Guo Lan, Wang Wanxin, Du Xueying, Guo Yangfeng, Li Wenyan, Zhao Meijun, Wu Ruipeng, Lu Ciyong
Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.
Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, China.
Front Psychiatry. 2021 Jan 18;11:611579. doi: 10.3389/fpsyt.2020.611579. eCollection 2020.
Adolescence has been described as a period of increased health risk-taking behaviors. Given the variety of cultural contexts, healthcare systems, and public health policies in different regions, the present study aimed to determine whether there are similar or different associations of substance use behaviors with suicidal ideation and suicide attempts among US and Chinese adolescents. This study included a total of 14,765 US adolescents from the 2017 National Youth Risk Behavior Surveillance System (YRBSS) and 24,345 Chinese adolescents from the 2017 School-based Chinese Adolescents Health Survey (SCAHS). The proportions of suicidal ideation and suicide attempts were 17.4 and 5.7% among US adolescents, which were higher than those among Chinese adolescents (suicidal ideation: 13.7% and suicide attempts: 2.7%). Among Chinese adolescents, the most common substance use behavior was "alcohol use (55.4%)," followed by "cigarette use (11.6%)." Among US adolescents, the most popular substance was alcohol (ever used: 55.9%), followed by marijuana (ever used: 34.6%). Moreover, alcohol use was significantly related to suicidal ideation/suicide attempts only in Chinese adolescents [suicidal ideation: Adjusted odds ratio (AOR) = 1.88, 95% CI = 1.712.06; suicide attempts: AOR = 2.12, 95% CI = 1.712.63], and marijuana use was associated with suicidal ideation and suicide attempts only in the US adolescent group (suicidal ideation: AOR = 1.23, 95% CI = 1.061.44; suicide attempts: AOR = 1.51, 95% CI = 1.211.87). Moreover, although the associations of prescription pain medication use with suicide attempts were significant in both Chinese and US adolescent groups, the adjusted associations were stronger in Chinese adolescents than in US adolescents (Chinese adolescents: AOR = 3.97, 95% CI = 2.765.72; US adolescents: AOR = 1.76, 95% CI = 1.432.16; < 0.05). The associations of alcohol use with suicidal ideation and suicide attempts were only significant in Chinese adolescents. Marijuana use was associated with suicidal ideation and suicide attempts only in the US adolescent group. Although the associations of prescription pain medication use with suicide attempts were significant in both Chinese and US adolescent groups, the adjusted associations were significantly stronger for Chinese adolescents. These findings might be related to the differences in cultural contexts, healthcare systems, and public health policies in the two different countries.
青春期被描述为健康风险行为增加的时期。鉴于不同地区文化背景、医疗保健系统和公共卫生政策的多样性，本研究旨在确定美国和中国青少年中物质使用行为与自杀意念及自杀未遂之间是否存在相似或不同的关联。本研究共纳入了来自2017年美国国家青少年风险行为监测系统（YRBSS）的14765名美国青少年以及来自2017年中国青少年学校健康状况调查（SCAHS）的24345名中国青少年。美国青少年中有自杀意念和自杀未遂的比例分别为17.4%和5.7%，高于中国青少年（自杀意念：13.7%，自杀未遂：2.7%）。在中国青少年中，最常见的物质使用行为是“饮酒（55.4%）”，其次是“吸烟（11.6%）”。在美国青少年中，最常见的物质是酒精（曾经使用过：55.9%），其次是大麻（曾经使用过：34.6%）。此外，仅在中国青少年中，饮酒与自杀意念/自杀未遂显著相关[自杀意念：调整后的优势比（AOR）=1.88，95%置信区间（CI）=1.712.06；自杀未遂：AOR=2.12，95%CI=1.712.63]，而仅在美国青少年组中，大麻使用与自杀意念和自杀未遂相关（自杀意念：AOR=1.23，95%CI=1.061.44；自杀未遂：AOR=1.51，95%CI=1.211.87）。此外，虽然在中国和美国青少年组中，使用处方止痛药与自杀未遂之间的关联均显著，但中国青少年的调整后关联比美国青少年更强（中国青少年：AOR=3.97，95%CI=2.765.72；美国青少年：AOR=1.76，95%CI=1.432.16；P<0.05）。饮酒与自杀意念和自杀未遂的关联仅在中国青少年中显著。大麻使用仅在美国青少年组中与自杀意念和自杀未遂相关。虽然使用处方止痛药与自杀未遂之间的关联在中国和美国青少年组中均显著，但中国青少年的调整后关联显著更强。这些发现可能与两个不同国家的文化背景、医疗保健系统和公共卫生政策的差异有关。
