Associations of Substance Use Behaviors With Suicidal Ideation and Suicide Attempts Among US and Chinese Adolescents

Background: Adolescence has been described as a period of increased health risk-taking behaviors. Given the variety of cultural contexts, healthcare systems, and public health policies in different regions, the present study aimed to determine whether there are similar or different associations of substance use behaviors with suicidal ideation and suicide attempts among US and Chinese adolescents.Methods: This study included a total of 14,765 US adolescents from the 2017 National Youth Risk Behavior Surveillance System (YRBSS) and 24,345 Chinese adolescents from the 2017 School-based Chinese Adolescents Health Survey (SCAHS).Results: The proportions of suicidal ideation and suicide attempts were 17.4 and 5.7% among US adolescents, which were higher than those among Chinese adolescents (suicidal ideation: 13.7% and suicide attempts: 2.7%). Among Chinese adolescents, the most common substance use behavior was “alcohol use (55.4%),” followed by “cigarette use (11.6%).” Among US adolescents, the most popular substance was alcohol (ever used: 55.9%), followed by marijuana (ever used: 34.6%). Moreover, alcohol use was significantly related to suicidal ideation/suicide attempts only in Chinese adolescents [suicidal ideation: Adjusted odds ratio (AOR) = 1.88, 95% CI = 1.71~2.06; suicide attempts: AOR = 2.12, 95% CI = 1.71~2.63], and marijuana use was associated with suicidal ideation and suicide attempts only in the US adolescent group (suicidal ideation: AOR = 1.23, 95% CI = 1.06~1.44; suicide attempts: AOR = 1.51, 95% CI = 1.21~1.87). Moreover, although the associations of prescription pain medication use with suicide attempts were significant in both Chinese and US adolescent groups, the adjusted associations were stronger in Chinese adolescents than in US adolescents (Chinese adolescents: AOR = 3.97, 95% CI = 2.76~5.72; US adolescents: AOR = 1.76, 95% CI = 1.43~2.16; P < 0.05).Conclusions: The associations of alcohol use with suicidal ideation and suicide attempts were only significant in Chinese adolescents. Marijuana use was associated with suicidal ideation and suicide attempts only in the US adolescent group. Although the associations of prescription pain medication use with suicide attempts were significant in both Chinese and US adolescent groups, the adjusted associations were significantly stronger for Chinese adolescents. These findings might be related to the differences in cultural contexts, healthcare systems, and public health policies in the two different countries.

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Substance Use Frequency Relates to Suicidal Ideation Through Perceived Burdensomeness and to Suicide Attempts Through Capability for Suicide

Archives of Suicide Research ◽

10.1080/13811118.2021.1931595 ◽

2021 ◽

pp. 1-21

Author(s):

Margaret M. Baer ◽

Matthew T. Tull ◽

Kim L. Gratz

Keyword(s):

Substance Use ◽

Suicidal Ideation ◽

Suicide Attempts ◽

Perceived Burdensomeness

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Associations between Abortion, Mental Disorders, and Suicidal Behaviour in a Nationally Representative Sample

The Canadian Journal of Psychiatry ◽

10.1177/070674371005500407 ◽

2010 ◽

Vol 55 (4) ◽

pp. 239-247 ◽

Cited By ~ 35

Author(s):

Natalie P Mota ◽

Margaret Burnett ◽

Jitender Sareen

Keyword(s):

Substance Use ◽

Suicidal Ideation ◽

Mental Disorders ◽

Mental Disorder ◽

Representative Sample ◽

Suicide Attempts ◽

World Health ◽

Population Attributable Fractions ◽

Attributable Fractions ◽

Nationally Representative

Objective: Most previous studies that have investigated the relation between abortion and mental illness have presented mixed findings. We examined the relation between abortion, mental disorders, and suicidality using a US nationally representative sample. Methods: Data came from the National Comorbidity Survey Replication ( n = 3310 women, aged 18 years and older). The World Health Organization-Composite International Diagnostic Interview was used to assess mental disorders based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria and lifetime abortion in women. Multiple logistic regression analyses were employed to examine associations between abortion and lifetime mood, anxiety, substance use, eating, and disruptive behaviour disorders, as well as suicidal ideation and suicide attempts. We calculated the percentage of respondents whose mental disorder came after the first abortion. The role of violence was also explored. Population attributable fractions were calculated for significant associations between abortion and mental disorders. Results: After adjusting for sociodemographics, abortion was associated with an increased likelihood of several mental disorders—mood disorders (adjusted odds ratio [AOR] ranging from 1.75 to 1.91), anxiety disorders (AOR ranging from 1.87 to 1.91), substance use disorders (AOR ranging from 3.14 to 4.99), as well as suicidal ideation and suicide attempts (AOR ranging from 1.97 to 2.18). Adjusting for violence weakened some of these associations. Forall disorders examined, less than one-half of women reported that their mental disorder had begun after the first abortion. Population attributable fractions ranged from 5.8% (suicidal ideation) to 24.7% (drug abuse). Conclusions: Our study confirms a strong association between abortion and mental disorders. Possible mechanisms of this relation are discussed.

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The Association of Alcohol Use Disorders with Suicidal Ideation and Suicide Attempts in a Population-Based Sample with Mood Symptoms

Archives of Suicide Research ◽

10.1080/13811118.2015.1004489 ◽

2015 ◽

Vol 20 (2) ◽

pp. 219-232 ◽

Cited By ~ 12

Author(s):

Yoon-kyu Sung ◽

Lareina N. La Flair ◽

Ramin Mojtabai ◽

Li-Ching Lee ◽

Stanislav Spivak ◽

...

Keyword(s):

Suicidal Ideation ◽

Alcohol Use ◽

Suicide Attempts ◽

Alcohol Use Disorders ◽

Population Based ◽

Mood Symptoms

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Suicidal Ideation and Suicide Attempts among Women Seeking Treatment for Substance Use and Trauma Symptoms

Health & Social Work ◽

10.1093/hsw/hly004 ◽

2018 ◽

Vol 43 (2) ◽

pp. 76-83 ◽

Cited By ~ 1

Author(s):

Stella M Resko ◽

Sarah Kruman Mountain ◽

Suzanne Browne ◽

David C Kondrat ◽

Michael Kral

Keyword(s):

Substance Use ◽

Suicidal Ideation ◽

Suicide Attempts ◽

Trauma Symptoms

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Emergency Psychiatric Consultations During and After the COVID-19 Lockdown in Italy. A Multicentre Study

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.697058 ◽

2021 ◽

Vol 12 ◽

Author(s):

Matteo Balestrieri ◽

Paola Rucci ◽

Davide Amendola ◽

Miki Bonizzoni ◽

Giancarlo Cerveri ◽

...

Keyword(s):

Substance Use ◽

Suicidal Ideation ◽

Multicentre Study ◽

Suicide Attempts ◽

Gradual Increase ◽

Psychiatric Services ◽

Lower Percentage ◽

Hospital Emergency ◽

Psychiatric Hospitalizations ◽

Hospital Emergency Departments

Aims: The aim was to analyse the psychiatric consultations in nine Italian hospital emergency departments, by comparing the lockdown and post-lockdown periods of 2020 with the equivalent periods of 2019.Methods: Characteristics of psychiatric consultations, patients, and drug prescriptions were analyzed. Joinpoint models were used to identify changes in the weekly trend of consultations.Results: A 37.5% decrease in the number of consultations was seen during the lockdown period and 17.9% after the lockdown. The number of individual patients seen decreased by 34.9% during the lockdown and 11.2% after the lockdown. A significant change in the number of consultations from week 11 to week 18 occurred, followed by a gradual increase. There was a higher percentage of patients with previous psychiatric hospitalizations during the lockdown period (61.1 vs. 56.3%) and a lower percentage after the lockdown (59.7 vs. 64.7%). During the lockdown there was a large increase in psychiatric consultations for substance use disorders, whereas more consultations for manic episodes occurred after the lockdown. A 3.4% decrease was observed in consultations for suicidal ideation and planning during the lockdown, followed by an upward rebound after the lockdown, along with an increase in consultations for suicide attempts. During lockdown antipsychotic and benzodiazepine prescriptions increased by 5.2 and 4.1%, respectively. After the lockdown, the number of compulsory hospitalizations was higher than in 2019.Conclusions: We observed a decrease of psychiatric consultations during and after the lockdown. There was an increase in consultations for manic episodes and suicidality after the lockdown. The focus of psychiatric services must remain high particularly in this latter period.

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The Prevalence and Correlates of Suicidality in a Sample of Adolescents in Guangdong, China

Journal of Social and Clinical Psychology ◽

10.1521/jscp.2020.39.02.77 ◽

2020 ◽

Vol 39 (2) ◽

pp. 77-100

Author(s):

Pei Yan ◽

Yaxuan Ren ◽

Minyi Li ◽

Min-Pei Lin ◽

Sian Xu ◽

...

Keyword(s):

Depressive Symptoms ◽

Suicidal Ideation ◽

Suicide Attempts ◽

Multinomial Logistic Regression ◽

Chinese Adolescents ◽

Health Concern ◽

Suicide Attempters ◽

Male Adolescents ◽

The Past ◽

Communication Problems

Background: Suicidality is a public health concern among Chinese adolescents. This study aimed to examine the prevalence and correlates of suicidal ideation and suicide attempts in a large sample of Chinese adolescents. Methods: A total of 30,644 Chinese students (56.7% male; Mage = 14.14 years) completed the questionnaires, and a multinomial logistic regression was conducted to analyze the data. Results: About 17.0% of the participants reported having suicidal ideation and 4.4% reported suicide attempts in the past year. Adolescents with more rumination, more severe depressive symptoms, more communication problems with their parents, and more feelings of burdensomeness were more likely to be suicidal ideators or suicide attempters rather than non-suicidal controls. Additionally, male adolescents, adolescents from incomplete families, adolescents whose parents have lower educational levels, and adolescents with less rumination, more severe depressive symptoms, less communication problems with their parents were more likely to be suicide attempters rather than suicidal ideators. Discussion: Suicidality is prevalent and correlates with various familial and individual factors in Chinese adolescents. Theoretical and clinical implications of the findings were discussed.

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Associations between Chinese adolescents subjected to traditional and cyber bullying and suicidal ideation, self-harm and suicide attempts

BMC Psychiatry ◽

10.1186/s12888-019-2319-9 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 7

Author(s):

Zhekuan Peng ◽

Anat Brunstein Klomek ◽

Liping Li ◽

Xuefen Su ◽

Lauri Sillanmäki ◽

...

Keyword(s):

Suicidal Ideation ◽

Suicide Ideation ◽

Suicide Attempts ◽

Multinomial Logistic Regression ◽

Population Based ◽

Cyber Bullying ◽

Adverse Outcomes ◽

Chinese Adolescents ◽

Bullying Victimization ◽

Self Harm

Abstract Background The incidence of bullying is high among adolescents. Adolescents who were victims of bullying have a higher risk of self-harm and suicidal behavior than adolescents who were non-victims. However, research on suicide and both traditional and cyber bullying was limited in China. Therefore, this study examined the associations between Chinese adolescents who were the victims of traditional and cyber bullying and the prevalence of suicidal ideation, self-harm and suicide attempts. Methods This was a population-based study of 2647 students (51.2% girls) with a mean age of 13.6 ± 1.1 years from 10 junior high schools in Shantou, China. Information on bullying victimization, suicidal ideation, self-harm and suicide attempts were collected using a self-administered questionnaire and the psychopathology of the students was assessed using the Strengths and Difficulties Questionnaire (SDQ). The associations were examined with multinomial logistic regression, adjusted for covariates. Results Traditional bullying victimization was reported by 16.7% of the adolescents, cyber bullying victimization by 9.0% and both by 3.5%. The prevalence of suicidal ideation was 23.5%, self-harm was 6.2% and suicide attempts was 4.2%. Psychopathology symptoms were risk factors for suicide ideation only, ideation plus self-harm, self-harm only and suicide attempts. Victims of both traditional and cyber bullying had the highest risk of suicidal ideation only, ideation plus self-harm and suicide attempts, compared to those reporting one form of bullying. Victims of cyber bullying only had the second highest risk of suicidal ideation only and suicidal ideation plus self-harm compared to non-victims. Conclusions Adolescents who were victims of both traditional and cyber bullying had greater risks of adverse outcomes of suicidal ideation only, suicidal ideation plus self-harm and suicide attempts. The results of the current study suggest that those exposed to both forms of bullying should be routinely screened for suicidal risk. In addition, school-based anti-bully interventions should also target cyber bullying.

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Sexual minority status and suicidal behaviour among Chinese adolescents: a nationally representative cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2017-020969 ◽

2018 ◽

Vol 8 (8) ◽

pp. e020969 ◽

Cited By ~ 6

Author(s):

Yeen Huang ◽

Pengsheng Li ◽

Lan Guo ◽

Xue Gao ◽

Yan Xu ◽

...

Keyword(s):

Suicidal Ideation ◽

Sexual Minority ◽

Suicidal Behaviour ◽

Suicide Attempts ◽

Chinese Adolescents ◽

Minority Status ◽

Same Sex ◽

Cross Sectional ◽

Romantic Attraction ◽

Minority Adolescents

ObjectivesSuicidality among sexual minority adolescents has generated worldwide concern in recent decades, and previous Western studies have demonstrated that sexual minority status is associated with adolescent suicidality. However, whether this association exists in Chinese adolescents remains largely unknown. This study aimed to estimate the associations between sexual minority status and suicidal behaviour among Chinese adolescents.DesignCross-sectional survey.SettingA total of 506 high schools in 7 provinces of China.ParticipantsA total of 150 822 students in grades 7–12 who completed the questionnaires (response rate of 95.9%) were included.Main outcome measuresSuicidal ideation and suicide attempts were used to measure suicidal behaviour, and sexual attraction (opposite sex, same sex or both sex) was used as a measure for sexual minority status.ResultsOf the 150 822 adolescents analysed, 4.1% self-reported as sexual minorities and 17.3% were unsure. Compared with heterosexual and unsure adolescents, same-sex romantic attraction (SSA) and both-sex romantic attraction (BSA) adolescents reported a higher prevalence of past-year suicidal ideation (SSA: 21.6% for males and 30.4% for females; BSA: 34.7% for males and 42.3% for females) and suicide attempts (SSA: 6.9% for males and 8.9% for females; BSA: 12.2% for males and 10.9% for females). After adjustment for covariates, SSA and BSA adolescents were more likely to have past-year suicidal ideation and suicide attempts than their heterosexual and unsure peers. BSA adolescents reported the highest risk of suicidal ideation (males: adjusted OR (AOR) 2.42, 95% CI 2.03 to 2.88; females: AOR 2.61, 95% CI 2.41 to 2.82) and suicide attempts (males: AOR 3.83, 95% CI 2.85 to 5.14; females: AOR 2.59, 95% CI 2.19 to 3.06).ConclusionsOur study suggested that Chinese sexual minority adolescents were at increased risk of suicidality, and those with BSA had an especially high risk in this population. These findings emphasised the urgent need to develop targeted interventions to effectively address suicide-related problems among Chinese sexual minority adolescents.

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