Magnitude and Associated Factors of Suicidal Ideation and Attempt Among High School Adolescents of Jimma Town, Southwest, Ethiopia

Abstract

Background: More than three-fourth of the global suicides occur in low- and middle-income countries, which is the one of the leading causes of death in adolescents. Studies show that suicidal ideation and attempt as the leading pathways for suicide. There have been limited researches in Ethiopia regarding suicidal ideation and suicidal attempt; yet varaibles such as cyber bullying, household wealth, family and school environment and were not addressed in the previous studies. Objective: To determine the magnitude and associated factors of suicidal ideation and suicidal attempt in high school adolescents of Jimma Town, Southwest Ethiopia 2022. Methods: A school based cross-sectional study was conducted from January 1- June 30. A sample of 1144 adolescents of grades 9 to 12 were the participants. Multistage sampling technique was used and data was collected using a self-administered questionnaire. Data was cleaned and entered to Epi-data version 3.1 and then exported to SPSS version 26 for analysis with binary logistic regression. Factors that were found significantly associated during bi variable analysis (p value < 0.25) were entered into the multi-variable analysis. A statistical significance was considered at p value <0.05 and considering 95% confidence interval. Results: Life time suicidal ideation and attempt were reported by 22.5% (95% CI: 20.1, 24.9) and 13.3% (95% CI: 11.4, 15.4) of the participants respectively, while 12-month suicidal ideation and attempt were reported by 14.6% (95% CI: 12.4, 16.7) and 10% (95% CI: 8.1,11.8) of the respondents. Being female was one of the factors associated with higher odds of both suicidal ideation (AOR: 1.7; 95% CI: 1.4, 2.6) and suicide attempt (AOR: 2; 95% CI: 1.2, 3.4). Those disappointed in school had two and half (AOR: 2.3; 95% CI: 1.4, 4) and three and half ((AOR: 3.5; 95% CI: 1.8, 6.8) times higher odds of ideating and attempting suicide. Other factors associated with both suicidal ideation and attempt with their respective odds for suicidal ideation and attempt are family history of suicide attempt ( AOR: 2.7; 95% CI: 1.7,4.2) and (AOR :2.9; 95% CI: 1.8, 4.9); current alcohol use (AOR: 3.6; 95% CI: 2,6.4) and (AOR :4.8; 95% CI: 2.6, 8.8); severe anxiety ( AOR: 2.4; 95% CI: 1, 2.5) and (AOR :2.9; 95% CI: 1.4,6.1) ; extremely severe anxiety (AOR :4.1; 95% CI: 2,8.3) and (AOR :5.5; 95% CI: 2.9, 10.3); having chronic medical condition (AOR: 2.1; 95% CI: 1.3, 2.3) and (AOR :2: 2; 95% CI: 1.2, 3.2). The factor III only associated with suicidal ideation was cyber bullying ( AOR: 2.2; 95% CI: 1.4, 3.4).Wealth index was found to be associated with suicidal ideation; while family history of suicide was also found associated to both suicidal ideation and attempt even if both variables‘ association wasn‘t statistically significant in the multi-variable analysis. Conclusion and Recommendations: The magnitude of suicidal ideation is consistent with the previous studies in Ethiopia and lower than of the neighboring countries but is not ignorable since suicidal ideation and attempt are concepts directly related to mortality. School administrations should work on creating favorable environment for mental health awareness creation and parents should help their adolescent children seek help from health professionals when facing mental health problems. Additionally, there should be parental guidance of adolescents‘ mobile phone use. Future researchers are recommended consider variables such as wealth index to further explain their relationship with suicidal ideation and attempt.