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Tu JH, Lu Y, Yue ZC, Ling KN, Xing YR, Chen DD, Zhu ZR, Chen TX. Suicidal incidence and gender-based discrepancies in prolonged grief disorder: insights from a meta-analysis and systematic review. Front Psychiatry 2024; 15:1427486. [PMID: 39211541 PMCID: PMC11358064 DOI: 10.3389/fpsyt.2024.1427486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Accepted: 07/17/2024] [Indexed: 09/04/2024] Open
Abstract
Background In the aftermath of bereavement, our research explores the subtleties of Prolonged Grief Disorder (PGD), focusing particularly on its correlation with suicidal behaviors and their variation across genders. This study seeks to elucidate the impact of gender on these behaviors among individuals suffering from PGD, thereby enhancing our understanding and facilitating the development of tailored therapeutic interventions. Methods By November 24th, 2023, we had rigorously reviewed key databases such as PubMed, Web of Science, Cochrane Library, PsycINFO, and Embase. Independently, two researchers conducted detailed interviews and filled out questionnaires with participants to gather demographic information and record instances of prolonged grief disorder. The study also meticulously tracked occurrences of suicidal ideation, suicide attempts, suicide deaths, and self-injury among the participants. Results The findings indicate that 22.34% of males reported suicidal ideation (95% CI: 21.33-23.35), a figure that rises to 26.84% among females (95% CI: 25.99-27.69). Notably, 12.11% of males attempted suicide (95% CI: 11.49-12.72), marginally surpassing the 9.60% observed in females (95% CI: 9.17-10.04). More striking disparities were observed in suicide deaths, with rates for males at 3.66% (95% CI: 3.32-4.00) compared to a notably higher 7.12% for females (95% CI: 6.44-7.81). Furthermore, the incidence of self-injury was lower among males, at 2.48% (95% CI: 2.03-2.94), than in females, who reported a rate of 5.09% (95% CI: 4.69-5.49). These patterns underscore the critical need for gender-specific interventions aimed at reducing these significant disparities. Conclusion This study distinctly underscores the profound impact of gender on the manifestation of suicidal behaviors in individuals afflicted with prolonged grief disorder. It reveals that females are more prone to suicidal ideation, self-injury, and suicide deaths, while males predominantly exhibit a higher incidence of suicide attempts and risk-taking behaviors. These unmediated trends highlight the necessity for gender-specific clinical interventions tailored to address particular behaviors and modify prevalent patterns that typically resist conventional approaches. Systematic review registration PROSPERO (york.ac.uk), identifier CRD42023480035.
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Affiliation(s)
- Jin-Heng Tu
- School of Nursing and Rehabilitation, Nantong University, Nantong, China
| | - Yun Lu
- School of Nursing and Rehabilitation, Nantong University, Nantong, China
| | - Zong-Chao Yue
- School of Nursing, Harbin Medical University, Harbin, Heilongjiang, China
| | - Ke-Nan Ling
- School of Nursing and Rehabilitation, Nantong University, Nantong, China
| | - Yu-Run Xing
- School of Nursing and Rehabilitation, Nantong University, Nantong, China
| | - Dan-Dan Chen
- School of Nursing and Rehabilitation, Nantong University, Nantong, China
| | - Zhi-Ren Zhu
- School of Nursing and Rehabilitation, Nantong University, Nantong, China
| | - Tian-Xi Chen
- Department of Emergency Medicine, Affiliated Hospital of Nantong University, Nantong, Jiangsu, China
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Mmethi TG, Modjadji P, Mathibe M, Thovhogi N, Sekgala MD, Madiba TK, Ayo-Yusuf O. Substance Use among School-Going Adolescents and Young Adults in Rural Mpumalanga Province, South Africa. Behav Sci (Basel) 2024; 14:543. [PMID: 39062366 PMCID: PMC11274307 DOI: 10.3390/bs14070543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Revised: 06/17/2024] [Accepted: 06/25/2024] [Indexed: 07/28/2024] Open
Abstract
The ongoing public health crisis of substance use among school adolescents and young adults (AYAs) in South Africa is not new in research parlance, amidst the national policy of drug abuse management in schools. In view of no tangible progress to reduce substance use in high schools in the country, we conducted a cross-sectional quantitative study aimed at investigating substance use among adolescents and young adults in the four public high schools selected through multi-stage sampling in rural Mpumalanga province, South Africa. Data on substance use, demographics, household socio-demographics, and related factors were collected via a validated self-administered questionnaire. Hierarchical logistic regression was performed using STATA 18. The study included 402 AYAs aged between 14 and 23 years (18 ± 1 years), and 45% reported substance use in the last twelve months. Alcohol was the most used substance (74%), followed by cigarettes (12%) and cannabis (11%). AYAs used substances out of social influence, curiosity, to find joy, and to eliminate stress, especially in social events, on the streets, and at home, and reported negative physical health outcomes, mainly hallucinations, sleeping disorders, body weakness, and dry mouths. Hierarchical logistic regression showed that the likelihood of substance use was three times in a particular high school (S4) (AOR = 3.93, 95%CI: 1.72-8.99), twice among the grade 12s (AOR = 2.73, 95%CI: 1.46-5.11), over twenty times in the communities with substance availability (AOR = 22.45, 95%CI: 2.75-183.56), almost ten times among AYAs participating in recreational/sports activities (AOR = 9.74, 95%CI: 4.21-22.52), and twice likely to happen in larger households (AOR = 2.96, 95%CI: 1.57-5.58). Prevention and intervention efforts should consider these specific health concerns to develop targeted strategies for mitigating substance use and its adverse consequences in this vulnerable population towards achieving the United Nations' Sustainable Development Goal Target 3.5, which aims to strengthen the prevention and treatment of substance abuse, including narcotic drug abuse and the harmful use of alcohol.
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Affiliation(s)
- Tabeho Godfrey Mmethi
- Department of Public Health, School of Health Care Sciences, Sefako Makgatho Health Sciences University, Pretoria 0208, South Africa; (T.G.M.)
- Department of Community Dentistry, School of Dentistry, University of Pretoria, Pretoria 0208, South Africa
| | - Perpetua Modjadji
- Department of Public Health, School of Health Care Sciences, Sefako Makgatho Health Sciences University, Pretoria 0208, South Africa; (T.G.M.)
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Tygerberg, Cape Town 7505, South Africa
- Department of Life and Consumer Sciences, College of Agriculture and Environmental Sciences, University of South Africa, Roodepoort, Johannesburg 1709, South Africa
- Africa Centre for Tobacco Industry Monitoring and Policy Research (ATIM), School of Health Systems and Public Health, University of Pretoria, Pretoria 0028, South Africa;
| | - Mmampedi Mathibe
- Department of Public Health, School of Health Care Sciences, Sefako Makgatho Health Sciences University, Pretoria 0208, South Africa; (T.G.M.)
| | - Ntevhe Thovhogi
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Tygerberg, Cape Town 7505, South Africa
| | - Machoene Derrick Sekgala
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Tygerberg, Cape Town 7505, South Africa
| | - Thomas Khomotjo Madiba
- Department of Community Dentistry, School of Dentistry, University of Pretoria, Pretoria 0208, South Africa
| | - Olalekan Ayo-Yusuf
- Africa Centre for Tobacco Industry Monitoring and Policy Research (ATIM), School of Health Systems and Public Health, University of Pretoria, Pretoria 0028, South Africa;
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Gitonga B, Muthoni S. Suicidal Ideation Among Kenyan Youth: A Qualitative Analysis of Online Life Stories. OMEGA-JOURNAL OF DEATH AND DYING 2024:302228241264040. [PMID: 38903020 DOI: 10.1177/00302228241264040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/22/2024]
Abstract
This study examines the experiences of suicidal ideation among Kenyan youth through a qualitative analysis of online narratives, a sample that comprised 15 young individuals aged 17-26 who shared their stories on online platforms. Employing Interpretative Phenomenological Analysis (IPA), the study highlights complex interactions of societal pressures, mental health challenges, and identity struggles that contribute to suicidal ideation. Key themes identified include the impact of cultural expectations, mental health stigma, isolation, and identity crises. By prioritizing the personal voices of the youth, the study sheds light on the deeply contextual nature of suicidal ideation and offers insights into the meanings individuals ascribe to their experiences. The findings advocate for culturally sensitive interventions and underscore the need to address mental health stigma, aiming to foster a supportive societal environment for Kenyan youth grappling with these issues.
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Affiliation(s)
- Benjamin Gitonga
- Department of Sociology, Psychology & Anthropology, School of Arts and Social Sciences, Moi University, Eldoret, Kenya
| | - Sheila Muthoni
- Department of Sociology, Psychology & Anthropology, School of Arts and Social Sciences, Moi University, Eldoret, Kenya
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Glenn CR, Kalgren T, Dutta S, Kandlur R, Allison KK, Duan A, Eskin CK, Leets M, Gould MS. Evaluating the Experience of Teen-to-Teen Crisis Line Volunteers: A Pilot Study. Community Ment Health J 2024:10.1007/s10597-024-01298-z. [PMID: 38833081 DOI: 10.1007/s10597-024-01298-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 05/15/2024] [Indexed: 06/06/2024]
Abstract
Teen-to-teen (t2t) crisis lines are a special type of crisis service where youth volunteers help their peers. Although prior research has examined the experience of adult crisis line responders, no research has examined the experience of adolescents who do this work. In collaboration with two of the largest t2t lines in the U.S., this pilot study is the first examination of t2t crisis line work. Volunteers (ages 14-20) reported: their primary motivation for joining the crisis lines was to help others and give back to the community; responding to a range of peers' problems on the t2t crisis line, including high-risk suicide contacts; and a range of ways the crisis line work impacted their lives. Findings provide preliminary information about the experience of adolescents engaging in t2t crisis line work. Additional research is needed in larger and more diverse samples to understand the impact of crisis line work for youth.
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Affiliation(s)
- Catherine R Glenn
- Old Dominion University, Norfolk, VA, USA.
- Virginia Consortium Program in Clinical Psychology, Norfolk, VA, USA.
| | | | | | - Raksha Kandlur
- Old Dominion University, Norfolk, VA, USA
- Virginia Consortium Program in Clinical Psychology, Norfolk, VA, USA
| | | | - Annie Duan
- University of Rochester, Rochester, NY, USA
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de Oliveira Gracini CL, Nascimento GG, Vidigal MTC, de Oliveira MN, Herval ÁM, Blumenberg C, Vieira WA, Lima RR, Paranhos LR. Suicide ideation and psychotropic recreational drug use by adolescents: a systematic review and meta-analysis. SAO PAULO MED J 2024; 142:e2022641. [PMID: 38655989 PMCID: PMC11034886 DOI: 10.1590/1516-3180.2022.0641.r2.23012024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 12/23/2023] [Accepted: 01/23/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND Adolescence is characterized by complex and dynamic changes, often involving experimentation, including the use of psychotropic substances. Although it is well-established that recreational psychotropic drugs are associated with suicide ideation in adults, evidence of this association in adolescents remains limited. OBJECTIVE To investigate the relationship between suicide ideation and psychotropic recreational drug use among adolescents. DESIGN AND SETTING Systematic review with meta-analysis developed at Universidade Federal de Uberlândia (UFU) and Universidade Estadual de Campinas (UNICAMP), Brazil. METHODS A search across eight electronic databases for observational studies, without language or publication year restrictions, was conducted. The Joanna Briggs Institute tool was used to assess the risk of bias. Random-effects meta-analyses and odds ratios were used to measure the effects. RESULTS The search yielded 19,732 studies, of which 78 were included in the qualitative synthesis and 32 in the meta-analysis. The findings indicated that suicidal ideation was 1.96 times more likely (95% confidence interval, CI = 1.47; 2.61) for adolescents who used some drug recurrently and 3.32 times more likely (95%CI = 1.86; 5.93) among those who abused drugs. Additionally, adolescents who used cannabis were 1.57 times more likely (95%CI = 1.34; 1.84) to experience suicide ideation compared with non-users, while cocaine users had 2.57 times higher odds (95%CI = 1.47; 4.50). CONCLUSIONS Psychotropic recreational drug use is associated with suicidal ideation among adolescents regardless of current or previous use, abuse, or type of substance used. SYSTEMATIC REVIEW REGISTRATION Registered in the PROSPERO database under the identification number CRD42021232360. https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021232360.
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Affiliation(s)
- Cássia Lima de Oliveira Gracini
- MSc. Nurse, Master’s student, Postgraduate Program in Management and Public Health, Universidade Estadual de Campinas (UNICAMP), Piracicaba (SP), Brazil
| | - Gustavo Giacomelli Nascimento
- PhD. Dentist, Principal Investigator, National Dental Centre Singapore, National Dental Research Institute Singapore, Singapore, Singapore; Professor, Oral Health Academic Clinical Programme, Duke-NUS Medical School, Singapore, Singapore
| | - Maria Tereza Campos Vidigal
- MSc. Dentist, Master’s student, Postgraduate Program in Dentistry, School of Dentistry, Universidade Federal de Uberlândia (UFU), Uberlândia (MG), Brazil
| | - Murilo Navarro de Oliveira
- MSc. Dentist, Doctoral student, Postgraduate Program in Dentistry, School of Dentistry, Universidade Federal de Uberlândia (UFU), Uberlândia (MG), Brazil
| | - Álex Moreira Herval
- PhD. Dentist, Professor, Division of Preventive and Community Dentistry, School of Dentistry, Universidade Federal de Uberlândia (UFU), Uberlândia (MG), Brazil
| | - Cauane Blumenberg
- PhD. Computer Scientist, Collaborative Researcher, Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Walbert A. Vieira
- MSc. Dentist, Doctoral student, Department of Restorative Dentistry, Endodontics Division, School of Dentistry of Piracicaba, Universidade Estadual de Campinas (UNICAMP), Piracicaba (SP), Brazil
| | - Rafael Rodrigues Lima
- PhD. Dentist, Professor, Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Universidade Federal do Pará, Belém (PA), Brazil
| | - Luiz Renato Paranhos
- PhD. Dentist, Professor, Division of Preventive and Community Dentistry, School of Dentistry, Federal University of Uberlândia, Uberlândia, Brazil
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Babajani F, Salari N, Hosseinian-Far A, Abdoli N, Mosafer H, Heidarian P, Mohammadi M. Prevalence of suicide attempts across the African continent: A systematic review and meta-analysis. Asian J Psychiatr 2024; 91:103878. [PMID: 38142521 DOI: 10.1016/j.ajp.2023.103878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 12/12/2023] [Accepted: 12/15/2023] [Indexed: 12/26/2023]
Abstract
BACKGROUND Over 700,000 people worldwide lose their lives through suicide every year. The prevalence of suicide has increased, especially in low- and middle-income countries such as many African countries. For every fatal suicidal attempt, there are approximately 20 other non-fatal suicide attempts within the population. The purpose of this study is to investigate the prevalence of attempts of suicides in the African continent through a systematic review and meta-analysis. METHODS To identify relevant sources, the PubMed, Scopus, Web of Science, Embase, ScienceDirect and Google Scholar repositories and databases were systematically searched without a lower time limit and until July 2023. The heterogeneity of the studies was checked with the I2 index, and accordingly random effects model was adopted to perform the analysis. Data analysis was conducted within the Comprehensive Meta-Analysis software (v.2). RESULTS In the review of 48 studies with a sample size of 244,701 people, the prevalence of suicide attempts in Africa was found to be 9.9% (95%CI: 8.5%-11.6%). With the increase in the year of study, the prevalence of suicide attempt in the African continent increases. Also, with the increase in the sample size, the prevalence of suicide attempts in Africa decreases. The suicide attempt prevalence among African men and woman slightly differed with 7.6% and 8.2%, respectively. CONCLUSION Suicide attempt is an important public health concern in Africa. The findings of this study are important not only for African health policy making, but also to contribute to the accuracy of global estimates with respect to suicide attempts.
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Affiliation(s)
- Fateme Babajani
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Nader Salari
- Department of Biostatistics, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Amin Hosseinian-Far
- Department of Business Systems & Operations, University of Northampton, Northampton, UK
| | - Nasrin Abdoli
- Department of Psychiatry, Substance Abuse Prevention Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Hadis Mosafer
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Pegah Heidarian
- Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Masoud Mohammadi
- Cellular and Molecular Research Center, Gerash University of Medical Sciences, Gerash, Iran.
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Cooke LM, Moodley S, Paruk L. The profile of adolescent patients presenting to a tertiary maternal mental health clinic. S Afr J Psychiatr 2023; 29:2185. [PMID: 38223306 PMCID: PMC10784263 DOI: 10.4102/sajpsychiatry.v29i0.2185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 11/13/2023] [Indexed: 01/16/2024] Open
Abstract
Background Between March 2021 and April 2022, there were 90 037 documented adolescent pregnancies in South Africa. Statistics SA reports that this number is growing. Pregnancy places adolescents at greater risk of psychiatry-related morbidity and may have far-reaching consequences for their children. To date, there is no published data describing the patient profile of adolescent pregnancies in Gauteng Province, South Africa. Aim To describe the patient profile (demographics, schooling history and type of accommodation), pregnancy-related factors, substance use habits and contraceptive use in pregnant adolescents seen at a tertiary care maternal mental health clinic (MMHC). Setting The MMHC at Chris Hani Baragwanath Academic Hospital, Soweto, Johannesburg, South Africa. Methods A retrospective file review of all pregnant adolescents referred to the MMHC between January and June 2022. Results The mean age of the patients was 15.2 years; 72% attended school and 97.4% planned to return. Most pregnancies were unplanned (97.9%), wanted (84%) and presented in the second (41.24%) and third (51.55%) trimesters. Most did not report using substances (76.7%). Fifty percent of the participants met the criteria for a major depressive disorder. Repeating a grade was an identifiable risk factor for an increased Edinburgh depression score. An unplanned pregnancy was associated with a higher risk factor assessment. Conclusion Pregnant adolescents represent a vulnerable population group. A greater understanding of this patient profile may inform early psychiatric and psychosocial interventions, improved service delivery and help-seeking behaviour. Contribution This study gives significant insights into the challenges faced, as well as the health and social needs of pregnant adolescents. This contributes to wholistic care and opportunities for early intervention, including awareness of contraceptive use and the risks of substance use and adolescent pregnancy on mental health, benefiting all South African adolescents.
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Affiliation(s)
- Luzaan M Cooke
- Department of Psychiatry, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Sanushka Moodley
- Department of Psychiatry, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Laila Paruk
- Department of Psychiatry, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Diallo I, Aldridge LR, Bass J, Adams LB, Spira AP. Factors Associated With Suicide in Four West African Countries Among Adolescent Students: An Analysis Using the Global School-Based Student Health Survey. J Adolesc Health 2023; 73:494-502. [PMID: 37330706 DOI: 10.1016/j.jadohealth.2023.04.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 03/21/2023] [Accepted: 04/11/2023] [Indexed: 06/19/2023]
Abstract
PURPOSE Globally, suicide is a leading cause of death among adolescents, with the highest burden of suicide occurring in Africa. Despite this, little is known about the epidemiology of suicide among adolescents in West Africa. In this study, we explore suicidality among West African adolescents. METHODS Using pooled data from the Global School-Based Student Health Survey in four West African countries (Ghana, Benin, Liberia, and Sierra Leone), we investigated the prevalence of suicidal ideation and suicide attempt and examined associations with 15 covariates using univariate and multivariable logistic regression. RESULTS Overall, 18.6% of adolescents in the pooled sample (N = 9,726) had considered suicide, while 24.7% reported attempting suicide. Significant correlates of suicide attempt included older age (16+ years; odds ratio [OR]: 1.70, confidence interval [CI]: 1.09-2.63), difficulty sleeping due to worry (OR: 1.27, CI: 1.04-1.56), loneliness (OR: 1.65, CI: 1.39-1.96), truancy (OR: 1.38. CI: 1.05-1.82), being a target of bullying (OR: 1.53, CI: 1.26-1.85), getting physically attacked (OR: 1.73, CI: 1.42-2.11), physical fighting (OR: 1.47, CI: 1.21-1.79), current cigarette use (OR: 2.71, CI: 1.88-3.89), and initiation of drug use (OR: 2.19, CI: 1.71-2.81). Conversely, having close friends was associated with lower odds of suicide attempt (OR: 0.67, CI: 0.48-0.93). Several covariates were also significantly associated with suicidal ideation. DISCUSSION Suicidal ideation and attempts are highly prevalent among school-going adolescents in these West African countries. Multiple modifiable risk and protective factors were identified. Programs, interventions, and policies aimed at addressing these factors may play a significant role in preventing suicides in these countries.
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Affiliation(s)
- Idiatou Diallo
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
| | - Luke R Aldridge
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Judith Bass
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Leslie B Adams
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Adam P Spira
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Department of Psychiatry and Behavioral Services, Johns Hopkins School of Medicine, Baltimore, Maryland; Johns Hopkins Center on Aging and Health, Baltimore, Maryland
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Beranbaum S, Kouri N, Van der Merwe N, DePierro VK, D’Andrea W. Behavioral and Biological Indicators of Risk and Well-Being in a Sample of South African Youth. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2023; 16:163-172. [PMID: 37234824 PMCID: PMC10205918 DOI: 10.1007/s40653-021-00426-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/29/2021] [Indexed: 05/28/2023]
Abstract
Self report measures have been widely used in research to illustrate high rates of exposure to violence among youth in trauma-saturated regions, such as Cape Town, South Africa. To better understand the risk and resilience factors of youth who have been exposed to, witnessed, or directly experienced violence, the current study used a multi-method assessment in a naturalistic setting that included heart rate variability (an index of regulatory flexibility and cardiovascular health), a computerized risk-taking task, and self report measures. Youth (N = 83) from Cape Town, South Africa, participated in a psychobiological assessment. Findings suggest elevated age-adjusted heart rate variability compared to age related norms, which is indicative of overregulation of behavior and emotion. Additionally, youth, all of whom had witnessed or experienced violence at least once, demonstrated a low risk taking and reward seeking propensity. Low risk taking in the context of elevated heart rate variability may reflect youth's affective and behavioral inhibition, suggestive of stress among children who have an overgeneralized threat response. These results both demonstrate the feasibility of psychophysiological research in community youth settings, and counter the traditional narrative that there is an overarching lack of capacity to regulate and a high propensity to risk in violence-exposed youth. Supplementary Information The online version contains supplementary material available at 10.1007/s40653-021-00426-1.
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Bete T, Birhanu A, Negash A, Yadeta E, Lemi M, Balcha T, Sertsu A, Birhanu B, Nigussie S, Gemechu K, Meseret F, Mohammed H, Alemu A, Dechasa DB, Asmerom H, Arkew M, Shewangizaw A, Mohamed A, Ahemed F, Wodaje D, Dessie Y, Debella A, Getachew T, Nigussie K, Eyeberu A. Suicidal ideation, attempt and associated factor among secondary school students in Harari regional state, Eastern Ethiopia. A multi-center cross-sectional study. Front Psychiatry 2023; 14:1069910. [PMID: 37215668 PMCID: PMC10196371 DOI: 10.3389/fpsyt.2023.1069910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 03/27/2023] [Indexed: 05/24/2023] Open
Abstract
Background Suicide is a major public health issue across the globe. It is the second leading cause of death in adolescents. Even though the rate of suicide has increased, no study has been conducted to investigate the determinants of suicide in the study area. Therefore, this study aimed to assess the magnitude of suicidal ideation, suicide attempts, and its associated factors among secondary school students in the Harari regional state of Eastern Ethiopia. Methods An institutional-based cross-sectional study was conducted among randomly selected 1,666 secondary school students. A structured-self-administered questionnaire was used for data collection. The WHO Composite International Diagnostic Interview (CIDI) was used to assess suicidal ideation and suicide attempts. The Depression Anxiety and Stress Scale (DASS) was also used to assess depression, anxiety, and stress. Data were entered into EpiData version 3.1 and exported to Stata version 14.0 for the analysis. A logistic regression analysis was performed to determine the association between the outcome and independent variables and the statistical significance was declared at a p-value of < 0.05. Result The overall magnitude of suicidal ideation and attempts was 13.82% at 95% confidence interval (CI): 12.16-15.66 and 7.61% at 95% CI: 6.37-9.07, respectively. Suicidal ideations and suicide attempts were significantly associated with undergoing depressive symptoms (adjusted odds ratio [AOR]: 1.54; 95% CI: 1.08-2.19 and AOR: 2.37; 95% CI: 1.46-3.86, respectively), experiencing anxiety symptoms (AOR: 1.80; 95% CI: 1.25-2.59 and AOR: 1.89; 95% CI: 2.14-10.65, respectively), being exposed to sexual violence (AOR: 3.36; 95% CI: 1.65-6.84), and having a family history of suicidal attempts (AOR: 2.12; 95% CI: 1.21-3.69 and AOR: 4.74; 95% CI: 2.14-10.65, respectively), whereas living in a rural residence (AOR: 1.65 95%, CI: 1.08-2.55) was significantly associated only with suicide attempts. Conclusion and recommendations Nearly one in six secondary school students had both suicidal ideation and attempted to take their own life. Suicide is one of the psychiatric emergencies that need immediate action. Therefore, the concerned body from either a governmental or a non-governmental organization should work in setting strategies to minimize sexual violence as well as depressive and anxiety symptoms.
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Affiliation(s)
- Tilahun Bete
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Abdi Birhanu
- School of Medicine, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Abraham Negash
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Elias Yadeta
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Magarsa Lemi
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Tegenu Balcha
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Addisu Sertsu
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Bekelu Birhanu
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Shambel Nigussie
- School of Pharmacy, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Kabtamu Gemechu
- School of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Fentahun Meseret
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Hanan Mohammed
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Addisu Alemu
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Deribe Bekele Dechasa
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Haftu Asmerom
- School of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Mesay Arkew
- School of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Abayneh Shewangizaw
- School of Nursing and Midwifery, College of Health and Medical Sciences, Debre Birhan University, Debre Berhan, Ethiopia
| | - Ahmed Mohamed
- School of Medicine, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Fila Ahemed
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Dawud Wodaje
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Yadeta Dessie
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Adera Debella
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Tamirat Getachew
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Kabtamu Nigussie
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Addis Eyeberu
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Quarshie ENB, Dey NEY, Oppong Asante K. Adolescent suicidal behaviour in Namibia: a cross-sectional study of prevalence and correlates among 3,152 school learners aged 12-17 years. BMC Psychiatry 2023; 23:169. [PMID: 36922818 PMCID: PMC10018865 DOI: 10.1186/s12888-023-04646-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 03/01/2023] [Indexed: 03/17/2023] Open
Abstract
BACKGROUND While adolescent suicidal behaviour (ideation, planning, and attempt) remains a global public health concern, available county-specific evidence on the phenomenon from African countries is relatively less than enough. The present study was conducted to estimate the 12-month prevalence and describe some of the associated factors of suicide behaviour among school-going adolescents aged 12-17 years old in Namibia. METHODS Participants (n = 4531) answered a self-administered anonymous questionnaire developed and validated for the nationally representative Namibia World Health Organization Global School-based Student Health Survey conducted in 2013. We applied univariate, bivariable, and multivariable statistical approaches to the data. RESULTS Of the 3,152 analytical sample, 20.2% (95% confidence interval [CI]: 18.3-22.2%) reported suicidal ideation, 25.2% (95% CI: 22.3-28.4%) engaged in suicide planning, and 24.5% (95% CI: 20.9-28.6%) attempted suicide during the previous 12 months. Of those who attempted suicide, 14.6% (95% CI: 12.5-16.9%) reported one-time suicide attempt, and 9.9% (95% CI: 8.1-12.1%) attempted suicide at least twice in the previous 12 months. The final adjusted multivariable models showed physical attack victimisation, bullying victimisation, loneliness, and parental intrusion of privacy as key factors associated with increased likelihood of suicidal ideation, planning, one-time suicide attempt, and repeated attempted suicide. Cannabis use showed the strongest association with increased relative risk of repeated attempted suicide. CONCLUSION The evidence highlights the importance of paying more attention to addressing the mental health needs (including those related to psychological and social wellness) of school-going adolescents in Namibia. While the current study suggests that further research is warranted to explicate the pathways to adolescent suicide in Namibia, identifying and understanding the correlates (at the individual-level, family-level, interpersonal-level, school context and the broader community context) of adolescent suicidal ideations and non-fatal suicidal behaviours are useful for intervention and prevention programmes.
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Affiliation(s)
| | | | - Kwaku Oppong Asante
- Department of Psychology, University of Ghana, P.O. Box LG 84, Accra, Ghana
- Department of Psychology, University of the Free State, Bloemfontein, South Africa
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Peer pressure and social acceptability between hookah pipe users and non-users among a sample of South African adolescents. SOUTH AFRICAN JOURNAL OF CHILD HEALTH 2022. [DOI: 10.7196/sajch.2022.v16.i3.1709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
Abstract
Background. Hookah pipe smoking is a high-risk phenomenon which is widely seen as an acceptable social practice, but the extent of its acceptability is not very clear among South African youth, nor is the influence of peers very clear.Objective. To establish a link between social acceptability and peer pressure and to compare this relationship among hookah pipe users and non-users in a sample of South African adolescents.Methods. A cross-sectional comparative correlation study was conducted among Grade 9 adolescents attending secondary schools in the Metro East Education District in Cape Town. The final sample comprised 270 participants. A questionnaire was used to collect data which were analysed using SPSS.Results. No relationship was found between peer pressure and social acceptability, but a relationship was found between parental rules and monitoring around tobacco use for hookah pipe users. A significant difference was also found in attitudes towards hookah use among users and non-users.Conclusion. This descriptive study of hookah pipe users and non-users among Grade 9 adolescents is a further study in the quantitative research approach and may be helpful in gaining more insight into understanding how parental rules and monitoring are put in place and why users’ and non-users’ attitudes towards tobacco use differ significantly. The implications and significance of this study are further explained.
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Geremew AB, Gelagay AA, Yeshitila HY, Azale T, Habitu YA, Abebe SM, Birru EM, Fentie EA. Suicide attempt and its determinants among youth in central, north, and west Gondar zones, northwest Ethiopia: Findings from the youth health project. Front Psychiatry 2022; 13:1031402. [PMID: 36684019 PMCID: PMC9846129 DOI: 10.3389/fpsyt.2022.1031402] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 11/29/2022] [Indexed: 01/05/2023] Open
Abstract
INTRODUCTION Suicide is a deliberate attempt to take one's own life. Suicidal behavior among adolescents and young people, a significant global public health issue, is under-researched, particularly in developing nations like Ethiopia. Therefore, this study aimed to assess the prevalence of suicide attempts and their determinants among school-aged and out-of-school youth in the central, north, and west Gondar zones of Ethiopia. METHODS A community-based cross-sectional study was conducted from 15 March to 15 April 2019, among youth in the central, north, and west Gondar zones. The data for this study were extracted from information collected for the assessment of common health problems and risky behaviors among youth. A multistage cluster sampling technique was used to collect the data using face-to-face interviewer-administered questionnaires. Bivariable and multivariable logistic regression analyses were done to identify the independent determinants of suicide attempts. An adjusted odds ratio (AOR) with a 95% confidence interval (CI) was used to identify the presence and direction of the association between the dependent and independent variables. RESULTS A total of 1,597 youth participated in this study, and the mean age of the participants was 19.1 ± 2.8 standard deviations (SDs). The lifetime prevalence of suicide attempts in the study participants was 5.5% (95% CI: 4.4, 6.8%). Risky sexual practices (AOR = 1.89, 95%CI: 1.19-2.99), the presence of common mental health problems (AOR = 6.31, 95% CI: 3.78-10.88), having a personal income (AOR = 1.68, 95% CI: 1.05-2.71), and a history of violence (AOR = 2.81, 95% CI 1.76-4.49) were significantly associated with a suicide attempt. CONCLUSION In this study, the prevalence of lifetime suicide attempts among youth is high. The presence of common mental health problems, having a personal income, risky sexual practices, and a history of violence increase the likelihood of suicide attempts. Working on the reduction of risky sexual practices, ensuring the integration of psychological treatment into medical treatment programs for victims of violence, psychosocial support for young people, and integrating youth-friendly health services to promote mental health would help to reduce suicide attempts among youth.
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Affiliation(s)
- Alehegn Bishaw Geremew
- Department of Reproductive Health, College of Medicine and Health Science, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Abebaw Addis Gelagay
- Department of Reproductive Health, College of Medicine and Health Science, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Hedija Yenus Yeshitila
- Department of Reproductive Health, College of Medicine and Health Science, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Telake Azale
- Department of Health Education and Behavioural Sciences, College of Medicine and Health Sciences, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Yohannes Aynaw Habitu
- Department of Reproductive Health, College of Medicine and Health Science, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Solomon Mekonnen Abebe
- Department of Human Nutrition, College of Medicine and Health Science, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Eshetie Melese Birru
- Department of Pharmacology, School of Pharmacy, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Elsa Awoke Fentie
- Department of Reproductive Health, College of Medicine and Health Science, Institute of Public Health, University of Gondar, Gondar, Ethiopia
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Tetteh J, Ekem-Ferguson G, Quarshie ENB, Swaray SM, Ayanore MA, Seneadza NAH, Asante KO, Yawson AE. Marijuana use and suicidal behaviours among school-going adolescents in Africa: assessments of prevalence and risk factors from the Global School-Based Student Health Survey. Gen Psychiatr 2021; 34:e100558. [PMID: 34557644 PMCID: PMC8395261 DOI: 10.1136/gpsych-2021-100558] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 07/13/2021] [Indexed: 11/05/2022] Open
Abstract
Background Marijuana use among adolescents, including high school students, has been consistently reported to be associated with a high incidence of suicidal behaviours. Little empirical research has been conducted on the propensity impact of marijuana use on suicidal behaviours in Africa. Aims To assess factors associated with marijuana use and further quantify marijuana use as an associated factor of suicidal behaviours, including repeated attempted suicide, suicidal ideation and suicide planning, among high school students in Africa. Methods A cross-sectional study was conducted among 32 802 school-going adolescents using the Global School-Based Student Health Survey data from 10 African countries grouped into West Africa, North Africa, South-East Africa, South Africa and East Africa subregions. Marijuana use and repeated attempted suicide were the main outcome variables. We employed double selection least absolute shrinkage and selection operator poisson regression model to assess risk factors associated with marijuana use and dominance analysis to establish ranked important and common risk factors. Inverse probability weighting poisson regression adjustment was applied to assess impact. Results The prevalence of marijuana use and repeated attempted suicide were 3.7% (95% CI: 3.1 to 4.3) and 6.6% (95% CI: 5.9 to 7.4), respectively. The most important risk factor for marijuana use generally across the countries and specifically in three subregions was alcohol consumption, which constituted approximately 40% of the impact. The average treatment effect on the treated (ATT) indicated that marijuana use significantly increased the risk of suicidal ideation, suicide planning and repeated attempted suicide by 12% (ATT=0.12 (95% CI: 0.02 to 0.22)), 18% (ATT=0.18 (95% CI: 0.13 to 0.22)) and 31% (ATT=0.31 (95% CI: 0.20 to 0.41)), respectively. Conclusions Marijuana use was significantly associated with suicidal behaviours (suicidal ideation, planning and repeated attempted suicide) among the students. To achieve Sustainable Development Goal 3.5 (to strengthen prevention and treatment of substance abuse), school-based psychosocial interventions should be streamlined to adequately assess and manage marijuana use. Targeting the most dominant risk factors in this population could translate into the reduction of suicidal behaviours in countries within Africa.
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Affiliation(s)
- John Tetteh
- Community Health, University of Ghana Medical School, Accra, Ghana
| | | | - Emmanuel Nii-Boye Quarshie
- Department of Psychology, School of Social Sciences, University of Ghana College of Humanities, Accra, Ghana
| | | | - Martin Amogre Ayanore
- Department of Family and Community Health, University of Health and Allied Sciences School of Public Health, Hohoe, Ghana
| | | | - Kwaku Oppong Asante
- Department of Psychology, School of Social Sciences, University of Ghana College of Humanities, Accra, Ghana
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The prevalence of mental health problems in sub-Saharan adolescents: A systematic review. PLoS One 2021; 16:e0251689. [PMID: 33989357 PMCID: PMC8121357 DOI: 10.1371/journal.pone.0251689] [Citation(s) in RCA: 72] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 05/01/2021] [Indexed: 12/11/2022] Open
Abstract
Background and purpose Most research regarding child and adolescent mental health prevention and promotion in low-and middle-income countries is undertaken in high-income countries. This systematic review set out to synthesise findings from epidemiological studies, published between 2008 and 2020, documenting the prevalence of mental health problems in adolescents from across sub-Saharan Africa. Methods A systematic search of multiple databases (MEDLINE, PsycINFO, Scopus) and Google Scholar was conducted guided by the Joanna Briggs Institute (JBI) Reviewer’s manual for systematic reviews of observational epidemiological studies. Studies included reported prevalence outcomes for adolescents aged 10–19 using either clinical interviews or standardized questionnaires to assess psychopathology. Clinical samples were excluded. Results The search yielded 1 549 records of which 316 studies were assessed for eligibility and 51 met the inclusion criteria. We present a qualitative synthesis of 37 of these 51 included articles. The other 14 studies reporting prevalence rates for adolescents living with HIV are published elsewhere. The prevalence of depression, anxiety disorders, emotional and behavioural difficulties, posttraumatic stress and suicidal behaviour in the general adolescent population and selected at-risk groups in 16 sub-Saharan countries (with a total population of 97 616 adolescents) are reported.
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Khajedaluee M, Khadem-Rezaiyan M, Jarahi L, Khatibi-Moghadam H, Faridpak A. Suicidal continuum (ideation, planning, attempting) in an Islamic country; which should be focused on? J Inj Violence Res 2021; 13:47-54. [PMID: 33517341 PMCID: PMC8142339 DOI: 10.5249/jivr.v13i1.1556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 01/14/2021] [Indexed: 11/28/2022] Open
Abstract
Background: The aim of this study was to identify the characteristics of suicidal ideation (SI), suicidal plan (SP), and suicide attempt (SA) in patients who had survived suicide attempts. Methods: In a one-year cross-sectional design in Khorasan Razavi province, all suicide attempters who were referred to urban and rural health care centers, hospital’s emergency rooms and agreed to participate in the study were included. The previous twelve-month SI, SP and lifelong SA (prior to the current suicide attempt) were obtained. Results: The mean age of 856 included individuals was 24.2±8.3 years. The majority (652,76.4%) were females. Half of them were first-time suicide attempters. The mean age of first SI was 22±7.7; SP 22±7.9; and SA 22.2±8 years. The twelve-month prevalence of SI and SP prior to the current suicide attempt was 30% and 26.7%, respectively. Males, unlettered, wedded, and employees were significantly older at their first time SI, SP, and SA (all p less than 0.001). SI (25,44.6%), SP(25,47.2%) and SA(34,75.6%) were more prevalent in widow/divorced individuals(all p-values less than 0.02). SI (OR=53.4,CI95%=33.6-85) increased the risk of SP, and SP(OR=6.7,CI95%=4.5-9.9) increased the risk of SA. Conclusions: SI seems to be a more important predictor of suicide compared to SP, however, the fact that a significant number of attempters had not any previous detectable suicidal ideation or plan, indi-cates particular clinical considerations. We need to have some presuppositions about the factors leading to unplanned and unthoughtful suicide attempts.
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Affiliation(s)
- Mohamad Khajedaluee
- Department of Community Medicine and Public Health, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Majid Khadem-Rezaiyan
- Department of Community Medicine and Public Health, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Lida Jarahi
- Department of Community Medicine and Public Health, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hoda Khatibi-Moghadam
- Department of Psychiatry, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Afsaneh Faridpak
- Vice Chancellor for Health, Bam University of Medical Sciences, Kerman, Iran
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Self-harm with suicidal and non-suicidal intent in young people in sub-Saharan Africa: a systematic review. BMC Psychiatry 2020; 20:234. [PMID: 32408896 PMCID: PMC7222461 DOI: 10.1186/s12888-020-02587-z] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 04/05/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Self-harm, whether attributed to suicidal or non-suicidal motives, is associated with several poor outcomes in young people, including eventual suicide. Much of our understanding of self-harm in young people is based on literature from Europe (particularly, the UK), North America, and Australia. We aimed to synthesise the available evidence on prevalence, the commonly reported self-harm methods, correlates, risk and protective factors, and reasons for self-harm, in adolescents (aged 10-25 years) in sub-Saharan Africa. METHOD We searched MEDLINE, PsycINFO, PubMed, African Journals OnLine, and African Index Medicus for records from 1950 through August 2019, without language restrictions. We supplemented the database searches by searching relevant portals for postgraduate theses, reference harvesting, contacting authors for unpublished studies, and hand searching relevant print sources. We applied narrative synthesis to the evidence. RESULTS Seventy-four studies from 18 sub-Saharan African countries met the inclusion criteria. The median lifetime prevalence estimate was 10·3% (interquartile range [IQR] 4·6% - 16·1%); median 12-month prevalence estimate was 16·9% (IQR: 11·5% - 25·5%); median 6-month prevalence estimate was 18·2% (IQR: 12·7% - 21·8%); and the median 1-month prevalence estimate was 3·2% (IQR: 2·5-14·8%). Studies from Western sub-Saharan Africa reported the highest 12-month prevalence estimates (median = 24·3%; IQR = 16·9% - 27·9%). Clinical samples commonly reported overdose, whereas self-cutting was most commonly reported in non-clinical samples. Academic failure, sexual, emotional, and physical abuse, romantic relationship problems, family conflict, depression, and previous self-harm were identified as key correlates of self-harm. No study reported protective factors against self-harm. CONCLUSION Variation in estimates was explained by small sample sizes and variation in definitions and measures used. Exploration of associations, risks and protective factors was based upon concepts and measures derived from high income countries. More detailed and culturally sensitive research is needed to understand the context-specific risks and protective factors for self-harm in adolescents in sub-Saharan Africa.
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Pengpid S, Peltzer K. Suicide attempt and associated factors among in-school adolescents in Mozambique. JOURNAL OF PSYCHOLOGY IN AFRICA 2020. [DOI: 10.1080/14330237.2020.1746569] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Supa Pengpid
- ASEAN Institute for Health Development, Mahidol University, Salaya, Phutthamonthon, Nakhon Pathom, Thailand
- Department of Research Administration and Development, University of Limpopo, Turfloop, South Africa
| | - Karl Peltzer
- Department for Management of Science and Technology Development, Ton Duc Thang University, Ho Chi Minh City, Vietnam
- Faculty of Pharmacy, Ton Duc Thang University, Ho Chi Minh City, Vietnam
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Sakamoto JL, Shibanuma A, Jimba M. Depressed mood, suicidal behaviors, and health risk behaviors among youths in the Commonwealth of the Northern Mariana Islands: the 2017 CNMI Youth Risk Behavior Survey. BMC Public Health 2020; 20:489. [PMID: 32293384 PMCID: PMC7161215 DOI: 10.1186/s12889-020-08663-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 04/06/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND The current study investigated the prevalence of depressed mood, suicide ideation, suicide plan, and suicide attempt and their associations with health risk behaviors among high school adolescents in the Commonwealth of the Northern Mariana Islands (CNMI). METHODS This is a cross-sectional study analyzing self-reported data from the 2017 CNMI Youth Risk Behavior Survey (n = 1943). Modified Poisson regression models were used to identify the associations between 17 health risk behavior variables, including violence-related behaviors, substance use behaviors, sexual behaviors, and early risk-taking behaviors, and four variables related to depressed mood and suicidal behaviors. RESULTS 40.7% adolescents reported being depressed, 25.0% reported suicide ideation, 22.8% reported formulating a suicide plan, and 13.6% attempted suicide. Female adolescents were more likely to report depressed mood and all included suicidal behaviors (p < 0.001). Being in a physical fight and forced sexual intercourse were associated with depressed mood, suicide ideation, suicide plan, and suicide attempt for both female and male adolescents. Use of "soft drugs" such as current smoking was associated with depressed mood (ARR = 2.33, 95% CI = 1.56-3.45, p < 0.001), suicide ideation (ARR = 1.23, 95% CI = 1.08-1.43, p < 0.001), suicide plan (ARR = 1.19; 95% CI = 1.05-1.35; p < 0.001), and suicide attempt (ARR = 1.18; 95% CI = 1.06-1.30; p < 0.001) for females, whereas use of "hard drugs" such as heroin was associated with depressed mood (ARR = 2.27, 95% CI = 1.37-3.85, p < 0.01), suicide ideation (ARR = 1.30, 95% CI = 1.01-1.67, p < 0.05), suicide plan (ARR = 1.82; 95% CI = 1.22-2.70; p < 0.01), and suicide attempt (ARR = 2.78; 95% CI = 1.47-5.26; p < 0.01) for male adolescents. CONCLUSION The prevalence of depressed mood, suicide ideation, suicide plan, and suicide attempt among CNMI adolescents was high, especially in female adolescents. While there were gender differences, many of the health risk behaviors were associated with depressed mood and suicidal behaviors. As sociodemographic factors are difficult to change, modifiable factors should be targeted to improve the mental health of adolescents.
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Affiliation(s)
- Jennifer Lisa Sakamoto
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Akira Shibanuma
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
| | - Masamine Jimba
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Guedria-Tekari A, Missaoui S, Kalai W, Gaddour N, Gaha L. Suicidal ideation and suicide attempts among Tunisian adolescents: prevalence and associated factors. Pan Afr Med J 2019; 34:105. [PMID: 31998428 PMCID: PMC6961937 DOI: 10.11604/pamj.2019.34.105.19920] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 10/01/2019] [Indexed: 11/11/2022] Open
Abstract
Introduction Studies directed on suicidal behavior in North African adolescents are rare. This study was conducted to estimate the prevalence of suicidal thoughts and attempts among high school students in Tunisia and to determine factors associated with this suicidal behavior. Methods This is an analytical cross-sectional study composed of a population containing 821 high school students obtained through cluster sampling. The participants completed a pre-established form related to socio-demographic characteristics and anxiety symptoms, the Suicide Behavior Questionnaire-Revised, the Beck depression scale, and the Rosenberg self-esteem scale. Results The mean age of the adolescents was 17.7±0.97 years. Prevalence of suicidal behavior was 26.9% for brief passing suicidal thoughts, 9.6% for serious suicidal thoughts, and 7.3% for suicide attempts. Six determining factors of suicidal behavior were found: female gender (OR=2.56 (1.32-4.95); p= 0.005), personal history of depression (OR=2.29 (1.38-3.80); p=0.001), tobacco smoking (OR=3.59 (1.61-8.01); p=0.002), current depression symptoms (OR=5.50 (2.14-14.11); p<0.001), history of non-suicidal self-injurious behavior (OR= 3.16 (2.05-4.86); p<0.001), and low self-esteem (OR=2.74 (1.71-4.38); p<0.001). Conclusion Suicidal ideation and attempts are frequent among Tunisian adolescents and represent a serious public health problem. An urgent national prevention program is required.
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Affiliation(s)
- Asma Guedria-Tekari
- Department of Psychiatry, Fattouma Bourguiba University Hospital, Monastir, Tunisia.,University of Monastir, Monastir, Tunisia
| | - Sonia Missaoui
- Service de Pédopsychiatrie, CISSS de Lanaudière, Québec, Canada
| | | | - Naoufel Gaddour
- Department of Psychiatry, Fattouma Bourguiba University Hospital, Monastir, Tunisia.,University of Monastir, Monastir, Tunisia
| | - Lotfi Gaha
- Department of Psychiatry, Fattouma Bourguiba University Hospital, Monastir, Tunisia.,University of Monastir, Monastir, Tunisia
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Popovac M, Hadlington L. Exploring the role of egocentrism and fear of missing out on online risk behaviours among adolescents in South Africa. INTERNATIONAL JOURNAL OF ADOLESCENCE AND YOUTH 2019. [DOI: 10.1080/02673843.2019.1617171] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Affiliation(s)
- Maša Popovac
- School of Psychology and Wellbeing, University of Buckingham , Buckingham, UK
| | - Lee Hadlington
- Psychology Division, De Montfort University , Leicester, UK
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Brittain K, Myer L, Phillips N, Cluver LD, Zar HJ, Stein DJ, Hoare J. Behavioural health risks during early adolescence among perinatally HIV-infected South African adolescents and same-age, HIV-uninfected peers. AIDS Care 2018; 31:131-140. [PMID: 30340446 DOI: 10.1080/09540121.2018.1533233] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Behavioural health risks, including substance use, early sexual debut, bullying and suicidality, are common during adolescence, but may be complicated among perinatally HIV-infected adolescents. However, there are few data exploring these behaviours in sub-Saharan Africa. We compared behavioural health risks (any self-report of substance use, sexual activity, bullying others or suicidality, or a positive urine toxicology screen) among perinatally-infected adolescents ages 9-14 years to that of an HIV-uninfected comparator group; and explored the effect of behavioural health risks on adolescent and caregiver report of adolescent suboptimal adherence (missed antiretroviral therapy dose(s) on ≥1 day during the preceding 30 days) and elevated HIV viral load (≥50 and ≥1000 copies/mL in sensitivity analyses) in multivariable logistic regression models. Among 506 HIV-infected and 110 HIV-uninfected adolescents (median age overall: 12 years), 15% and 25% reported any behavioural health risk (p = 0.018), respectively. Tobacco and other drug use was uncommon, while alcohol use was reported by 8% of HIV-infected versus 12% of HIV-uninfected adolescents (p = 0.185). One HIV-infected (0.2%) and 3 HIV-uninfected adolescents (3%) reported any sexual activity (p = 0.019). Among HIV-infected adolescents, report of any behavioural health risk was more common among male adolescents [adjusted odds ratio (aOR): 1.78; 95% confidence interval (CI): 1.08-2.95] and was associated with adolescent report of suboptimal adherence (aOR: 1.66; 95% CI: 0.99-2.78) but not with caregiver report of suboptimal adherence or with elevated viral load. In this group of perinatally-infected youth entering early adolescence, the prevalence of behavioural health risks was lower than that among same-age, HIV-uninfected peers. Longitudinal data are needed to explore the reasons underlying these differences, for example the possibility of more protective caregiving and supportive family environments, or of emotional and physical immaturity, as well as the emergence of risk behaviours over time in this population.
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Affiliation(s)
- Kirsty Brittain
- a Division of Epidemiology & Biostatistics, School of Public Health & Family Medicine , University of Cape Town , Cape Town , South Africa.,b Centre for Infectious Disease Epidemiology & Research, School of Public Health & Family Medicine , University of Cape Town , Cape Town , South Africa
| | - Landon Myer
- a Division of Epidemiology & Biostatistics, School of Public Health & Family Medicine , University of Cape Town , Cape Town , South Africa.,b Centre for Infectious Disease Epidemiology & Research, School of Public Health & Family Medicine , University of Cape Town , Cape Town , South Africa
| | - Nicole Phillips
- c Department of Psychiatry & Mental Health , University of Cape Town , Cape Town , South Africa
| | - Lucie D Cluver
- c Department of Psychiatry & Mental Health , University of Cape Town , Cape Town , South Africa.,d Centre for Evidence-Based Intervention, Department of Social Policy & Intervention , University of Oxford , Oxford , United Kingdom
| | - Heather J Zar
- e Department of Paediatrics & Child Health , University of Cape Town , Cape Town , South Africa.,f Medical Research Council Unit on Child & Adolescent Health , Cape Town , South Africa
| | - Dan J Stein
- c Department of Psychiatry & Mental Health , University of Cape Town , Cape Town , South Africa
| | - Jacqueline Hoare
- c Department of Psychiatry & Mental Health , University of Cape Town , Cape Town , South Africa
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Lara GAG, Zúñiga JO, Pérez OC, Solís SH, Jiménez CEP, Méndez MC. Predictors of suicidal ideation and depressive symptoms among adolescents in Chiapas, Mexico. CIENCIA & SAUDE COLETIVA 2018; 23:1089-1096. [PMID: 29694595 DOI: 10.1590/1413-81232018234.14492016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Accepted: 06/29/2016] [Indexed: 11/21/2022] Open
Abstract
The aim of this study was to assess the presence of suicidal ideation and depressive symptoms among adolescents in Chiapas, Mexico based on predictor variables. A cross-sectional study adopting an ex post facto design was conducted with a non-probability sample of 4,759 students of both sexes with an average age of 18.4 years and using the following tools: the Center for Epidemiologic Studies Depression Scale, Roberts' Suicidal Ideation Scale, the Impulsiveness Scale (IS), and the Rosenberg Self-Esteem Scale. The mean score obtained by the suicidal ideation scale was 0.2, which is lower than that reported by other studies, while the mean score for depressive symptoms was similar to those in the literature. The prevalence of suicidal ideation was 7.8%, which is lower than reported in national and international studies. Multivariable logistic regression showed that impulsiveness (OR = 1.907) and depressive symptoms (OR = 9.006) lead to a twofold and ninefold increase in the likelihood of suicidal ideation, respectively. The findings also showed a strong association between suicidal ideation and depressive symptoms, showing that the latter is a predictor of suicidal ideation among adolescents.
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Affiliation(s)
| | - Jesús Ocaña Zúñiga
- Facultad de Ciencias Humanas y Sociales, Universidad de Ciencias y Artes de Chiapas, Mexico,
| | - Oscar Cruz Pérez
- Facultad de Ciencias Humanas y Sociales, Universidad de Ciencias y Artes de Chiapas, Mexico,
| | - Soledad Hernández Solís
- Facultad de Ciencias Humanas y Sociales, Universidad de Ciencias y Artes de Chiapas, Mexico,
| | | | - Martín Cabrera Méndez
- Facultad de Ciencias Humanas y Sociales, Universidad de Ciencias y Artes de Chiapas, Mexico,
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Prevalence and Associated Factors of Suicide Ideation and Attempt among Adolescent High School Students in Dangila Town, Northwest Ethiopia. PSYCHIATRY JOURNAL 2018; 2018:7631453. [PMID: 29992132 PMCID: PMC6016154 DOI: 10.1155/2018/7631453] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Revised: 03/30/2018] [Accepted: 04/11/2018] [Indexed: 11/17/2022]
Abstract
Background Suicide is a major public health problem and is common among adolescents worldwide. The true extent of the problem in Ethiopia is difficult to ascertain as suicides and suicidal behavior are significantly underreported and understudied. Objective We assessed the prevalence and factors associated with suicide ideation and suicide attempt among adolescent high school students in Dangila Town, Ethiopia. Methods This school-based cross-sectional study was conducted from April to May 2015 in Dangila Town. Data were collected from adolescent high school students using pretested, self-administered Amharic-language questionnaire. We conducted bivariable and multivariable logistic regression to identify the independent factors associated with suicide ideation and attempt. Results A total of 573 of 603 sampled students participated in the study (95% response rate). The mean (±SD) age of the respondents was 17.52 (±0.97) years. The minimum and maximum ages were 15 and 19 years, respectively. The prevalence of suicide ideation and attempt was 22.5% and 16.2%, respectively. School absenteeism [AOR 4.30, 95% CI (2.03, 9.10)] and poor social support [AOR 5.58, 95% CI (2.25, 13.84)] were positively associated with suicide ideation. Poor social support [AOR 4.55, 95% CI (1.40, 14.77)] and being physically hurt [AOR 4.25, 95% CI (1.77, 10.20)] were positively associated with suicide attempt. Unlike previous studies of adolescents in low-income countries, we find no association between gender or alcohol use and suicidal thoughts or attempts. Conclusion This study revealed that at least one in five of the adolescents in our sample had experienced suicide ideation and one in six had attempted suicide. School absenteeism, poor social support, and experience of violence were identified as independent contributors to suicide ideation and attempt. These findings suggest a need for education policymakers to implement school-based behavioral therapy programs in collaboration with health institutions and programs to provide social support for vulnerable students.
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Almansour AM, Siziya S. Suicidal ideation and associated factors among school going adolescents in Swaziland. Afr Health Sci 2017; 17:1172-1177. [PMID: 29937889 PMCID: PMC5870276 DOI: 10.4314/ahs.v17i4.26] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background and objective Suicide among children has been a major issue and the statistics are considerably alarming. However, no studies have been conducted in Swaziland on suicidal ideation which is a starting point for committing suicide. The objective of the study was to determine the prevalence of suicidal ideation and its correlates. Methods A secondary analysis of data was conducted using data collected in a Swaziland 2013 Global School-based Student Health Survey (GSHS). The survey assessed among other factors, mental health of the students using a self-administered questionnaire. We considered factors that have been reported to be associated with suicidal ideation in the literature. Unadjusted odds ratios (OR) and adjusted odds ratios (AOR) together with their 95 confidence intervals (CI) are reported. Results The overall proportions of students who considered suicide were 18.3% of 1866 females and 15.6% of 1672 males. In bivariate models the risk factors for suicidal ideation were feeling lonely, anxiety, using drugs and smoking marijuana. In multivariate model to include age, gender, food security, close friends, truancy, bullied, attacked, physical fight, drugs, marijuana, parental understanding anxiety and loneliness, all the considered factors were significantly associated with suicide except close friends. Conclusion The rate of suicidal ideation was high among adolescents in Swaziland and intervention considering violence, social support from friends and parents, and drug abuse should be designed to prevent suicidal thoughts.
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Affiliation(s)
- Aseel M Almansour
- Department of Statistics, School of Science, King Abdul Aziz University, Jeddah, KSA
| | - Seter Siziya
- Department of Clinical Sciences, Michael Chilufya Sata School of Medicine, Copperbelt University, Ndola, Zambia
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Choo CC, Harris KM, Chew PKH, Ho RC. What predicts medical lethality of suicide attempts in Asian youths? Asian J Psychiatr 2017; 29:136-141. [PMID: 29061412 DOI: 10.1016/j.ajp.2017.05.008] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 04/06/2017] [Accepted: 05/06/2017] [Indexed: 11/20/2022]
Abstract
This study explores youth suicide attempts in Singapore using multiple databases of comprehensive archival records. Three years of medical records related to suicide attempters (N=666) who were admitted to the emergency department of a large teaching hospital in Singapore were subjected to retrospective analysis. Compared to other age groups, a peak in suicide attempts (n=207) was observed in youths aged between 15 and 24 years old (76.3% females; 23.7% males, mean age=19.30, SD=2.89). The model using recognized risk and protective factors was significant in predicting medical lethality, and correctly classified 62.8% of high lethality cases. Only resolution of precipitant made a unique statistical significant contribution. Analysis was separately conducted for males and females. Implications of the findings are discussed.
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Affiliation(s)
- Carol C Choo
- College of Healthcare Sciences, James Cook University, Singapore.
| | - Keith M Harris
- School of Medicine, University of Tasmania, Australia; University of Queensland, Australia
| | - Peter K H Chew
- College of Healthcare Sciences, James Cook University, Singapore
| | - Roger C Ho
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Goldstone D, Bantjes J. Mental health care providers' perceptions of the barriers to suicide prevention amongst people with substance use disorders in South Africa: a qualitative study. Int J Ment Health Syst 2017; 11:46. [PMID: 28811835 PMCID: PMC5553916 DOI: 10.1186/s13033-017-0153-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Accepted: 08/03/2017] [Indexed: 12/05/2022] Open
Abstract
Background Substance use is a well-established, and potentially modifiable, risk factor for suicide. Suicide prevention interventions are typically framed within the biomedical paradigm and focus on addressing individual risk factors, improving access to psychiatric care, and improving the skills of medical personnel to recognise at-risk individuals. Few studies have focused on contextual factors that hinder suicide prevention in people with substance use disorders, particularly in low-resource settings. The aim of this qualitative study was to explore mental health care providers’ perceptions of barriers to suicide prevention in people with substance use disorders in South Africa. Methods Semi-structured interviews were conducted with 18 mental health care providers who worked with suicidal people with substance use disorders in Cape Town, South Africa. Data were analysed using thematic analysis and Atlas.ti software was used to code the data inductively. Results Two superordinate themes were identified: structural issues in service provision and broad contextual issues that pose barriers to suicide prevention. Participants thought that inadequate resources and insufficient training hindered them from preventing suicide. Fragmented service provision was perceived to lead to patients not receiving the psychiatric, psychological, and social care that they needed. Contextual problems such as poverty and inequality, the breakdown of family, and stigma made participants think that preventing suicide in people with substance use disorders was almost impossible. Conclusions These findings suggest that structural, social, and economic issues serve as barriers to suicide prevention. This challenges individual risk-factor models of suicide prevention and highlights the need to consider a broad range of contextual and socio-cultural factors when planning suicide prevention interventions. Findings suggest that the responsibility for suicide prevention may need to be distributed between multiple stakeholders, necessitating intersectoral collaboration, more integrated health services, cautious use of task shifting, and addressing contextual factors in order to effectively prevent suicide in people with substance use disorders.
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Affiliation(s)
- Daniel Goldstone
- Department of Psychology, Stellenbosch University, Stellenbosch, South Africa
| | - Jason Bantjes
- Department of Psychology, Stellenbosch University, Stellenbosch, South Africa
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The prevalence and correlates of suicidal behaviours (ideation, plan and attempt) among adolescents in senior high schools in Ghana. SSM Popul Health 2017; 3:427-434. [PMID: 29349236 PMCID: PMC5769048 DOI: 10.1016/j.ssmph.2017.05.005] [Citation(s) in RCA: 99] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 05/04/2017] [Accepted: 05/05/2017] [Indexed: 11/26/2022] Open
Abstract
Suicide is recognised as the third leading cause of death among adolescents globally. There is however limited data on the prevalence and factors associated with suicide particularly in Ghana. To explore the prevalence and risk and protective factors associated with suicide in Ghana, a nationwide Global School-based Student Health Survey data collected among senior high school adolescents in Ghana was used. The prevalence of suicidal behaviours was 18.2%, 22.5% and 22.2% for suicidal ideation, suicidal plan and suicidal attempt respectively. In the final analysis, anxiety increases the odds of suicidal behaviour, even after controlling for other variables. Loneliness increases the odds of suicidal behaviour but after adjusting for other factors the odds remained for only suicidal plan. Being bullied, physically attacked, involved in a physical fight and food insecurity remained risk factors for suicidal behaviour (i.e. ideation, plan and attempt) after adjusting for other factors. Truancy was found as a risk factor for both suicidal ideation and plans but such effect diminished for suicidal plan after adjusting for other variables. Increasing number of close friends remained a risk factor for both suicidal plan and attempt but such effect diminished for suicidal ideation after adjusting for other variables. Parental understanding of adolescents’ problems and worries remained a significant protective factor for all the indices of suicidal behaviour after adjusting for other variables. Parental respect for privacy was protective of suicidal attempt but was not significant after adjusting for other variables. Early identification and intervention for at-risk adolescents in senior high schools, for example those experiencing different forms of physical abuse, drug and substance use and hunger can potentially reduce the prevalence of suicide among this population in Ghana. The study showed high prevalence of suicidal behaviour among school-going adolescents. Anxiety, loneliness, hunger, physical abuse, bullying and the lack of parental understanding were strongly related suicidal behaviour. Interventions for suicide prevention should take into consideration the school and family settings.
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Vawda NBM, Milburn NG, Steyn R, Zhang M. The development of a screening tool for the early identification of risk for suicidal behavior among students in a developing country. PSYCHOLOGICAL TRAUMA-THEORY RESEARCH PRACTICE AND POLICY 2017; 9:267-273. [PMID: 28459269 DOI: 10.1037/tra0000229] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Adolescent suicidal behavior is a public health concern in South Africa. The purpose of this article is to report on the development of a screening tool for teachers to identify South African students who are most at risk for suicidal behavior. This need is addressed within the context of the limited number of mental health professionals available to provide screening and care services in South Africa. METHOD Grade 8 students participated by completing sociodemographic questionnaires and self-report psychometric instruments. A screening tool for suicidal behavior was developed using a 4-phase approach. RESULTS Twelve factors for high-risk suicidal behavior were identified and included in the screening tool. While further research is needed to validate the screening tool, the findings provide a useful preliminary starting point for teachers to refer students at high risk for suicidal behavior to mental health services for treatment. CONCLUSION This screening tool is based on factors that were identified as being associated with suicidal behavior from local research on South African adolescents. The tool contributes to research on adolescent mental health, particularly suicidal behavior, in developing low and middle income countries like South Africa, with the aim of creating African prevention and intervention programs. (PsycINFO Database Record
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Affiliation(s)
- Naseema B M Vawda
- Department of Behavioural Medicine, College of Health Sciences, University of KwaZulu Natal
| | - Norweeta G Milburn
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
| | - Renier Steyn
- Department of Leadership and Organizational Behaviour, Graduate School of Business Leadership, University of South Africa
| | - Muyu Zhang
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
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Chen H, Wang XT, Bo QG, Zhang DM, Qi ZB, Liu X, Jia CX. Menarche, menstrual problems and suicidal behavior in Chinese adolescents. J Affect Disord 2017; 209:53-58. [PMID: 27886570 DOI: 10.1016/j.jad.2016.11.027] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2016] [Revised: 10/29/2016] [Accepted: 11/16/2016] [Indexed: 11/26/2022]
Abstract
BACKGROUND Menarche is the first menstrual cycle. Menstrual problems, such as dysmenorrheal menorrhagia, oligomenorrhea, and irregular cycle are common in female adolescents. This research aims to examine the associations between age at menarche and menstrual problems and suicidal behavior among Chinese female adolescents. METHODS An epidemiological survey of 5831 female adolescents from eight high schools of three counties of Shandong province, China, was conducted. A self-administered paper-and-pencil questionnaire was used to collect information. Logistic regression analyses were used to examine the association between menstruation and suicidality. RESULTS The mean age of the sample was 15.02 (SD=1.44) years. Of the sample, 5,231 (90.0%) had experienced their first menstrual cycle, and 23.2%, 10.4%, and 4.5% of the sample reported having had suicidal ideation, plan and attempt, respectively. In multivariate models, menarche at ≤11 years was associated with increased risk of suicidal ideation (OR=1.41, 95%CI: 1.10-1.81) and menarche at 12 years was associated with suicide plan (OR=1.23, 95%CI: 1.00-1.51). Irregular menstrual cycle was significantly associated with increased risk of suicidal ideation (OR=1.40, 95%CI: 1.05-1.86) and menstrual period less than or equal to 4 days was significantly associated with increased risk of suicide plan (OR=1.32, 95%CI: 1.06-1.66). LIMITATIONS This cross-sectional study cannot establish the causal directions between menstrual problems and suicidality in adolescents. CONCLUSIONS Our study suggests that earlier menarche, irregular menstrual cycle and short menstrual period are associated with suicidal behavior in female adolescents. Further research is warranted to examine the causal relationship between menstrual problems and suicidal behavior in adolescents.
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Affiliation(s)
- Hua Chen
- Department of Epidemiology, Shandong University School of Public Health & Shandong University Center for Suicide Prevention Research, Jinan, China
| | - Xin-Ting Wang
- Department of Epidemiology, Shandong University School of Public Health & Shandong University Center for Suicide Prevention Research, Jinan, China
| | - Qi-Gui Bo
- Centers for Disease Control and Prevention of Lijin County, Lijin, China
| | - Dao-Ming Zhang
- Centers for Disease Control and Prevention of Yanggu County, Yanggu, China
| | - Zhen-Biao Qi
- Centers for Disease Control and Prevention of Zoucheng County, Zoucheng, China
| | - Xianchen Liu
- Department of Epidemiology, Shandong University School of Public Health & Shandong University Center for Suicide Prevention Research, Jinan, China; The University of Tennessee Health Science Center, Memphis, TN, USA
| | - Cun-Xian Jia
- Department of Epidemiology, Shandong University School of Public Health & Shandong University Center for Suicide Prevention Research, Jinan, China.
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Martins Junior DF, Felzemburgh RM, Dias AB, Caribé AC, Bezerra-Filho S, Miranda-Scippa Â. Suicide attempts in Brazil, 1998-2014: an ecological study. BMC Public Health 2016; 16:990. [PMID: 27632979 PMCID: PMC5025588 DOI: 10.1186/s12889-016-3619-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Accepted: 09/01/2016] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Attempted suicide is the main predictor of suicide constituting a major public health issue worldwide. It is estimated that for every completed suicide, 10 to 20 suicide attempts occur. Important part of the occurrences of suicide attempts in Brazil are registered in the hospital information system for coverage of more than 70 % allows to evaluate the extent of this problem in the country. The scope of this article is to analyse hospitalizations resulting from suicide attempts at public hospitals or services contracted out by the public health system (SUS) in Brazil from 1998 to 2014. METHODS This is an ecological study of secondary morbidity data obtained from the Hospital Information System. The overall rate of suicide attempts per 100 000 (10(5)) individuals and rates stratified by age group and sex were calculated. To measure trends, simple linear regression coefficients were calculated. The hospital mortality rate was calculated per 100 individuals. RESULTS The overall rate of hospitalization decreased from 1998 to 2014. The young and adult age groups had the highest hospitalization rates. Men were admitted more and the elderly had higher hospital mortality rates. The main cause of hospitalization was poisoning, accounting for 70.4 % of hospitalizations. Among the people who used poisoning by non-medical drugs as the method of attempted suicide, 58 178 (69.6 %) were men and 49 585 people who are poisoned by medical drugs (60.1 %) were women. CONCLUSIONS Although hospitalization rates for attempted suicide have declined in Brazil, it remains a serious public health problem. Because a suicide attempt is the main predictor of suicide, studies to identify those most vulnerable to attempted suicide will help in the development of prevention strategies for mental health.
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Affiliation(s)
- Davi Félix Martins Junior
- Postgraduate Programme in Medicine and Health (PPgMS), Federal University of Bahia, Salvador, BA Brazil
- Department of Health, State University of Feira de Santana (UEFS), Feira de Santana, BA Brazil
- VI Módulo - Departamento de Saúde, Av. Transnordestina, S/N, Bairro: Novo Horizonte, CEP: 44.036.900 Feira de Santana, BA Brazil
| | | | - Acácia Batista Dias
- Department of Humanities and Philosophy, State University of Feira de Santana (UEFS), Feira de Santana, BA Brazil
| | - André C. Caribé
- Postgraduate Programme in Medicine and Health (PPgMS), Federal University of Bahia, Salvador, BA Brazil
- Program of Mood and Anxiety Disorders (CETHA), Federal University of Bahia (UFBA), Salvador, BA Brazil
| | - S. Bezerra-Filho
- Postgraduate Programme in Medicine and Health (PPgMS), Federal University of Bahia, Salvador, BA Brazil
- Program of Mood and Anxiety Disorders (CETHA), Federal University of Bahia (UFBA), Salvador, BA Brazil
| | - Ângela Miranda-Scippa
- Postgraduate Programme in Medicine and Health (PPgMS), Federal University of Bahia, Salvador, BA Brazil
- Program of Mood and Anxiety Disorders (CETHA), Federal University of Bahia (UFBA), Salvador, BA Brazil
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Kazi TB, Naidoo S. Does Religiosity Mediate Suicidal Tendencies? A South African Study of Muslim Tertiary Students. JOURNAL OF RELIGION AND HEALTH 2016; 55:1010-1023. [PMID: 26661826 DOI: 10.1007/s10943-015-0167-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Despite international studies into religion's protective mechanism against suicidal tendencies, within South Africa there is a paucity of research investigating this relationship. This quantitative study investigates the relationship between religiosity and suicidal tendencies in a sample of Muslim students (N = 111). Two scales were used to test the hypothesis that religion mediates suicidal tendency: the Religious Orientation Test and the Multi-Attitude Suicide Tendency Scale. The findings confirmed this hypothesis but disconfirmed our second hypothesis that there would be gender differences between the variables. We concluded that a high degree of religiosity acts as a protective mechanism against suicidal tendencies and discuss the implications of our findings.
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Affiliation(s)
- Tasnim Bibi Kazi
- Discipline of Psychology, University of KwaZulu-Natal, Howard College Campus, Durban, 4041, South Africa
| | - Sarojini Naidoo
- Discipline of Psychology, University of KwaZulu-Natal, Howard College Campus, Durban, 4041, South Africa.
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Ng LC, Kirk CM, Kanyanganzi F, Fawzi MCS, Sezibera V, Shema E, Bizimana JI, Cyamatare FR, Betancourt TS. Risk and protective factors for suicidal ideation and behaviour in Rwandan children. Br J Psychiatry 2015; 207:262-8. [PMID: 26045350 PMCID: PMC4555444 DOI: 10.1192/bjp.bp.114.154591] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Accepted: 11/17/2014] [Indexed: 11/23/2022]
Abstract
BACKGROUND Suicide is a leading cause of death for young people. Children living in sub-Saharan Africa, where HIV rates are disproportionately high, may be at increased risk. AIMS To identify predictors, including HIV status, of suicidal ideation and behaviour in Rwandan children aged 10-17. METHOD Matched case-control study of 683 HIV-positive, HIV-affected (seronegative children with an HIV-positive caregiver), and unaffected children and their caregivers. RESULTS Over 20% of HIV-positive and affected children engaged in suicidal behaviour in the previous 6 months, compared with 13% of unaffected children. Children were at increased risk if they met criteria for depression, were at high-risk for conduct disorder, reported poor parenting or had caregivers with mental health problems. CONCLUSIONS Policies and programmes that address mental health concerns and support positive parenting may prevent suicidal ideation and behaviour in children at increased risk related to HIV.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Theresa S. Betancourt
- Correspondence: Theresa S. Betancourt, Department of Global Health and Population, Harvard School of Public Health, Boston, MA 02115, USA.
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Akpa OM, Bamgboye EA, Baiyewu O. The Adolescents' Psychosocial Functioning Inventory (APFI): scale development and initial validation using Exploratory and Confirmatory Factor Analysis. AFRICAN JOURNAL FOR THE PSYCHOLOGICAL STUDY OF SOCIAL ISSUES : JOURNAL OF THE AFRICAN SOCIETY FOR THE PSYCHOLOGICAL STUDY OF SOCIAL ISSUES 2015; 18:1-21. [PMID: 25893221 PMCID: PMC4399859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Most of the existing measures of psychosocial functioning among adolescents are developed outside Lower-middle-income countries (LMIC). Measures relevant to the LMIC setting will provide opportunity to assess the functioning of adolescents in these settings based on their background or context. The Adolescents' Psychosocial Functioning Inventory (APFI) which addresses relevant challenges and expectations of adolescents in the LMIC settings was developed to bridge this gap in knowledge. A total of 753 adolescents from purposively selected secondary schools participated in this study. Preliminary analyses were performed using descriptive statistics. The underlying factor structure of the APFI was explored using Exploratory and confirmatory Factor Analysis. Chi-square Goodness of Fit (CGF) and other fit indices were used to assess model fit. Cronbachs alpha was used to assess the reliability of the items and subscales of the APFI. The final model derived from the factor analyses yielded a 23-item three-factor model that provided the best fit to the data. Estimate of overall reliability of the APFI scale was α = 0.83 while all three factors/subscales: Optimism and Coping Strategy (OCS), Behaviour and Relationship Problems (BRP), and General Psychosocial Dysfunctions (GPD) had moderate to high reliability (α = 0.59 for OCS, α = 0.57 for BRP and α = 0.90 for GPD). The CGF yielded χ2/df < = 1.58 while all other fit indices were in the acceptable range. The three-factor model APFI is a reliable measure for assessing psychosocial functioning among adolescents in the LMIC.
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Affiliation(s)
- Onoja Matthew Akpa
- Department of Epidemiology and Medical statistics, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Elijah Afolabi Bamgboye
- Department of Epidemiology and Medical statistics, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Olusegun Baiyewu
- Department of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Nigeria
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Shilubane HN, Ruiter RAC, Bos AER, Reddy PS, van den Borne B. High school students' knowledge and experience with a peer who committed or attempted suicide: a focus group study. BMC Public Health 2014; 14:1081. [PMID: 25326033 PMCID: PMC4216354 DOI: 10.1186/1471-2458-14-1081] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2014] [Accepted: 08/15/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Suicide is a major public health problem for adolescents in South Africa, and also affects those associated with them. Peers become more important during adolescence and can be a significant source of social support. Because peers may be the first to notice psychological problems among each other, the present study's objectives were to assess students' knowledge about suicide, perceived risk factors, signs of poor mental health in adolescents who committed suicide, students' awareness of available mental health care and resources, and beliefs about prevention. METHODS This qualitative study used focus group discussions to elicit the thoughts and feelings of high school students who had a peer who committed or attempted suicide. Peers and class mates of suicide attempters and suicide completers were identified with the help of a social worker and school management and were invited to participate. All focus group discussions were audio taped and analyzed. A total of 56 adolescents (13-19 years of age) from Limpopo schools in South Africa participated in six focus group discussions. The data were analyzed by NVivo version 8, using an inductive approach. RESULTS Participants reported to be affected by the suicide attempt or completed suicide. They felt guilty about their failure to identify and prevent the suicide and displayed little knowledge of warning signs for suicidal behaviour. They identified several risk factors for the suicide of their peers, such as poor relationship issues, teenage pregnancy, punishment, and attention seeking behaviour. Resources for students with mental health problems and survivors of suicide attempts were not perceived to be available at schools and elsewhere. CONCLUSION School-based suicide prevention programs based on theory and evidence are necessary. Such interventions should also focus on detection of mental health problems by peers. Counseling services for students with mental health problems and suicide survivors should be available and made known to students at risk and peers.
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Affiliation(s)
- Hilda N Shilubane
- />Department of Advanced Nursing Sciences, University of Venda, Private Bag X 5050, Thohoyandou, South Africa
| | - Robert AC Ruiter
- />Department of Work and Social Psychology, Maastricht University, Maastricht, The Netherlands
| | - Arjan ER Bos
- />Department of Clinical Psychology, Open University, Limburg, The Netherlands
| | - Priscilla S Reddy
- />Population Health, Health Systems and Innovations (PHHSI) Research Programme, Human Sciences Research Council, Cape Town, South Africa
| | - Bart van den Borne
- />Department of Health Promotion, Maastricht University, Maastricht, The Netherlands
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Outcome of a school-based intervention to promote life-skills among young people in Cambodia. Asian J Psychiatr 2014; 9:78-84. [PMID: 24813042 DOI: 10.1016/j.ajp.2014.01.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2013] [Revised: 01/18/2014] [Accepted: 01/23/2014] [Indexed: 11/19/2022]
Abstract
BACKGROUND Most of the school-based interventions to prevent suicide are from high income countries and there is a need for evidence based interventions in resource-poor settings. The aim of this study is to evaluate the outcome of a school based intervention to reduce risk factors for suicide among young people in Cambodia by promoting life skills. METHOD Six classes were randomly selected from two schools each, one designated as experimental and the other as control school, respectively. In experimental school 168 young people (M=92, F=76) received 6 sessions of life skills education and in the control school 131 students (M=53, F=78) received three general sessions on health. We looked at the pre-post differences on Life-Skills Development Scale Adolescent Form (LSDS-AF)- and Youth Self-Report (YSR) questionnaire to measure the effect size (ES) from the intervention after 6 months. We analyzed the data by stratifying for gender and for those who reported more severe suicidal expressions at baseline (high-risk group). RESULTS The girls showed improvement in Human Relationship (ES=0.57), Health Maintenance (ES=0.20) and the Total Life Skills Dimensions (ES=0.24), whereas boys with high-risk behavior improved on Human Relationship (ES=0.48), Purpose in Life (ES=0.26) and Total Life Skills Dimensions (ES=0.22). Effect size for YSR-syndrome scores among all individuals showed no improvement for either gender. Among high-risk individuals boys had a small to moderate effect size from intervention on Withdrawn/Depressed (ES=0.40), Attention problems (ES=0.46), Rule breaking behavior (ES=0.36), Aggressive behavior (ES=0.48) and Externalizing syndrome (ES=0.64). CONCLUSION Promoting life skills in schools may enhance the overall mental health of young people, indirectly influencing suicide, particularly among boys with high-risk behavior in Cambodia.
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