The Role of Social Support in Preventing Suicidal Ideations and Behaviors: A Systematic Review and Meta-Analysis

Abstract

Background: Numerous epidemiological studies have explored the relationship between social support and suicidal behaviors; however, the overall impact remains unclear. Therefore, a systematic assessment of the association between social support and suicide is necessary. Study Design: This is a systematic review study. Methods: We conducted a comprehensive search of PubMed, Web of Science, and Scopus databases until March 2023 and screened reference lists for relevant studies. Epidemiological studies that investigated the associations between social support and suicidal behaviors were included. Furthermore, between-study heterogeneity was investigated using I2 statistics. In addition, the likelihood of publication bias was evaluated using the Begg and Egger tests, and a trim-and-fill analysis was conducted. The overall effect size was calculated as an odds ratio (OR) with 95% confidence intervals (CIs) using a random-effects model. Results: Out of the 21004 identified studies, 118 studies (involving 692266 participants) met the eligibility criteria. The analysis of data revealed a significant inverse association between social support and suicidal ideation (OR: 0.79, 95% CI: 0.76-0.82), suicide plans (OR: 0.86, 95% CI: 0.79-0.95), suicide attempts (OR: 0.96, 95% CI: 0.94-0.98), and suicide death (OR: 0.85, 95% CI: 0.75-0.96). Moreover, significant heterogeneity was observed across studies, but there was little concern regarding the presence of publication bias. Conclusion: Our meta-analysis provides clear evidence for a significant inverse association between social support and suicidal behaviors. However, the observational nature of the included studies and the significant heterogeneity observed across studies highlight the need for further research, including prospective studies and intervention trials, to explore the complex relationship between social support and suicidal behaviors.