Substance use, sexual behaviours, and suicidal ideation and attempts among adolescents: findings from the 2004 Guangzhou Youth Risk Behaviour Survey

Socioeconomic differences in adolescents' smoking: a comparison between Finland and Beijing, China

BACKGROUND

Various studies have demonstrated the associations between socioeconomic status (SES) and health and health behaviour among adolescents. However, few studies have compared the socioeconomic difference in adolescent smoking between countries with different stage of smoking. The purpose of this study was to examine and compare the relationship between socioeconomic status (SES) and adolescent smoking in Beijing, China and Finland through the Health Behaviour in School-aged Children (HBSC) study.

METHODS

The data used in this study were derived from the Chinese HBSC linked project survey 2008 in Beijing and the Finnish HBSC survey 2006. The final sample included 2005 Chinese and 1685 Finnish 15-year-old schoolchildren. The associations between Family Affluence Scale (FAS), as the SES measure, and adolescents' smoking behaviour, including ever smoked, weekly smoking and the early onset of smoking were examined separately in two countries through binary logistic regression.

RESULTS

Compared to students from the high FAS group, Chinese boys from the low FAS group were more likely to report having ever smoked (OR = 2.12, 95 % CI = 1.49-3.01) and being early onset of smoking (OR = 2.17, 95 % CI = 1.44-3.26). Finnish girls from the low FAS group were more likely to report being weekly smokers (OR = 1.68, 95 % CI = 1.07-2.65). No significant difference was found for Chinese girls and Finnish boys.

CONCLUSIONS

This study indicated different patterns of socioeconomic difference in smoking between Chinese and Finnish adolescents by gender and by smoking behaviour, which suggests that socioeconomic inequalities in smoking are different among adolescents in countries with different stage of smoking. Country specific policies and interventions for different target groups should be encouraged and designed for reducing the prevalence of adolescents' smoking.

Prevalence and risk factors associated with suicidal ideation among adolescents in Malaysia

BACKGROUND

Suicidal ideation, defined as thoughts, ideas and the desire to commit suicide, is becoming a major public health problem among adolescents. Indeed, suicidal ideation is known as a key predictor of future suicide risk.

OBJECTIVE

This study aims to determine the prevalence and risk factors associated with suicidal ideation among adolescents in Malaysia.

METHODS

This study used data from the 2013 Malaysian adolescent health risk behavior (MyAHRB) study, a cross-sectional school survey conducted in Peninsular Malaysia among school-going adolescents aged 16-17 years (n=2789). Logistic regression analysis was used to determine the risk factors associated with suicidal ideation among Malaysian adolescents.

RESULTS

The overall prevalence of suicidal ideation among the adolescents was 6.2%. The prevalence was significantly higher among females than males (7.6% vs. 4.7%; p=0.002). Multivariate regression analysis revealed that adolescents who were females [odds ratio (OR)=2.02; 95% confidence interval (CI): 1.40-2.92] or of Indian ethnicity (OR=2.32; 95% CI: 1.35-3.98) were more likely to report suicidal ideation. Loneliness (OR=2.54; 95% CI: 1.57-4.11), anxiety or worry (OR=2.70; 95% CI: 1.70-4.31), no close friends (OR=2.71; 95% CI: 1.43-5.14), and lack of supportive peers (OR=1.69; 95% CI: 1.15-2.47) were identified as risk factors for adolescents' suicidal ideation. Adolescents who ever had sexual intercourse (OR=2.70; 95% CI: 1.48-4.92) and had been in a physical fight (OR=2.45; 95% CI: 1.62-3.70) were also reported to have higher risks of suicidal ideation.

CONCLUSION

This study provides evidence on risk factors associated with suicidal ideation among Malaysian adolescents. Targeted mental health and health risk behavioral interventions for high-risk adolescents are recommended.

Serious Suicide Attempts: Evidence on Variables for Manage and Prevent this Phenomenon

The aim of this study is to investigate the variables shown to be linked to serious suicide attempts. Cases requiring emergency admission to intensive care were collected from medical records of the University Hospital in Messina (Italy) for the years 2006-2010. 107 cases of serious attempted suicide were examined, 39 of which ended in the death of the patient. The results showed the following variables to be linked highly significantly (P < 0.01) and have good nominal association (V > 0.30) with a fatal suicidal attempt: the year of the attempt, deceased father, history of physical illness prior to hospitalization and method used to carry out the suicide attempt. These results confirm the severity and the multidisciplinary importance of this phenomenon.

Suicide ideation and acceptability among females aged 15 to 34 years in rural China

The suicide rate of females is very close to that of males in China, in contrast to Western societies, in which the rates of male suicide outnumber those of females by three to four times. This study investigated the prevalence of suicidal ideation and prosuicide attitude (acceptability) among females of childbearing age. With the Chinese version of the Scale for Suicide Ideation and the General Social Survey questionnaire, we examined the demographic and psychological risk factors of suicide among Chinese rural young females aged 15 to 34 years. Logistic regression analysis was performed to explore the factors related to suicidal ideation and suicide acceptability. The prevalence rates of suicidal ideation and suicide acceptability among the sampled females are 22.5% and 3.8%, respectively. Education, depression, social support, hopelessness, and negative life events were significantly associated with suicidal ideation. Ethnicity, education, abortion, and depression were significantly associated with suicide acceptability. There is statistical difference between suicide ideation and acceptability. The results indicate that mental disorder remains a major risk factor of suicidal ideation. Sociodemographic and psychological characteristics are associated with suicide acceptability.

Risk factors related to suicidal ideation and attempted suicide: comparative study of Korean and American youth

Suicidal trends and related characteristics such as sociodemographic factors, psychological factors, and health behaviors can differ between countries. This study investigated the predictors of suicidal ideation and attempted suicide including health behaviors among American and Korean youth from two national representative data sets. In both countries, depression was the most predominant predictor to suicidal ideation and attempted suicide. Unique predictors of suicidal youth in each country were also found. In America, attempted suicide was predicted by poor body image, whereas in Korea attempted suicide was predicted by medical diagnosis such as asthma, concern about weight, and alcohol consumption. The value of our approach lies in the comparative analysis of analogous and unique characteristics of suicidal youths in these two huge data sets from different countries. These results should be helpful for school and mental health care providers to plan interventions for youth at risk of suicide to prevent suicidal completion in these nations.

Soft drink and sweet food consumption and suicidal behaviours among Chinese adolescents

AIM

Greater soft drink consumption was associated with increased risk of mental health problems in Western countries. The objective of the study was to examine the association between soft drink and sweet food consumption and suicidal behaviours among adolescents in China.

METHODS

In 2005, a population-based cross-sectional study was conducted in 100 schools in Jiangsu Province, China. Participants were aged 12-19 years old (n = 23,976).

RESULTS

Among the participants, 20.5% reported daily soft drink consumption; 18.6% reported having suicidal ideation. Soft drink consumption was significantly and positively associated with risk of suicidal plan or suicide attempt. Prevalence of suicidal plan was 12.8% among those who consumed soft drink at least three times per day and 6.2% among those who did not consume any soft drinks. In multivariate analyses, compared with soft drink consumption less than once per day, consumption at least three times per day was associated with 80% increased risk for suicidal plan and more than 3.5-fold increased risk for suicide attempt. Of note, nonconsumption of soft drinks was also associated with about 32% elevated risk for suicidal plan and suicidal attempt. High frequency intake of sweet food was associated with increased risk of suicidal behaviours.

CONCLUSIONS

There is a positive association between consumption of soft drinks and sweet food and risks for suicidal behaviours among adolescents in China. Prospective studies are warranted to confirm these findings.

Increasing self-reported suicide attempts by adolescents in Greece between 1984 and 2007

PURPOSE

This study examines trends in self-reported suicide attempts by Greek adolescents.

METHODS

Data were obtained from five nationwide school probability surveys, each of approximately 8,000-10,000 adolescents aged 14-18 years, carried out from 1984 to 2007. Students answered an anonymous questionnaire in their classrooms supervised by research assistants. Logistic regression analysis used as dependent variable any self-reported suicide attempts and as independent variables basic sociodemographic information and the year of the survey.

RESULTS

Self-reported suicide attempts doubled in prevalence from 7.0% in 1984 to 13.4% in 2007. Female gender (odds ratio OR 2.49, 95% confidence interval CI 2.30-2.71), living in a single parent family (OR 1.91, CI 1.73-2.11), lower paternal education (OR 1.20, CI 1.10-1.31) and living in a major city (OR 1.17, CI 1.08-1.27 for Greater Athens and OR 1.13, CI 1.00-1.28 for Thessaloniki) were significantly associated with suicide attempts. A larger increase among males, from 2.4 to 8.4%, compared to females (11.5 to 17.9%) contributed to a decrease in gender differences.

CONCLUSIONS

Changes in Greek society during the last 30 years, including loosening of family ties, increased drug use and stress because of the demands of school work, are hypothesised to have had an impact on the increasing trend in suicide attempts among adolescents.

Epidemiology of child and adolescent mental health disorders in Asia

PURPOSE OF REVIEW

Global epidemiological data indicate a significant burden of child and adolescent mental health (CAMH) problems. Collating similar data from Asian countries, the majority of which have vast needs but limited resources in CAMH, will help in improving the policy-making, service development and clinical practice.

RECENT FINDINGS

A nonclinic-based English literature search for epidemiological studies in the past 12-18 months from 51 Asian countries showed the general prevalence of CAMH problems/disorders to be in the range of 10-20%. There was nonuniformity in the instruments used for these studies. The majority of studies did not utilize a second stage of detailed assessment for diagnostic confirmation. Many countries moved from general prevalence of mental health disorders to prevalence of specific mental health disorders. Socioeconomic status, academic achievement and abnormal psychosocial situations most commonly influence CAMH in this population.

SUMMARY

This review highlights the challenges in CAMH epidemiological studies in Asia. Suggestions are made and implications are discussed regarding improving the methodology and bringing in uniformity in such future studies.

Sexual intercourse and high-risk sexual behaviours among a national sample of urban adolescents in China

BACKGROUND

To describe the characteristics of a population with high-risk sexual behaviours and associations between sexual intercourse, high-risk sexual behaviours and socio-demographic characteristics among Chinese urban adolescents.

METHODS

In 2005, 109,754 students in grades 10-12 and 33,653 college students were anonymously surveyed using a Chinese Youth Risk Behaviour Survey. Demographic variables and indicators of forced sex, condom use and unintended pregnancy were analysed with multiple logistic regressions.

RESULTS

Of students surveyed, median age was 17.6 (range 14-24 years) and 76,233 were female (53.2%); 4.8% of high school students reported had experienced sexual intercourse; of these, 32.8% reported had forced sex; 11.3% of college students reported had experienced sexual intercourse and of these, the prevalence of forced sex, condom use and unintended pregnancy were 23.5, 49.7 and 24.2%, respectively. School type and socioeconomic status were found to be independently associated with sexual intercourse and forced sex for high school students. For college students, educational level, school type, family structure, maternal education and socioeconomic status were independently associated with high-risk sexual behaviours.

CONCLUSION

This study highlights the association between high-risk sexual behaviours and school type and socioeconomic status. These results strongly suggest the importance of providing sex education in high schools and lower socioeconomic areas.