Suicidal behavior among school-going adolescents in Bangladesh: findings of the global school-based student health surve

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ORIGINAL PAPER

Suicidal behavior among school‑going adolescents in Bangladesh: findings of the global school‑based student health survey Md. Mostaured Ali Khan1 · Md. Mosfequr Rahman1   · Md. Rafiqul Islam1 · Masud Karim1 · Mahmudul Hasan1 · Syeda S. Jesmin2 Received: 5 October 2019 / Accepted: 25 March 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020

Abstract Purpose  Suicidal behavior, defined as non-fatal suicidal thoughts and behaviors that include having suicide ideation, plan, and attempts, is a leading cause of injury and death among adolescents globally. This study aimed to explore the prevalence of and the factors associated with suicidal behavior among school-going adolescents in Bangladesh. Methods  This study utilized data from the 2014 Global School-based Student Health Survey (GSHS), Bangladesh. A sample of (n = 2989) school-going adolescents aged 11–18 years was selected for this study. Risk factors of suicidal behavior were identified using a generalized estimating equation-modified Poison regression approach. Results  The age-adjusted prevalence of suicidal behavior among adolescents in Bangladesh was 11.7%. The result indicated that individual psychosocial factors such as loneliness [adjusted risk ratio (ARR) 1.36; 95% confidence interval (CI) 1.02–1.81], anxiety (ARR 2.01; 95% CI 1.43–2.81), being bullied (ARR 1.88; 95% CI 1.51–2.33), and having no close friends (ARR 2.30; 95% CI 1.77–2.97) were associated with increased likelihood of suicidal behavior. Health-risk behaviors such as ever having sexual intercourse, alcohol and drug abuse, and social–environmental factors, such as rare parental homework check, and lack of peer support were found to be positively associated with adolescents’ suicidal behavior. Additionally, a dose–response relationship is observed between the experience of multiple adverse psychosocial factors and suicidal behavior. Conclusion  Suicidal behavior is prevalent among school-going adolescents in Bangladesh. This study underscores the importance of early screening and interventions targeted to adolescents at risk, which might reduce the suicide rate among this population in Bangladesh. Keywords  Adolescents · Adverse childhood experiences · Bangladesh · Suicide · Suicidal behavior

Introduction Suicide is a global health issue [1]. Although suicide affects people of all ages, the rates of suicide are highest among the adolescents and young adults [2]. Suicide is the second leading cause of death in late childhood and adolescence, which constitutes 8.5% of all deaths [3]. However, non-fatal suicidal behaviors (defined as non-fatal suicidal thoughts and behaviors that include having suicide ideation, plan, and * Md. Mosfequr Rahman [email protected] 1



Department of Population Science and Human Resource Development, University of Rajshahi, Rajshahi 6205, Bangladesh



Department of Sociology and Psychology, University of North Texas at Dallas, Dallas, TX, USA

2

attempts [3, 4]) are much more common and more frequent than actual suicide. For example