Determination of the social related factors of suicide in Iran: a systematic review and meta-analysis

BACKGROUND Suicide, a social phenomenon, is a major health problem in most countries. Yet data relating to the role social factors play in the development of this condition are lacking, with some factors shrouded in greater ambiguity than others. As such, this review aimed to determine the prevalence of social-related factors resulting in suicide and to present these findings through meta-analyses, allowing for causes of heterogeneity to be examined. METHODS Scientific databases including PubMed and Science direct were searched using sensitive keywords. Two researchers reviewed the eligibility of studies and extracted data. Meta-regression with the Mantel-Haenszel method was conducted using a random effect model, in addition to subgroup analysis and Egger's test. RESULTS A total of 2,526 articles were retrieved through the initial search strategy, producing 20 studies from 16 provinces for analysis. The most frequent cause of attempted suicide among the 20 analyzed articles was family conflict with 32% (95% CI: 26-38). Other related factors included marital problems (26%; 95% CI: 20-33), economic constrains (12%; 95% CI: 8-15) and educational failures (5%; 95% CI: 3-8). Results of meta-regression analysis found that sample size significantly affects heterogeneity for the factor 'family conflict'. CONCLUSIONS Social factors such as family conflicts and marital problems have a noticeable role in Iranian suicidology.