampling error. Pooled estimates were generally higher for females, as compared with males (risk ratios in the range 1.12–1.67). Higher STB estimates were also found in samples with lower response rates, when using broad definitions of suicidality, and in samples from Asia.

Conclusions

Based on the currently available evidence, STB seem to be common among college students. Future studies should: (1) incorporate refusal conversion strategies to obtain adequate response rates, and (2) use more fine-grained measures to assess suicidal ideation.

Keywords

between-study heterogeneitycollege studentsmeta-analysismultivariate meta-regression modelsprevalencerandom-effects meta-analysissuicidal thoughts and behaviourssuicide
Type
Review Article
Information
Psychological Medicine , Volume 48 , Issue 4 , March 2018 , pp. 554 - 565
Copyright
Copyright © Cambridge University Press 2017 

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