Cross-national examination of adolescent suicidal behavior: a pooled and multi-level analysis of 193,484 students from 53 LMIC countries

Author:

Abio Anne,Owusu Priscilla N.,Posti Jussi P.,Bärnighausen Till,Shaikh Masood Ali,Shankar Viswanathan,Lowery Wilson Michael

Abstract

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.

Funder

Ruprecht-Karls-Universität Heidelberg

Publisher

Springer Science and Business Media LLC

Subject

Psychiatry and Mental health,Social Psychology,Health (social science),Epidemiology

Reference49 articles.

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3. Ncds | global school-based student health survey (gshs) (2018). https://www.who.int/ncds/surveillance/gshs/en/

4. Bando DH, Brunoni AR, Benseñor IM, Lotufo PA (2012) Suicide rates and income in são paulo and brazil: a temporal and spatial epidemiologic analysis from 1996 to 2008. BMC Psychiatry. https://doi.org/10.1186/1471-244x-12-127

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