Department of Psychology, University of Ghana, Legon, Accra, Ghana; Department of Psychology, University of the Free State, Bloemfontein, South Africa.
School of Psychology, University of Leeds, Lifton Place, Leeds LS2 9JT, UK; Department of Psychology, University of Ghana, Legon, Accra, Ghana.
J Affect Disord. 2021 Dec 1;295:989-996. doi: 10.1016/j.jad.2021.08.147. Epub 2021 Sep 3.
Children and young people living in post-conflict contexts are at an increased risk of suicidal behaviours (ideations and attempts). Not much is known about the extent of suicidal behaviours amongst adolescents in most notable post-conflict countries in sub-Saharan Africa, including Sierra Leone.
We performed a secondary analysis of data from the 2017 Sierra Leone World Health Organisation Global School-based Student Health Survey conducted amongst students in secondary schools nationwide. We estimated the 12-month prevalence and performed bivariable and multivariable analyses to assess the correlates of suicidal behaviours.
Of the 2,798 analytic sample, 14.6% (males = 15.1%, females = 14.0%) reported suicidal ideation, and the 12-month prevalence estimate of suicide attempt was 19.6% (male = 20.9%, females =17.8%). The factors associated with suicidal behaviours were multi-layered. While no statistically significant gender association with suicide ideation or attempt was observed at the personal level, being aged 18 or older, loneliness, and health risk behaviours (cannabis use, and leisure time sedentary behaviour) were associated with increased odds of suicidal behaviours. Within the family context, parental monitoring was associated with increased odds of suicidal ideation, but parental supervision was associated with reduced odds of suicide ideation.
The cross-sectional nature of the data did not support causal inferences.
Taken together, professional mental healthcare would be helpful in treating adolescent emotional problems (e.g., depression and loneliness) related to suicidal behaviours; but prevention and intervention programmes targeted at addressing adolescent health risk behaviours, and familial and interpersonal problems may yield more favourable outcomes.
生活在冲突后环境中的儿童和年轻人自杀行为（意念和尝试）的风险增加。在撒哈拉以南非洲大多数著名的冲突后国家，包括塞拉利昂，青少年自杀行为的程度知之甚少。
我们对全国中学 2017 年世界卫生组织全球学校学生健康调查的数据进行了二次分析。我们估计了 12 个月的患病率，并进行了双变量和多变量分析，以评估自杀行为的相关性。
在 2798 名分析样本中，14.6%（男生 15.1%，女生 14.0%）报告有自杀意念，自杀企图的 12 个月患病率估计为 19.6%（男生 20.9%，女生 17.8%）。与自杀行为相关的因素是多层次的。虽然在个人层面上，自杀意念或自杀企图与性别之间没有统计学上的显著关联，但 18 岁或以上、孤独和健康风险行为（大麻使用和闲暇时间久坐行为）与自杀行为的可能性增加有关。在家庭环境中，父母监督与增加自杀意念的可能性有关，但父母监督与减少自杀意念的可能性有关。
数据的横断面性质不支持因果推论。
综上所述，专业的心理健康护理有助于治疗与自杀行为相关的青少年情绪问题（如抑郁和孤独）；但预防和干预方案针对解决青少年健康风险行为以及家庭和人际问题可能会产生更有利的结果。
