Allergic Rhinitis is Associated with Increased Suicidality: A Systematic Review and Meta-Analysis

Allergic rhinitis (AR) is a common inflammatory condition affecting millions globally. Emerging evidence suggests a potential link between AR and suicidality; however, this association remains underexplored compared to other atopic diseases. This systematic review and meta-analysis aimed to investigate the association between AR and the risks of suicidal ideation, attempts, and death. Following PRISMA guidelines, we conducted a systematic search across PubMed, Embase, PsycINFO, Cochrane databases, Web of Science, Scopus, CINAHL, and Google Scholar. A total of 590 studies were screened, with 9 eligible cross-sectional studies involving 1,604,962 participants included. Data on suicidal ideation, suicide attempts, and death were synthesized using random-effects meta-analyses. Odds ratios (ORs) were calculated with 95% confidence intervals (CIs). The risk of bias was assessed using the Joanna Briggs Institute Critical Appraisal Checklist, and evidence was graded using the GRADE framework. AR was not significantly associated with suicidal ideation (OR: 1.12, 95% CI: 0.97-1.30; 1,101,819 participants from 7 studies). However, AR patients demonstrated an elevated risk of suicide attempts (OR: 1.25, 95% CI: 1.00-1.57; 1,554,297 participants from 5 studies) and suicide death (OR: 1.65, 95% CI: 1.46-1.86; 478,244 participants from 2 studies). This meta-analysis highlights an association between allergic rhinitis and increased risk of suicide attempts and death. However, due to the cross-sectional nature of included studies, causality cannot be inferred.