Abstract
OBJECTIVES: Suicidal behaviours are common among medical students, and the prevalence might vary across various regions. Even though various systematic reviews have been conducted to assess the suicidal behaviours among medical students in general, no review has ever explored or carried out a sub-analysis to show the burden of suicidal behaviours among Bangladeshi medical students. DESIGN: This is a systematic review and meta-analysis of prevalence studies among Bangladeshi medical students. The review applied truncated and phrase-searched keywords and relevant subject headings for study identification using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines. DATA SOURCES: PubMed (Medline), Scopus, PsycINFO and Google Scholar databases were searched between January 2000 and May 2024. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: The designed study included cross-sectional, case series, case reports and cohort studies of Bangladeshi medical students reporting suicidal behaviours (suicidal ideation, suicidal planning or suicidal attempts). Only freely accessible, full-text articles in English were included for analysis. DATA EXTRACTION AND SYNTHESIS: Study screening, data extraction and methodological assessment were performed by two independent reviewers. Risk of bias was assessed using the Joanna Briggs Institute critical appraisal tool. A random-effects meta-analysis model was conducted to pool prevalence rates, complemented by narrative synthesis. Heterogeneity was assessed using the I (2) statistic. RESULTS: Data were obtained from 6 eligible studies, including 1625 medical students (691 male) of Bangladesh. The pooled prevalence of lifetime suicidal behaviours was 25%, for suicidal ideation (95% CI: 14% - 37%, I (2)=91%; p<0.01), 6% for suicidal plan (95% CI: 2% - 12%, I (2)=91%; p<0.01), and 8% for suicidal attempt (95% CI: 1% - 17%, I (2)=96%; p<0.01). The factors associated with suicidal ideation were female gender, depression, familial suicidal history and drug addiction. Only depression and drug addiction were significantly associated with suicidal attempts, while hanging was the most attempted method. CONCLUSIONS: Suicidal behaviours particularly, suicidal ideation, are high among Bangladeshi medical students. However, very few studies were done in this country to quantify the burden and its associated factors. PROSPERO REGISTRATION NUMBER: CDR 42023493595.