背景:本研究旨在评估自杀行为的患病率,即自杀意念(SI),自杀计划(SP),以及包括孟加拉国在内的八个东南亚国家的青少年自杀企图(SA),重点是父母和同伴的支持,不丹,印度尼西亚,马尔代夫,缅甸,尼泊尔,斯里兰卡和泰国。
方法:数据来自全球基于学校的学生健康调查(GSHS),涵盖42,888名11-17岁青少年。SI的加权患病率,SP,和SA以及国家特定的患病率被计算和二元逻辑回归被用来识别相关的危险因素。
结果:在42,888名青少年中,男性19,113名(44.9%),女性23,441名(55.1%)。SI的总体患病率,SP和SA为9.10%,10.42%和8.54%,分别。缅甸的SI最低(1.07%)和SP最低(0.18%),而印度尼西亚的SA最低(3.79%)。马尔代夫的SI患病率最高,SP和SA分别为14.13%,分别为19.02%和13.38%。总体自杀行为与女性相关[AOR:SI-1.26(1.06,1.50),SP-1.34(1.14,1.57)],高水平的久坐行为[AOR:SI-2.08(1.62,2.66),SP-1.86(1.49,2.32),SA-1.96(1.45,2.64)],参与体育锻炼[AOR:SI-1.30(1.07,1.58),SP-1.37(1.14,1.65),SA-1.50(1.17,1.90)],严重受伤[AOR:SI-1.40(1.17,1.67),SP-1.44(1.22,1.69),SA-1.74(1.39,2.17)],被欺负[AOR:SI-1.68(1.39,2.02),SP-1.34(1.12,1.60),SA-1.88(1.50,2.36)],感到孤独(大部分时间或总是)[AOR:SI-3.41(2.60,4.46),SP-1.92(1.48,2.47),SA-2.25(1.62,3.13)],缺乏父母的支持(从不检查家庭作业)[AOR:SI-1.59(1.25,2.02),SP-1.52(1.22,1.90)]并且没有密友[AOR:SI-2.19(1.66,2.89),SP-2.26(1.74,2.94),SA-4.23(3.10,5.78)]。
结论:尽管自杀行为的发生率各不相同,存在一系列交叉风险因素,值得进一步研究.我们建议重点加强父母和同伴的支持,有针对性的计划解决身体活动,欺凌,青少年的孤独感和心理健康。
This study aimed to estimate the prevalence of suicidal behaviors, i.e. suicidal ideation (SI), suicidal plan (SP), and suicidal attempt (SA) among adolescents with a focus on parental and peer support in eight South-East Asian countries including Bangladesh, Bhutan, Indonesia, Maldives, Myanmar, Nepal, Sri Lanka and Thailand.
Data were drawn from Global School-based Student Health Survey (GSHS) covering 42,888 adolescents aged 11-17 years. Weighted prevalence of SI, SP, and SA along with country specific prevalence was computed and binary logistic regression was used to identify associated risk factors.
Among 42,888 adolescents 19,113 (44.9%) were males and 23,441 (55.1%) females. Overall prevalence of SI, SP and SA is 9.10%, 10.42% and 8.54%, respectively. Myanmar demonstrated the lowest SI (1.07%) and SP (0.18%) whereas lowest SA was found in Indonesia (3.79%). Maldives had the highest prevalence of SI, SP and SA which were 14.13%, 19.02% and 13.38% respectively. Overall suicidal behaviors were associated with being female [AOR: SI-1.26 (1.06,1.50), SP-1.34 (1.14,1.57)], high levels of sedentary behavior [AOR: SI-2.08 (1.62,2.66), SP-1.86 (1.49,2.32), SA-1.96 (1.45,2.64)], involvement in physical fighting [AOR: SI-1.30 (1.07,1.58), SP-1.37 (1.14,1.65), SA-1.50 (1.17,1.90)], being seriously injured [AOR: SI-1.40 (1.17,1.67), SP-1.44 (1.22,1.69), SA-1.74 (1.39,2.17)], being bullied [AOR: SI- 1.68 (1.39,2.02), SP-1.34 (1.12,1.60), SA-1.88 (1.50,2.36)], feeling lonely (most of time or always) [AOR: SI-3.41(2.60,4.46), SP-1.92 (1.48,2.47), SA-2.25 (1.62,3.13)], lack of parental support (never checking homework) [AOR: SI-1.59 (1.25,2.02), SP-1.52 (1.22,1.90)] and not having close friends [AOR: SI-2.19 (1.66,2.89), SP-2.26 (1.74,2.94), SA-4.23 (3.10,5.78)].
Though prevalence of suicidal behaviors varies, a range of cross-cutting risk factors exists that warrant further examination. We recommend focusing on strengthening parental and peer support, targeted programs addressing physical activity, bullying, loneliness and mental-health of adolescents.