Impacts of socioeconomic, Family, School, Behavioral and Mental Difficulties on Suicide attempts in Youth

This study may help participants to recognize factors influencing suicide attempt which have to be assessed/monitored in boys and girls. Purpose: To assess the impacts of socioeconomic factors, alcohol/tobacco/cannabis/hard drugs uses, repeating a school-year, sustained physical/verbal violence, sexual abuse, depressive symptoms, and involvement in violence on suicide attempt among boys and girls in early adolescents. Methods: The sample included 1,559 middle-school students from north-eastern France (778 boys and 781 girls, mean age 13.5, SD 1.3), who completed a self-administered questionnaire including gender, birth date, father’s occupation, parents’ education, nationality, income, social supports (9-item scale), and lifetime history reconstruction of parents’ separation/divorce/death, alcohol/tobacco/ cannabis/hard drugs uses, repeating a school-year, sustained physical/verbal violence (20-item scale), sexual abuse, depressive symptoms (Kandel scale), involvement in violence (11-item scale), and suicide attempts. Data were analyzed using Cox regression models. Results: Lifetime suicide attempt affected 7.2% of boys and 12.5% of girls (p<0.001). Among boys, the factors with significant crude hazard ratio cHR were: insufficient income (2.29), alcohol use (2.33), tobacco use (3.76), hard drugs use (4.48), depressive symptoms (3.60), sustained physical/verbal violence (2.72), sexual abuse (4.30), involvement in violence (3.16), and lack of social support (2.64 for score 1-2, 3.08 for score 3+, vs. score 0). Full model including all factors retained only insufficient income (adjusted hazard ratio aHR 2.11), alcohol use (1.99), depressive symptoms (3.29), and involvement in violence (2.64). Among girls, the factors with significant cHR were: parents’ separation/divorce (2.44), insufficient income (2.23), low parents’ education (1.86), repeating a school-year (2.56), alcohol use (2.04), tobacco use (5.19), cannabis use (3.72), hard drugs use (11.65), depressive symptoms (3.51), sustained physical/verbal violence (1.71), sexual abuse (8.09), involvement in violence (2.04), and lack of social support (3.46 for score 1-2, 6.92 for score 3+, vs. score 0). Full model retained only parents’ separation/divorce (aHR 1.56), repeating a school-year (1.98), alcohol use (1.58), tobacco use (3.60), depressive symptoms (1.86), sexual abuse (6.60), and lack of social support (2.62 for score 1-2 and 4.38 for score 3+, vs. score 0). Compared with boys, girls had a significant cHR of 1.74 which decreased to 1.57 when controlling for all covariates (contribution 23%). Conclusion: This study has achieved our objectives to identify a wide range of socioeconomic, family, school, behavioral and mental difficulties generating suicide attempt among boys and girls in early adolescence. Our findings are original. They reported their causal relationships, the knowledge of which may help public policy preventing suicide attempt.