Lai Wenjian, Wu Herui, Yang Liwen, Chen Ruiying, Huang Guoliang, Wang Wanxin, Lu Ciyong, Zhang Wei-Hong
Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-Sen University, 74 Zhongshan Rd 2, Guangzhou, 510080, China.
Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou, 510080, People's Republic of China.
Eur Child Adolesc Psychiatry. 2025 May 31. doi: 10.1007/s00787-025-02762-1.
Mental health among adolescents is a critical public health concern. This study aimed to investigate trends in suicidal ideation, suicide attempts, and sleep disturbances among Chinese high school students from 2014 to 2023, encompassing the COVID-19 pandemic period. Data were drawn from five waves (2014, 2016, 2018, 2021, 2023) of the School-based Chinese Adolescents Health Survey (SCAHS) in Guangdong province. A total of 110,193 high school students in grades 7-12 were included in the analysis. The weighted prevalence and its trends of suicidal ideation, suicide attempt, and sleep disturbance was analyzed. From 2014 to 2018, the weighted prevalence of suicidal ideation increased from 16.3% to 18.0%, suicide attempt increased from 2.8% to 3.7%, and sleep disturbances increased from 28.0% to 29.1%. These trends peaks in 2021 (18.5%, 4.2%, and 31.5% for suicidal ideation, suicide attempt and sleep disturbance, respectively). By 2023, all prevalence showed significant decreases from their peaks: suicidal ideation, suicide attempt and sleep disturbance declined to 17.4%, 3.4%, and 27.7, respectively. Students aged 11-14 years and girls consistently showed higher prevalence in suicidal behaviors throughout study period. This study reveals fluctuating trends in suicidal behaviors and sleep disturbance among high school students over a decade in China, with pronounced effects during the COVID-19 pandemic. While recent declines are encouraging, the persistent burden, particularly among girls and students aged 11-14 years, underscores the urgent need for targeted mental health interventions for these high-risk groups, as well as continued surveillance to inform public health policy and practice.
青少年心理健康是一个至关重要的公共卫生问题。本研究旨在调查2014年至2023年期间中国高中生自杀意念、自杀未遂和睡眠障碍的趋势，其中涵盖了新冠疫情时期。数据来自广东省基于学校的中国青少年健康调查（SCAHS）的五轮调查（2014年、2016年、2018年、2021年、2023年）。分析共纳入了110193名7至12年级的高中生。对自杀意念、自杀未遂和睡眠障碍的加权患病率及其趋势进行了分析。2014年至2018年，自杀意念的加权患病率从16.3%升至18.0%，自杀未遂从2.8%升至3.7%，睡眠障碍从28.0%升至29.1%。这些趋势在2021年达到峰值（自杀意念、自杀未遂和睡眠障碍分别为18.5%、4.2%和31.5%）。到2023年，所有患病率均较峰值显著下降：自杀意念、自杀未遂和睡眠障碍分别降至17.4%、3.4%和27.7%。在整个研究期间，11至14岁的学生和女生的自杀行为患病率始终较高。本研究揭示了中国高中生在十年间自杀行为和睡眠障碍的波动趋势，在新冠疫情期间影响显著。虽然近期的下降趋势令人鼓舞，但持续存在的负担，尤其是在女孩和11至14岁学生中，凸显了针对这些高危群体进行有针对性的心理健康干预的迫切需求，以及持续监测以指导公共卫生政策和实践的必要性。
