BackgroundAdolescent 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.MethodsThis 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.ResultsThe 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.ConclusionsThe 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.

中文翻译：

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77 个低收入和中等收入到高收入国家的 251,763 名在校青少年自杀负担的风险和保护因素：评估全球、区域和国家差异

背景青少年自杀是一个全球性的公共卫生问题，也是全球青少年死亡的第二大原因。本研究旨在评估世界卫生组织 (WHO) 六个区域的 77 个国家的在校青少年的青少年自杀行为负担及其与暴力和意外伤害、心理社会、保护、生活方式和粮食安全相关因素的关系。方法本研究包含 251 763 名青少年的样本，该样本来自 77 个国家的 11-17 岁在校青少年的最新全球校本学生健康调查。采用逻辑回归分析来估计独立因素对青少年自杀行为的调整影响。结果人口加权的 12 个月自杀意念（SI）流行率，在校青少年的自杀计划（SP）和自杀企图（SA）分别为 18%、18% 和 16%。青少年自杀行为（即 SI、SP 和 SA）分别与遭受身体攻击、身体打架、高度焦虑、感到孤独、被欺负、缺乏父母支持、同伴支持差、没有亲密朋友和高水平的自杀行为相关。久坐的行为。总体而言，这些关联还扩展到跨地区和国家收入组的粮食不安全背景，其中关联程度略有不同，从 1.25 倍到 3.13 倍的优势比。结论 上学青少年自杀念头、自杀计划和自杀企图的负担在资源匮乏的国家尤其令人担忧。