90 个国家青少年的自杀行为：全球基于学校的学生健康调查的 pooled 分析。
Suicidal behaviours among adolescents from 90 countries: a pooled analysis of the global school-based student health survey.
机构信息
Centre for Global Child Health, Hospital for Sick Children, 686 Bay Street, 11th Floor, Suite 11.9805, Toronto, ON, M5G 0A4, Canada.
Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Medical Sciences Building, 1 King's Circle College, Toronto, Ontario, M5S 1A8, Canada.
出版信息
BMC Public Health. 2020 Aug 10;20(1):1102. doi: 10.1186/s12889-020-09209-z.
BACKGROUND
Understanding the burden and determinants of suicide during adolescence is key to achieving global health goals. We examined the prevalence and determinants of self-reported suicidal ideation and attempts among younger (13-15 years) and older adolescents (16-17 years).
METHODS
Pooled prevalence estimates with 95% confidence interval, were calculated for suicide ideation and attempts for 118 surveys from 90 countries that administered the Global School-based Student Health Survey (GSHS) to adolescents (13-17 years of age) from 2003 to 2017. Indicators (including individual and social factors) associated with suicidal ideation and attempts were determined from multivariable linear regressions on key outcomes.
RESULTS
The prevalence of suicidal ideation representing 397,299 adolescents (51.3% female) was significantly higher among girls than boys whereas attempts did not differ by age or sex. Being bullied, or having no close friends was associated with suicidal ideation among girls 13-15 years and 16-17 years, respectively. Among all boys, being in a fight and having no close friends was associated with suicidal ideation with the addition of serious injury for boys 13-15 years. Common to all younger adolescents was an association of suicide attempt with being bullied and having had a serious injury. Among young boys, having no close friends was an additional indicator for suicide attempt. Having no close friends was associated with suicide attempt in older adolescents with the addition to being bullied in older girls and serious injury in older boys.
CONCLUSIONS
Building positive social relationships with peers and avoiding serious injury appear key to suicide prevention strategies for vulnerable adolescents. Targeted programs by age group and sex for such indicators could improve mental health during adolescence in low and middle-income countries, given the diverse risk profiles for suicidal ideation and attempts.
背景
了解青少年时期自杀的负担和决定因素是实现全球健康目标的关键。我们研究了较年轻（13-15 岁）和较年长（16-17 岁）青少年中自我报告的自杀意念和自杀未遂的流行率及其决定因素。
方法
我们对 2003 年至 2017 年期间，在 90 个国家中，对 118 项调查进行了汇总，这些调查使用全球学校学生健康调查（GSHS）对 13-17 岁的青少年进行了调查，计算了自杀意念和自杀未遂的流行率估计值及其 95%置信区间。从关键结果的多变量线性回归中确定了与自杀意念和自杀未遂相关的指标（包括个人和社会因素）。
结果
自杀意念的流行率代表了 397,299 名青少年（51.3%为女性），女性明显高于男性，而自杀未遂的发生率则与年龄或性别无关。在 13-15 岁和 16-17 岁的女孩中，被欺负或没有亲密朋友与自杀意念有关，而在所有男孩中，打架和没有亲密朋友与自杀意念有关，对于 13-15 岁的男孩，加上严重受伤则与自杀意念有关。所有较年轻的青少年都存在自杀未遂与被欺负和严重受伤有关的情况。在年轻男孩中，没有亲密朋友是自杀未遂的另一个指标。在年长的青少年中，没有亲密朋友与自杀未遂有关，在年长的女孩中，被欺负和年长的男孩中严重受伤也是如此。
结论
与同龄人建立积极的社会关系并避免严重受伤似乎是预防脆弱青少年自杀的关键策略。针对这些指标按年龄组和性别制定的针对性计划，可以改善中低收入国家青少年的心理健康，因为自杀意念和自杀未遂的风险概况各不相同。
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