Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
J Adolesc Health. 2023 Sep;73(3):494-502. doi: 10.1016/j.jadohealth.2023.04.017. Epub 2023 Jun 15.
Globally, suicide is a leading cause of death among adolescents, with the highest burden of suicide occurring in Africa. Despite this, little is known about the epidemiology of suicide among adolescents in West Africa. In this study, we explore suicidality among West African adolescents.
Using pooled data from the Global School-Based Student Health Survey in four West African countries (Ghana, Benin, Liberia, and Sierra Leone), we investigated the prevalence of suicidal ideation and suicide attempt and examined associations with 15 covariates using univariate and multivariable logistic regression.
Overall, 18.6% of adolescents in the pooled sample (N = 9,726) had considered suicide, while 24.7% reported attempting suicide. Significant correlates of suicide attempt included older age (16+ years; odds ratio [OR]: 1.70, confidence interval [CI]: 1.09-2.63), difficulty sleeping due to worry (OR: 1.27, CI: 1.04-1.56), loneliness (OR: 1.65, CI: 1.39-1.96), truancy (OR: 1.38. CI: 1.05-1.82), being a target of bullying (OR: 1.53, CI: 1.26-1.85), getting physically attacked (OR: 1.73, CI: 1.42-2.11), physical fighting (OR: 1.47, CI: 1.21-1.79), current cigarette use (OR: 2.71, CI: 1.88-3.89), and initiation of drug use (OR: 2.19, CI: 1.71-2.81). Conversely, having close friends was associated with lower odds of suicide attempt (OR: 0.67, CI: 0.48-0.93). Several covariates were also significantly associated with suicidal ideation.
Suicidal ideation and attempts are highly prevalent among school-going adolescents in these West African countries. Multiple modifiable risk and protective factors were identified. Programs, interventions, and policies aimed at addressing these factors may play a significant role in preventing suicides in these countries.
自杀是全球青少年死亡的主要原因之一,自杀负担最高的地区在非洲。尽管如此,人们对西非青少年自杀的流行病学知之甚少。在这项研究中,我们探讨了西非青少年的自杀意念和自杀企图。
我们利用来自四个西非国家(加纳、贝宁、利比里亚和塞拉利昂)的全球学校学生健康调查的汇总数据,使用单变量和多变量逻辑回归调查了自杀意念和自杀企图的发生率,并研究了 15 个协变量的关联。
在汇总样本(N=9726)中,18.6%的青少年有过自杀念头,24.7%的青少年报告曾企图自杀。自杀企图的显著相关因素包括年龄较大(16 岁及以上;优势比 [OR]:1.70,置信区间 [CI]:1.09-2.63)、因担忧而难以入睡(OR:1.27,CI:1.04-1.56)、孤独(OR:1.65,CI:1.39-1.96)、逃学(OR:1.38,CI:1.05-1.82)、成为欺凌目标(OR:1.53,CI:1.26-1.85)、遭受身体攻击(OR:1.73,CI:1.42-2.11)、身体打斗(OR:1.47,CI:1.21-1.79)、当前吸烟(OR:2.71,CI:1.88-3.89)和开始使用毒品(OR:2.19,CI:1.71-2.81)。相反,有亲密朋友与自杀企图的可能性降低相关(OR:0.67,CI:0.48-0.93)。一些协变量也与自杀意念显著相关。
在这些西非国家,在校青少年有很高的自杀意念和企图发生率。确定了多个可改变的风险和保护因素。旨在解决这些因素的方案、干预措施和政策可能在预防这些国家的自杀方面发挥重要作用。