The risk and protective factors for suicidal burden among 251 763 school-based adolescents in 77 low- and middle-income to high-income countries: Assessing global, regional and national variations

Article

Mahumud, Rashidul Alam, Dawson, Angela J., Chen, Wen, Biswas, Tuhin, Keramat, Syed Afroz, Morton, Rachael Lisa and Renzaho, Andre M.N.. 2022. "The risk and protective factors for suicidal burden among 251 763 school-based adolescents in 77 low- and middle-income to high-income countries: Assessing global, regional and national variations." Psychological Medicine. 52 (2), pp. 379-397. https://doi.org/10.1017/S0033291721002774
Article Title

The risk and protective factors for suicidal burden among 251 763 school-based adolescents in 77 low- and middle-income to high-income countries: Assessing global, regional and national variations

ERA Journal ID6592
Article CategoryArticle
AuthorsMahumud, Rashidul Alam, Dawson, Angela J., Chen, Wen, Biswas, Tuhin, Keramat, Syed Afroz, Morton, Rachael Lisa and Renzaho, Andre M.N.
Journal TitlePsychological Medicine
Journal Citation52 (2), pp. 379-397
Number of Pages19
Year2022
PublisherCambridge University Press
Place of PublicationUnited Kingdom
ISSN0033-2917
1469-8978
Digital Object Identifier (DOI)https://doi.org/10.1017/S0033291721002774
Web Address (URL)https://www.cambridge.org/core/journals/psychological-medicine/article/abs/risk-and-protective-factors-for-suicidal-burden-among-251-763-schoolbased-adolescents-in-77-low-and-middleincome-to-highincome-countries-assessing-global-regional-and-national-variations/28433C25104FD2B5FB2B2BC449FEFF64
Abstract

Background
Adolescent suicide is a global public health concern and the second leading cause of adolescent death worldwide. This study aimed to estimate the burden of adolescent suicidal behaviours and its association with violence and unintentional injury, psychosocial, protective, lifestyle and food security-related factors amongst school-based adolescents across 77 countries in the six World Health Organization (WHO) regions.

Methods
This study comprised a sample of 251 763 adolescents drawn from the latest Global School-based Student Health Survey of school-based adolescents, aged 11–17 years, across 77 countries. Logistic regression analyses were employed to estimate the adjusted effect of independent factors on adolescent suicidal behaviours.

Results
The population-weighted 12-month prevalence of suicidal ideation (SI), suicidal planning (SP) and suicidal attempts (SA) amongst school-based adolescents was 18, 18 and 16%, respectively. Adolescent suicidal behaviours (i.e. SI, SP and SA) were respectively associated with being physically attacked, physical fighting, high levels of anxiety, feeling lonely, being bullied, lack of parental support, poor peer support, not having close friends and high levels of sedentary behaviours. Overall, these associations also extended to the context of food insecurity across regions and country income groups, where the magnitude of association slightly varied from odds ratios of 1.25 times to 3.13.

Conclusions
The burden of school-going adolescent suicidal thoughts, suicide planning and suicide attempts is of particular concern in low-resource countries. Comprehensive suicide prevention programmes for school-going adolescents in LMICs are needed that address socio-cultural inequities related to violence and unintentional injury, social support and psychological factors, protective, and lifestyle-related factors.

KeywordsAdolescents' suicidal behaviours; bullying victimisation; parental and peer supports; psychological factors; sedentary behaviours; violence and unintentional injury
Related Output
Is supplemented byThe risk and protective factors for suicidal burden among 251,763 school-based adolescents in 77 low- and middle-income to high-income countries: assessing global, regional, and national variations – Corrigendum
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This article has been corrected. Please see the Related Output.

Byline AffiliationsUniversity of Sydney
Western Sydney University
Centre for Health Research
University of Technology Sydney
Sun Yat-sen University, China
University of Queensland
Khulna University, Bangladesh
Burnet Institute, Australia
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Mahumud, Rashidul Alam, Ali, Mohammad Afshar, Kundu, Satyajit, Rahman, Md Ashfikur, Kamara, Joseph Kihika and Renzaho, Andre M. N.. 2022. "Effectiveness of COVID-19 Vaccines against Delta Variant (B.1.617.2): A Meta-Analysis ." Vaccines. 10 (2). https://doi.org/10.3390/vaccines10020277
Job satisfaction dynamics: how do they impact employment mode choice for people with a disability?
Keating, Byron W., Keramat, Syed Afroz, Wallace, Iain and Hashmi, Rubayyat. 2022. "Job satisfaction dynamics: how do they impact employment mode choice for people with a disability? " Heliyon. 8 (10), pp. 1-9. https://doi.org/10.1016/j.heliyon.2022.e11076
Disability, physical activity, and health-related quality of life in Australian adults: An investigation using 19 waves of a longitudinal cohort
Keramat, Syed Afroz, Ahammed, Benojir, Mohammed, Aliu, Seidu, Abdul-Aziz, Farjana, Fariha, Hashmi, Rubayyat, Ahmad, Kabir, Haque, Rezwanul, Ahmed, Sazia, Ali, Mohammad Afshar and Ahinkorah, Bright Opoku. 2022. "Disability, physical activity, and health-related quality of life in Australian adults: An investigation using 19 waves of a longitudinal cohort ." PLoS One. 17 (5 May), pp. 1-17. https://doi.org/10.1371/journal.pone.0268304
Corrigendum: Effectiveness of Psychological Interventions on Young Refugees' Social Adjustment: A Meta-analysis
Ahmadi Forooshani, Sayedhabibilah, Izadikhah, Zahra, Renzaho, Andre M. N. and O'Connor, Peter J.. 2022. "Corrigendum: Effectiveness of Psychological Interventions on Young Refugees' Social Adjustment: A Meta-analysis ." Journal of Refugee Studies. 35 (1), pp. 744-744. https://doi.org/10.1093/jrs/feab085
Maternal health and health-related behaviours and their associations with child health: evidence from an Australian birth cohort
Ahmad, Kabir, Kabir, Enamul, Keramat, Sayed Afroz and Khanam, Rasheda. 2021. "Maternal health and health-related behaviours and their associations with child health: evidence from an Australian birth cohort." PLoS One. 16 (9), pp. 1-18. https://doi.org/10.1371/journal.pone.0257188
A systematic literature review of the impact of COVID-19 lockdowns on air quality in China
Rana, Rezwanul Hasan, Keramat, Syed Afroz and Gow, Jeff. 2021. "A systematic literature review of the impact of COVID-19 lockdowns on air quality in China." Aerosol and Air Quality Research. 21 (8), pp. 1-20. https://doi.org/10.4209/aaqr.200614
Age and gender differences in the relationship between obesity and disability with self-perceived employment discrimination: Results from a retrospective study of an Australian national sample
Keramat, Syed Afroz, Alam, Khorshed, Rana, Rezwanul Hasan, Shuvo, Suvasish Das, Gow, Jeff, Biddle, Stuart J. H. and Keating, Byron Keating. 2021. "Age and gender differences in the relationship between obesity and disability with self-perceived employment discrimination: Results from a retrospective study of an Australian national sample." Social Science and Medicine – Population Health. 16, pp. 1-9. https://doi.org/10.1016/j.ssmph.2021.100923
Self-reported disability and its association with obesity and physical activity in Australian adults: results from a longitudinal study
Keramat, Syed Afroz, Alam, Khorshed, Sathi, Nusrat Jahan, Gow, Jeff, Biddle, Stuart J. H. and Al-Hanawi, Mohammed Khaled. 2021. "Self-reported disability and its association with obesity and physical activity in Australian adults: results from a longitudinal study." Social Science and Medicine – Population Health. 14, pp. 1-7. https://doi.org/10.1016/j.ssmph.2021.100765
Obesity, disability and self-perceived health outcomes in Australian adults: a longitudinal analysis using 14 annual waves of the HILDA cohort
Keramat, Syed Afroz, Alam, Khorshed, Ahinkorah, Bright Opoku, Islam, Md Sariful, Islam, Md Irteja, Hossain, Md Zobayer, Ahmed, Sazia, Gow, Jeff and Biddle, Stuart J. H.. 2021. "Obesity, disability and self-perceived health outcomes in Australian adults: a longitudinal analysis using 14 annual waves of the HILDA cohort." ClinicoEconomics and Outcomes Research. 13, pp. 777-788. https://doi.org/10.2147/CEOR.S318094
Association of maternal obesity with fetal and neonatal death: evidence from South and South-East Asian countries
Haque, Rezwanul, Keramat, Syed Afroz, Rahman, Syed Mahbubur, Mustafa, Maimun Ur Rashid and Alam, Khorshed. 2021. "Association of maternal obesity with fetal and neonatal death: evidence from South and South-East Asian countries." PLoS One. 16 (9), pp. 1-16. https://doi.org/10.1371/journal.pone.0256725
Women’s empowerment and fertility decision-making in 53 low and middle resource countries: a pooled analysis of demographic and health surveys
Haque, Rezwanul, Alam, Khorshed, Rahman, Syed Mahbubur, Keramat, Syed Afroz and Al-Hanawi, Mohammed Khaled. 2021. "Women’s empowerment and fertility decision-making in 53 low and middle resource countries: a pooled analysis of demographic and health surveys." BMJ Open. 11 (6), pp. 1-12. https://doi.org/10.1136/bmjopen-2020-045952
Trends in the prevalence of adult overweight and obesity in Australia, and its association with geographic remoteness
Keramat, Syed Afroz, Alam, Khorshed, Al-Hanawi, Mohammed Khaled, Gow, Jeff, Biddle, Stuart J. H. and Hashmi, Rubayyat. 2021. "Trends in the prevalence of adult overweight and obesity in Australia, and its association with geographic remoteness." Scientific Reports. 11, pp. 1-9. https://doi.org/10.1038/s41598-021-90750-1
Interaction between the place of residence and wealth on the risk of overweight and obesity in Bangladeshi women
Ahmad, Kabir, Khanam, Taslima, Keramat, Sayed Afroz, Islam, Md. Irteja, Kabir, Enamul and Khanam, Rasheda. 2020. "Interaction between the place of residence and wealth on the risk of overweight and obesity in Bangladeshi women." PLoS One. 15 (12), pp. 1-15. https://doi.org/10.1371/journal.pone.0243349
Association of dietary intake, physical activity, and sedentary behaviours with overweight and obesity among 282,213 adolescents in 89 low and middle income to high-income countries
Mahumud, Rashidul Alam, Sahle, Berhe W., Owusu-Addo, Ebenezer, Chen, Wen, Morton, Rachael Lisa and Renzaho, Andre M. N.. 2021. "Association of dietary intake, physical activity, and sedentary behaviours with overweight and obesity among 282,213 adolescents in 89 low and middle income to high-income countries." International Journal of Obesity. 45 (11), pp. 2404-2418. https://doi.org/10.1038/s41366-021-00908-0
Untangling the health consequences and adverse labour market outcomes of obesity in the Australian adult population: new insights from longitudinal data
Keramat, Syed Afroz. 2021. Untangling the health consequences and adverse labour market outcomes of obesity in the Australian adult population: new insights from longitudinal data. PhD Thesis Doctor of Philosophy. University of Southern Queensland. https://doi.org/10.26192/q6wwq
Job-related characteristics and obesity in Australian employees: evidence from a longitudinal nationally representative sample
Keramat, Syed Afroz, Alam, Khorshed, Gow, Jeff and Biddle, Stuart J. H.. 2020. "Job-related characteristics and obesity in Australian employees: evidence from a longitudinal nationally representative sample." American Journal of Health Promotion. 34 (7), pp. 729-739. https://doi.org/10.1177/0890117119901093
Impact of disadvantaged neighborhoods and lifestyle factors on adult obesity: evidence from a 5-year cohort study in Australia
Keramat, Syed Afroz, Alam, Khorshed, Gow, Jeff and Biddle, Stuart J. H.. 2021. "Impact of disadvantaged neighborhoods and lifestyle factors on adult obesity: evidence from a 5-year cohort study in Australia." American Journal of Health Promotion. 35 (1), pp. 28-37. https://doi.org/10.1177/0890117120928790
Distribution and predictors associated with the use of breast cancer screening services among women in 14 low-resource countries
Mahumud, Rashidul Alam, Gow, Jeff, Keramat, Syed Afroz, March, Sonja, Dunn, Jeff, Alam, Khorshed and Renzaho, Andre M. N.. 2020. "Distribution and predictors associated with the use of breast cancer screening services among women in 14 low-resource countries." BMC Public Health. 20, pp. 1-15. https://doi.org/10.1186/s12889-020-09557-w
A longitudinal exploration of the relationship between obesity, and long term health condition with presenteeism in Australian workplaces, 2006-2018
Keramat, Syed Afroz, Alam, Khorshed, Gow, Jeff and Biddle, Stuart J. H.. 2020. "A longitudinal exploration of the relationship between obesity, and long term health condition with presenteeism in Australian workplaces, 2006-2018." PLoS One. 15 (8), pp. 1-17. https://doi.org/10.1371/journal.pone.0238260
Cost-effectiveness evaluations of the 9-Valent human papillomavirus (HPV) vaccine: evidence from a systematic review
Mahumud, Rashidul Alam, Alam, Khorshed, Keramat, Syed Afroz, Ormsby, Gail M., Dunn, Jeff and Gow, Jeff. 2020. "Cost-effectiveness evaluations of the 9-Valent human papillomavirus (HPV) vaccine: evidence from a systematic review." PLoS One. 15 (6), pp. 1-15. https://doi.org/10.1371/journal.pone.0233499
Gender differences in the longitudinal association between obesity, and disability with workplace absenteeism in the Australian working population
Keramat, Syed Afroz, Alam, Khorshed, Gow, Jeff and Biddle, Stuart. 2020. "Gender differences in the longitudinal association between obesity, and disability with workplace absenteeism in the Australian working population." PLoS One. 15 (5), pp. 1-14. https://doi.org/10.1371/journal.pone.0233512
Wealth stratified inequalities in service utilisation of breast cancer screening across the geographical regions: A pooled decomposition analysis
Mahumud, Rashidul Alam, Alam, Khorshed, Keramat, Syed Afroz, Renzaho, Andre M.N., Hossain, Md. Golam, Haque, Rezwanul, Ormsby, Gail M., Dunn, Jeff and Gow, Jeff. 2020. "Wealth stratified inequalities in service utilisation of breast cancer screening across the geographical regions: A pooled decomposition analysis." Archives of Public Health. 78, pp. 1-12. https://doi.org/10.1186/s13690-020-00410-5
Wealth-related inequalities of women’s knowledge of cervical cancer screening and service utilisation in 18 resource-constrained countries: evidence from a pooled decomposition analysis
Mahumud, Rashidul Alam, Keramat, Syed Afroz, Ormsby, Gail M., Sultana, Marufa, Rawal, Lal B., Alam, Khorshed, Gow, Jeff and Renzaho, Andre M. N.. 2020. "Wealth-related inequalities of women’s knowledge of cervical cancer screening and service utilisation in 18 resource-constrained countries: evidence from a pooled decomposition analysis." International Journal for Equity in Health. 19 (1), pp. 1-15. https://doi.org/10.1186/s12939-020-01159-7
Cost-effectiveness of the introduction of two-dose bi valent (Cervarix) and quadrivalent (Gardasil) HPV vaccination for adolescent girls in Bangladesh
Mahumud, Rashidul Alam, Gow, Jeff, Alam, Khorshed, Keramat, Syed Afroz, Hossain, Md Golam, Sultana, Marufa, Sarker, Abdur Razzaque and Islam, Sheikh M. Shariful. 2020. "Cost-effectiveness of the introduction of two-dose bi valent (Cervarix) and quadrivalent (Gardasil) HPV vaccination for adolescent girls in Bangladesh." Vaccine. 38 (2), pp. 165-172. https://doi.org/10.1016/j.vaccine.2019.10.037
Effectiveness of psychological interventions on young refugees' social adjustment: a meta-analysis
Ahmadi Forooshani, Sayedhabibilah, Izadikhah, Zahra, Renzaho, Andre M. N. and O'Connor, Peter J.. 2021. "Effectiveness of psychological interventions on young refugees' social adjustment: a meta-analysis." Journal of Refugee Studies. 34 (1), pp. 976-992. https://doi.org/10.1093/jrs/fez035
Obesity, long-term health problems, and workplace satisfaction: a longitudinal study of Australian workers
Keramat, Syed Afroz, Alam, Khorshed, Gow, Jeff and Biddle, Stuart J. H.. 2020. "Obesity, long-term health problems, and workplace satisfaction: a longitudinal study of Australian workers." Journal of Community Health. 45, pp. 288-300. https://doi.org/10.1007/s10900-019-00735-5
Correction: Emerging cancer incidence, mortality, hospitalisation and associated burden among Australian cancer patients, 1982 – 2014: an incidence-based approach in terms of trends, determinants and inequality
Mahumud, Rashidul Alam, Alam, Khorshed, Dunn, Jeff and Gow, Jeff. 2020. "Correction: Emerging cancer incidence, mortality, hospitalisation and associated burden among Australian cancer patients, 1982 – 2014: an incidence-based approach in terms of trends, determinants and inequality ." BMJ Open. 10 (1). https://doi.org/10.1136/bmjopen-2019-031874corr1
Determinants of access to eHealth services in regional Australia
Alam, Khorshed, Mahumud, Rashidul Alam, Alam, Fariha, Keramat, Syed Afroz, Erdiaw-Kwasie, Michael O. and Sarker, Abdur Razzaque. 2019. "Determinants of access to eHealth services in regional Australia." International Journal of Medical Informatics. 131, pp. 1-9. https://doi.org/10.1016/j.ijmedinf.2019.103960
Changes in inequality of childhood morbidity in Bangladesh 1993-2014: a decomposition analysis
Mahumud, Rashidul Alam, Alam, Khorshed, Renzaho, Andre M. N., Sarker, Abdur Razzaque, Sultana, Marufa, Sheikh, Nurnabi, Rawal, Lal B. and Gow, Jeff. 2019. "Changes in inequality of childhood morbidity in Bangladesh 1993-2014: a decomposition analysis." PLoS One. 14 (6), pp. 1-19. https://doi.org/10.1371/journal.pone.0218515
Prevalence of underweight, overweight and obesity and their associated risk factors in Nepalese adults: Data from a Nationwide Survey, 2016
Rawal, Lal B., Kanda, Kie, Mahumud, Rashidul Alam, Joshi, Deepak, Mehata, Suresh, Shrestha, Nipun, Poudel, Prakash, Karki, Surendra and Renzaho, Andre. 2018. "Prevalence of underweight, overweight and obesity and their associated risk factors in Nepalese adults: Data from a Nationwide Survey, 2016." PLoS One. 13 (11), pp. 1-14. https://doi.org/10.1371/journal.pone.0205912