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Kusuma K, Larsen M, Quiroz JC, Torok M. Age-stratified predictions of suicide attempts using machine learning in middle and late adolescence. J Affect Disord 2024:S0165-0327(24)01261-8. [PMID: 39142588 DOI: 10.1016/j.jad.2024.08.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 07/29/2024] [Accepted: 08/11/2024] [Indexed: 08/16/2024]
Abstract
BACKGROUND Prevalence of suicidal behaviour increases rapidly in middle to late adolescence. Predicting suicide attempts across different ages would enhance our understanding of how suicidal behaviour manifests in this period of rapid development. This study aimed to develop separate models to predict suicide attempts within a cohort at middle and late adolescence. It also sought to examine differences between the models derived across both developmental stages. METHODS This study used data from the nationally representative Longitudinal Study of Australian Children (N = 2266). We selected over 700 potential suicide attempt predictors measured via self-report questionnaires, and linked healthcare and education administrative datasets. Logistic regression, random forests, and gradient boosting algorithms were developed to predict suicide attempts across two stages (mid-adolescence: 14-15 years; late adolescence: 18-19 years) using predictors sampled two years prior (mid-adolescence: 12-13 years; late adolescence: 16-17 years). RESULTS The late adolescence models (AUROC = 0.77-0.88, F1-score = 0.22-0.28, Sensitivity = 0.54-0.64) performed better than the mid-adolescence models (AUROC = 0.70-0.76, F1-score = 0.12-0.19, Sensitivity = 0.40-0.64). The most important features for predicting suicide attempts in mid-adolescence were mostly school-related, while the most important features in late adolescence included measures of prior suicidality, psychosocial health, and future plans. CONCLUSIONS To date, this is the first study to use machine learning models to predict suicide attempts at different ages. Our findings suggest that the optimal suicide risk prediction model differs by stage of adolescence. Future research and interventions should consider that risk presentations can change rapidly during adolescence.
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Affiliation(s)
- Karen Kusuma
- University of New South Wales, Sydney, NSW 2052, Australia.
| | - Mark Larsen
- University of New South Wales, Sydney, NSW 2052, Australia
| | - Juan C Quiroz
- University of New South Wales, Sydney, NSW 2052, Australia
| | - Michelle Torok
- University of New South Wales, Sydney, NSW 2052, Australia
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Campos S, Nuñez D, Pérez JC, Robinson J. Characterization of Psychopathology in Latin American Adolescents Using a Web-Based Screening Tool: Cross-Sectional Study. JMIR Form Res 2024; 8:e57038. [PMID: 39116425 DOI: 10.2196/57038] [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: 02/02/2024] [Revised: 05/28/2024] [Accepted: 06/15/2024] [Indexed: 08/10/2024] Open
Abstract
BACKGROUND Mental health problems and suicide ideation are common in adolescents. Early detection of these issues could prevent the escalation of mental health-related symptoms in the long term. Moreover, characterizing different profiles of prevalent symptoms in conjunction with emotional regulation strategies could guide the design of specific interventions. The use of web-based screening (WBS) tools has been regarded as a suitable strategy to timely detect symptomatology while improving the appeal, cost, timeliness, and reach of detection in young populations. However, the evidence regarding the accuracy of these approaches is not fully conclusive. OBJECTIVE The study aims (1) to examine the capability of a WBS to identify adolescents with psychiatric symptoms and suicidality and (2) to characterize the mental health profiles of a large sample of adolescents using WBS. METHODS A total of 1599 Latin American Spanish-speaking adolescents (mean age 15.56, SD 1.34 years), consisting of 47.3% (n=753) female, 98.5% Chilean (n=1570), and 1.5% Venezuelan (n=24) participants, responded to a mental health WBS. A randomized subsample of participants also responded to the Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-KID). McNemar χ2 and receiver-operating characteristic curves tested the detection accuracy of WBS contrasted with the MINI-KID. Latent profile analyses explored the symptomatic and emotional regulation profiles of participants. RESULTS Both measures showed an adequate level of agreement (area under the curve per symptom domain ranging from 0.70 to 0.89); however, WBS yielded a higher prevalence than MINI-KID for all psychiatric symptoms, except suicide ideation and depression. Latent profile analyses yielded 4 profiles-one of them presented elevated psychopathological symptoms, constituting 11% of the sample (n=175). Rumination (odds ratio [OR] 130.15, 95% CI 51.75-439.89; P<.001), entrapment (OR 96.35, 95% CI 29.21-317.79; P<.001), and defeat (OR 156.79, 95% CI 50.45-487.23; P<.001) contributed significantly to the prediction of latent profile memberships, while cognitive reappraisal did not contribute to the prediction of any latent profile memberships, and expressive suppression was only associated to profile-2 membership. CONCLUSIONS WBS is acceptable for the timely detection of adolescents at risk of mental health conditions. Findings from the symptomatic and emotional regulation profiles highlight the need for comprehensive assessments and differential interventions.
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Affiliation(s)
- Susana Campos
- Center of Applied Psychology, Faculty of Psychology, University of Talca, campus Talca, Talca, Chile
- Millennium Nucleus to Improve the Mental Health of Adolescents and Youths (Imhay), Santiago, Chile
| | - Daniel Nuñez
- Millennium Nucleus to Improve the Mental Health of Adolescents and Youths (Imhay), Santiago, Chile
- Center of Cognitive Sciences, Faculty of Psychology, University of Talca, Talca, Chile
- Faculty of Psychology, University of Talca, Campus Talca, Talca, Chile
| | - J Carola Pérez
- Instituto de Bienestar Socioemocional, Facultad de Psicología, Universidad del Desarrollo, Santiago, Chile
| | - Jo Robinson
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
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Wang Z, Tang Y, Wang G, Deng Y, Jiang Y, Sun W, Sun X, Ip P, Owens J, Zhao M, Xiao Y, Jiang F, Wang G. Insufficient Sleep is Associated With Increasing Trends in Adolescent Suicidal Behaviors. J Adolesc Health 2024; 74:1198-1207. [PMID: 38506779 PMCID: PMC11137680 DOI: 10.1016/j.jadohealth.2024.01.030] [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: 06/07/2023] [Revised: 11/03/2023] [Accepted: 01/12/2024] [Indexed: 03/21/2024]
Abstract
PURPOSE Youth suicide has been increasing and became a public health concern worldwide. Identifying insufficient sleep as the potential risk factor is critical to reducing suicide risk and increasing trends. This study aimed to determine whether insufficient sleep is associated with increasing trends in suicidal behaviors and disparities by sex, age, and race/ethnicity among school adolescents. METHODS The present study used biennial data from the US nationally representative Youth Risk Behavior Survey from 2007 to 2019. Joinpoint regression models were used to estimate biennial percent changes (BPCs) and average BPCs (ABPCs) of suicidal behaviors by sleep duration. Logistic regression models were used to examine the association between insufficient sleep and suicidal behaviors. RESULTS Of 73,356 adolescent students included (mean [standard deviation] age, 16.11 [1.23] years), 50.03% were female. Suicidal ideation and suicide plan among insufficient sleep group increased from 2007 to 2019 (BPC = 2.88% [95% confidence interval {CI}: 1.65%, 4.13%]; BPC = 3.42% [95% CI: 2.09%, 4.77%]), but were nonsignificant among sufficient sleep group. Trends in suicidal ideation (ABPC = 3.03% [95% CI: 1.35%, 4.73%]) and suicide plan (ABPC = 4.03% [95% CI: 2.47%, 5.62%]) among female adolescents with insufficient sleep increased, but nonsignificant among male adolescents with insufficient sleep. Suicidal ideation (ABPC = 1.73% [95% CI: 0.51%, 2.97%]) and suicide plan (ABPC = 2.31% [95% CI: 0.70%, 3.95%]) increased among younger adolescents only with insufficient sleep, whereas suicide trends by sleep duration were similar among older adolescents. Suicide plan among insufficient sleep group increased across the four racial groups, with BPC highest for the White (BPC = 3.48% [95% CI: 1.31%, 5.69%]), and lowest for the Hispanic/Latino (BPC = 1.18% [95% CI: 0.15%, 2.23%]), but were nonsignificant among sufficient sleep group except for the White (BPC = 2.83% [95% CI: 0.62%, 5.09%]). DISCUSSION Insufficient sleep was disproportionately associated with increasing trends in suicidal behaviors among female, younger, and non-White adolescent students. Ensuring sufficient sleep can potentially reduce suicide among school adolescents.
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Affiliation(s)
- Zijing Wang
- Department of Developmental and Behavioral Pediatrics, Pediatric Translational Medicine Institute, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yijia Tang
- Department of Developmental and Behavioral Pediatrics, Pediatric Translational Medicine Institute, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Guangshuai Wang
- Faculty Artificial Intelligence in Education, National Engineering Research Center of Educational Big Data, Central China Normal University, Wuhan, Hubei, China
| | - Yujiao Deng
- Department of Neurology, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yanrui Jiang
- Department of Developmental and Behavioral Pediatrics, Pediatric Translational Medicine Institute, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wanqi Sun
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaoning Sun
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Institute of Psychology and Behavioral Science, Antai College of Economics and Management, Shanghai Jiao Tong University, Shanghai, China
| | - Patrick Ip
- Department of Paediatrics and Adolescent Medicine, University of Hong Kong, Hong Kong, China
| | - Judith Owens
- Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Min Zhao
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China; CAS Center for Excellence in Brain Science and Intelligence Technology (CEBSIT), Chinese Academy of Sciences, Shanghai, China
| | - Yunyu Xiao
- Department of Population Health Sciences, Weill Cornell Medicine|NewYork-Presbyterian, New York, New York.
| | - Fan Jiang
- Department of Developmental and Behavioral Pediatrics, Pediatric Translational Medicine Institute, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai Center for Brain Science and Brain-Inspired Technology, Shanghai, China.
| | - Guanghai Wang
- Department of Developmental and Behavioral Pediatrics, Pediatric Translational Medicine Institute, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai Center for Brain Science and Brain-Inspired Technology, Shanghai, China.
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4
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Li H, Zhang W, Yan J. Physical activity and sedentary behavior among school-going adolescents in low- and middle-income countries: insights from the global school-based health survey. PeerJ 2024; 12:e17097. [PMID: 38680891 PMCID: PMC11055511 DOI: 10.7717/peerj.17097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 02/21/2024] [Indexed: 05/01/2024] Open
Abstract
Background The Global School Student Health Survey (GSHS) is being carried out by students in various countries across the globe to advance improved health programs for youth. However, in comparison to high-income countries, adolescents in low- and middle-income countries (LMICs) are generally at an early stage of understanding regarding physical activity (PA) and sedentary behavior (SB), often exhibiting low levels of PA and high levels of SB. Furthermore, there is limited evidence connecting PA and SB in school-going adolescents from LMICs. Purpose The objective of this review was to synthesize the available evidence regarding PA and sedentary behavior among school-going adolescents in LMICs using data from the GSHS. Method On March 18, 2023, a systematic literature search was performed across four electronic databases, namely Web of Science, PubMed, ScienceDirect, and EBSCO with n odaterestrictions. Studies were eligible if they: (1) utilization of data sourced from the Global Student-based Health Survey; (2) exploration of physical activity; (3) specific focus on adolescents; (4) conducted in low- and middle-income countries; (5) study design encompassing observational; (6) published as English journal articles. Results Among the 29 studies included in the analysis, the majority revealed elevated levels of sedentary behavior and diminished levels of PA in low- and middle-income countries. Furthermore, notable disparities in physical engagement and sedentary behavior were noted between male and female adolescents (p < 0.001). Augmented PA among teenagers was observed to correlate with higher consumption of vegetables and fruits (AOR = 1.30; 95% CI [1.13-1.50]; p < 0.001), decreased alcohol consumption, and a reduced prevalence of loneliness and depression (aOR 1.37, 95% CI [1.18-1.59]). Conclusions The results of this review affirm that in contrast to high-income countries, adolescents in low- and middle-income countries (LMICs) are in the early stages of comprehending physical activity, marked by low levels of PA. Physical activity and sedentary behavior in school-going adolescents from LMICs appear to be influenced by factors such as policies, cultural norms, socioeconomic conditions, as well as gender, and age.
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Affiliation(s)
- Hui Li
- College of Physical Education and Health Sciences, Zhejiang Normal University, Jinhua, China
| | - Wenyu Zhang
- Foundation Department of Education, Shandong Communication and Media College, Jinan, China
| | - Jin Yan
- School of Physical Education and Sports Science, Soochow University, Suzhou, China
- Centre for Active Living and Learning, College of Human and Social Futures, University of Newcastle, Newcastle, NSW, Australia
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Keyes KM, Platt JM. Annual Research Review: Sex, gender, and internalizing conditions among adolescents in the 21st century - trends, causes, consequences. J Child Psychol Psychiatry 2024; 65:384-407. [PMID: 37458091 DOI: 10.1111/jcpp.13864] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/07/2023] [Indexed: 07/18/2023]
Abstract
Internalizing conditions of psychopathology include depressive and anxiety disorders; they most often onset in adolescence, are relatively common, and contribute to significant population morbidity and mortality. In this research review, we present the evidence that internalizing conditions, including depression and anxiety, as well as psychological distress, suicidal thoughts and self-harm, and fatal suicide, are considerably increasing in adolescent populations across many countries. Evidence indicates that increases are currently greatest in female adolescents. We present an epidemiological framework for evaluating the causes of these increases, and synthesize research on whether several established risk factors (e.g., age of pubertal transition and stressful life events) and novel risk factors (e.g., digital technology and social media) meet conditions necessary to be plausible causes of increases in adolescent internalizing conditions. We conclude that there are a multitude of potential causes of increases in adolescent internalizing conditions, outline evidence gaps including the lack of research on nonbinary and gender nonconforming populations, and recommend necessary prevention and intervention foci from a clinical and public health perspective.
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Affiliation(s)
- Katherine M Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Jonathan M Platt
- College of Public Health, University of Iowa, Iowa City, IA, USA
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6
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Liu X, Yang Y, Liu ZZ, Jia CX. Bidirectional associations between sleep problems and suicidal thought/attempt in adolescents: A 3-wave data path analysis. J Affect Disord 2024; 350:983-990. [PMID: 38244795 DOI: 10.1016/j.jad.2024.01.153] [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: 11/11/2023] [Revised: 01/12/2024] [Accepted: 01/14/2024] [Indexed: 01/22/2024]
Abstract
PURPOSE This longitudinal data analysis examined the bidirectional relationships between sleep problems and suicidal thought (ST)/attempt (SA) in a large sample of Chinese adolescents. METHODS A total of 6995 adolescents (mean age = 14.86 years and 51.4% males) participated in a 3-wave longitudinal study of behavior and health in Shandong, China. A self-administered questionnaire and standardized scales were used to assess ST, SA, sleep duration, insomnia, daytime sleepiness, and behavioral/emotional problems in 2015 (T1), 1 year later (T2), and 2 years later (T3). Path analyses were performed without and with adjustment for covariates, including gender, grade level, chronic diseases, cigarette smoking, alcohol use, anxiety/depressive symptoms, paternal education, and family economic status. RESULTS The prevalence rates of short sleep (<7 h/night), insomnia symptoms, and daytime sleepiness were 46.9-58.8%, 16.0-19.4%, and 25.1-25.3% at T1, T2, and T3, respectively. The rates of past-year ST and SA were 9.1-12.4% and 1.6-2.4% at T1, T2, and T3, respectively. Path analyses showed that short sleep, insomnia, and daytime sleepiness predicted subsequent ST, and vice versa. Daytime sleepiness and SA predicted each other 1 year later. Sleep problems and ST/SA in the previous year significantly predicted themselves in the follow-up year. STUDY LIMITATION All data were based on self-report. CONCLUSION Short sleep, insomnia, and daytime sleepiness all had bidirectional relationships with ST. Daytime sleepiness and SA were bidirectionally linked. Our findings suggest that interventions should be taken for both night sleep disturbances and daytime sleepiness to prevent suicide. Adverse sleep outcomes in suicidal adolescents should be assessed, which can in turn increase suicide risk.
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Affiliation(s)
- Xianchen Liu
- Department of Epidemiology, School of Public Health, Cheeloo Medical College, Shandong University, Jinan 250012, China; South China Normal University School of Psychology, Guangzhou 510631, China; The University of Tennessee Health Science Center, Memphis, TN 38163, USA.
| | - Yanyun Yang
- Department of Educational Psychology and Learning Systems, Florida State University, Tallahassee, FL, USA
| | - Zhen-Zhen Liu
- School of Psychology, Northeast Normal University, Changchun 130024, China
| | - Cun-Xian Jia
- Department of Epidemiology, School of Public Health, Cheeloo Medical College, Shandong University, Jinan 250012, China
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7
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Liu X, Yang Y, Liu ZZ, Jia CX. Life stress and suicidality mediated by insomnia and depressive symptoms in adolescents: a three-wave longitudinal study. Sleep 2024; 47:zsad121. [PMID: 37075813 DOI: 10.1093/sleep/zsad121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 04/07/2023] [Indexed: 04/21/2023] Open
Abstract
STUDY OBJECTIVES Little empirical work has investigated the associations between life stress (LS), insomnia, depression, and suicidality in multi-wave longitudinal studies. With three waves of data collection 1-year apart, this longitudinal study with a large sample of adolescents examined the predicting effects of LS on suicidality 1-year later and 2 years later and the mediating roles of insomnia and depression in the LS-suicidality link. METHODS A total of 6995 adolescents (mean age = 14.86 years, 51.4% male) participated in a three-wave longitudinal study of behavior and health in Shandong, China. A self-administered structured questionnaire and standardized scales were used to assess suicidality (including suicidal thought [ST], suicide plan [SP], and suicide attempt [SA]), LS, insomnia, and depression in 2015 (T1), 1-year later (T2), and 2 years later (T3). Mediation effects were examined with path models. RESULTS The overall prevalence rates of past-year suicidality were 13.4% at T1, 10.0% at T2, and 9.5% at T3, respectively. The prevalence rates of suicidality across T1-T3 significantly increased with elevated levels of baseline LS, insomnia, and depression (p < .001). Path models indicated that the relationship between baseline LS and suicidal ideation (i.e., ST/SP) 2 years later was significantly mediated by both insomnia and depression. Depression was also a significant mediator between LS and SA. CONCLUSIONS LS is a significant predictor of suicidality 1-2 years later in adolescents. Depression mediates the association between LS and suicidal ideation and suicide attempt while insomnia appears to be a mediator for suicidal ideation rather than suicide attempt.
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Affiliation(s)
- Xianchen Liu
- Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, PA, USA
| | - Yanyun Yang
- Department of Educational Psychology and Learning Systems, Florida State University, Tallahassee, FL, USA
| | - Zhen-Zhen Liu
- School of Psychology, Northeast Normal University, Changchun, China
| | - Cun-Xian Jia
- Department of Epidemiology, School of Public Health, Cheeloo Medical College, Shandong University, Jinan, China
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Gao H, Wang Y, Wang X, Gao M. Mediation of the association between screen time and suicidality by overweight/obesity and perceived overweight: results from the youth risk behavior surveillance system of the United States. Front Psychiatry 2024; 15:1287021. [PMID: 38501093 PMCID: PMC10944958 DOI: 10.3389/fpsyt.2024.1287021] [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: 09/01/2023] [Accepted: 02/01/2024] [Indexed: 03/20/2024] Open
Abstract
Aim Adolescent suicide is a major public health concern, and modifiable risk factors associated with adolescent suicide remain poorly understood. This study aimed to assess the association between screen time and overweight/obesity and self-perceived overweigh and suicidality in adolescents. Methods Adolescents from the United States Youth Risk Behavior Surveillance System (YRBSS) between 2013 and 2019 were included in this cross-sectional study. The outcome was suicidality, including considered suicide, made a suicide plan, attempted suicide, and injurious suicide attempt. Multivariable logistic regression model was used to investigate the associations between screen time, overweight/obesity, self-perceived overweight, and suicidality, and expressed as odds ratio (OR) and 95% confidence interval (CI). Mediation analysis was used to explore the role of overweight/obesity and self-perceived overweight on the association between screen time and suicidality. Results A total of 30,731 adolescents were included, of which 6,350 (20.65%) had suicidality, including 5,361 (17.45%) with considered suicide, 4,432 (14.42%) with made a suicide plan, 2,300 (7.45%) with attempted suicide, and 677 (2.21%) with injurious suicide attempt. Adolescents with screen time ≥3h were related to higher odds of suicidality (OR=1.35, 95%CI: 1.23-1.46), overweight/obesity (OR=1.27, 95%CI: 1.19-1.38), and self-perceived overweight (OR=1.38, 95%CI: 1.30-1.48) after adjusting confounders. Adolescents with overweight/obesity (OR=1.30, 95%CI: 1.19-1.43) and self-perceived overweight (OR=1.54, 95%CI: 1.39-1.70) were associated with higher odds of suicidality. The association between screen time and suicidality was 4.67% mediated by overweight/obesity and 9.66% mediated by self-perceived overweight. Moreover, the mediating role of overweight/obesity was observed only in females, whereas there were no sex differences in the mediating effect of self-perceived overweight. Conclusion Both overweight/obesity and self-perceived overweight mediated the association between screen time and suicidality.
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Affiliation(s)
- Hong Gao
- Department of Mental Health, The Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Yifei Wang
- Taiyuan University of Technology, Shanxi, China
| | - Xugang Wang
- Shanxi Xinyue Psychological Counseling Research Center, Taiyuan, Shanxi, China
| | - Ming Gao
- Department of Physical Education, Shanxi Medical University, Taiyuan, Shanxi, China
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9
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Cen Y, He J, Zhong Y, Zhou J, Zeng J, Huang G, Luo J. The mediating role of sleep problems and depressed mood between psychological abuse/neglect and suicidal ideation in adolescent childhood: a multicentred, large sample survey in Western China. BMC Psychiatry 2024; 24:64. [PMID: 38262997 PMCID: PMC10804755 DOI: 10.1186/s12888-024-05503-x] [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: 04/28/2023] [Accepted: 01/06/2024] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND Adolescent suicidal ideation are associated with factors including psychological abuse/neglect, sleep problems, and depressed mood, but the systematic effects of these factors on suicidal ideation remain unclear, which is a research gap this work aims to fill. METHODS A multi-center, the cluster sampling method was employed to collect general demographic data, such as age, gender, the experience of being left behind, and parents' marital status, from 12,192 students across 17 secondary schools in China. The Child Psychological Abuse and Neglect Scale (CPANS), Pittsburgh Sleep Quality Index (PSQI), the Chinese version of the Depressed mood, Anxiety and Stress Scale - 21 Items (DASS-21) and Chinese version of Positive and Negative Suicide Ideation Inventory (PANSI) were utilized. Data were analyzed using t-tests, chi-square tests, correlation analyses, and structural equation modeling mediation analyses. RESULTS The prevalence of psychological abuse/neglect and adolescent suicidal ideation was 34.8% and 13%, respectively. This mediation analysis suggests that, in the relationship between psychological abuse/neglect and suicidal ideation, sleep problems and depressed mood play both parallel and sequential mediating roles. CONCLUSION Sleep problems and depressed mood play a mediating role in the development of suicidal ideation in adolescents. Good sleep habits and depressed mood interventions help reduce the risk of suicidal ideation in adolescents who experience psychological neglect/abuse.
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Affiliation(s)
- Yu Cen
- Mental Health Center, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
- School of Psychiatry, North Sichuan Medical College, Nanchong, China
| | - Jinlong He
- Mental Health Center, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
- School of Psychiatry, North Sichuan Medical College, Nanchong, China
| | - Yunling Zhong
- Mental Health Center, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Jinhui Zhou
- School of Psychiatry, North Sichuan Medical College, Nanchong, China
| | - Jiaxin Zeng
- School of Psychiatry, North Sichuan Medical College, Nanchong, China
| | - Guoping Huang
- School of Psychiatry, North Sichuan Medical College, Nanchong, China
| | - Jiaming Luo
- Mental Health Center, Affiliated Hospital of North Sichuan Medical College, Nanchong, China.
- School of Psychiatry, North Sichuan Medical College, Nanchong, China.
- Department of Psychiatry, Nanchong Psychosomatic Hospital, Nanchong, China.
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Núñez D, Gaete J, Guajardo V, Libuy N, Araneda AM, Contreras L, Donoso P, Ibañez C, Mundt AP. Brief Report: The Association of Adverse Childhood Experiences and Suicide-Related Behaviors Among 10th-Grade Secondary School Students. Arch Suicide Res 2024; 28:399-410. [PMID: 36330838 DOI: 10.1080/13811118.2022.2134067] [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] [Indexed: 11/06/2022]
Abstract
The association between adverse childhood experiences and suicide-related behaviors (SRB) of adolescents has been widely studied in Western high-income countries, but not yet in Latin America. The aim of this study was to determine this association and to explore a dose-response relationship between adverse childhood experiences and SRB in Chile. We conducted a cross-sectional survey to assess adverse childhood experiences up to 1 year prior to the survey and SRB (suicide ideation and attempts) in a sample of secondary school students. Multilevel and multivariable logistic regressions were run with SRB as dependent and adverse childhood experiences as independent variables, adjusted by self-esteem, general mental health, friend and parental support, and the age at onset of cannabis and alcohol use. We included 7,458 adolescents (48.7% girls), mean age = 16.0 (SD = 0.7), and found a prevalence of 78.1% for at least one adverse childhood experience. The 6-month prevalence of suicidal ideation was 18.1% (95% confidence interval [CI]: 17.2%-19.0%), and the prevalence of suicide attempts was 5.0% (95% CI: 4.6-5.6). Among all adverse childhood experiences, only sexual abuse was a risk factor for both SRB. We also found an independent effect of the total number of adverse childhood experiences on suicidal ideation (p < .001) and on suicide attempts (p < .001). Additionally, ages at onset of alcohol and cannabis use were associated with suicidal ideation and suicidal attempts, respectively. This is the first study exploring the influence of adverse childhood experiences on suicide-related behaviors in adolescents from Latin America.HIGHLIGHTSSexual abuse is associated with suicidal ideation and suicide attempts in 10th-grade secondary school studentsThere is a dose-response effect between adverse childhood experiences and suicide-related behaviorAges at onset of alcohol and cannabis use were associated with suicidal ideation and suicidal attempts, respectively.
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Branjerdporn G, Erlich F, Ponraj K, McCosker LK, Woerwag-Mehta S. What Is Helpful and What Is Challenging for the Caregivers of Young People Receiving Interventions to Prevent Suicide? Caregivers' Perspectives-A Rapid Scoping Review. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1801. [PMID: 38002892 PMCID: PMC10670828 DOI: 10.3390/children10111801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 11/03/2023] [Accepted: 11/08/2023] [Indexed: 11/26/2023]
Abstract
(1) Background: Suicide is a leading cause of death among young people. Preventing suicide in young people is a priority. Caregivers play a vital role in ensuring interventions for young people experiencing suicide ideation and/or attempts are implemented, and that they are maintained over time. Despite this, little is known about what caregivers find helpful and challenging in relation to suicide prevention interventions. This rapid scoping review is the first to address this gap. (2) Methods: Searches were completed on six electronic databases using keywords relating to 'suicide prevention, 'young people', and 'caregivers'. Ten studies-using both qualitative and quantitative methods, and involving >1400 carers from the United States and Europe-were selected for inclusion. (3) Results: The review shows that caregivers value interventions that are delivered by non-judgmental clinicians, that are suitable to the particular needs of their child, that are available when needed, and that support their confidence and communication. Caregivers experience difficulties with interventions that require their attendance at specific times, and that fail to recognize and/or address their own mental health needs. (4) Conclusions: The findings can be used to inform and improve the intervention design, with the aim of improving outcomes for caregivers and young people.
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Affiliation(s)
- Grace Branjerdporn
- Mental Health and Specialist Services, Gold Coast Hospital and Health Service, Southport, QLD 4215, Australia; (L.K.M.); (S.W.-M.)
- Faculty of Health Sciences and Medicine, Bond University, Robina, QLD 4226, Australia; (F.E.); (K.P.)
| | - Ferrell Erlich
- Faculty of Health Sciences and Medicine, Bond University, Robina, QLD 4226, Australia; (F.E.); (K.P.)
| | - Karthikeyan Ponraj
- Faculty of Health Sciences and Medicine, Bond University, Robina, QLD 4226, Australia; (F.E.); (K.P.)
| | - Laura K. McCosker
- Mental Health and Specialist Services, Gold Coast Hospital and Health Service, Southport, QLD 4215, Australia; (L.K.M.); (S.W.-M.)
- School of Medicine and Dentistry, Griffith University, Nathan, QLD 4111, Australia
| | - Sabine Woerwag-Mehta
- Mental Health and Specialist Services, Gold Coast Hospital and Health Service, Southport, QLD 4215, Australia; (L.K.M.); (S.W.-M.)
- Faculty of Health Sciences and Medicine, Bond University, Robina, QLD 4226, Australia; (F.E.); (K.P.)
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Hernández-Vásquez A, Vargas-Fernández R, Bendezu-Quispe G. Binge drinking and suicidal ideation in Peruvian adolescents: Evidence from a pooled cross-sectional survey. J Affect Disord 2023; 340:321-326. [PMID: 37567347 DOI: 10.1016/j.jad.2023.08.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 08/01/2023] [Accepted: 08/02/2023] [Indexed: 08/13/2023]
Abstract
BACKGROUND Binge drinking and suicidal ideation are public health problems that have consequences on the well-being of Peruvian adolescents. This study aimed to evaluate the relationship between binge drinking and suicidal ideation in Peruvian adolescents. METHODS A secondary data analysis of the health questionnaire of the Demographic and Family Health Surveys from 2013 to 2019 was performed. The outcome variable was suicidal ideation in the last 14 days, assessed with one of the Patient Health Questionnaire (PHQ-9) questions, while the independent variable was binge drinking in the last 30 days. Generalized linear models of the Poisson family with logarithmic link (crude and adjusted) were used to assess the association of interest. RESULTS Data from a total of 11,609 participants were analyzed. The pooled prevalence of suicidal ideation was 8.5 % (95 % confidence interval [CI]: 7.8-9.2), and that of binge drinking was 5.8 % (95 % CI: 5.2-6.5). An association was found between binge drinking and suicidal ideation in the adjusted analysis (adjusted prevalence ratio: 2.95; 95 % CI: 1.69-3.09). LIMITATIONS The cross-sectional design of the study does not allow for establishing a causal relationship. CONCLUSIONS Between 2013 and 2019, nine out of every 100 Peruvian adolescents had suicidal ideation, and six out of every 100 adolescents had binge drinking. An association was found between both risk behaviors in Peruvian adolescents.
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Affiliation(s)
- Akram Hernández-Vásquez
- Centro de Excelencia en Investigaciones Económicas y Sociales en Salud, Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima, Peru.
| | | | - Guido Bendezu-Quispe
- Vicerrectorado de Investigación, Universidad Privada Norbert Wiener, Lima, Peru.
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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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Dadras O, Wang CW. Suicidal behaviours and their correlates in school-going Lebanese adolescents: findings from a national survey. Child Adolesc Psychiatry Ment Health 2023; 17:89. [PMID: 37438736 DOI: 10.1186/s13034-023-00642-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 07/07/2023] [Indexed: 07/14/2023] Open
Abstract
BACKGROUND Adolescent suicide is regarded as a serious phenomenon that affects the well-being of the youth. This study aims to investigate the prevalence of suicidal behaviours and their association with physical/psychological harm and substance use in a nationally representative sample of adolescents in Grades 7-12 in Lebanon. METHODS Data from the latest Global School-Based Student Health Survey conducted in 2017 were used in this study. The prevalence and correlates of suicidal ideation and suicide attempts among those who had considered committing suicide, at least once, were explored. RESULTS An estimated 13.45% of Lebanese adolescents, particularly females in Grades 7-12 had considered suicide at least once in the past 12 months. More importantly, almost half of them had attempted it at least once in the past 12 months. Those who frequently felt lonely or worried (previous year), were involved in physical fights or assaults (previous year), had been verbally or physically bullied (previous month), had missed more school days, experienced food insecurity, and had a history of substance abuse (marijuana, amphetamine, alcohol, and tobacco products) were more likely to exhibit suicidal behaviours. Parental support and older age at drug initiation appeared to be protective factors. DISCUSSION The findings characterise the correlates of suicidal behaviours among school-going Lebanese adolescents and determine the attributes of the risk group susceptible to engaging in suicide attempts. Future interventions and policies should consider these attributes when monitoring target groups, particularly those with the alarming behaviours identified in this study. In addition, awareness campaigns that engage all stakeholders, particularly parents, should be prioritised by the authorities.
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Affiliation(s)
- Omid Dadras
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
- Section Global Health and Rehabilitation, Western Norway University of Applied Sciences, Bergen, Norway.
| | - Chia-Wen Wang
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
- Lloyd's Register Foundation Institute for the Public Understanding of Risk, National University of Singapore, Singapore, Singapore
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Sarfo JO, Amoadu M, Obeng P, Gbordzoe NI, Debrah TP, Ofori COB, Hagan JE. Suicidal Behaviour among School-Going Adolescents in Saint Lucia: Analysis of Prevalence and Associated Factors. Behav Sci (Basel) 2023; 13:535. [PMID: 37503982 PMCID: PMC10376735 DOI: 10.3390/bs13070535] [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: 05/19/2023] [Revised: 06/17/2023] [Accepted: 06/25/2023] [Indexed: 07/29/2023] Open
Abstract
Suicide poses a debilitating threat to adolescents' lives worldwide. Although suicide prevention efforts are evident globally, there is limited evidence on the prevalence and correlations of suicidal behaviour among school-going adolescents in Saint Lucia. We used a dataset from the 2018 Global School-based Student Health Survey to examine the prevalence and associated factors of suicidal behaviour among 1864 students from schools in Saint Lucia. Prevalence rates of 25.5%, 22.1%, and 17.5% were found for suicidal ideation, suicide plan, and suicide attempt, respectively. After adjusting for other factors, being male and having understanding parents were protective against suicidal behaviour. However, suicidal ideation was predicted by being physically attacked and bullied, parental guidance, tobacco use, loneliness, and worry. Moreover, being a victim of physical attacks and bullying, having close friends, being lonely, and worrying were predictive of making suicidal plans among adolescents. Attempting suicide was predicted by cigarette smoking, current use of tobacco and related products, bullying, having close friends, being lonely, and worrying. School-based preventive interventions are required to help address triggers of suicidal behaviour among adolescents in Saint Lucia and to help attain the targets for suicide prevention in the global Sustainable Development Goals.
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Affiliation(s)
- Jacob Owusu Sarfo
- Department of Health, Physical Education and Recreation, University of Cape Coast, Cape Coast PMB TF0494, Ghana
| | - Mustapha Amoadu
- Department of Health, Physical Education and Recreation, University of Cape Coast, Cape Coast PMB TF0494, Ghana
| | - Paul Obeng
- Department of Health, Physical Education and Recreation, University of Cape Coast, Cape Coast PMB TF0494, Ghana
| | | | - Timothy Pritchard Debrah
- Department of Nursing, Kwame Nkrumah University of Science and Technology, Private Mail Bag, University Post Office, Kumasi 00233, Ghana
| | | | - John Elvis Hagan
- Department of Health, Physical Education and Recreation, University of Cape Coast, Cape Coast PMB TF0494, Ghana
- Neurocognition and Action-Biomechanics-Research Group, Faculty of Psychology and Sports Science, Bielefeld University, Postfach 10 01 31, 33501 Bielefeld, Germany
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Abstract
PURPOSE OF REVIEW We review recent research on the epidemiology and etiology of suicide in the global context. We focus on data from low- and middle-income countries (LMIC), with the goal of highlighting findings from these under-researched, over-burdened settings. RECENT FINDINGS Prevalence of suicide in LMIC adults varies across region and country income-level, but is, on average, lower than in high-income countries. Recent gains in suicide reduction, however, have been smaller in LMIC compared to global rates. LMIC youth have much higher rates of suicide attempts than youth from high-income countries. Females as well as people with psychiatric disorders, those living with HIV, those who are LGBTQ + , and those with poor socioeconomic status are highly vulnerable populations in LMIC. Limited and low-quality data from LMIC hinder clear interpretation and comparison of results. A greater body of more rigorous research is needed to understand and prevent suicide in these settings.
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Affiliation(s)
- Kathryn L Lovero
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, NY, USA
| | | | - Amalio X Come
- Department of Mental Health, Ministry of Health, Maputo, Mozambique
| | - Milton L Wainberg
- Department of Psychiatry, New York State Psychiatric Institute and Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Maria A Oquendo
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Suite 200, Philadelphia, PA, 19104, USA.
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Busby Grant J, Batterham PJ, McCallum SM, Werner-Seidler A, Calear AL. Specific anxiety and depression symptoms are risk factors for the onset of suicidal ideation and suicide attempts in youth. J Affect Disord 2023; 327:299-305. [PMID: 36764362 DOI: 10.1016/j.jad.2023.02.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 02/02/2023] [Accepted: 02/04/2023] [Indexed: 02/11/2023]
Abstract
BACKGROUND Suicidality research has typically focused on affective disorders to identify at-risk youth. Investigating the predictive role of individual symptoms, particularly anxiety symptoms, may allow for preventative targeting of additional risk factors for suicidal ideation and attempts. METHODS This analysis used the Sources of Strength Australia project dataset, a cluster randomised controlled trial which assessed the impact of a schools-based intervention for youth help-seeking over 18 months (Calear et al., 2022). Symptoms of anxiety, depression and distress at baseline were used to predict the onset of suicidal ideation, planning for suicide and suicide attempts at 18 months. RESULTS Worry, lack of sleep and anxiety interfering with everyday activities at baseline predicted new onset of suicidal ideation 18 months later. Worry about the future and past, reduced appetite and a belief that life wasn't worth living were risk factors for later suicide plans and attempts. Total scale scores on the scales were typically poor predictors of onset of suicidal behaviours. LIMITATIONS Analyses were impacted by dropouts over the 18 month study period and restricted further investigation into potential behaviour transition trajectories. CONCLUSIONS These findings identify individual symptom profiles associated with later onset of suicidal behaviour. Broadening the focus beyond depression and hopelessness to incorporate anxiety, worry and reduced sleep as risk factors for suicidality is important for public health and clinical settings.
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Affiliation(s)
- Janie Busby Grant
- Faculty of Health, University of Canberra, Canberra, ACT, Australia.
| | - Philip J Batterham
- Centre for Mental Health Research, Australian National University, Canberra, ACT, Australia
| | - Sonia M McCallum
- Centre for Mental Health Research, Australian National University, Canberra, ACT, Australia
| | | | - Alison L Calear
- Centre for Mental Health Research, Australian National University, Canberra, ACT, Australia
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Shirima J, Mhando L, Mavura R, Mboya IB, Ngocho JS. Suicidal Attempts among Secondary School-Going Adolescents in Kilimanjaro Region, Northern Tanzania. Behav Sci (Basel) 2023; 13:bs13040288. [PMID: 37102802 PMCID: PMC10136214 DOI: 10.3390/bs13040288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 03/23/2023] [Accepted: 03/24/2023] [Indexed: 03/30/2023] Open
Abstract
Suicide attempts among adolescents are common and can lead to death. The study aimed to determine the prevalence and factors associated with suicide attempts among secondary school-going adolescents in the Kilimanjaro region, northern Tanzania. The study used data from two repeated regional school-based student health surveys (RSHS), conducted in 2019 (Survey 1) and 2022 (Survey 2). Data were analyzed for secondary school students aged 13 to 17 years from four districts of the Kilimanjaro region. The study included 4188 secondary school-going adolescents: 3182 in Survey 1 and 1006 in Survey 2. The mean age in Survey 1 was 14 years and the median age in Survey 2 was 17 years (p < 0.001). The overall prevalence of suicide attempts was 3.3% (3.0% in Survey 1 and 4.2% in Survey 2). Female adolescents had higher odds of suicide attempts (aOR = 3.0, 95% CI 1.2–5.5), as did those who felt lonely (aOR = 2.0, 95% CI 1.0–3.6), had ever been worried (aOR = 1.9, 95% CI 1.0–3.5), or had ever been bullied (aOR = 2.2, 95% CI 1.2–4.1). Suicidal attempts are prevalent among secondary school-going adolescents in the Kilimanjaro region, northern Tanzania. In-school programs should be established to prevent such attempts.
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Zhu S, Li X, Wong PWC. Risk and protective factors in suicidal behaviour among young people in Hong Kong: A comparison study between children and adolescents ✰. Psychiatry Res 2023; 321:115059. [PMID: 36796255 DOI: 10.1016/j.psychres.2023.115059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 01/05/2023] [Accepted: 01/14/2023] [Indexed: 02/05/2023]
Abstract
Suicide is the leading cause of death among young people worldwide. Few studies examined the factors of childhood suicidality and compared them with adolescent suicidality to meet their age-specific needs. We examined the similarities and differences in risk and protective factors of children and adolescent suicidality in Hong Kong. A school-based survey with 541 students in grades 4-6 and 3,061 students in grades 7-11 from 15 schools was conducted. We measured the demographic, familial, school, mental health, and psychological factors of suicidality. Hierarchical binary logistic regressions were performed to examine the association between correlates and child and youth suicidality, and the interaction effects of these factors and school-age groups. Approximately 17.51% and 7.84% of secondary school respondents and 15.76% and 8.17% of primary school respondents reported suicidal ideation and attempt, respectively. Common correlates for suicidal ideation were depression, bullying, loneliness, self-compassion, and growth mindset, while those for suicide attempt were depression and bullying. Secondary school respondents with higher life satisfaction reported less suicidal ideation, while primary school respondents with higher self-control reported fewer suicide attempts. In conclusion, we recommended recognizing the factors of suicidal ideation and attempt in children and adolescents to tailor preventive strategies in a culturally sensitive manner.
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Affiliation(s)
- Shimin Zhu
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Room GH348, Kowloon, Hong Kong; Mental Health Research Centre, The Hong Kong Polytechnic University, Hong Kong.
| | - Xiaomin Li
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Room GH348, Kowloon, Hong Kong
| | - Paul W C Wong
- Department of Social Work and Social Administration, The University of Hong Kong, Room 511, JC Teaching Tower, Centennial Campus, Pokfulam, Hong Kong.
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Wang H, Bragg F, Guan Y, Zhong J, Li N, Yu M. Association of bullying victimization with suicidal ideation and suicide attempt among school students: A school-based study in Zhejiang Province, China. J Affect Disord 2023; 323:361-367. [PMID: 36460180 DOI: 10.1016/j.jad.2022.11.087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 11/21/2022] [Accepted: 11/25/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Evidence of associations between type-specific bullying victimization and suicidal ideation and suicide attempt among adolescents is scant. This study examined these associations among middle and high school students in China. METHODS A cross-sectional study of 27,030 students with mean age of 15.7 ± 1.7 years, including 13,946 boys and 13,084 girls, was carried out between April and June 2022. RESULTS The prevalence of suicidal ideation and attempt was 19.7 % and 2.9 %, respectively. 30.0 % (95%CI: 28.8-31.1) of students reported being bullied (i.e., bullying victimization) in the past 30 days, and the corresponding figs. (95%CI) for verbal bullying, relational bullying, property-related bullying, physical bullying, and cyberbullying were 11.0 % (10.4-11.7), 2.8 % (2.5-3.0), 1.9 % (1.7-2.2), and 5.7 % (5.3-6.0), respectively. After adjustment for socio-demographic status, lifestyle factors, academic performance, self-reported health and mental health, compared to those who reported not being bullied in the past 30 days, the odds ratios (95%CI) for suicidal ideation and suicide attempt among students who reported being bullied were 1.75 (1.60-1.90) and 2.01 (1.63-2.52), respectively. The corresponding odds ratios (95%CI) for verbal bullying were 1.77 (1.61-1.93) and 2.09 (1.67-2.61), respectively, for relational bullying were 1.77 (1.57-2.00) and 2.31 (1.79-2.98), respectively, for property-related bullying were 1.88 (1.48-2.37) and 2.44 (1.60-3.70), respectively, for physical bullying were 1.79 (1.30-2.47) and 2.86 (1.67-4.90), respectively, and for cyberbullying were 2.02 (1.71-2.39) and 2.83 (2.08-3.84), respectively. CONCLUSION All types of bullying victimization are strongly associated with both suicidal ideation and suicide attempt among middle and high school students.
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Affiliation(s)
- Hao Wang
- Department of NCDs Control and Prevention, Zhejiang Provincial Center for Diseases Control and Prevention, Hangzhou, Zhejiang 310051, China
| | - Fiona Bragg
- Medical Research Council Population Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK; Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, OX3 7LF, UK.
| | - Yunqi Guan
- Department of NCDs Control and Prevention, Zhejiang Provincial Center for Diseases Control and Prevention, Hangzhou, Zhejiang 310051, China.
| | - Jieming Zhong
- Department of NCDs Control and Prevention, Zhejiang Provincial Center for Diseases Control and Prevention, Hangzhou, Zhejiang 310051, China.
| | - Na Li
- Department of NCDs Control and Prevention, Zhejiang Provincial Center for Diseases Control and Prevention, Hangzhou, Zhejiang 310051, China.
| | - Min Yu
- Department of NCDs Control and Prevention, Zhejiang Provincial Center for Diseases Control and Prevention, Hangzhou, Zhejiang 310051, China.
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Examining mediators of associations of food insecurity and being bullied with suicide among in-school adolescents in Eswatini: a cross-sectional study. Sci Rep 2023; 13:1668. [PMID: 36717579 PMCID: PMC9886993 DOI: 10.1038/s41598-023-28767-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Accepted: 01/24/2023] [Indexed: 01/31/2023] Open
Abstract
We examined the potential mediating roles of anxiety and loneliness on the association of concurrent food insecurity (FI) and being bullied (BB) with suicidal behavior (SB) in Eswatini, a lower-middle-income country. We used data from the Global School-based Student Health Survey (GSHS; N = 3264), which employed a two-stage cluster sampling: first, 25 schools were selected based on the proportionate probability of enrollment; second, classes were randomly selected. A self-reported 84-item GSHS questionnaire was used to collect data for students aged 13-17 years. FI was measured by requesting students to recall how often they went hungry because of a lack of food at home in the 30 days before the study. Multiple logistic regressions and binary mediation function was applied to examine mediating factors of SB. The prevalence of SB, FI, and BB among adolescents was 27.5%, 7.7%, and 30.2%, respectively. Moreover, the relationship between FI and BB with SB was partly (approximately 24%) mediated by anxiety and loneliness. Our results highlight the mediating roles of anxiety and loneliness in suicidal adolescents who experience FI and BB. In conclusion, interventions for alleviating SB in high-risk adolescents experiencing FI and BB should also be aimed at ameliorating anxiety and loneliness.
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Cai S, Guo Z, Wang X, Huang K, Yuan K, Huang L. Cortical thickness differences are associated with cellular component morphogenesis of astrocytes and excitatory neurons in nonsuicidal self-injuring youth. Cereb Cortex 2023; 33:811-822. [PMID: 35253859 DOI: 10.1093/cercor/bhac103] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 02/16/2022] [Accepted: 02/17/2022] [Indexed: 02/03/2023] Open
Abstract
Nonsuicidal self-injury (NSSI) generally occurs in youth and probably progresses to suicide. An examination of cortical thickness differences (ΔCT) between NSSI individuals and controls is crucial to investigate potential neurobiological correlates. Notably, ΔCT are influenced by specific genetic factors, and a large proportion of cortical thinning is associated with the expression of genes that overlap in astrocytes and pyramidal cells. However, in NSSI youth, the mechanisms underlying the relations between the genetic and cell type-specific transcriptional signatures to ΔCT are unclear. Here, we studied the genetic association of ΔCT in NSSI youth by performing a partial least-squares regression (PLSR) analysis of gene expression data and 3D-T1 brain images of 45 NSSI youth and 75 controls. We extracted the top-10 Gene Ontology terms for the enrichment results of upregulated PLS component 1 genes related to ΔCT to conduct the cell-type classification and enrichment analysis. Enrichment of cell type-specific genes shows that cellular component morphogenesis of astrocytes and excitatory neurons accounts for the observed NSSI-specific ΔCT. We validated the main results in independent datasets to verify the robustness and specificity. We concluded that the brain ΔCT is associated with cellular component morphogenesis of astrocytes and excitatory neurons in NSSI youth.
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Affiliation(s)
- Suping Cai
- School of Life Science and Technology, Xidian University, Xi'an, Shaanxi 710071, PR China
| | - Zitong Guo
- School of Life Science and Technology, Xidian University, Xi'an, Shaanxi 710071, PR China
| | - Xuwen Wang
- School of Life Science and Technology, Xidian University, Xi'an, Shaanxi 710071, PR China
| | - Kexin Huang
- School of Life Science and Technology, Xidian University, Xi'an, Shaanxi 710071, PR China
| | - Kai Yuan
- School of Life Science and Technology, Xidian University, Xi'an, Shaanxi 710071, PR China.,School of Life Science andTechnology, Xidian University, Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, Xi'an, Shaanxi 710071, PR China.,Information Processing Laboratory, School of Information Engineering, Inner Mongolia University of Science and Technology, Baotou, Inner Mongolia 014010, PR China.,Xi'an Key Laboratory of Intelligent Sensing and Regulation of Trans-Scale Life Information, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi 710126, PR China
| | - Liyu Huang
- School of Life Science and Technology, Xidian University, Xi'an, Shaanxi 710071, PR China
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Yu Z, He F, Cai G, Wang M, Fu J. Relationships between Weight Perceptions and Suicidal Behaviors in Chinese Adolescents: Results from an Ongoing School-Based Survey in Zhejiang Province. Behav Sci (Basel) 2022; 13:bs13010008. [PMID: 36661580 PMCID: PMC9854802 DOI: 10.3390/bs13010008] [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: 09/16/2022] [Revised: 11/10/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Weight perception has been implicated in suicidal behaviors among children and adolescents, yet little is known about the relationships in China. We examined the associations of self-perceived weight status and weight misperception with suicidal behaviors among Chinese adolescents. METHODS Data used in this analysis were from the 2017 Zhejiang Youth Risk Behavior Survey, which included 17,359 middle and high school students aged 9 to 18 years. Information on perceived weight status, as well as the actual height, weight and other related traits, was extracted by a self-reported questionnaire. Multivariate logistic regression models were used to estimate adjusted odds ratios (ORs) with 95% confidence intervals (CIs) for suicidal behaviors associated with perceived weight status and weight misperception. RESULTS Overall, the mean (SD) age was 15.7 (1.6) years among the study participants. Students who perceived themselves as overweight were more likely to have increased suicidal ideation and attempts reports, with ORs of 1.22 (95% CI: 1.09-1.37) and 1.32 (1.06-1.34), compared to those who perceive themselves as having about the right weight. Overestimated weight was significantly associated with greater odds of suicidal ideation (OR: 1.15, 95% CI: 1.03-1.27) and attempts (1.35, 1.10-1.65) relative to accurate weight perception. CONCLUSIONS Controlling for potential confounders, we found that both self-perception of overweight and overestimated perception were significantly associated with suicidal ideation and attempts among Chinese adolescents.
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Affiliation(s)
- Zhu Yu
- Department of Endocrinology, Children’s Hospital Zhejiang University School of Medicine, 3333 Binsheng Road, Hangzhou 310051, China
- National Clinical Research Center for Child Health, 3333 Binsheng Road, Hangzhou 310051, China
- National Children’s Regional Medical Center, 3333 Binsheng Road, Hangzhou 310051, China
| | - Fan He
- Zhejiang Provincial Center for Disease Control and Prevention, 3399 Binsheng Road, Hangzhou 310051, China
| | - Gaofeng Cai
- Zhejiang Provincial Center for Disease Control and Prevention, 3399 Binsheng Road, Hangzhou 310051, China
| | - Meng Wang
- Zhejiang Provincial Center for Disease Control and Prevention, 3399 Binsheng Road, Hangzhou 310051, China
- Correspondence: (M.W.); (J.F.); Tel.: +86-0571-87115104 (M.W.); +86-0571-88873013 (J.F.)
| | - Junfen Fu
- Department of Endocrinology, Children’s Hospital Zhejiang University School of Medicine, 3333 Binsheng Road, Hangzhou 310051, China
- National Clinical Research Center for Child Health, 3333 Binsheng Road, Hangzhou 310051, China
- National Children’s Regional Medical Center, 3333 Binsheng Road, Hangzhou 310051, China
- Correspondence: (M.W.); (J.F.); Tel.: +86-0571-87115104 (M.W.); +86-0571-88873013 (J.F.)
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Sarfo JO, Obeng P, Debrah TP, Gbordzoe NI, Fosu AK. Suicidal behaviours (ideation, plan and attempt) among school-going adolescents: A study of prevalence, predisposing, and protective factors in Saint Vincent and the Grenadines. DIALOGUES IN HEALTH 2022; 1:100077. [PMID: 38515915 PMCID: PMC10954014 DOI: 10.1016/j.dialog.2022.100077] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 11/08/2022] [Accepted: 11/08/2022] [Indexed: 03/23/2024]
Abstract
Suicide occurs throughout life and is among the leading causes of death among adolescents globally. Aside from the growing literature on this serious mental health issue, little is known about the prevalence of suicide and the variables that predispose and protect adolescents against it in Saint Vincent and the Grenadines. We analysed the Global School-based Student Health Survey data collection among school-going adolescents in Saint Vincent and the Grenadines to explore the prevalence, risk and protective variables associated with suicidal behaviours. We observed prevalence rates of 26%, 26%, and 19% for suicide ideation, plan, and attempt, respectively. Furthermore, sex (being male) and having parents or guardians who understand the problems and worries of adolescents served as protective factors against all three suicide behaviours. However, we observed truancy, cigarette smoking, bullying victims (on/off school property), being cyberbullied, loneliness, and worry as risk factors for suicide ideation among adolescents. Risk for suicide plan was predicted by truancy, cigarette smoking, physical fight, bullying victims (on/off school property), being cyberbullied, loneliness, and worry. After controlling for other factors, truancy, amphetamine or methamphetamine use, cigarette smoking, physical fight, bullying victims (on/off school property), serious injury, close friends, loneliness, and worrying about life issues predicted suicide attempt risk among adolescents in Saint Vincent and the Grenadines. Early identification and suicide prevention interventions focusing on identified protective and risk factors may help minimise the prevalence of suicide behaviours among school-going adolescents in Saint Vincent and the Grenadines.
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Benjet C, Borges G, Miah S, Albor Y, Gutiérrez-García RA, Zavala Berbena A, Guzmán R, Vargas-Contreras E, Hermosillo de la Torre AE, Hernández Uribe PC, Quevedo G, Covarrubias Díaz A, Martínez Ruiz S, Valdés-García KP, Martínez Jerez AM, Mortier P. One-year incidence, predictors, and accuracy of prediction of suicidal thoughts and behaviors from the first to second year of university. Depress Anxiety 2022; 39:727-740. [PMID: 35980836 DOI: 10.1002/da.23278] [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: 10/23/2021] [Revised: 06/01/2022] [Accepted: 06/18/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Research is scarce on the prospective predictors of first onset suicidal thoughts and behaviors (STB) and the accuracy of these predictors in university students, particularly in low-and-middle income countries. Therefore, we assessed the 1-year incidence of STB among first-year students, a broad range of prospective predictors of STB incidence, and evaluated the prediction accuracy of a baseline multivariate risk prediction model to identify students at highest risk for STB onset over the subsequent 12 months. METHODS Students (n = 3238) from 13 universities in Mexico completed an online survey developed for the World Mental Health International College Student Surveys in their first year and again 12 months after. We ran generalized linear models and receiver operator curves. RESULTS The 1-year incidence of suicidal ideation, plan and attempt was 8.53%, 3.75%, and 1.16%, respectively. Predictors in final models were female sex (ideation only), minority sexual orientation (ideation only), depression, eating disorders, ADHD (ideation and plan), ongoing arguments or breakup with a romantic partner (ideation only), emotional abuse (ideation only), parental death (ideation, plan), not Catholic/Christian (ideation, plan), not having someone to rely on, psychotic experiences (plan only), and insufficient sleep (attempt only). Prediction accuracy for ideation, plan and attempt was area under the curve = 0.76, 0.81 and 0.78, respectively. Targeting the top 10% of students at highest risk could reduce STB in the subsequent year up to 36%. CONCLUSIONS By assessing these risk/protective factors in incoming students we identified students at greatest risk for developing STB to whom suicide prevention strategies could be targeted.
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Affiliation(s)
- Corina Benjet
- Epidemiological and Psychosocial Research, Center for Global Mental Health, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico City, Mexico
| | - Guilherme Borges
- Epidemiological and Psychosocial Research, Center for Global Mental Health, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico City, Mexico
| | - Sumaiya Miah
- Department of Biostatistics and Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Yesica Albor
- Escuela de Educación a Distancia, Universidad Cuauhtémoc, plantel Aguascalientes, Aguascalientes, Mexico
| | - Raúl A Gutiérrez-García
- Facultad de Ciencias Sociales y Humanidades, Universidad De La Salle Bajío, campus Salamanca, Salamanca, Mexico
| | - Alicia Zavala Berbena
- Dirección de Investigación, Universidad De La Salle Bajío, campus Campestre, León, Mexico
| | - Rebeca Guzmán
- Instituto de Ciencias de la Salud y Coordinación de Investigación, Universidad Autónoma del Estado de Hidalgo, Pachuca, Mexico
| | - Eunice Vargas-Contreras
- Facultad de Ciencias Administrativas y Sociales, Universidad Autónoma de Baja California, Ensenada, Mexico
| | | | | | - Guillermo Quevedo
- Coordinación de psicología, Universidad La Salle Cancún, Cancún, Mexico
| | | | | | | | - Ana María Martínez Jerez
- Unidad Académica de Ciencias Jurídicas y Sociales, Universidad Autónoma de Tamaulipas, Ciudad Victoria, Mexico
| | - Philippe Mortier
- Health Services Research Unit, IMIM Hospital del Mar Medical Research Institute, Barcelona, Spain.,Epidemiología y Salud Pública, CIBER, Madrid, Spain
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Bersia M, Koumantakis E, Berchialla P, Charrier L, Ricotti A, Grimaldi P, Dalmasso P, Comoretto RI. Suicide spectrum among young people during the COVID-19 pandemic: A systematic review and meta-analysis. EClinicalMedicine 2022; 54:101705. [PMID: 36338787 PMCID: PMC9621691 DOI: 10.1016/j.eclinm.2022.101705] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 09/29/2022] [Accepted: 09/29/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND There are concerns that suicidal behaviors are arising among adolescents. The COVID-19 pandemic could have worsened the picture, however, studies on this topic reported contrasting results. This work aimed to summarise findings from the worldwide emerging literature on the rates of suicidality among young people during the COVID-19 pandemic. METHODS A systematic review and meta-analysis were performed, searching five electronic databases for studies published from January 1, 2020 until July 27, 2022. Studies reporting rates for each of the three considered outcomes (suicide, suicidal behaviors, and suicidal ideation) among young people under 19 years old during the COVID-19 pandemic were included. Random-effects meta-analyses were conducted, and the intra-study risk of bias was assessed. When pre-COVID-19 data were available, incidence rate ratio (IRR) and prevalence ratio (PR) estimates were calculated between the two periods. All the analyses were performed according to the setting explored: general population, emergency department (ED), and psychiatric services. The review protocol was registered on PROSPERO (CRD42022308014). FINDINGS Forty-seven observational studies were selected for more than 65 million subjects. The results of the meta-analysis showed a pooled annual incidence rate of suicides of 4.9 cases/100,000 during 2020, accounting for a non-statistically significant increase of 10% compared to 2019 (IRR 1.10, 95% CI: 0.94-1.29). The suicidal behaviors pooled prevalence during the COVID-19 pandemic was higher in the psychiatric setting (25%; 95% CI: 17-36%) than in the general population (3%; 1-13%) and ED (1%; 0-9%). The pooled rate of suicidal ideation was 17% in the general population (11-25%), 36% in psychiatric setting (20-56%) and 2% in ED (0-12%). The heterogeneity level was over 97% for both outcomes in all settings considered. The comparison between before and during COVID-19 periods highlighted a non-statistically significant upward trend in suicidal behaviors among the general population and in ED setting. The only significant increase was found for suicidal ideation in psychiatric setting among studies conducted in 2021 (PR 1.15; 95% CI: 1.04-1.27), not observed exploring 2020 alone. INTERPRETATION During the pandemic, suicide spectrum issues seemed to follow the known pattern described in previous studies, with higher rates of suicidal ideation than of suicidal behaviors and suicide events. Governments and other stakeholders should be mindful that youth may have unique risks at the outset of large disasters like the COVID-19 pandemic and proactive steps are necessary to address the needs of youth to mitigate those risks. FUNDING The present study was funded by the University of Torino (CHAL_RILO_21_01).
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Affiliation(s)
- Michela Bersia
- Department of Public Health and Pediatrics, University of Torino, Via Santena 5 bis, 10126 Torino, Italy
| | - Emanuele Koumantakis
- Department of Public Health and Pediatrics, University of Torino, Via Santena 5 bis, 10126 Torino, Italy
| | - Paola Berchialla
- Department of Clinical and Biological Sciences, University of Torino, Regione Gonzole 43, 10043, Orbassano, Italy
| | - Lorena Charrier
- Department of Public Health and Pediatrics, University of Torino, Via Santena 5 bis, 10126 Torino, Italy
- Corresponding author.
| | - Andrea Ricotti
- Department of Public Health and Pediatrics, University of Torino, Via Santena 5 bis, 10126 Torino, Italy
| | - Piercesare Grimaldi
- Department of Public Health and Pediatrics, University of Torino, Via Santena 5 bis, 10126 Torino, Italy
| | - Paola Dalmasso
- Department of Public Health and Pediatrics, University of Torino, Via Santena 5 bis, 10126 Torino, Italy
| | - Rosanna I. Comoretto
- Department of Public Health and Pediatrics, University of Torino, Via Santena 5 bis, 10126 Torino, Italy
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Associations between humiliation, shame, self-harm and suicidal behaviours among adolescents and young adults: A systematic review protocol. PLoS One 2022; 17:e0278122. [PMID: 36417449 PMCID: PMC9683542 DOI: 10.1371/journal.pone.0278122] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 11/08/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Suicide is the second leading cause of death among young people worldwide and remains a major public health concern. Research indicates that negative social contexts involving familial and peer relationships, have far-reaching influences on levels of suicidal behaviours in later life. Previous systematic reviews have focused on evaluating associations between negative life events such as abuse and bullying in childhood and subsequent self-harm or suicidality. However, the association between adolescent experiences of humiliation and shame, and subsequent self-harm or suicidal behaviour among children and young adults has not been well examined. As such, this systematic review is conducted to examine the prevalence and association between humiliation and shame and self-harm, suicidal ideation, and death by suicide among adolescents and young adults. METHODS A systematic literature search in extant electronic databases including; MEDLINE, Web of Science Core Collection, CINAHL, PsycINFO, and Embase will be conducted to identify potential studies. Google Scholar, and the reference list of the retrieved articles and/or previous systematic reviews in this area, will also be scanned to identify further potential studies. ProQuest will be searched to identify relevant studies available within grey literature. There are no restrictions on the date of publications. Based on our initial review, the following terms were identified: Population: Adolescent (MESH), young adult (MESH), teen, teenage. Exposure: Humiliation, degradation, shame (MESH) or embarrassment (MESH), harassment victimisation, abasement. Outcome: Self-injurious behaviour (MESH), suicide (MESH), suicide attempted (MESH), suicide completed (MESH), self-harm, intentional self-injury, deliberate self-harm, overdose, deliberate self-poisoning, non-suicidal self-injury, self-mutilation, suicidal thought, suicidal ideation, suicidal intent, suicide. At least one term from each category will be used for conducting the literature search. All original quantitative studies published in the English language which examined the prevalence or association between humiliation or shame and self-harm and/or suicidal ideation and/or completed suicide will be included. The studies will be assessed for methodological quality using the Joanna Briggs Institute critical appraisal tools. Narrative synthesis will be performed for all of the studies. If the studies are sufficiently homogenous, the results will be pooled for a meta-analysis. This systematic review protocol followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocol (PRISMA-P) guidelines. The protocol has been registered with the International Prospective Register of Systematic Reviews (PROSPERO) [CRD42022289843]. DISCUSSION This is the first review to synthesise evidence on the prevalence of, and associations between the experiences of humiliation and shame and subsequent self-harm and/or suicidal behaviours among adolescents and young adults. As there is growing evidence on increased self-harm among this age group, it is important to identify population-specific risk factors for self-harm and suicidality which will have significance in formulating tailored and effective treatment and therapeutic services for adolescents and young adults.
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Aboagye RG, Ahinkorah BO, Seidu AA, Okyere J, Frimpong JB, Kumar M. In-school adolescents’ loneliness, social support, and suicidal ideation in sub-Saharan Africa: Leveraging Global School Health data to advance mental health focus in the region. PLoS One 2022; 17:e0275660. [PMID: 36350793 PMCID: PMC9645589 DOI: 10.1371/journal.pone.0275660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 09/21/2022] [Indexed: 11/11/2022] Open
Abstract
Introduction Adolescent and youth mental health problems are increasingly becoming an area of concern in global health. Young people in sub-Saharan Africa experience significant adversities and systemic challenges despite technological advancements and demographic transition that the region is experiencing. We examined the nexus between experiences of loneliness, low social support, and presence of suicidal ideation among in-school adolescents in sub-Saharan Africa. Method A total of 19,119 in-school adolescents from eight countries in sub-Saharan Africa were included in this study. Suicidal ideation was the main outcome variable and loneliness, and social support were the explanatory variables. Percentages were used to summarise the prevalence of suicidal ideation, loneliness, and social support among the in-school adolescents. A multivariable binary logistic regression analysis was later used to determine the association between suicidal ideation and the explanatory variables and covariates using Stata v16. Four models were tested using the regression analysis. We presented the regression results using adjusted odds ratios (aOR), with their respective 95% confidence intervals (CIs). Results Overall, the past year prevalence of loneliness, peer support, one or more close friends, and suicidal ideation were 10%, 33.4%, 90.1%, and 14.5%, respectively. In-school adolescents who felt lonely (aOR = 1.88, 95% CI = 1.69, 2.09) were more likely to experience suicidal ideation. However, those who received peer support (aOR = 0.89, 95% CI = 0.82, 0.97) and had one or more close friends (aOR = 0.77, 95% CI = 0.68, 0.86) were less likely to experience suicidal ideation. Conclusion These results point to the significant roles of loneliness, and lack of social support, in understanding suicidal ideations. Countries in sub-Saharan Africa need to improve child and adolescent mental health policies and programmes to respond to these risk factors and mental health challenges. Programmes with a differential focus on the needs of males and females, younger and older adolescents will be important in the future.
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Affiliation(s)
- Richard Gyan Aboagye
- Department of Family and Community Health, Fred N. Binka School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Bright Opoku Ahinkorah
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Abdul-Aziz Seidu
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
- Department of Estate Management, Takoradi Technical University, Takoradi, Ghana
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Douglas, Australia
| | - Joshua Okyere
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
| | - James Boadu Frimpong
- Department of Health, Physical Education, and Recreation, University of Cape Coast, Cape Coast, Ghana
- Department of Kinesiology, New Mexico State University, Las Cruces, NM, United States of America
- * E-mail:
| | - Manasi Kumar
- Brain and Mind Institute, Aga Khan University, Nairobi, Kenya
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Bischops AC, Radev ST, Köthe U, Chen S, Geldsetzer P, Sarker M, Su TT, Mohamed FA, Darwish N, Ahmad NA, Ould Baba SA, Bärnighausen T, Barteit S. Data Resource Profile: The Global School-based Student Health Survey—behavioural risk and protective factors among adolescents. Int J Epidemiol 2022; 52:e102-e109. [PMID: 36350584 DOI: 10.1093/ije/dyac208] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 10/28/2022] [Indexed: 11/11/2022] Open
Affiliation(s)
- Anne C Bischops
- Faculty of Medicine and University Hospital, Heidelberg Institute of Global Health (HIGH), Heidelberg University , Heidelberg, Germany
- General Paediatrics, Neonatology and Paediatric Cardiology, Duesseldorf University Hospital, Düsseldorf University , Düsseldorf, Germany
| | - Stefan T Radev
- Cluster of Excellence STRUCTURES, Heidelberg University , Heidelberg, Germany
| | - Ullrich Köthe
- Interdisciplinary Centre for Scientific Computing (IWR), Heidelberg University , Heidelberg, Germany
| | - Simiao Chen
- Faculty of Medicine and University Hospital, Heidelberg Institute of Global Health (HIGH), Heidelberg University , Heidelberg, Germany
- Chinese Academy of Medical Sciences and Peking Union Medical College , Beijing, China
| | - Pascal Geldsetzer
- Division of Primary Care and Population Health, Department of Medicine, Stanford University , Stanford, CA, USA
- Chan Zuckerberg Biohub , San Francisco, CA, USA
| | - Malabika Sarker
- CoE Science of Implementation and Scale-Up BRAC James P Grant School of Public Health, BRAC University , Dhaka, Bangladesh
| | - Tin Tin Su
- Faculty of Medicine and University Hospital, Heidelberg Institute of Global Health (HIGH), Heidelberg University , Heidelberg, Germany
- South East Asia Community Observatory (SEACO) and Global Public Health, Jeffrey Cheah School of Medicine & Health Sciences, Monash University , Bandar Sunway, Malaysia
| | - Fawzia Ahmed Mohamed
- Public Health Department, Faculty of Medical Technology, University of Tripoli, Health Protection and Promotion , Tripoli, Libya
| | - Noorali Darwish
- RMNCAH Department, Ministry of Public Health Afghanistan , Kabul, Afghanistan
| | - Noor Ani Ahmad
- Institute for Public Health, Ministry of Health Malaysia , Putrajaya, Malaysia
| | | | - Till Bärnighausen
- Faculty of Medicine and University Hospital, Heidelberg Institute of Global Health (HIGH), Heidelberg University , Heidelberg, Germany
- Department of Global Health and Population, Harvard T.H. Chan, School of Public Health , Boston, MA, USA
- Africa Health Research Institute (AHRI) , KwaZulu-Natal, South Africa
| | - Sandra Barteit
- Faculty of Medicine and University Hospital, Heidelberg Institute of Global Health (HIGH), Heidelberg University , Heidelberg, Germany
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Abstract
PURPOSE OF THE REVIEW The rate of youth suicidal behaviors has gradually increased over the last 15 years and continues to grow during the COVID-19 pandemic. This trend burdens mental health services and demands significant developments in risk detection and delivery of interventions to reduce the risk. In this article we outline significant advances and recent findings in youth suicide research that may facilitate strategies for identifying and preventing suicide risk among youth at risk in general and in specific risk groups. RECENT FINDINGS The rise in suicide and suicidal behaviors is most likely to affect young people of racial, ethnic, sexual, and gender identity minorities and those living in poverty or experiencing maltreatment. The suicide rate in children is rising and demands special attention. Proximal risk factors for suicidal behavior compared with suicidal ideation have been suggested to identify near-term suicidal risk. Effective and scalable prevention strategies were identified, and the role of new technologies in suicide prevention among youth is to be determined. SUMMARY To reach broader suicide prevention in youth and reduce the pressure on mental healthcare, public health approaches and improved service access for minority youth and those living in underserved areas of the world are needed.
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Affiliation(s)
- Shira Barzilay
- Department of Community Mental Health, University of Haifa
| | - Alan Apter
- Schneider Children's Medical Center of Israel, Petach Tikva
- Ivcher School of Psychology, Reichman University, Herzliya, Israel
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31
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Li L, Xu G, Yang H, Wang Y, Fu R, Wang Y, Bian G. Temporal trends in suicide attempts among adolescents aged 12-15 years from 12 low- and middle-income countries. Soc Psychiatry Psychiatr Epidemiol 2022; 57:2267-2277. [PMID: 35804059 DOI: 10.1007/s00127-022-02290-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Accepted: 04/12/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE Suicide is a major public health problem, especially in low- and middle-income countries (LMICs). However, current data on temporal trends in suicide attempts are limited. Therefore, we explored the temporal trends in suicide attempts among adolescents aged 12-15 years from 12 LMICs. METHODS The data for this study were obtained from the Global School-based Student Health Survey (GSHS) 2009-2017, wherein the interval between two surveys in most of the participating countries was approximately 6 years. The prevalences of suicide attempts were reported as weighted prevalences and 95% confidence intervals (CIs). Pooled overall estimates were calculated using meta-analysis with a random-effects model. Linear regression was used to assess the associations of a country's GNI/capita with the prevalence and temporal variations of suicide attempts. RESULTS The pooled prevalence of suicide attempts in the LMICs decreased significantly from 17.56% in the first survey to 13.77% in the second survey (difference = 3.65%, 95% CI = 0.35-6.95%, P = 0.03). However, significant decreasing trends were only observed in two countries (Benin and Samoa), the prevalence in the remaining countries remained relatively stable. The pooled prevalence of suicide attempts decreased significantly in boys and in the 12- to 13 year age group (difference = 3.77% and 4.44%, Both P < 0.05). In addition, the correlations of gross national income per capita with the prevalences of suicide attempts was negative but not significant (P > 0.05). CONCLUSIONS Our findings reveal a decreasing trend in the prevalence of suicide attempts among 12-15 year-old adolescents in 12 LMICs. However, the trend varied in each country. This suggests the need for tailored suicide prevention strategies in each country to reduce suicide attempts.
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Affiliation(s)
- Lian Li
- Ningbo Kangning Hospital, Ningbo, Zhejiang, China
| | - Guodong Xu
- Precaution and Health Care Section, Ningbo Medical Center Lihuili Hospital, Ningbo, Zhejiang, China
| | | | - Yunfeng Wang
- Ningbo Kangning Hospital, Ningbo, Zhejiang, China
| | - Rong Fu
- Ningbo Kangning Hospital, Ningbo, Zhejiang, China
| | - Yucheng Wang
- Ningbo Kangning Hospital, Ningbo, Zhejiang, China.
| | - Guolin Bian
- Ningbo Kangning Hospital, Ningbo, Zhejiang, China.
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Do associations between suicide ideation and its correlates (substance use, anxiety, and depression) differ according to victimization type among youth? A Smart platform study. Prev Med Rep 2022; 29:101944. [PMID: 36161124 PMCID: PMC9502327 DOI: 10.1016/j.pmedr.2022.101944] [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: 01/17/2022] [Revised: 07/14/2022] [Accepted: 08/05/2022] [Indexed: 12/03/2022] Open
Abstract
23% of the youth reported suicide ideation in the past year. Suicide ideation was higher among those victimized by bullying. Suicide ideation was also higher with reported anxiety, or poor subjective health. Poor health did not play a role between victimization and suicide ideation.
The issues associated with mental health, substance misuse, and suicide ideation are complex and sensitive among youth. We sought to investigate the role that subjective health, internalizing and externalizing risk factors play in the association between victimization and suicide ideation among youth in Canada via used a custom-built digital epidemiological smartphone application (Smart Platform) on their personal smartphones. A sample of 818 youth citizen scientists in Saskatchewan, Canada downloaded the app to provide information on victimization, subjective health, internalizing problems (symptoms of stress, anxiety, and depression), externalizing behaviours (cannabis use, alcohol, smoking), and suicide ideation. Binary regression models were used to estimate associations and controlled for gender, age, perpetration, and ethnicity. From our sample, 23% of youth reported suicide ideation (i.e., thoughts) in the past year. Three types of victimization (cyberbullied, made fun or teased, or bullied via being left out) are associated with a two-times higher risk of suicide ideation. Although certain risk factors (anxiety, poor subjective health, and cannabis use) were associated with higher suicide ideation risk, they did not moderate the association between victimization and suicide ideation. Symptoms of depression were found to be protective against suicide ideation. Suicide ideation is high among this sample of youth in Canada. Certain types of victimization, internalizing and externalizing risk factors, and poor subjective health are associated with a higher risk of suicide ideation. However, our findings confirm that the pathway from victimization to suicide ideation is complex and is potentially moderated by factors other than the ones explored here.
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Kreniske P, Morrison C, Spencer BH, Levine A, Liotta L, Fisher PW, Nguyen N, Robbins RN, Dolezal C, Kluisza L, Wiznia A, Abrams EJ, Mellins CA. HIV and suicide risk across adolescence and young adulthood: an examination of socio-demographic, contextual and psychosocial risk factors for attempted suicide in a longitudinal cohort of ageing adolescents affected by HIV living in the New York City Area. J Int AIDS Soc 2022; 25 Suppl 4:e25984. [PMID: 36176026 PMCID: PMC9522633 DOI: 10.1002/jia2.25984] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 08/01/2022] [Indexed: 12/22/2022] Open
Abstract
Introduction As children become adolescents and young adults (AYA), their risk for attempting suicide increases dramatically, with chronic health conditions an important risk factor. This study examined correlates of suicidality across development in AYA living with perinatally acquired HIV (AYALPHIV) and those perinatally HIV‐exposed but uninfected (AYAPHEU). Methods Data come from an ongoing longitudinal New York City‐based study (N = 339) with AYALPHIV and AYAPHEU interviewed every 12–18 months from 2003 to 2019 (mean enrolment age = 12 years; current mean age = 27 years). The Diagnostic Interview Schedule for Children (adolescent or young adult version) assessed psychiatric disorders and first‐reported suicide attempt. Generalized estimating equations were used to examine associations between first‐reported suicide attempt and socio‐demographic, contextual and psychosocial correlates measured concurrently across six timepoints. Results At enrolment, 51% of participants were female, 72% heterosexual, 60% Black and 50% Latinx. Attempted suicide was significantly higher among AYALPHIV (27%, CI 21–33%) compared to AYAPHEU (16%, CI 10–22%), with an OR of 1.74 (CI 1.04–2.92) in a model adjusting for age. For AYALPHIV, anxiety (OR 2.66, CI 1.46–4.85), mood (OR 3.62, CI 1.49–8.81) and behaviour disorders (OR 5.05, CI 2.15–11.87) and past‐year arrest (OR 3.05, CI 1.26–7.4), negative life events (OR 1.27, CI 1.11–1.46), city stress (OR 2.28, CI 1.46–3.57), pregnancy (OR 2.28, CI 1.08–4.81) and HIV stigma (OR 2.46, CI 1.27–4.75) were associated with increased odds of attempted suicide, while identifying as heterosexual (OR 0.27, CI 0.14–0.52), higher personal (OR 0.45, CI 0.26–0.80) and family self‐concept (OR 0.36, CI 0.22–0.57) were protective. Interactions by HIV status and age were found: substance use was more strongly associated with attempted suicide among AYAPHEU than AYALPHIV, while negative life events and higher religiosity were more strongly associated with increased odds of attempted suicide among AYA ≥ 19 versus ≤ 18 years. Conclusions AYALPHIV compared to AYAPHEU faced unique risks for attempted suicide as they age into adulthood, with the highest risk among AYALPHIV experiencing HIV stigma or pregnancy and the highest risk among AYAPHEU with substance use. Assessing for suicide risk and correlates with attention to ageing can inform preventive interventions tailored to meet AYALPHIV and AYAPHEU needs.
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Affiliation(s)
- Philip Kreniske
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York City, New York, USA
| | - Corey Morrison
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York City, New York, USA
| | - Bailey Holmes Spencer
- Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York City, New York, USA
| | - Alina Levine
- Mental Health Data Science, Research Foundation for Mental Hygiene, New York City, New York, USA
| | - Lucy Liotta
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York City, New York, USA
| | - Prudence W Fisher
- Child and Adolescent Psychiatry, New York State Psychiatric Institute and Columbia University, New York City, New York, USA
| | - Nadia Nguyen
- The Aaron Diamond AIDS Research Center, New York City, New York, USA
| | - Reuben N Robbins
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York City, New York, USA
| | - Curtis Dolezal
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York City, New York, USA
| | - Luke Kluisza
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York City, New York, USA
| | - Andrew Wiznia
- Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Elaine J Abrams
- ICAP at Columbia University, Mailman School of Public Health and Vagelos College of Physicians & Surgeons, Columbia University, New York City, New York, USA
| | - Claude A Mellins
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York City, New York, USA
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Pengpid S, Peltzer K. Factors associated with single and multiple suicide attempts in adolescents attending school in Argentina: national cross-sectional survey in 2018. BJPsych Open 2022; 8:e128. [PMID: 35795969 PMCID: PMC9301764 DOI: 10.1192/bjo.2022.524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Factors associated with single suicide attempts (SSA) and multiple suicide attempts (MSA) may differ. AIMS The study aimed to assess the factors associated with MSA in adolescents with a history of suicide attempts during the past 12 months in Argentina. METHOD National cross-sectional data from the Global School-based Student Health Survey in Argentina in 2018 were analysed. Students who reported having a history of suicide attempts in the past 12 months were included in the final sample (n = 8507). Students with MSA were compared with students with an SSA through multiple logistic regression. RESULTS In a subsample of adolescents attending school (mean age 14.8 years, s.d. = 1.3), 59.4% had an SSA and 40.6% had MSA in the past 12 months. In the final adjusted logistic regression model, compared with participants with SSA, both male and female students with MSA more frequently had no close friends, reported feeling more lonely and had more anxiety-induced sleep disturbances. Furthermore, among female participants, having been physically attacked, having participated in physical fights, low parental support, current tobacco use and lifetime amphetamine use were associated with MSA. Among male students, multiple sexual partners were associated with MSA. Furthermore, among both boys and girls, compared with participants without psychosocial distress, participants with one, two, three or more psychosocial distress factors had higher odds of MSA. Compared with students with one or two social or environmental risk factors, students with seven or eight social or environmental risk factors had higher odds of MSA; compared with students who had zero or one health risk behaviours, students with six or more health risk behaviours had higher odds of MSA. CONCLUSIONS Psychosocial distress (anxiety-induced sleep disturbance, having no close friends and loneliness) increased the odds of MSA among both sexes. The odds of MSA were increased by interpersonal violence, low parental support and substance use among girls, and by having multiple sexual partners among boys. This suggests the potential relevance of these variables in identifying multiple suicide attempters among adolescents attending school in Argentina.
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Affiliation(s)
- Supa Pengpid
- Department of Health Education and Behavioral Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand; and Department of Research Administration and Development, University of Limpopo, Turfloop, South Africa
| | - Karl Peltzer
- Department of Psychology, University of the Free State, Bloemfontein, South Africa; and Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan
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McLoughlin A, Abdalla A, Gonzalez J, Freyne A, Asghar M, Ferguson Y. Locked in and locked out: sequelae of a pandemic for distressed and vulnerable teenagers in Ireland : Post-COVID rise in psychiatry assessments of teenagers presenting to the emergency department out-of-hours at an adult Irish tertiary hospital. Ir J Med Sci 2022:10.1007/s11845-022-03080-0. [PMID: 35739358 PMCID: PMC9225813 DOI: 10.1007/s11845-022-03080-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 06/05/2022] [Indexed: 11/20/2022]
Abstract
Objective The aim of this study is to investigate the impact of the coronavirus pandemic on teenage psychiatry referrals following crisis presentation to the adult emergency department (ED) of an Irish tertiary hospital. In doing so, this study will specifically examine the effect of COVID-19 on self-injurious behaviour, suicidality and substance use among older adolescents (age 16/17 years). Methods This is a retrospective descriptive analysis of acute adolescent psychiatry referrals assessed out-of-hours via the adult ED psychiatry service across three consecutive time points (during the months of March, April and May) from pre-pandemic, 2019 (T1); initial pandemic, 2020 (T2); and peak pandemic, 2021 (T3). Data were obtained via the hospital’s ED-specific electronic database, review of original assessment notes and cross-referenced by manually extracting data logged in the on-call register. Results Crisis psychiatry assessments of teenagers during on-call hours trebled during the period of this study (p < 0.001). Although ED/crisis referrals initially decreased overall at the start of the pandemic, the rate of teenage referrals remained constant, before increasing as restrictions tightened in lockdown. The negative impact of COVID-19 on teenagers’ ability to cope was found to be statistically significant (p = 0.001). Changes in rates of self-harming and/or suicidal behaviours were not statistically significant between 2019, 2020 and 2021 (p = 0.082). Alcohol misuse occurred in up to one-third of cases across each timeframe and remained virtually constant throughout the pandemic. Drug misuse decreased from onset of COVID-19 (p = 0.01). Conclusions To our knowledge, this is the first study to specifically examine the impact of COVID-19 on suicidality, self-harming behaviours, substance misuse and on-call ED presentations of teenagers in Ireland. This study demonstrates that coronavirus-related stress is associated with negative mental health sequelae for vulnerable at-risk older adolescents, as evidenced by a rise in ED presentations and on-call referrals since the onset of the pandemic. Presentation of increased numbers of under-18’s for psychiatry assessment at the adult ED/general hospital indicates a deepening chasm between available and aspirational emergency (adolescent-specific) psychiatric care in the community. Mobilising resilience factors and maximising coping skills for at-risk youth will inform tailored intervention and support strategies along with adequate resourcing of services for vulnerable adolescents in the community.
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Affiliation(s)
| | - Ahad Abdalla
- Centre for Inflammation Research, University of Edinburgh, Edinburgh, Scotland
| | - Jade Gonzalez
- Crumlin Sector, Tallaght University Hospital, Dublin 24, Ireland
| | - Aoife Freyne
- Clondalkin Sector, Tallaght University Hospital, Dublin 24, Ireland
| | - Muhammad Asghar
- National Drug Treatment Centre, Pearse Street, Dublin 2, Ireland
| | - Yolande Ferguson
- Dublin South Central Mental Health Service & Psychiatry Department, Tallaght University Hospital, Tallaght University Hospital, Dublin 24, Ireland
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Park JY, Lee I. Factors influencing suicidal tendencies during COVID-19 pandemic in Korean multicultural adolescents: a cross-sectional study. BMC Psychol 2022; 10:158. [PMID: 35729606 PMCID: PMC9212200 DOI: 10.1186/s40359-022-00867-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 06/15/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is concern that the COVID-19 pandemic has had a negative impact on the psychological wellbeing of many populations, including increase of fear, anxiety, and uncertainty. Since the start of the COVID-19 pandemic, adolescents specifically have experienced direct and indirect impacts on their mentally, resulting in severe depression, self-harm and suicide. This study aimed to identify factors influencing suicidal tendencies and the mental health status of multicultural adolescents in Korea during the COVID-19 pandemic. METHODS This cross-sectional study was conducted with 784 multicultural adolescents (Korean fathers and foreign mothers) who participated in the 16th national Korean Youth Risk Behaviour online survey. Research variables were measured using self-reported questionnaires for mental health and suicidal tendencies. Data was analysed using SPSS 26.0 program. RESULTS The factors influencing suicidal tendencies (contemplating suicide, suicidal plans, and suicide attempts) were sexual intercourse experience (adjusted odds ratio [aOR], 7.67, 5.04, 7.10), depressive mood (aOR 1.03, 0.98, 0.97, 0.90), and unhappiness (aOR 13.00, 7.28, 5.56). CONCLUSIONS In conclusion, the factors that affect suicidal tendencies showed sexual intercourse experience, depressive mood and unhappiness. Screening for suicidal tendencies and suicide prevention programs that consider the significant factors that affect suicidal tendencies should be developed for multicultural adolescents. School health professions and mental health counselors at schools need to emphasize the mental health and psychosocial support needs of senior high school students.
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Affiliation(s)
- Ju-Young Park
- College of Nursing, Konyang University, Deajeon City, Republic of Korea
| | - Insook Lee
- Department of Nursing, Changwon National University, 20 Changwon Daehak-ro, Uichang-gu, Changwon, Gyeongnam, 51140, Republic of Korea.
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Vaivada T, Lassi ZS, Irfan O, Salam RA, Das JK, Oh C, Carducci B, Jain RP, Als D, Sharma N, Keats EC, Patton GC, Kruk ME, Black RE, Bhutta ZA. What can work and how? An overview of evidence-based interventions and delivery strategies to support health and human development from before conception to 20 years. Lancet 2022; 399:1810-1829. [PMID: 35489360 DOI: 10.1016/s0140-6736(21)02725-2] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 09/14/2021] [Accepted: 11/23/2021] [Indexed: 12/14/2022]
Abstract
Progress has been made globally in improving the coverage of key maternal, newborn, and early childhood interventions in low-income and middle-income countries, which has contributed to a decrease in child mortality and morbidity. However, inequities remain, and many children and adolescents are still not covered by life-saving and nurturing care interventions, despite their relatively low costs and high cost-effectiveness. This Series paper builds on a large body of work from the past two decades on evidence-based interventions and packages of care for survival, strategies for delivery, and platforms to reach the most vulnerable. We review the current evidence base on the effectiveness of a variety of essential and emerging interventions that can be delivered from before conception until age 20 years to help children and adolescents not only survive into adulthood, but also to grow and develop optimally, support their wellbeing, and help them reach their full developmental potential. Although scaling up evidence-based interventions in children younger than 5 years might have the greatest effect on reducing child mortality rates, we highlight interventions and evidence gaps for school-age children (5-9 years) and the transition from childhood to adolescence (10-19 years), including interventions to support mental health and positive development, and address unintentional injuries, neglected tropical diseases, and non-communicable diseases.
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Affiliation(s)
- Tyler Vaivada
- Center for Global Child Health, The Hospital for Sick Children, Toronto, ON, Canada
| | - Zohra S Lassi
- Robinson Research Institute and Adelaide Medical School, the University of Adelaide, SA, Australia; Division of Women and Child Health, Aga Khan University Hospital, Karachi, Pakistan
| | - Omar Irfan
- Center for Global Child Health, The Hospital for Sick Children, Toronto, ON, Canada
| | - Rehana A Salam
- Division of Women and Child Health, Aga Khan University Hospital, Karachi, Pakistan
| | - Jai K Das
- Division of Women and Child Health, Aga Khan University Hospital, Karachi, Pakistan
| | - Christina Oh
- Center for Global Child Health, The Hospital for Sick Children, Toronto, ON, Canada
| | - Bianca Carducci
- Center for Global Child Health, The Hospital for Sick Children, Toronto, ON, Canada; Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Reena P Jain
- Center for Global Child Health, The Hospital for Sick Children, Toronto, ON, Canada
| | - Daina Als
- Center for Global Child Health, The Hospital for Sick Children, Toronto, ON, Canada
| | - Naeha Sharma
- Center for Global Child Health, The Hospital for Sick Children, Toronto, ON, Canada
| | - Emily C Keats
- Center for Global Child Health, The Hospital for Sick Children, Toronto, ON, Canada
| | - George C Patton
- Centre for Adolescent Health, Murdoch Children's Research Institute, Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia
| | - Margaret E Kruk
- Department of Global Health and Population, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Robert E Black
- Institute for International Programs, Johns Hopkins Bloomberg School of Public Health, Baltimore, Johns Hopkins University, MD, USA
| | - Zulfiqar A Bhutta
- Center for Global Child Health, The Hospital for Sick Children, Toronto, ON, Canada; Centre of Excellence in Women and Child Health and Institute for Global Health and Development, The Aga Khan University, Karachi, Pakistan.
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Kruk ME, Lewis TP, Arsenault C, Bhutta ZA, Irimu G, Jeong J, Lassi ZS, Sawyer SM, Vaivada T, Waiswa P, Yousafzai AK. Improving health and social systems for all children in LMICs: structural innovations to deliver high-quality services. Lancet 2022; 399:1830-1844. [PMID: 35489361 PMCID: PMC9077444 DOI: 10.1016/s0140-6736(21)02532-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 06/10/2021] [Accepted: 11/11/2021] [Indexed: 12/25/2022]
Abstract
Despite health gains over the past 30 years, children and adolescents are not reaching their health potential in many low-income and middle-income countries (LMICs). In addition to health systems, social systems, such as schools, communities, families, and digital platforms, can be used to promote health. We did a targeted literature review of how well health and social systems are meeting the needs of children in LMICs using the framework of The Lancet Global Health Commission on high-quality health systems and we reviewed evidence for structural reforms in health and social sectors. We found that quality of services for children is substandard across both health and social systems. Health systems have deficits in care competence (eg, diagnosis and management), system competence (eg, timeliness, continuity, and referral), user experience (eg, respect and usability), service provision for common and serious conditions (eg, cancer, trauma, and mental health), and service offerings for adolescents. Education and social services for child health are limited by low funding and poor coordination with other sectors. Structural reforms are more likely to improve service quality substantially and at scale than are micro-level efforts. Promising approaches include governing for quality (eg, leadership, expert management, and learning systems), redesigning service delivery to maximise outcomes, and empowering families to better care for children and to demand quality care from health and social systems. Additional research is needed on health needs across the life course, health system performance for children and families, and large-scale evaluation of promising health and social programmes.
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Affiliation(s)
- Margaret E Kruk
- Department of Global Health and Population, Harvard T H Chan School of Public Health, Boston, MA, USA.
| | - Todd P Lewis
- Department of Global Health and Population, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Catherine Arsenault
- Department of Global Health and Population, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Zulfiqar A Bhutta
- Centre for Global Child Health, Hospital for Sick Children, Toronto, ON, Canada; Center of Excellence in Women and Child Health and Institute for Global Health and Development, Aga Khan University, Karachi, Pakistan
| | - Grace Irimu
- Kenya Medical Research Institute-Wellcome Trust Research Programme, Nairobi, Kenya; Department of Paediatrics and Child Health, University of Nairobi, Nairobi, Kenya
| | - Joshua Jeong
- Department of Global Health and Population, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Zohra S Lassi
- Robinson Research Institute, University of Adelaide, Adelaide, SA, Australia
| | - Susan M Sawyer
- Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia; Centre for Adolescent Health, Royal Children's Hospital, Parkville, VIC, Australia; Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - Tyler Vaivada
- Centre for Global Child Health, Hospital for Sick Children, Toronto, ON, Canada
| | - Peter Waiswa
- Maternal, Newborn and Child Health Centre of Excellence, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda; Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Aisha K Yousafzai
- Department of Global Health and Population, Harvard T H Chan School of Public Health, Boston, MA, USA
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Finding the Link between Cyberbullying and Suicidal Behaviour among Adolescents in Peninsular Malaysia. Healthcare (Basel) 2022; 10:healthcare10050856. [PMID: 35627992 PMCID: PMC9141303 DOI: 10.3390/healthcare10050856] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 04/29/2022] [Accepted: 05/03/2022] [Indexed: 11/23/2022] Open
Abstract
Social media engagement has contributed to the rise of cyberbullying, which has recently triggered tragic suicides among adolescents. The objective of this cross-sectional study is to determine the prevalence of cyberbullying, suicidal behaviour, and their association among adolescents in Peninsular Malaysia. The study was conducted among 1290 secondary school adolescents aged between 13 and 17 years old in Peninsular Malaysia using a self-administered and anonymous online questionnaire. Our findings reveal that the prevalence of cyberbullying victimization and perpetrator is 13.7% and 3.8%, respectively. The prevalence of suicidal behaviour among adolescents is 17.1%, in which 11.9% had suicidal thoughts, 10.2% had a suicide plan, and 8.4% had made a suicide attempt. Multiple logistic regression shows that adolescents experiencing cyberbullying victimization is a significant risk factor (p < 0.001) for suicidal behaviour after adjusting for other confounders. An alarming number of adolescents in Peninsular Malaysia found to be involved in cyberbullying and its significant association with suicidal behaviour warrant the need to strengthen current interventions. Since the study was conducted during the COVID-19 pandemic, our findings make an important contribution in reporting current trends in cyberbullying and suicide among adolescents, especially when they are becoming ever-more present in cyberspaces.
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Wang Y, Zhang Y, Wang G, Duan Z, Wilson A, Yang Y, Sun S, Chen R. Latent profile analysis to identify subgroups of Chinese sexual minority adolescents at risk of suicidality. Prev Med 2022; 157:107007. [PMID: 35247440 DOI: 10.1016/j.ypmed.2022.107007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 02/14/2022] [Accepted: 02/26/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND This study aimed to identify latent class profiles of sexual minority adolescents (Men Sexually attracted to Men, Women Sexually attracted to Women, and Bisexual) with elevated suicidal ideation. METHODS Data were collected from 18 secondary schools in China. Sub-group classifications were identified using variables associated with suicidal ideation in sexual minority adolescents, including parental relationship quality, electronic equipment time, school bullying, and sleep quality using the Chinese version of the Pittsburgh Sleep Quality Index to measure sleep. Anxiety was measured using the Generalized Anxiety Disorder 7 (GAD-7), depression was measured using the Patient Health Questionnaire 9 (PHQ-9), hypomania using the Hypomanic Checklist-32 (HCL-32), positive coping style was identified using the Trait Coping Style Questionnaire, and self-efficacy was measured by the General Self-Efficacy Scale. RESULTS Four distinctive profiles were derived from the data. Compared to "low-risk" group (Class 3), the "adolescent with mood problems" group (Class 2) had a 9.81 times higher risk of suicidal ideation; the those who classified as "severe bullied adolescent" (Class 4) had a 9.26 times higher risk of suicidal ideation. and the "adolescents with low self-efficacy" group (Class 1) had a 4.48 times higher risk of suicidal ideation. CONCLUSIONS Sexual minority adolescents with mood problems have the highest risk of suicidal ideation, followed by adolescents frequently being bullied at school. Interventions aimed at reducing suicide risk among sexual minority adolescents may benefit from attending to such profile factors identified in this study to develop targeted clinical care.
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Affiliation(s)
- Yuanyuan Wang
- Division of Psychology, Faculty of Health and Life Sciences, De Montfort University, Leicester, UK; Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, China; School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, China
| | - Yanwen Zhang
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Guosheng Wang
- Suzhou Guangji Hospital Affiliated Guangji Hospital of Soochow University, Soochow University, Suzhou, China
| | - Zhizhou Duan
- Preventive Health Service, Jiangxi Provincial People's Hospital, Affiliated People's Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Amanda Wilson
- Division of Psychology, Faculty of Health and Life Sciences, De Montfort University, Leicester, UK
| | - Yong Yang
- Suzhou Guangji Hospital Affiliated Guangji Hospital of Soochow University, Soochow University, Suzhou, China.
| | - Shufang Sun
- Brown University School of Public Health, Department of Behavioral and Social Sciences, International Health Institute, USA
| | - Runsen Chen
- Vanke School of Public Health, Tsinghua University, Beijing, China; Institute for Healthy China, Tsinghua University, Beijing, China.
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The gap between perceived mental health needs and actual service utilization in Australian adolescents. Sci Rep 2022; 12:5430. [PMID: 35361817 PMCID: PMC8971377 DOI: 10.1038/s41598-022-09352-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 03/22/2022] [Indexed: 01/16/2023] Open
Abstract
Despite being highly prevalent, adolescent mental health problems are undertreated. To better understand the mental health treatment gap, we assessed the prevalence and correlates of help-seeking, including perceived need for care and access to that care. Data were drawn from Young Minds Matter (YMM) survey-the second Australian child and adolescents survey of mental health and wellbeing. Parent-reported data and self-reported child data were combined into one dataset to analyse 2464 Australian adolescents aged 13-17 years. We employed bivariate and multivariate logistic regression models to assess the correlation between independent variables (professionally assessed with mental disorders only, self-reported self-harm/suicidality only and both) and their distribution over outcome variables (perceived need and service use). Mental disorders include depression, anxiety, ADHD and conduct disorder. Our study revealed 15.0%, 4.6% and 7.7% had professionally assessed with mental disorders only, self-reported self-harm/suicidality only and both, respectively. Overall, 47.4% and 27.5% of adolescents respectively perceived need for care and used services in the past-12-months. While among those only who perceived the need, only 53% of adolescents used any services. Professionally assessed with mental disorders only, self-reported self-harm/suicidality only and both were associated with higher likelihood of perceived need and service use (p < 0.001 for all). However, adolescents who self-reported self-harm/suicidality only were not found to be significantly associated with service use among those who perceived the need for care. Adolescents who perceived the need for mental health care but did not seek care represent a treatment gap. Our results suggest the importance of reducing the wide treatment gap that exists between need and care.
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Ren J, Qi X, Cao W, Wang Z, Guo Y, Gaoshan J, Liang X, Tang K. Early Sexual Initiation Is Associated with Suicide Attempts among Chinese Young People. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19073966. [PMID: 35409650 PMCID: PMC8997714 DOI: 10.3390/ijerph19073966] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 03/15/2022] [Accepted: 03/17/2022] [Indexed: 02/06/2023]
Abstract
This study aimed to investigate the association between early sexual initiation and suicide attempts (SAs) among Chinese young people. Our analysis included 9131 college students who had sexual experience from a national sample of 31 provincial administrative regions. Self-reported age at first intercourse was categorized as ≤15, 15–18, and ≥18 years, and the experience of SAs was recorded and analyzed. Compared with females whose sexual debut age was ≥18 years, those ≤15 years (defined as early sexual initiation) had higher odds of SAs in both the forced debut group (odds ratio (OR) 17.04, 95% confidence interval (CI) 4.87–59.66) and the voluntary debut group (OR 37.63, 95% CI 14.96–94.66). Early sexual initiators who lived in rural areas were more inclined to have SAs (female: OR 65.76, 95% CI 19.80–218.42; male: OR 15.39, 95% CI 1.64–144.19). Early sexual initiators who never had parent–child communication about sex were more likely to report having SAs (female: OR 37.81, 95% CI 12.28–116.46). Sexual debut during adolescence, particularly early sexual initiation, was a crucial risk factor for SAs among both sexes. Comprehensive sexuality education and smooth parental communication about sex will provide a supportive environment for young people and hence reduce the potential risks of SAs.
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Affiliation(s)
- Jianing Ren
- Vanke School of Public Health, Tsinghua University, Beijing 100084, China; (J.R.); (X.Q.); (Z.W.)
- School of Public Health, Peking University, Beijing 100191, China
| | - Xinran Qi
- Vanke School of Public Health, Tsinghua University, Beijing 100084, China; (J.R.); (X.Q.); (Z.W.)
- School of Nursing, Capital Medical University, Beijing 100069, China
| | - Wenzhen Cao
- School of Public Health and Management, Wenzhou Medical University, Wenzhou 325035, China;
| | - Zhicheng Wang
- Vanke School of Public Health, Tsinghua University, Beijing 100084, China; (J.R.); (X.Q.); (Z.W.)
- Research Center for Public Health, School of Medicine, Tsinghua University, Beijing 100084, China
| | - Yueping Guo
- School of Journalism and Communication, Graduate School of Chinese Academy of Social Sciences, Beijing 102488, China;
| | - Junjian Gaoshan
- Department for Health, University of Bath, Bath BA2 7AY, UK;
| | - Xiao Liang
- China Family Planning Association, Beijing 100035, China;
| | - Kun Tang
- Vanke School of Public Health, Tsinghua University, Beijing 100084, China; (J.R.); (X.Q.); (Z.W.)
- Correspondence:
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Badarch J, Chuluunbaatar B, Batbaatar S, Paulik E. Suicide Attempts among School-Attending Adolescents in Mongolia: Associated Factors and Gender Differences. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052991. [PMID: 35270685 PMCID: PMC8910274 DOI: 10.3390/ijerph19052991] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 02/26/2022] [Accepted: 03/03/2022] [Indexed: 11/27/2022]
Abstract
Attempting suicide is an important risk factor that can lead to suicide death. The aim of the current study was to examine the prevalence of suicide attempts and to identify the gender-specific predictors of suicide among adolescents in Mongolia. We analyzed data from the 2019 Mongolian Global School-Based Health Survey (GSHS) conducted nationwide among 13–18-year-old students. Univariable and multivariable analyses were performed to assess the correlates of suicide attempts. Overall, 32.1% of the adolescents reported to have had suicide attempts. Multivariable analysis showed a significant association in the total sample of suicide attempts with lack of close friends, anxiety, injury and violence, smoking and alcohol drinking, and sexual intercourse. Male suicide attempters were less likely to have close friends and more likely to have injuries, been physically attacked, been bullied, smoke, drink alcohol, and have had sexual intercourse. Within the female subgroup, anxiety, injury and violence, smoking and alcohol drinking significantly increased the odds of reporting suicide attempts. Increase of the student’s age by one year decreased the odds ratio of suicide attempts. Nearly one in three students had had a suicide attempt. Several factors, including mental distress, violence, and risky behaviors were found to be associated with suicide attempts. These can aid in designing intervention strategies for preventing suicidal behaviors among adolescents.
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Affiliation(s)
- Javzan Badarch
- Department of Public Health, Albert Szent-Györgyi Medical School, University of Szeged, 6720 Szeged, Hungary;
- Correspondence:
| | - Bayar Chuluunbaatar
- Medicine and Medical Devices Regulatory Agency, Ulaanbaatar 14210, Mongolia;
| | - Suvd Batbaatar
- Department of Environmental Health, National Center for Public Health, Ulaanbaatar 13381, Mongolia;
| | - Edit Paulik
- Department of Public Health, Albert Szent-Györgyi Medical School, University of Szeged, 6720 Szeged, Hungary;
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The global and regional burden of sexual behaviors and food insecurity and their combined association on the magnitude of suicidal behaviors among 121,248 adolescent girls: An international observational study in 67 low- and middle-income and high-income countries. J Affect Disord 2022; 298:481-491. [PMID: 34774975 DOI: 10.1016/j.jad.2021.11.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 11/06/2021] [Accepted: 11/09/2021] [Indexed: 01/21/2023]
Abstract
BACKGROUND Food insecurity and early sexual behaviors increase the risk of suicidal behavior, however their combined association on social behaviors receive little attention. Therefore, this study estimated the magnitude of adolescent global suicidal burden, it correlates with food insecurity and sexual behaviors, and assessed the combined association of food insecurity and sexual behaviors on the burden of suicidal behaviors (SBs) among school-going adolescent girls aged between 11 and 17 years. METHODS The study design is multi-county, and pooled cross-sectional in nature. Data for 67 countries from the Global School-based Student Health Survey (GSHS) were used. A random-effects meta-analysis was used to generate national and overall pooled estimates of suicidal behaviors. Multinomial logistic regression analyses were employed to estimate the adjusted effect of independent factors and the combined associations of sexual behaviors and food insecurity on adolescent SBs in the context of global, regional, and country income groups and adjusted by a set of explanatory factors. RESULTS The study included 121,248 girls aged 11-17 years. The population-weighted prevalence of high-level (SBs) was 40.65% among school-going girls who experienced sexual intercourse and 7.41% among those who reported severe food insecurity. However, the burden of SBs varied according to type of sexual behaviors and the age. The burden of SB among girls who had sexual intercourse with 1-2 sex partners, 3-4 sex partners, or >4 sex partners was 11.49%, 13.28%, or 18.43%, respectively. The high-level SB was double (23.08%) among adolescent girls who had first sexual intercourse aged 11-13 years old compared to adolescent girls aged 14-17 years (11.49%). The burden of SBs (for at least one SB, for two SBs, or for three SBs) were significantly associated with adolescent girls who experienced sexual intercourse (relative risk ratio, RRR = 2.04, 95% confidence interval, CI:1.83-2.28; RRR = 2.24, 1.99-2.52; RRR = 1.86, 1.59-2.18), sexual intercourse with four or more sex partners (RRR = 1.44, 1.15-1.79; RRR = 1.65, 1.33-2.06; RRR = 2.47, 1.94-3.16), first sexual intercourse aged 11-13 years (RRR = 1.22, 1.02-1.46; RRR = 1.51, 1.26-1.82; RRR = 2.26, 1.81-2.83), compared to adolescents who had no experience of SBs. Compared to adolescent girls who did neither experience food insecurity nor sexual intercourse, the overall burden of SBs (for at least one SB, for two SBs or for three SBs) were significantly higher among girls reporting to have experienced both food insecurity and sexual intercourse (RRR = 1.55, 1.29-1.86; RRR = 1.70, 1.42-2.04; RRR = 1.54, 1.26-1.88); and those reporting having experienced food insecurity but have never had sexual intercourse (RRR = 1.66, 1.48-1.87; RRR = 1.45, 1.26-1.67; RRR = 1.62, 1.36-1.92). However, it was significantly lower among girls reporting to have had sexual intercourse but never experienced food insecurity. This association was extended among adolescents in the context of regional and country income groups. CONCLUSION The high burden of suicidal behaviors among adolescents calls for an urgent policy interventions to address food insecurity as a means to keep adolescents in school. The interventions should also aim to integrate safeguards that dissuade youngsters from early sex and protect them from sexual victimisation, and the associated adverse outcomes that that hamstring the attainment of SDG 3.4.2.
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Abio A, Owusu PN, Posti JP, Bärnighausen T, Shaikh MA, Shankar V, Lowery Wilson M. Cross-national examination of adolescent suicidal behavior: a pooled and multi-level analysis of 193,484 students from 53 LMIC countries. Soc Psychiatry Psychiatr Epidemiol 2022; 57:1603-1613. [PMID: 35445842 PMCID: PMC9288956 DOI: 10.1007/s00127-022-02287-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 03/31/2022] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Suicide is a leading cause of adolescent mortality worldwide. We aimed to estimate the prevalence and identify individual-level and country-level factors which might explain the variability in suicidal behavior among students in 53 low to middle income countries. METHODS We used data on adolescents aged 12-16 years from the Global School-based Student Health Surveys from 2009-2016. The suicidal behaviors investigated included suicide ideation, suicidal planning and suicide attempt. The prevalence was estimated for 53 countries, while a multilevel logistic regression analysis (33 countries) was used to investigate the associations of these behaviors with individual and country-level contextual risk factors. The contextual variables included the Gini Coefficient, Gross Domestic Product per capita, pupil-to-teacher ratios, population density, homicide rates, law criminalizing suicide and the night light index. RESULTS The overall prevalence of suicide ideation, making a plan and suicide attempt were 10.4%, 10.3% and 11.0%, respectively. The highest prevalence rates reported were from the Americas. The strongest risk factors associated with suicidal behavior included anxiety, loneliness, no close friends and the substance abuse. Among the country level variables, the night light index was associated with making a suicide plan and attempting suicide. CONCLUSION The non-significant country level findings were not entirely surprising given the mixed results from prior studies. Additional knowledge is thus achieved with regard to country level factors associated with suicidal behavior across adolescent populations.
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Affiliation(s)
- Anne Abio
- Injury Epidemiology and Prevention (IEP) Research Group, Turku Brain Injury Centre, Turku University Hospital and University of Turku, Turku, Finland ,Heidelberg Institute of Global Health (HIGH), University of Heidelberg, Heidelberg, Heidelberg, Germany
| | - Priscilla N. Owusu
- Heidelberg Institute of Global Health (HIGH), University of Heidelberg, Heidelberg, Heidelberg, Germany
| | - Jussi P. Posti
- Department of Neurosurgery and Turku Brain Injury Center, Neurocenter, Turku University Hospital and University of Turku,
Turku, Finland
| | - Till Bärnighausen
- Heidelberg Institute of Global Health (HIGH), University of Heidelberg, Heidelberg, Heidelberg, Germany
| | - Masood Ali Shaikh
- Injury Epidemiology and Prevention (IEP) Research Group, Turku Brain Injury Centre, Turku University Hospital and University of Turku, Turku, Finland
| | - Viswanathan Shankar
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY USA
| | - Michael Lowery Wilson
- Heidelberg Institute of Global Health (HIGH), University of Heidelberg, Heidelberg, Heidelberg, Germany.
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Semenova N. Psychocorrection of adolescents with suicidal behavior with the CBT-SP method. Zh Nevrol Psikhiatr Im S S Korsakova 2022; 122:98-105. [DOI: 10.17116/jnevro202212203198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Renaud J, MacNeil SL, Vijayakumar L, Spodenkiewicz M, Daniels S, Brent DA, Turecki G. Suicidal ideation and behavior in youth in low- and middle-income countries: A brief review of risk factors and implications for prevention. Front Psychiatry 2022; 13:1044354. [PMID: 36561636 PMCID: PMC9763724 DOI: 10.3389/fpsyt.2022.1044354] [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: 09/14/2022] [Accepted: 11/07/2022] [Indexed: 12/12/2022] Open
Abstract
Although global rates of suicide have dropped in the last 30 years, youth in low- and middle-income countries (LMICs) continue to be highly represented in suicide statistics yet underrepresented in research. In this review we present the epidemiology of suicide, suicidal ideation, and suicide attempts among youth in LMICs. We also describe population-level (attitudes toward suicide, socioeconomic, and societal factors) and individual-level clinical and psychosocial risk factors, highlighting specific considerations pertaining to youth in LMICs. These specific considerations in risk factors within this population can inform how multi-level prevention strategies may be targeted to meet their specific needs. Prevention and intervention strategies relying on the stepped-care framework focusing on population-, community-, and individual level targets while considering locally- and culturally relevant practices are key in LMICs. In addition, systemic approaches favoring school-based and family-based interventions are important among youth. Cross-culturally adapted multimodal prevention strategies targeting the heterogeneity that exists in healthcare systems, suicide rates, and risk factors in these countries should be accorded a high priority to reduce the burden of suicide among youth in LMICs.
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Affiliation(s)
- Johanne Renaud
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montréal, QC, Canada.,Department of Psychiatry, Faculty of Medicine and Health Sciences, McGill University, Montréal, QC, Canada
| | | | | | - Michel Spodenkiewicz
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montréal, QC, Canada.,Department of Psychiatry, Faculty of Medicine and Health Sciences, McGill University, Montréal, QC, Canada.,Pôle de Santé Mentale, CIC-EC 1410, Université et CHU de La Réunion Sainte-Pierre, Saint-Pierre, France.,INSERM UMR-1178 Moods Team CESP Le Kremlin-Bicêtre France, Le Kremlin-Bicêtre, France
| | - Sylvanne Daniels
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montréal, QC, Canada.,Department of Psychiatry, Faculty of Medicine and Health Sciences, McGill University, Montréal, QC, Canada
| | - David A Brent
- Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, PA, United States
| | - Gustavo Turecki
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montréal, QC, Canada.,Department of Psychiatry, Faculty of Medicine and Health Sciences, McGill University, Montréal, QC, Canada
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Peltzer K, Pengpid S. Suicidal ideation, plans, and attempts: Prevalence and associated factors in school-going adolescents in Sierra Leone in 2017. JOURNAL OF PSYCHOLOGY IN AFRICA 2021. [DOI: 10.1080/14330237.2021.2001993] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Karl Peltzer
- Department of Psychology, University of the Free State, Bloemfontein, South Africa
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | - Supa Pengpid
- ASEAN Institute for Health Development, Mahidol University, Salaya, Phutthamonthon, Nakhon Pathom, Thailand
- Department of Research Administration and Development, University of Limpopo, Polokwane, South Africa
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Li L, Zhao Y, Shi M, Wang Y. Relationship Between the Early Initiation of Substance Use and Attempted Suicide Among in-School Adolescents in Seven Low- or Middle-Income African Countries: An Analysis of the Global School-Based Student Health Survey Data. Front Psychol 2021; 12:753824. [PMID: 34858282 PMCID: PMC8631758 DOI: 10.3389/fpsyg.2021.753824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 10/21/2021] [Indexed: 12/02/2022] Open
Abstract
Background: Preventing suicide among adolescents is an urgent global public-health challenge, especially in Africa. Accordingly, the aim of this study was to examine the relationship between the early initiation (< 12 years old) of substance use (cigarette smoking, alcohol use, and drug use) and attempted suicide among in-school adolescents in seven African countries. Methods: Data on the early initiation of substance use and on attempted suicide among in-school adolescents over the previous 12 months in Benin, Liberia, Mauritius, Mozambique, Namibia, Seychelles, and the United Republic of Tanzania were collected from Global School-based Student Health Surveys and were pooled to determine the overall prevalence of these behaviors in adolescents. Univariate and multivariate logistic regressions were then performed to evaluate country-specific associations between the early initiation of substance use and attempted suicide in these adolescents, followed by meta-analyses to evaluate overall pooled associations. Results: In the abovementioned seven African low- or middle-income countries (LMICs), overall weighted prevalences of attempted suicide and early initiation of cigarette smoking, alcohol use, and drug use among in-school adolescents were 16.05, 7.76, 17.68, and 3.48%, respectively. Multivariate logistic regression analyses revealed that relative to non-smoking, the early initiation of smoking was significantly associated with attempted suicide in these adolescents [OR (95% CI) = 1.783 (1.219–2.348)]. Additionally, the relationship between early initiation of cigarette smoking and attempted suicide is mostly driven by a higher association in girls [OR (95% CI) = 1.867 (1.031–2.703)] than boys [OR (95% CI) = 1.392 (0.995−1.789)]. Moreover, relative to not using other drugs, the early and later initiation of other drug use were also significantly associated with attempted suicide in these adolescents [ORs (95% CIs) = 2.455 (1.701–3.208) and 1.548 (1.198–1.898)]. Conclusion: Programs that can eliminate or decrease the early initiation of substance use among adolescents should be implemented in African LMICs to prevent subsequent suicide attempts, especially among adolescent girls.
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Affiliation(s)
- Lian Li
- Ningbo Kangning Hospital, Ningbo, China
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Oppong Asante K, Quarshie ENB, Onyeaka HK. Epidemiology of suicidal behaviours amongst school-going adolescents in post-conflict Sierra Leone. J Affect Disord 2021; 295:989-996. [PMID: 34706473 DOI: 10.1016/j.jad.2021.08.147] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 07/17/2021] [Accepted: 08/27/2021] [Indexed: 01/21/2023]
Abstract
BACKGROUND Children and young people living in post-conflict contexts are at an increased risk of suicidal behaviours (ideations and attempts). Not much is known about the extent of suicidal behaviours amongst adolescents in most notable post-conflict countries in sub-Saharan Africa, including Sierra Leone. METHODS We performed a secondary analysis of data from the 2017 Sierra Leone World Health Organisation Global School-based Student Health Survey conducted amongst students in secondary schools nationwide. We estimated the 12-month prevalence and performed bivariable and multivariable analyses to assess the correlates of suicidal behaviours. RESULTS Of the 2,798 analytic sample, 14.6% (males = 15.1%, females = 14.0%) reported suicidal ideation, and the 12-month prevalence estimate of suicide attempt was 19.6% (male = 20.9%, females =17.8%). The factors associated with suicidal behaviours were multi-layered. While no statistically significant gender association with suicide ideation or attempt was observed at the personal level, being aged 18 or older, loneliness, and health risk behaviours (cannabis use, and leisure time sedentary behaviour) were associated with increased odds of suicidal behaviours. Within the family context, parental monitoring was associated with increased odds of suicidal ideation, but parental supervision was associated with reduced odds of suicide ideation. LIMITATIONS The cross-sectional nature of the data did not support causal inferences. CONCLUSIONS Taken together, professional mental healthcare would be helpful in treating adolescent emotional problems (e.g., depression and loneliness) related to suicidal behaviours; but prevention and intervention programmes targeted at addressing adolescent health risk behaviours, and familial and interpersonal problems may yield more favourable outcomes.
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Affiliation(s)
- Kwaku Oppong Asante
- Department of Psychology, University of Ghana, Legon, Accra, Ghana; Department of Psychology, University of the Free State, Bloemfontein, South Africa
| | - Emmanuel Nii-Boye Quarshie
- School of Psychology, University of Leeds, Lifton Place, Leeds LS2 9JT, UK; Department of Psychology, University of Ghana, Legon, Accra, Ghana.
| | - Henry K Onyeaka
- Department of Psychiatry, Massachusetts General Hospital/Mclean Hospital, Boston, USA; Harvard Medical School, Boston, USA
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