Suicidal behaviours among Chinese adolescents exposed to suicide attempt or death

Abstract

Aims Suicidal behaviours in adolescents are prevalent and multifactorial. This study was conducted to examine the associations between exposure to suicide attempt (ESA) or suicide death (ESD) and suicidal behaviours in a large sample of Chinese adolescents. Methods Participants included for the analysis were 11 831 adolescent students who participated in the baseline survey of the Shandong Adolescent Behavior and Health Cohort (SABHC). Participants were sampled from five middle and three high schools in three counties of Shandong province, China. A self-administered structured questionnaire was used to collect data on demographics, behavioural and emotional problems, family environment, suicidal behaviours (suicidal thought, plan and attempt), and history of ESA or death of a family member, relative, friend or close acquaintance. Based on the sources of exposure, the participants were divided into four groups: non-exposure, exposure from relatives only, exposure from friends/close acquaintances only (EFO) and exposure from both relatives and friends (ERF). Logistic regressions were used to examine the associations between ESA or ESD and suicidal behaviours. Results Mean age of the participants was 14.97 ± 1.46 years and 50.9% were boys. Of the participants, 9.4% reported having ESA, and 6.6% reported having ESD. The prevalence rates of suicidal behaviours were significantly higher in adolescents who had been exposed to suicide attempt or death than those who had not. Multivariate logistic regressions showed that ESA and ESD were both significantly associated with increased risks of suicidal thought (ESA: OR = 1.96, 95% CI = 1.66–2.31; ESD: OR = 1.59, 95% CI = 1.31–1.94), plan (ESA: OR = 2.37, 95% CI = 1.84–3.05; ESD: OR = 1.62, 95% CI = 1.18–2.23) and attempt (ESA: OR = 2.73, 95% CI = 1.92–3.89; ESD: OR = 1.82, 95% CI = 1.18–2.82), respectively. When participants were exposed to suicide attempt, ERF and EFO groups had significantly higher risks of suicidal thought (ERF: OR = 2.61, 95% CI = 1.28–1.64; EFO: OR = 1.96, 95% CI = 1.64–2.36), plan (ERF: OR = 3.72, 95% CI = 2.04–6.78; EFO: OR = 2.31, 95% CI = 1.74–3.01) and attempt (ERF: OR = 4.83, 95% CI = 2.30–10.17; EFO: OR = 2.57, 95% CI = 1.73–3.81), respectively. Conclusions ESA or ESD was associated with increased risks of suicidal behaviours in adolescents. Exposure to suicidal behaviours of relatives and friends/close acquaintances appeared to have different influence on adolescent suicidal behaviours. Further research is warranted to examine the biological and psychosocial mechanisms between suicidal exposure and subsequent suicidal behaviours in adolescents.

Suicide Attempts among School-Attending Adolescents in Mongolia: Associated Factors and Gender Differences

“…In this study, the prevalence of suicide attempts during the previous 12 months was 32.1% (33.3% for the males and 31.3% for the females), which was much higher than in previous studies based on the Mongolian GSHS of 2010 (8.7%) [ 10 ] and 2013 (10%) [ 11 ]. In addition, this result was also higher than the 12-month prevalence of suicide attempts in China (9.4%) [ 30 ], the Philippines (15.34%) [ 31 ], Vietnam (21.2%) [ 32 ], or Thailand (13.3%) [ 33 ], but lower than in the Solomon Islands (36.9%) [ 34 ].…”

Worldwide prevalence of suicidal ideation and suicide plan among people with schizophrenia: a meta-analysis and systematic review of epidemiological surveys

“…Suicide is a critical global health challenge [ 5 ]. Suicidal behavior exists on a continuum, ranging from repeated thoughts of killing oneself (i.e., suicidal ideation, SI), making a plan for suicide (i.e., suicide plan, SP), suicide attempts (SA) to completed suicide [ 6 , 7 ]. SI, SP, and SA are the strong predictors of completed suicide [ 7 – 12 ].…”

“…Suicidal behavior exists on a continuum, ranging from repeated thoughts of killing oneself (i.e., suicidal ideation, SI), making a plan for suicide (i.e., suicide plan, SP), suicide attempts (SA) to completed suicide [ 6 , 7 ]. SI, SP, and SA are the strong predictors of completed suicide [ 7 – 12 ]. SI, SP, and SA are also common in people living with schizophrenia, but the epidemiological findings in this population are mixed [ 13 , 14 ].…”

Associations of bullying victimisation in different frequencies and types with suicidal behaviours among school-going adolescents in low- and middle-income countries

“…Suicidal behaviours are complex phenomena that are rooted in nonlinear interactions with multiple risk indicators (Goldman-Mellor et al ., 2014 ; Twenge et al ., 2018 ; Liu et al ., 2020 ). Rates of nonfatal suicidal behaviours differ across adolescents.…”