ArticleBMC global and public health2024
Clustering of lifestyle risk factors in relation to suicidal thoughts and behaviors in young adolescents: a cross-national study of 45 low- and middle-income countries.
Article in BMC global and public health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- A cluster analysis of psychosocial risk and hidden distress in adolescent students.Scientific reports · 2026Article
- The trend of self-harm incidence rates among adolescents in low- and lower-middle-income countries and its associated contextual factors.Global mental health (Cambridge, England) · 2026Article
- Psychological resilience partially mediates the relationship between negative life events and suicidal ideation in Chinese adolescents.Frontiers in psychiatry · 2026Article
- Identifying minimal risk factors for adolescent suicidal ideation and suicide attempts: A machine learning-optimized approach.PloS one · 2026Article
- 2024 at BMC Global and Public Health: a year in review.BMC global and public health · 2024Article
- The impact of health promotion training on university students' health perceptions, healthy lifestyle behaviors, and risky behaviors.Frontiers in psychology · 2024Article
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16 authors.
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Abstract
backgroundPrior research has reaffirmed lifestyle risk behaviors to cluster among adolescents. However, the lifestyle cluster effect on suicidal thoughts and behaviors (STBs) was unclear among adolescents in low- and middle-income countries (LMICs). No comparison of such associations was conducted across nations.
methodsData from 45 LMICs were obtained from the Global School-based Student Health Survey (GSHS) between 2009 and 2019. Lifestyle behavior factors were collected through a structured questionnaire. Suicidal ideation, plan, and attempt were ascertained by three single-item questions. Lifestyle risk scores were calculated via a sufficient dimension reduction technique, and lifestyle risk clusters were constructed using a latent class analysis. Generalized linear mixed models with odds ratio (OR) and 95% confidence interval (CI) were used to estimate the lifestyle-STB associations.
resultsA total of 229,041 adolescents were included in the final analysis. The weighted prevalence of suicidal ideation, plan, and attempt was 7.37%, 5.81%, and 4.59%, respectively. Compared with the favorable lifestyle group, the unfavorable group had 1.48-, 1.53-, and 3.11-fold greater odds of suicidal ideation (OR = 1.48, 95%CI: 1.30-1.69), plan (OR = 1.53, 95%CI 1.34-1.75), and attempt (OR = 3.11, 95%CI 2.64-3.65). Four clusters of lifestyle risk behaviors were identified, namely healthy lifestyles (H-L), insufficient intake of vegetables and fruit (V-F), frequent consumption of soft drinks and fast food (D-F), and tobacco smoking and alcohol drinking (S-A) clusters. Compared with H-L cluster, V-F cluster was associated with 43% and 42% higher odds of suicidal ideation and plan, followed by S-A cluster (26% for ideation and 20% for plan), but not significant in D-F cluster (P > 0.05). D-F cluster was associated with 2.85-fold increased odds of suicidal attempt, followed by V-F cluster (2.43-fold) and S-A cluster (1.18-fold).
conclusionsClustering of lifestyle risk behaviors is informative for risk stratification of STBs in resource-poor settings. Lifestyle-oriented suicide prevention efforts should be initiated among school-attending adolescents in LMICs.
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