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The risk and protective factors for suicidal burden among 251 763 school-based adolescents in 77 low- and middle-income to high-income countries: assessing global, regional and national variations

Published online by Cambridge University Press:  16 July 2021

Rashidul Alam Mahumud Open the ORCID record for Rashidul Alam Mahumud [Opens in a new window] ,
Angela J. Dawson Open the ORCID record for Angela J. Dawson [Opens in a new window] ,
Wen Chen ,
Tuhin Biswas ,
Syed Afroz Keramat ,
Rachael Lisa Morton  and
Andre M.N. Renzaho Open the ORCID record for Andre M.N. Renzaho [Opens in a new window]
Rashidul Alam Mahumud*
Affiliation:
NHMRC Clinical Trials Centre, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW-2006, Australia School of Social Sciences, Western Sydney University, Penrith 2751, Australia Centre for Health Research, University of Southern Queensland, Toowoomba, QLD-4350, Australia
Angela J. Dawson
Affiliation:
Faculty of Health, Australian Centre for Public and Population Health Research, University of Technology Sydney, Ultimo, NSW 2007, Australia
Wen Chen
Affiliation:
Faculty of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China Center for Migrant Health Policy, Sun Yat-sen University, Guangzhou, China
Tuhin Biswas
Affiliation:
Institute for Social Science Research, The University of Queensland, 80 Meiers Road, Indooroopilly, QLD 4068, Australia
Syed Afroz Keramat
Affiliation:
Economics Discipline, Khulna University, Khulna-9208, Bangladesh
Rachael Lisa Morton
Affiliation:
NHMRC Clinical Trials Centre, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW-2006, Australia
Andre M.N. Renzaho
Affiliation:
Translational Health Research Institute, School of Medicine, Western Sydney University, Campbelltown, Australia Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne 3004, Australia
*
Author for correspondence: Rashidul Alam Mahumud, E-mail: rashid.mahumud@ctc.usyd.edu.au; md.mahumud@sydney.edu.au
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Abstract

Background

Adolescent suicide is a global public health concern and the second leading cause of adolescent death worldwide. This study aimed to estimate the burden of adolescent suicidal behaviours and its association with violence and unintentional injury, psychosocial, protective, lifestyle and food security-related factors amongst school-based adolescents across 77 countries in the six World Health Organization (WHO) regions.

Methods

This study comprised a sample of 251 763 adolescents drawn from the latest Global School-based Student Health Survey of school-based adolescents, aged 11–17 years, across 77 countries. Logistic regression analyses were employed to estimate the adjusted effect of independent factors on adolescent suicidal behaviours.

Results

The population-weighted 12-month prevalence of suicidal ideation (SI), suicidal planning (SP) and suicidal attempts (SA) amongst school-based adolescents was 18, 18 and 16%, respectively. Adolescent suicidal behaviours (i.e. SI, SP and SA) were respectively associated with being physically attacked, physical fighting, high levels of anxiety, feeling lonely, being bullied, lack of parental support, poor peer support, not having close friends and high levels of sedentary behaviours. Overall, these associations also extended to the context of food insecurity across regions and country income groups, where the magnitude of association slightly varied from odds ratios of 1.25 times to 3.13.

Conclusions

The burden of school-going adolescent suicidal thoughts, suicide planning and suicide attempts is of particular concern in low-resource countries. Comprehensive suicide prevention programmes for school-going adolescents in LMICs are needed that address socio-cultural inequities related to violence and unintentional injury, social support and psychological factors, protective, and lifestyle-related factors.

Keywords

Adolescents' suicidal behavioursbullying victimisationparental and peer supportspsychological factorssedentary behavioursviolence and unintentional injury
Type
Original Article
Information
Psychological Medicine , Volume 52 , Issue 2 , January 2022 , pp. 379 - 397
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Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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Footnotes

‡

The online version of this article has been updated since original publication. A notice detailing the changes has also been published at: https://doi.org/10.1017/S0033291721003858.

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