Global risks of suicidal behaviours and being bullied and their association in adolescents: School-based health survey in 83 countries
Global risks of suicidal behaviours and being bullied and their association in adolescents: School-based health survey in 83 countries
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青少年自杀行为和被欺凌的全球风险及其关联：83 个国家的学校健康调查
DOI：
10.1016/j.eclinm.2019.100253
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发表时间：
2020-02-01
影响因子：
15.1
通讯作者：
Chen, Ruoling
中科院分区：
文献类型：
--
作者：
Tang, James Jie;Yu, Yizhen;Chen, Ruoling
背景：青少年自杀行为（SB）和受欺凌的全球风险及其关联尚未得到充分了解。我们旨在确定青少年自杀意念（SI）、自杀计划（SP）、自杀未遂（SA）和受欺凌的风险，以及它们在不同性别、国家和世界卫生组织不同区域之间的相关关联。
方法：我们分析了全球学校健康调查（GSHS）的数据，该调查记录了来自83个国家的12至15岁青少年的健康行为。我们计算了自杀行为和受欺凌的患病率及其95%置信区间（CIs）。采用多水平模型来检验受欺凌与自杀意念、自杀计划和自杀未遂风险之间的关联。
结果：自杀意念的总体患病率为16.5%，自杀计划为16.5%，自杀未遂为16.4%，受欺凌为35.3%。自杀行为和受欺凌风险最高的是非洲（自杀意念19.9%，自杀计划23.2%，自杀未遂20.8%，受欺凌48.0%）。与男孩相比，女孩自杀意念（18.2%）和自杀计划（17.3%）的风险增加，但自杀未遂（16.7%）和受欺凌（33.3%）的风险相似。受欺凌与自杀未遂相关（调整后的比值比 - aOR为2.14，95%CI为2.06 - 2.23），比与自杀意念（1.83，1.78 - 1.89）和自杀计划（1.70，1.65 - 1.76）的相关性更强。与自杀未遂相关性最强的是在西太平洋地区（2.68，2.45 - 2.92），与自杀意念（2.04，1.74 - 2.39）和自杀计划（1.81，1.68 - 1.95）相关性最强的是在东南亚地区。自杀意念和自杀计划的调整后比值比在性别上没有差异，但男孩自杀未遂的调整后比值比（2.28，2.14 - 2.42）显著高于女孩（2.04，1.93 - 2.15），两个比值比的比率为1.12（P = 0.008）。
解释：自杀行为和受欺凌在全球青少年中很常见。自杀行为、受欺凌及其关联的性别差异研究结果可为预防计划的设计提供信息，以降低全球青少年自杀意念、自杀计划和自杀未遂的风险。（C）2019由爱思唯尔有限公司出版
Background: Global risks of suicidal behaviours (SB) and being bullied as well as their association among adolescents have been poorly understood. We aimed to determine the risks of suicidal ideation (SI), suicide planning (SP), suicide attempt (SA) and being bullied in adolescents and their related associations across gender, countries and different WHO regions.Methods: We examined data from the Global School-based Health Survey (GSHS), which recorded health behaviours among adolescents aged 12 to 15 years from 83 countries. We computed prevalence rates of SB and being bullied and their 95% confidence intervals (CIs). Multilevel models were employed to examine the association of being bullied with risks of SI, SP and SA.Results: The overall prevalence of SI was 16.5%, SP 16.5%, SA 16.4%, and being bullied 35.3%. The highest risks of SB and being bullied were in Africa (SI 19.9%, SP 23.2%, SA 20.8%, being bullied 48.0%). Compared to boys, girls had an increased risk for SI (18.2%) and SP (17.3%) but similar risk for SA (16.7%) and being bullied (33.3%). Being bullied was associated with SA (adjusted odds ratio - aOR 2.14, 95%CI 2.06-2.23), more strongly than SI (1.83, 1.78-1.89) and SP (1.70, 1.65-1.76). The strongest association with SA was in the Western Pacific (2.68, 2.45-2.92) and with SI (2.04, 1.74-2.39) and SP (1.81, 1.68-1.95) were in Southeast Asia. There were no gender differences in aOR for SI and SP, but the aOR for SA among boys (2.28, 2.14-2.42) was significantly greater than among girls (2.04, 1.93-2.15), ratio of two odds ratios was 1.12 (P = 0.008).Interpretation: SB and being bullied were common among adolescents worldwide. The findings of gender differences in SB, being bullied and their association could inform the design of prevention programmes to reduce the risks of SI, SP and SA in adolescents worldwide. (C) 2019 Published by Elsevier Ltd.