Suicide and psychiatric disorders associated with amphetamine type stimulant use: a systematic review and meta-analysis

Objective This study reviews the literature to determine the prevalence and nature of suicidality and psychiatric comorbidity in individuals with amphetamine-type stimulant (ATS) use to inform targeted interventions. Methods We searched the Web of Science, PubMed, Scopus, and Cochrane Library databases for relevant papers published until March 2025. Two independent reviewers collected the following data: baseline information, outcomes, prevalence of suicidality, psychiatric disorders, employment status, marital status, additional substances used, age at onset of use, and duration of use. Results We collected 2,969 records after excluding 2,072 duplicates. Thorough screening yielded 70 entries eligible for inclusion. Our analysis revealed prevalence rates of 26% for depression, 22% for hallucinations, 20% for suicidality, 23% for suicidal ideation, 17% for suicide attempts, and 13% for deaths by suicide. Additionally, 38% of individuals who use ATS also used multiple other substances concurrently, and the mean duration of ATS use was estimated to be 5.13 years. The total pooled sample size across all included studies was 311,669 persons. Conclusion This systematic review highlights the high prevalence of psychiatric conditions, including depression, hallucinations, and suicidality, frequently co-occurring with concurrent use of multiple substances and psychiatric disorders. These findings represent prevalence rates within the ATS-using population, and no comparison with non-ATS populations was performed; therefore, they do not imply an excess or attributable risk. The results underscore the critical need for integrated screening and service-planning guidance in this vulnerable population.