Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Barcelona, Spain.
Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Barcelona, Spain.
J Affect Disord. 2020 Apr 1;266:311-318. doi: 10.1016/j.jad.2020.01.147. Epub 2020 Jan 27.
Adolescent suicide is a global public health concern. Given that physical activity has a positive effect in the prevention and treatment of common psychiatric disorders, it may also protect against suicides. However, global data examining associations between physical activity and suicide attempts among adolescents are lacking, and sex-specific associations remain poorly understood. Thus, we assessed the association between physical activity and suicide attempts among adolescents aged 12-15 year from 48 countries.
Cross-sectional data from the Global School-based Student Health Survey, which included 136,857 adolescents [mean age (SD) 13.8 (1.0) years; 48.9% girls] were analyzed. Suicide attempt was defined as at least one suicide attempt in the past 12 months. Physical activity was assessed by the PACE+ Adolescent Physical Activity Measure and participants were dichotomized into those who do and do not comply with the World Health Organization physical activity recommendations (60 min of moderate-to-vigorous intensity physical activity daily). Multivariable logistic regression analysis and meta-analysis were conducted to assess the associations.
Meeting physical activity guidelines was associated with lower odds for suicide attempts in boys (OR=0.78; 95%CI=0.70-0.86), but higher odds for suicide attempts in girls (OR=1.22; 95%CI=1.10-1.35). The associations for boys and girls were relatively consistent across countries.
Causality or temporal associations cannot be established due to the cross-sectional nature of the study.
Engagement in physical activity may be an effective strategy for prevention of suicide attempts for boys but not for girls. Future studies should investigate the factors that lead to this sex difference.
青少年自杀是全球公共卫生关注的一个问题。鉴于体力活动对预防和治疗常见精神障碍有积极作用，它也可能预防自杀。然而，目前缺乏全球数据来检验体力活动与青少年自杀企图之间的关系，且性别特异性关联仍知之甚少。因此，我们评估了来自 48 个国家的 12-15 岁青少年中体力活动与自杀企图之间的关联。
我们分析了全球学校学生健康调查的横断面数据，该调查包括 136857 名青少年[平均年龄（SD）13.8（1.0）岁；48.9%为女孩]。自杀企图被定义为过去 12 个月中至少有一次自杀企图。体力活动通过 PACE+青少年体力活动测量进行评估，参与者被分为符合和不符合世界卫生组织体力活动建议（每天进行 60 分钟中等至剧烈强度体力活动）的两类。采用多变量逻辑回归分析和荟萃分析来评估关联。
符合体力活动指南与男孩自杀企图的可能性降低相关（OR=0.78；95%CI=0.70-0.86），但与女孩自杀企图的可能性增加相关（OR=1.22；95%CI=1.10-1.35）。男孩和女孩的关联在各国之间相对一致。
由于研究的横断面性质，无法确定因果关系或时间关联。
对于男孩来说，参与体力活动可能是预防自杀企图的有效策略，但对于女孩则不然。未来的研究应调查导致这种性别差异的因素。
