Prevalence and risk factors of suicidal ideation and suicide attempts among young people in the MENAT region: a systematic review and meta-analysis.

BACKGROUND: Suicide is one of the leading causes of mortality among adolescents and young adults, with suicidal ideation and attempts representing critical predictors of suicide-related outcomes. Although global evidence highlights rising trends in suicidal behaviors, regional patterns remain varied. In the MENAT region (Middle East, North Africa, and Turkey), where cultural stigma, conflict, and insufficient mental health infrastructure may exacerbate vulnerability, evidence remains fragmented. This study systematically reviewed and meta-analyzed the prevalence, risk factors, and protective factors associated with suicidal ideation and suicide attempts among young people in the MENAT region.

METHODS: The study protocol was registered with PROSPERO (ID: CRD420251101524) and conducted following PRISMA guidelines. A systematic search of six electronic databases (PubMed, MEDLINE, Scopus, Web of Science, Embase, and PsycINFO) was conducted for studies published between January 2010 and June 2025. Eligible studies were observational in design, published in English, and reported the prevalence of suicidal ideation or suicide attempts among individuals aged ≤25 years in the MENAT region. Many included studies relied on single-item measures of suicidality rather than validated multi-item scales, which was considered when interpreting results. Pooled prevalence and odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using random-effects models. Heterogeneity, sensitivity analyses, and publication bias were examined.

RESULTS: A total of 47 studies encompassing 115,152 participants were included. The pooled prevalence of suicidal ideation was 25% (95% CI: 0.19-0.31), while suicide attempts were reported by 12% (95% CI: 0.06-0.19). Suicidal ideation reached as high as 52.7% in individual studies from Jordan, while suicide attempts were most prevalent in studies from Kuwait. Female gender, bullying (OR = 1.6), loneliness (OR = 2.2), substance use, including smoking (OR = 2.0), alcohol (OR = 3.0), and amphetamines (OR = 3.5), as well as depression (OR = 1.5), anxiety (OR = 2.1) and history of sexual abuse (OR = 2.0) were significantly associated with suicidal ideation. Suicide attempts were strongly linked to alcohol (OR = 3.0), cannabis use (OR = 1.7), anxiety (OR = 3.1), depression (OR = 1.5), and a history of sexual abuse (OR = 2.2). Evidence on protective factors such as family connectedness, religiosity, and social support was limited and inconsistently reported across studies, highlighting a major research gap in understanding resilience factors among youth in the MENAT region.

CONCLUSION: Suicidal ideation and attempts are prevalent among young people in the MENAT region and were significantly associated with psychosocial stressors and substance use. However, the reliance of many included studies on single-item assessments of suicidality limits the precision and comparability of estimates. These findings highlight the urgent need for culturally tailored, evidence-based suicide prevention strategies and enhanced mental health services in this vulnerable population.

CLINICAL TRIAL NUMBER: Not applicable.