Ismail Issam S, Hashemi Saeed S, Mehrabi Yadollah, Baiee Hasan A, Lami Faris H, Al Hasnawi Salih M
Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, IRN.
Mental Health Department, The Health General Directorate of Wasit Governorate, Ministry of Health, Wasit, IRQ.
Cureus. 2025 Sep 2;17(9):e91456. doi: 10.7759/cureus.91456. eCollection 2025 Sep.
Background Suicide represents a serious global public health challenge and a leading cause of mortality and morbidity in adolescents. This study aimed to investigate the occurrence and some determinants of suicidal ideation, planning, and attempts among school-going adolescents in the Wasit Governorate, Iraq. Methodology This was an updated, wide-scale cross-sectional study targeting public governmental middle- and high-school students aged 13 to 18 years. Schools and students were selected using a standardized two-stage cluster sampling design. A pretested Arabic Version of the Iraqi Global School-Based Student Health Survey questionnaire was used in addition to demographic and psychosocial variables, including parental socio-economic status and history of suicidal behaviors among family members and friends. All procedures were performed under ethical standards. The survey data analysis was performed using the primary sampling unit (PSU) and finite population correction (FPC) methods with a baseline univariate analysis and multivariate logistic regression to measure the associated factors. Results A total of 1810 students from 42 middle and high schools were included, with a mean age of 15.98 years. Boys formed 50.27% of the study population. The overall 12-month prevalence of suicidal ideation, planning, and attempts was 23.87% (95% CI: 19.65-28.67), 21.90% (95% CI: 18.04-26.32), and 22.37% (95% CI: 18.60-26.65), respectively. In the univariate analysis, suicidal behavior, and thoughts had significant associations with gender, social status, residency, parental conflict, and the presence of suicidal behavior history in family and friends. In the multivariate full-model analysis, the risk factors for suicide attempts were girls (adjusted odds ratio or AOR 1.64; 95% CI; 1.05-2.58), exposure to suicide attempts in family members (AOR 3.36, 95% CI: 1.60-7.06) and friends (AOR 1.99, 95% CI: 1.26-3.15). Suicidal ideation (AOR 11.81, 95% CI: 7.59-18.40) and planning (AOR 8.06, 95% CI: 4.30-15.10) were the most important associated risk factors for suicide attempts. Conclusion Suicidal ideation, planning, and attempts are alarmingly prevalent among school-going adolescents in Wasit, particularly among girls and those with a history of suicide attempts in friends and family members. Suicidal ideation and planning strongly relate to suicide attempts. Multi-level and collaborative efforts toward preventing the onset of ideation, planning, and attempts are crucial.
自杀是一项严峻的全球公共卫生挑战,也是青少年死亡和发病的主要原因。本研究旨在调查伊拉克瓦西特省在校青少年自杀意念、自杀计划和自杀未遂的发生情况及其一些决定因素。方法:这是一项更新的大规模横断面研究,针对13至18岁的公立政府初中和高中学生。学校和学生采用标准化的两阶段整群抽样设计进行选择。除人口统计学和社会心理变量外,还使用了经过预测试的伊拉克全球学校学生健康调查问卷阿拉伯语版本,这些变量包括父母的社会经济地位以及家庭成员和朋友的自杀行为史。所有程序均在伦理标准下进行。调查数据分析采用初级抽样单位(PSU)和有限总体校正(FPC)方法,并进行基线单变量分析和多变量逻辑回归以测量相关因素。结果:共纳入了来自42所初中和高中的1810名学生,平均年龄为15.98岁。男生占研究人群的50.27%。自杀意念、自杀计划和自杀未遂的总体12个月患病率分别为23.87%(95%置信区间:19.65 - 28.67)、21.90%(95%置信区间:18.04 - 26.32)和22.37%(95%置信区间:18.60 - 26.65)。在单变量分析中,自杀行为和想法与性别、社会地位、居住情况、父母冲突以及家庭成员和朋友的自杀行为史有显著关联。在多变量全模型分析中,自杀未遂的危险因素为女孩(调整后的优势比或AOR为1.64;95%置信区间:1.05 - 2.58)、家庭成员有自杀未遂经历(AOR为3.36,95%置信区间:1.60 - 7.06)和朋友有自杀未遂经历(AOR为1.99,95%置信区间:1.26 - 3.15)。自杀意念(AOR为11.81,95%置信区间:7.59 - 18.40)和自杀计划(AOR为8.06,95%置信区间:4.30 - 15.10)是自杀未遂最重要的相关危险因素。结论:自杀意念、自杀计划和自杀未遂在瓦西特的在校青少年中极为普遍,尤其是在女孩以及朋友和家庭成员有自杀未遂史的青少年中。自杀意念和自杀计划与自杀未遂密切相关。采取多层次和协作性的努力来预防意念、计划和未遂行为的发生至关重要。