Natural disasters and suicidal behaviours: a systematic literature review.
BACKGROUND
Various consequences including suicidal behaviours can arise in the aftermath of natural disasters. The aim of the present review was to systematically analyse the existing literature on the potential impact of natural disasters on suicidal behaviours.


METHODS
A systematic search of English-language articles indexed in electronic databases was conducted. The current review covers 42 papers containing empirical analyses of the relationship between natural disasters and suicidal behaviours.


RESULTS
In total, 19 papers analysed suicide mortality and 23 non-fatal suicidal behaviours. The effects of earthquakes on suicidal behaviours are the most frequently studied among natural disasters (n=20), followed by hurricanes (n=11). Further, there were four papers about tsunamis, three about floods, three about heat waves and drought, and one investigating the effects of multiple natural disasters. The studies show different directions in suicide mortality following natural disasters. Nevertheless, there seems to be a drop in non-fatal suicidal behaviours in the initial post-disaster period, which has been referred to as the 'honeymoon' phase. A delayed increase in suicidal behaviours has been reported in some studies. However, other factors increasing the risk of suicidal behaviours after natural disasters have been reported, such as previous and current mental health problems. Furthermore, contributing factors, such as economic conditions, should also be considered.


CONCLUSIONS
The exclusion of non-English articles.


CONCLUSIONS
In light of the various methodological limitations observed, there is a need for further studies using proper designs. Mental health and suicidal behaviours should continue to be monitored for several years after the disaster.
Australian Institute for Suicide Research and Prevention, National Centre of Excellence in Suicide Prevention, World Health Organization Collaborating Centre for Research and Training in Suicide Prevention, Griffith University, Mt Gravatt Campus, QLD 4122, Australia. k.kolves@griffith.edu.au
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D055867:Cyclonic Storms; D004190:Disasters; D055864:Droughts; D055866:Earthquakes; D055868:Floods; D006801:Humans; D007259:Infrared Rays; D012307:Risk Factors; D013405:Suicide / Q000523:psychology*; D057192:Tsunamis