Infectious Disease

Gender, racial / ethnic differences in adolescents with suicidal ideation

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Disclosure:
One study author reports that he received royalties for commercial use of the C-SSRS from the Research Foundation for Mental Hygiene. The other authors do not report any relevant financial information.

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Gender and racial / ethnic differences in trends over time were evident among adolescents with suicidal ideation, according to the results of a cross-sectional analysis published in JAMA Network Open.

“Previous studies have reported increasing rates of suicidal death, non-fatal suicidal ideation, planned attempts, and attempted injuries.” Yunyu Xiao, PhD, from the School of Social Work at Indiana University-Purdue University, and colleagues wrote. “However, to this day, most of the work did not separate the young people who had attempted suicide from those who had suicidal thoughts, but no attempts. This step is necessary because theoretical and empirical evidence suggests that the risk factors associated with suicidal ideation and attempted suicide are likely to be different. ”

According to the researchers, it is currently unknown whether the inequalities in suicide death also extend to groups targeting suicide prevention attempts, particularly those with suicidal ideation or non-fatal suicide attempts. In the current study, they aimed to examine differences in temporal trends between suicidal ideation and attempted suicide among U.S. adolescents between 1991 and 2019 by gender and ethnicity. They performed a cross-sectional analysis of the national Youth Risk Behavior Survey, weighted to represent U.S. adolescents in the desired timeframe, and they included 183,563 U.S. high school students in grades 9-12. Calendar year, gender, race / ethnicity and interactions of gender and race / ethnicity served as exposures.

Key endpoints and metrics included survey-weighted prevalence estimates, annual percentage changes, and average annual percentage change in the survey-weighted prevalence of suicidal ideation and non-fatal attempted suicide. They constructed these results / measures on the basis of self-reported suicidal thoughts, plans and attempts in each survey year according to gender, race / ethnicity and their interactions.

The results showed a decrease in the prevalence of suicidal ideation from 19.4% in 1991 to 15.8% in 2019. However, the prevalence of non-fatal suicide attempts increased from 7.3% in 1991 to 8.9% in 2019. Thoughts of suicide between 1991 and 2009 and then an annual increase of 3.4% between 2009 and 2019. The researchers found modest different turning points in female, white, Hispanic, and black adolescents based on a decrease in suicidal ideation followed by an increase in suicidal ideation. In addition, they did not observe any significant trends in suicide attempts between 1991 and 2019; however, male and black adolescents showed a greater increase in the prevalence of suicide attempts at 68.4% and 79.7%, respectively. The interaction of gender and race / ethnicity showed an increase in suicidal ideation among white women from 2009 to 2019, with an annual percentage change of 4.3%; Black women from 2005 to 2019, with an annual percentage change of 3.4%; and Hispanic women from 2009 to 2019, with an annual percentage change of 3.3%. The researchers also found an increase in suicide attempts among white women between 2009 and 2019, representing an annual percentage change of 3.1%.

“Men, especially black male adolescents, appear to have the greatest need for prevention of suicidal behaviors,” wrote Xiao and colleagues. “Both groups underperformed in terms of the ability to seek help, and there can be stigma and racial barriers to seeking psychiatric treatment for young black men. Policies that prioritize monitoring trends in risk factors for suicidal behavior in racial / ethnic subgroups, design culturally appropriate prevention programs, alleviate structural inequality, remove mental health stigma and barriers to health care, and encourage the search for help should be for a effective effect ethnically and sexually diversified will be suicide prevention. “

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