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Suicidal Expression among School-Attending Adolescents in a Middle-Income Sub-Saharan Country
Centre for Injury Prevention and Community Safety (CIPCS), PeerCorps Trust Fund, P.O. Box 22499 Dar es Salaam, Tanzania
Ministry of Health, Victoria, Republic of Seychelles
Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital (CHUV) Lausanne 1010, Switzerland
* Author to whom correspondence should be addressed.
Received: 21 August 2012; in revised form: 30 October 2012 / Accepted: 1 November 2012 / Published: 13 November 2012
Abstract: We investigated correlates for suicidal expression among adolescents in the Seychelles. Data on 1,432 students (52% females) were derived from the Global School-based Health Survey. Participants were divided into three groups: those with no suicidal behavior (N = 1,199); those with suicide ideation/SI (N = 89); and those reporting SI with a plan to carry out a suicide attempt/SISP (N = 139), each within a 12-month recall period. Using multinomial logistic regression, we examined the strength of associations with social, behavioral and economic indicators while adjusting for covariates. Sixteen percent of school-attending adolescents reported a suicidal expression (10% with a plan/6.2% without). Those reporting SI were younger (relative risk ratio RRR = 0.81; CI = 0.68–0.96), indicated signs of depression (RRR = 1.69; CI = 1.05–2.72) and loneliness (RRR=3.36; CI =1.93–5.84). Tobacco use (RRR = 2.34; CI = 1.32–4.12) and not having close friends (RRR = 3.32; CI = 1.54–7.15) were significantly associated with SI. Those with SISP were more likely to be female (RRR = 0.47; 0.30–0.74), anxious (RRR = 3.04; CI = 1.89–4.88) and lonely (RRR = 1.74; CI = 1.07–2.84). Having no close friends (RRR = 2.98; 1.56–5.69) and using tobacco (RRR = 2.41; 1.48–3.91) were also strongly associated. Having parents who were understanding was protective (RRR = 0.50; CI = 0.31–0.82). Our results suggest that school health promotion programs may benefit from targeting multiple factors associated with suicidal expression. More research, particularly multilevel designs are needed to identify peer and family influences which may modify associations with suicidality.
Keywords: suicidal expression; adolescent; school health; sub-Saharan Africa
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Wilson, M.L.; Dunlavy, A.C.; Viswanathan, B.; Bovet, P. Suicidal Expression among School-Attending Adolescents in a Middle-Income Sub-Saharan Country. Int. J. Environ. Res. Public Health 2012, 9, 4122-4134.
Wilson ML, Dunlavy AC, Viswanathan B, Bovet P. Suicidal Expression among School-Attending Adolescents in a Middle-Income Sub-Saharan Country. International Journal of Environmental Research and Public Health. 2012; 9(11):4122-4134.
Wilson, Michael L.; Dunlavy, Andrea C.; Viswanathan, Bharathi; Bovet, Pascal. 2012. "Suicidal Expression among School-Attending Adolescents in a Middle-Income Sub-Saharan Country." Int. J. Environ. Res. Public Health 9, no. 11: 4122-4134.