Abstract：
OBJECTIVE: This study assessed the direct and indirect effects (via depressive symptoms) of lifetime use of a broad range of substances on suicide risk among US adolescents.
METHODS: This was a cross-sectional study.
METHODS: Data from the 2021 Youth Risk Behavior Survey were used (N = 12,303, 48.7% female). Associations between five types of substance use (cigarette, e-cigarette, alcohol, marijuana, and prescription pain medicine) and three dimensions of suicide risk (suicidal ideation, suicide plan, and suicide attempt) were measured by multivariate logistic regression models. The role of depressive symptoms was further examined by structural equation modeling.
RESULTS: Almost three in five (57.5%) adolescents had used one or more substances in their lifetime (18.1% one type, 12.2% two types, 13.1% three types, 10.2% four types, and 3.8% five types). Adolescents using five substances were up to 16 times more likely to experience suicidal ideation and behaviors. Depressive symptoms significantly linked the pathway from substance use to suicide risk, resulting in much stronger indirect effects than the direct effects. Collectively, the five substance use behaviors and depressive symptoms explained about 60.4% of variance in suicidal ideation, 53.6% of variance in suicide plan, and 55.0% of variance in suicide attempt.
CONCLUSIONS: Lifetime use of multiple substances is significantly correlated with suicidal ideation and behaviors among adolescents via the pathway of depressive symptoms. Routine screening for a broad range of substance use behaviors is needed to identify adolescents at risk for suicide and accessible mental health services could potentially attenuate the linkage between substance use and suicide risk.
METHODS: This was a cross-sectional study.
METHODS: Data from the 2021 Youth Risk Behavior Survey were used (N = 12,303, 48.7% female). Associations between five types of substance use (cigarette, e-cigarette, alcohol, marijuana, and prescription pain medicine) and three dimensions of suicide risk (suicidal ideation, suicide plan, and suicide attempt) were measured by multivariate logistic regression models. The role of depressive symptoms was further examined by structural equation modeling.
RESULTS: Almost three in five (57.5%) adolescents had used one or more substances in their lifetime (18.1% one type, 12.2% two types, 13.1% three types, 10.2% four types, and 3.8% five types). Adolescents using five substances were up to 16 times more likely to experience suicidal ideation and behaviors. Depressive symptoms significantly linked the pathway from substance use to suicide risk, resulting in much stronger indirect effects than the direct effects. Collectively, the five substance use behaviors and depressive symptoms explained about 60.4% of variance in suicidal ideation, 53.6% of variance in suicide plan, and 55.0% of variance in suicide attempt.
CONCLUSIONS: Lifetime use of multiple substances is significantly correlated with suicidal ideation and behaviors among adolescents via the pathway of depressive symptoms. Routine screening for a broad range of substance use behaviors is needed to identify adolescents at risk for suicide and accessible mental health services could potentially attenuate the linkage between substance use and suicide risk.
摘要：
目的：本研究评估了美国青少年终生使用广泛药物对自杀风险的直接和间接影响（通过抑郁症状）。
方法：这是一项横断面研究。
方法：使用来自2021年青年风险行为调查的数据（N=12,303，女性占48.7％）。五种物质使用之间的关联(香烟，电子烟,酒精,大麻,和处方止痛药)和自杀风险的三个维度(自杀意念，自杀计划,和自杀企图）通过多变量逻辑回归模型进行测量。通过结构方程模型进一步检查了抑郁症状的作用。
结果：几乎五分之三（57.5％）的青少年一生中使用过一种或多种物质（一种类型为18.1％，12.2%两种类型，13.1%三种类型，10.2%四种类型，和3.8%的五种类型）。使用五种物质的青少年经历自杀意念和行为的可能性高达16倍。抑郁症状将物质使用与自杀风险的途径显着相关，导致间接效应比直接效应强得多。总的来说，五种物质使用行为和抑郁症状解释了约60.4%的自杀意念差异，自杀计划差异的53.6%，和55.0%的差异在自杀未遂。
结论：终生使用多种物质与青少年自杀意念和行为通过抑郁症状途径显著相关。需要对广泛的物质使用行为进行常规筛查，以确定有自杀风险的青少年，而可获得的心理健康服务可能会削弱物质使用与自杀风险之间的联系。
方法：这是一项横断面研究。
方法：使用来自2021年青年风险行为调查的数据（N=12,303，女性占48.7％）。五种物质使用之间的关联(香烟，电子烟,酒精,大麻,和处方止痛药)和自杀风险的三个维度(自杀意念，自杀计划,和自杀企图）通过多变量逻辑回归模型进行测量。通过结构方程模型进一步检查了抑郁症状的作用。
结果：几乎五分之三（57.5％）的青少年一生中使用过一种或多种物质（一种类型为18.1％，12.2%两种类型，13.1%三种类型，10.2%四种类型，和3.8%的五种类型）。使用五种物质的青少年经历自杀意念和行为的可能性高达16倍。抑郁症状将物质使用与自杀风险的途径显着相关，导致间接效应比直接效应强得多。总的来说，五种物质使用行为和抑郁症状解释了约60.4%的自杀意念差异，自杀计划差异的53.6%，和55.0%的差异在自杀未遂。
结论：终生使用多种物质与青少年自杀意念和行为通过抑郁症状途径显著相关。需要对广泛的物质使用行为进行常规筛查，以确定有自杀风险的青少年，而可获得的心理健康服务可能会削弱物质使用与自杀风险之间的联系。
