Association between suicide reporting in the media and suicide: systematic review and meta-analysis

Thomas Niederkrotenthaler; Marlies  Braun; Jane Pirkis; Benedikt Till; Steven Stack; Mark Sinyor; Ulrich Tran; Martin Voracek; Qijin  Cheng; Florian Arendt; Sebastian  Scherr; Paul S. F. Yip; Matthew J. Spittal

doi:10.1136/bmj.m575

Association between suicide reporting in the media and suicide: systematic review and meta-analysis

Thomas Niederkrotenthaler (Korresp. Autor*in)
, Marlies Braun
, Jane Pirkis
, Benedikt Till
, Steven Stack
, Mark Sinyor
, Ulrich Tran
, Martin Voracek
, Qijin Cheng
, Florian Arendt
, Sebastian Scherr
, Paul S. F. Yip
, Matthew J. Spittal

Veröffentlichungen: Beitrag in Fachzeitschrift › Artikel › Peer Reviewed

Abstract

Objective To examine the association between reporting on suicides, especially deaths of celebrities by suicide, and subsequent suicides in the general population.

Design Systematic review and meta-analysis.

Data sources PubMed/Medline, PsychInfo, Scopus, Web of Science, Embase, and Google Scholar, searched up to September 2019.

Review methods Studies were included if they compared at least one time point before and one time point after media reports on suicide; follow-up was two months or less; the outcome was death by suicide; and the media reports were about non-fictional suicides. Data from studies adopting an interrupted time series design, or single or multiple arm before and after comparisons, were reviewed.

Results 31 studies were identified and analysed, and 20 studies at moderate risk of bias were included in the main analyses. The risk of suicide increased by 13% in the period after the media reported a death of a celebrity by suicide (rate ratio 1.13, 95% confidence interval 1.08 to 1.18; 14 studies; median follow-up 28 days, range 7-60 days). When the suicide method used by the celebrity was reported, there was an associated 30% increase in deaths by the same method (rate ratio 1.30, 95% confidence interval 1.18 to 1.44; 11 studies; median follow-up 28 days, range 14-60 days). For general reporting of suicide, the rate ratio was 1.002 (0.997 to 1.008; five studies; median follow-up 1 day, range 1-8 days) for a one article increase in the number of reports on suicide. Heterogeneity was large and partially explained by celebrity and methodological factors. Enhanced funnel plots suggested some publication bias in the literature.

Conclusions Reporting of deaths of celebrities by suicide appears to have made a meaningful impact on total suicides in the general population. The effect was larger for increases by the same method as used by the celebrity. General reporting of suicide did not appear to be associated with suicide although associations for certain types of reporting cannot be excluded. The best available intervention at the population level to deal with the harmful effects of media reports is guidelines for responsible reporting. These guidelines should be more widely implemented and promoted, especially when reporting on deaths of celebrities by suicide.

Systematic review registration PROSPERO CRD42019086559.

Originalsprache	Englisch
Aufsatznummer	m575
Seitenumfang	17
Fachzeitschrift	British Medical Journal
Jahrgang	368
Frühes Online-Datum	18 März 2020
DOIs	https://doi.org/10.1136/bmj.m575
Publikationsstatus	Veröffentlicht - 18 März 2020

Fördermittel

No specific funding for this study. MB is funded by the Austrian Science Fund (FWF), grant No KLI627-B30. MJS is a recipient of an Australian Research Council Future Fellowship (project No FT180100075) funded by the Australian Government. The funding sources had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. Contributors: Substantial contributions to the conception or design of the work (MJS, TN, and JP); acquisition of the data (JP, BT, MB, SS, TN, and MJS); data extraction (MJS, TN, and MB); statistical analyses (MJS); interpretation of the data (all authors); drafting the work (TN, MJS, and MS); revising it critically for important intellectual content (all authors); final approval of the version to be published (all authors); agreement to be accountable for all aspects of the work (all authors). The corresponding author attests that all listed authors meet authorship criteria and that no others meeting the criteria have been omitted. TN and MJS act as guarantors. Funding: No specific funding for this study. MB is funded by the Austrian Science Fund (FWF), grant No KLI627-B30. MJS is a recipient of an Australian Research Council Future Fellowship (project No FT180100075) funded by the Australian Government. The funding sources had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. Competing interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf and declare: no support from any organisation for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work. Ethical approval: Not required.

UN SDGs

Dieser Output leistet einen Beitrag zu folgendem(n) Ziel(en) für nachhaltige Entwicklung

SDG 3 – Gesundheit und Wohlergehen

ÖFOS 2012

508007 Kommunikationswissenschaft
508014 Publizistik

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Zitationsweisen

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title = "Association between suicide reporting in the media and suicide: systematic review and meta-analysis",

abstract = "Objective To examine the association between reporting on suicides, especially deaths of celebrities by suicide, and subsequent suicides in the general population. Design Systematic review and meta-analysis. Data sources PubMed/Medline, PsychInfo, Scopus, Web of Science, Embase, and Google Scholar, searched up to September 2019. Review methods Studies were included if they compared at least one time point before and one time point after media reports on suicide; follow-up was two months or less; the outcome was death by suicide; and the media reports were about non-fictional suicides. Data from studies adopting an interrupted time series design, or single or multiple arm before and after comparisons, were reviewed. Results 31 studies were identified and analysed, and 20 studies at moderate risk of bias were included in the main analyses. The risk of suicide increased by 13\% in the period after the media reported a death of a celebrity by suicide (rate ratio 1.13, 95\% confidence interval 1.08 to 1.18; 14 studies; median follow-up 28 days, range 7-60 days). When the suicide method used by the celebrity was reported, there was an associated 30\% increase in deaths by the same method (rate ratio 1.30, 95\% confidence interval 1.18 to 1.44; 11 studies; median follow-up 28 days, range 14-60 days). For general reporting of suicide, the rate ratio was 1.002 (0.997 to 1.008; five studies; median follow-up 1 day, range 1-8 days) for a one article increase in the number of reports on suicide. Heterogeneity was large and partially explained by celebrity and methodological factors. Enhanced funnel plots suggested some publication bias in the literature. Conclusions Reporting of deaths of celebrities by suicide appears to have made a meaningful impact on total suicides in the general population. The effect was larger for increases by the same method as used by the celebrity. General reporting of suicide did not appear to be associated with suicide although associations for certain types of reporting cannot be excluded. The best available intervention at the population level to deal with the harmful effects of media reports is guidelines for responsible reporting. These guidelines should be more widely implemented and promoted, especially when reporting on deaths of celebrities by suicide. Systematic review registration PROSPERO CRD42019086559.",

keywords = "BIAS, CELEBRITY SUICIDE, COVERAGE, IDEATION",

author = "Thomas Niederkrotenthaler and Marlies Braun and Jane Pirkis and Benedikt Till and Steven Stack and Mark Sinyor and Ulrich Tran and Martin Voracek and Qijin Cheng and Florian Arendt and Sebastian Scherr and Yip, \{Paul S. F.\} and Spittal, \{Matthew J.\}",

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doi = "10.1136/bmj.m575",

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AU - Niederkrotenthaler, Thomas

AU - Braun, Marlies

AU - Pirkis, Jane

AU - Till, Benedikt

AU - Stack, Steven

AU - Sinyor, Mark

AU - Tran, Ulrich

AU - Voracek, Martin

AU - Cheng, Qijin

AU - Arendt, Florian

AU - Scherr, Sebastian

AU - Yip, Paul S. F.

AU - Spittal, Matthew J.

PY - 2020/3/18

Y1 - 2020/3/18

N2 - Objective To examine the association between reporting on suicides, especially deaths of celebrities by suicide, and subsequent suicides in the general population. Design Systematic review and meta-analysis. Data sources PubMed/Medline, PsychInfo, Scopus, Web of Science, Embase, and Google Scholar, searched up to September 2019. Review methods Studies were included if they compared at least one time point before and one time point after media reports on suicide; follow-up was two months or less; the outcome was death by suicide; and the media reports were about non-fictional suicides. Data from studies adopting an interrupted time series design, or single or multiple arm before and after comparisons, were reviewed. Results 31 studies were identified and analysed, and 20 studies at moderate risk of bias were included in the main analyses. The risk of suicide increased by 13% in the period after the media reported a death of a celebrity by suicide (rate ratio 1.13, 95% confidence interval 1.08 to 1.18; 14 studies; median follow-up 28 days, range 7-60 days). When the suicide method used by the celebrity was reported, there was an associated 30% increase in deaths by the same method (rate ratio 1.30, 95% confidence interval 1.18 to 1.44; 11 studies; median follow-up 28 days, range 14-60 days). For general reporting of suicide, the rate ratio was 1.002 (0.997 to 1.008; five studies; median follow-up 1 day, range 1-8 days) for a one article increase in the number of reports on suicide. Heterogeneity was large and partially explained by celebrity and methodological factors. Enhanced funnel plots suggested some publication bias in the literature. Conclusions Reporting of deaths of celebrities by suicide appears to have made a meaningful impact on total suicides in the general population. The effect was larger for increases by the same method as used by the celebrity. General reporting of suicide did not appear to be associated with suicide although associations for certain types of reporting cannot be excluded. The best available intervention at the population level to deal with the harmful effects of media reports is guidelines for responsible reporting. These guidelines should be more widely implemented and promoted, especially when reporting on deaths of celebrities by suicide. Systematic review registration PROSPERO CRD42019086559.

AB - Objective To examine the association between reporting on suicides, especially deaths of celebrities by suicide, and subsequent suicides in the general population. Design Systematic review and meta-analysis. Data sources PubMed/Medline, PsychInfo, Scopus, Web of Science, Embase, and Google Scholar, searched up to September 2019. Review methods Studies were included if they compared at least one time point before and one time point after media reports on suicide; follow-up was two months or less; the outcome was death by suicide; and the media reports were about non-fictional suicides. Data from studies adopting an interrupted time series design, or single or multiple arm before and after comparisons, were reviewed. Results 31 studies were identified and analysed, and 20 studies at moderate risk of bias were included in the main analyses. The risk of suicide increased by 13% in the period after the media reported a death of a celebrity by suicide (rate ratio 1.13, 95% confidence interval 1.08 to 1.18; 14 studies; median follow-up 28 days, range 7-60 days). When the suicide method used by the celebrity was reported, there was an associated 30% increase in deaths by the same method (rate ratio 1.30, 95% confidence interval 1.18 to 1.44; 11 studies; median follow-up 28 days, range 14-60 days). For general reporting of suicide, the rate ratio was 1.002 (0.997 to 1.008; five studies; median follow-up 1 day, range 1-8 days) for a one article increase in the number of reports on suicide. Heterogeneity was large and partially explained by celebrity and methodological factors. Enhanced funnel plots suggested some publication bias in the literature. Conclusions Reporting of deaths of celebrities by suicide appears to have made a meaningful impact on total suicides in the general population. The effect was larger for increases by the same method as used by the celebrity. General reporting of suicide did not appear to be associated with suicide although associations for certain types of reporting cannot be excluded. The best available intervention at the population level to deal with the harmful effects of media reports is guidelines for responsible reporting. These guidelines should be more widely implemented and promoted, especially when reporting on deaths of celebrities by suicide. Systematic review registration PROSPERO CRD42019086559.

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KW - CELEBRITY SUICIDE

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KW - IDEATION

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Association between suicide reporting in the media and suicide: systematic review and meta-analysis

Abstract

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UN SDGs

ÖFOS 2012

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