The associations between health risk behaviors and suicidal ideation and attempts in an urban Chinese sample of adolescents

BackgroundTo investigate the prevalence of suicidal ideation and attempts among adolescents in Guangzhou, China, and to explore the associations between health risk behaviors and suicidal behaviors.MethodsA two-stage stratified cluster sample design produced a representative sample of 12–19-year-old students who attended public middle schools in Guangzhou. Prevalence estimates and standard errors (SEs) of suicidal ideation and attempts were calculated using SUDAAN statistical software. Logistic regression was used to examine the associations between health risk behaviors and suicidal behaviors.ResultsOverall, 17.25% of students reported suicidal ideation, and 3.04% reported suicidal attempts during the past 12 months. Almost all investigated health risk behaviors were significantly associated with suicidal ideation and attempts among adolescent females and males. In adjusted logistic regression analyses, physical fight was associated with suicidal attempts (adjusted odds ratio (AOR) = 4.358; 95% confidence interval (CI) = 1.080, 17.589), but not with suicidal ideation for females. Considering themselves overweight (AOR = 1.257; 95%CI = 1.082, 1.610) and current smoking (AOR = 1.708; 95%CI = 1.134, 4.605) were associated with suicidal ideation, but not with suicidal attempts for females. Among adolescent males, sad/hopeless (AOR = 2.280; 95%CI = 1.615, 3.219), current drinking (AOR = 1.904; 95%CI = 1.269, 2.857), and participating in vigorous physical activities ≥ 3 times/week (AOR = 0.639; 95%CI = 0.477, 0.854) were associated with suicidal ideation, but not with suicidal attempts. Ever having had sexual intercourse was associated with suicidal attempts (AOR = 2.588; 95%CI = 1.125, 5.952), but not with suicidal ideation for males.ConclusionsThe associations of health risk behaviors with suicidal ideation and attempts varied by gender, and the correlates of suicidal ideation and suicidal attempts were different.