Joseph Nano Mental Health, Uncategorized

Childhood trauma tied to higher suicide risk in low‑ and middle‑income countries, major review finds

Bullying, abuse and family disruption among the experiences most strongly linked to suicidal thoughts, plans or attempts.

A sweeping review of 118 population‑based studies from across Africa, Asia, Latin America and other regions concludes that adverse childhood experiences (ACEs) are consistently linked with greater odds of suicidal thoughts, plans and attempts in low‑ and middle‑income countries (LMICs). The analysis, published in BMJ Global Health, arrives as LMICs shoulder 77% of the world’s suicide deaths.  

What the study did

Researchers searched five major databases (Medline, Embase, PsycINFO, CINAHL and Web of Science) and screened more than 12,000 records, ultimately including 118 studies that used representative sampling; 63 contributed data to meta‑analyses. Most studies were cross‑sectional (92%) and were conducted in middle‑income countries; only 4.2% came from low‑income nations. East Asia & Pacific and Latin America & the Caribbean were the most represented regions. (See Figure 1, PRISMA flow, page 3; Table 1, page 5.)    

The strongest signals

Six categories of ACEs showed statistically significant links with suicidality, with effect sizes ranging from modest to substantial:

  • Sexual abuse was associated with the highest odds of suicide planning (pooled OR 2.61; 95% CI 2.25–2.98). (Table 2, pages 6–7.)  
  • Emotional/verbal/psychological abuse was tied to both suicidal ideation (OR 2.36; 1.95–2.77) and attempt (OR 2.20; 1.80–2.60). (Table 2.)  
  • Physical abuse/violence showed elevated odds for ideation and attempt (for ideation, OR 2.07; 1.74–2.40). (Table 2.)  
  • Bullying victimisation (including cyberbullying) increased the odds of ideation (OR 1.66; 1.46–1.85) and planning (OR 1.46; 1.29–1.63). (Table 2.)  
  • Parental separation, divorce or death raised the odds of ideation (OR 1.39; 1.21–1.58) and attempt (OR 1.49; 1.11–1.88). (Table 2.)  
  • Physical attack (outside the home) was linked to suicide planning (OR 1.19; 1.07–1.32). (Table 2.)  

The authors found consistent positive associations across most subgroup and sensitivity analyses. Notably, food insecurity and community violence showed mixed or non‑significant results for some outcomes, underscoring that not all adversities carry the same measurable risk in available datasets. (Table 2, pages 6–7.)  

Why it matters

ACEs—ranging from bullying and abuse to household violence and family disruption—were common exposures in the studies captured. The pattern of risk seen here reinforces the need to prevent violence against children, support families and respond early when adversity occurs. (Table 1 lists the ACEs assessed across studies.)  

What the experts recommend

Prevention won’t look identical in every setting, but evidence‑based options for LMICs include: restricting access to lethal means, school‑based awareness and anti‑bullying programs, and expanding access to treatment for depression and other mental health conditions. Broader strategies aligned with WHO’s INSPIRE framework—such as economic empowerment of families and parenting programs—can reduce child maltreatment and, downstream, suicidal behavior.  

Important caveats

Despite its scope, the review highlights key gaps:

  • No included study reported suicide mortality, likely reflecting data limitations in many countries’ vital registration systems.  
  • Most evidence comes from upper‑ and lower‑middle‑income settings; low‑income countries are under‑represented.  
  • Many studies relied on self‑reported childhood exposures and outcomes and were cross‑sectional, which can inflate estimates and limit conclusions about timing and causality.  

Bottom line

The findings add weight to a clear message: protecting children from violence and adversity is suicide prevention.Early action in homes, schools and communities—paired with accessible mental health care—can reduce risk and save lives.  

If you or someone you know may be thinking about suicide, seek help right away. Contact your local emergency number or a crisis hotline in your country, or reach out to a trusted health professional.

Blair, D. L., Kingsbury, M., Eccles, H., Akther, A., Siddiqi, S., Condran, G., Obeegadoo, I., Murray, J., Geoffroy, M. C., Menezes, A. M. B., Sikora, L., & Colman, I. (2025). Adverse childhood experiences and suicidality in low-income and middle-income countries: a systematic review and meta-analysis. BMJ global health, 10(5), e018129. https://doi.org/10.1136/bmjgh-2024-018129

Editor’s note: This article is for information only and is not a substitute for professional medical advice.