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Cited by 290Suicide and Self-Harm StudiesMental Health Treatment and AccessChild and Adolescent Psychosocial and Emotional Development

Global variation in the prevalence of suicidal ideation, anxiety and their correlates among adolescents: a population based study of 82 countries

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Biswas, Tuhin, Scott, James G., Munir, Kerim, Renzaho, Andre M.N., Rawal, Lal B., Baxter, Janeen, Mamun, Abdullah A.·2020·eClinicalMedicine
DOI 10.1016/j.eclinm.2020.100395PMC PMC7525128
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Abstract

Background : Suicidal ideation and anxiety are common among adolescents although their prevalence has predominantly been studied in high income countries. This study estimated the population prevalence of suicidal ideation and anxiety and their correlates with peer support, parent-adolescent relationship, peer victimisation, conflict, isolation and loneliness across a range of low-income, lower-middle-income, upper-middle-income countries and high-income countries (LMIC-HICs). Methods: Data were drawn from the Global School-based Student Health Survey (GSGS) of adolescents aged 12–17 years between 2003 and 2015 in 82 LM-HICs from the six World Health Organization (WHO) regions. We estimated weighted prevalence of suicidal ideation and anxiety by country, region and at a global level. We used multiple binary logistic regression to estimate the adjusted association between adolescent age, sex, socioeconomic status, peer support, parent-adolescent relationship, peer victimisation, conflict, isolation and loneliness with suicidal ideation and anxiety. Findings: The sample comprised of 275,057 adolescents aged 12–17 years (mean age was 14·6 (SD 1·18) years of whom 51·8% were females). The overall pooled prevalence of suicidal ideation and anxiety were 14·0% (95% CI 10·0-17·0%) and 9·0% (7·0-12·0%) respectively. The highest pooled prevalence of suicidal ideation was observed in the Africa Region (21·0%; 20·0-21·0%) and the lowest was in the Asia region (8·0%, 8·0-8·0%). For anxiety, the highest pooled prevalence was observed in Eastern Mediterranean Region (17·0%, 16·0-17·0%) the lowest was in the European Region (4·0%, 4·0-4·0%). Being female, older age, having a lower socioeconomic status and having no close friends were associated with a greater risk of suicidal ideation and anxiety. A higher levels of parental control was positively associated with a greater likelihood of experiencing suicidal ideation (OR: 1·65, 1· 45-1·87) and anxiety (1·53, 1·30-1·80). Parental understanding and monitoring was negatively associated with mental health problems. Similarly, the odds of experiencing suicidal ideation and anxiety were higher among adolescents who had been experiencing peer conflict (1·36, 1·24-1·50; 1·54, 1·40-1·70), peer victimization (1·26, 1·15-1·38; 1·13, 1·02-1·26), peer isolation (1·69, 1·53-1·86; 1·76, 1·61-1·92) and reported loneliness (2· 56, 2·33-2·82; 5·63, 5·21-6·08). Interpretations: Suicidal ideation and anxiety are prevalent among adolescents although there is significant global variation· Reductions in suicidal ideation and anxiety may be facilitated by family and peer-based interventions aimed at increasing social connectedness between adolescents and enhancing parenting skills. Research to inform the factors that influence country and regional level differences in adolescent mental health problems may inform preventative strategies.Funding Statement: The authors stated: "None."Declaration of Interests: All authors have no conflict of interest.Ethics Approval Statement: Global School-based Student Health Survey (GSHS) data are publicly available.

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  • In low-resource settings, the prevalence and time trends of mental illness and related dimensions such as loneliness vary.

    “In low-resource settings, the prevalence and time trends of mental illness and related dimensions such as loneliness vary, as shown in various recent studies.”

    From The Lancet Psychiatry Commission on youth mental health (2024) · cites this paper as [83]

    The Results report substantial country-level variation in adolescent suicidal ideation and anxiety, and the paper examines loneliness as a correlate. But it does not establish varying time trends: the Methods say that, where countries had repeated surveys, the analysis used only the most recent one. It also does not report variation in the prevalence of loneliness itself. (LLM, conf=0.87)

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Authors
Biswas, T., Scott, J. G., Munir, K., Renzaho, A. M. N., Rawal, L. B., Baxter, J., & Mamun, A. A.
Affiliations
  • The University of Queensland (AU)
  • Western Sydney University (AU)
Corresponding author
Biswas, Tuhin
ORCID
Venue
eClinicalMedicine
Publisher
Elsevier BV
Published
2020-07
Volume
24
Pages
100395
ISSN
2589-5370 (ISSN-L)
DOI
10.1016/j.eclinm.2020.100395
PMC
PMC7525128
OpenAlex
W3036518845
Cited by
290
References
33
Citations by year
2026: 48 · 2025: 53 · 2024: 72 · 2023: 58 · 2022: 34 · 2021: 21 · 2020: 4
FWCI
11.71
Type
journal article
Language
en
Open access
Licence
Locations
  • EClinicalMedicine (publishedVersion, cc-by-nc-nd)
  • SSRN Electronic Journal (publishedVersion)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Figshare (submittedVersion, cc-by-nc-nd)
Funders
US
Topics
  • Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
  • Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
Keywords
suicidal ideation, adolescent anxiety, global prevalence, low- and middle-income countries, peer victimization, peer support, parent-adolescent relationships, parental control, loneliness, socioeconomic status, sex differences, adolescent mental health, cross-national comparison, Global School-based Student Health Survey, suicide risk factors, WHO regions, Africa, Eastern Mediterranean, Europe, Asia, Pacific Ocean, Americas, Oceania

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