TY  - JOUR
PY  - 2024//
TI  - 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
JO  - BMC Global and Public Health
A1  - Zhan, Yongle
A1  - Wang, Pei
A1  - Zhan, Yongan
A1  - Lu, Zhiming
A1  - Guo, Yidan
A1  - Ahmad, Noor Ani
A1  - Owusu, Andrew
A1  - Chher, Tepirou
A1  - Hinneh, Johnson T.
A1  - Aryal, Krishna Kumar
A1  - Darwish, Noorali
A1  - Senanayake, Sameera J.
A1  - Mufadhal, Bushra abdulrahman Ahmed
A1  - Rady, Alissar
A1  - Bassier-Paltoo, Marcia
A1  - Batbaatar, Suvd
SP  - e24
EP  - e24
VL  - 2
IS  - 1
N2  - Prior 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.    Methods  Data 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.    Results  A 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).    Conclusions  Clustering 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<p />  <p>Language: en</p>
LA  - en
SN  - 2731-913X
UR  - http://dx.doi.org/10.1186/s44263-024-00055-4
ID  - ref1
ER  -