Religion and Completed Suicide: a Meta-Analysis

INTRODUCTION Suicide is a major public health concern and a leading cause of death around the world. How religion influences the risk of completed suicide in different settings across the world requires clarification in order to best inform suicide prevention strategies. METHODS A meta-analysis using search results from Pubmed and Web of Science databases was conducted following PRISMA protocol and using the keywords "religion" or "religious" or "religiosity" or "spiritual" or "spirituality" plus "suicide" or "suicidality" or "suicide attempt". Random and fixed effects models were used to generate pooled ORs and I2 values. Sub-analyses were conducted among the following categories: young age (<45 yo), older age (≥45 yo), western culture, eastern culture, and religious homogeneity. RESULTS Nine studies that altogether evaluated 2339 suicide cases and 5252 comparison participants met all selection criteria and were included in the meta-analysis. The meta-analysis suggested an overall protective effect of religiosity from completed suicide with a pooled OR of 0.38 (95% CI: 0.21-0.71) and I2 of 91%. Sub-analyses similarly revealed significant protective effects for studies performed in western cultures (OR = 0.29, 95% CI: 0.18-0.46), areas with religious homogeneity (OR = 0.18, 95% CI: 0.13-0.26), and among older populations (OR = 0.42, 95% CI: 0.21-0.84). High heterogeneity of our meta-analysis was attributed to three studies in which the methods varied from the other six. CONCLUSION Religion plays a protective role against suicide in a majority of settings where suicide research is conducted. However, this effect varies based on the cultural and religious context. Therefore, public health professionals need to strongly consider the current social and religious atmosphere of a given population when designing suicide prevention strategies.