Behavioral and psychosocial factors associated with suicidal ideation in adolescents with depression: An ecological model of health behavior

Background: Although many studies have examined the relationship between suicidal ideation and psychosocial factors in adolescents, there are differences between the results.

Methods: Adopting the ecological model of health behavior as a theoretical framework, this study assessed individual, interpersonal and organizational factors associated with the prevalence of suicidal ideation and preventive behaviors in 305 Chinese adolescents hospitalized with depression. Clinical and demographic data were collected by a self-administered questionnaire. The Hamilton Depression Scale (HAMD) and suicidal ideation were assessed by interview.

Results: The prevalence of suicidal ideation among the sample was 75.7% (231/305). Logistic regression showed that the increase of suicide ideation was associated with woman (OR = 2.237, 95%CI = 1.074-4.659), degree of depression(moderate depression: OR = 10.198, 95%CI = 3.819-27.237; major depression: OR = 21.677, 95%CI = 7.006-67.076), and high emotion-oriented coping(OR = 1.985, 95%CI = 0.977-4.034). However, high psychological resilience had lower rates of suicidal ideation (OR = 0.384, 95%CI = 0.158-0.933).

Conclusion: These findings highlight the need to pay sufficient attention to individuals with these risk factors for suicidal ideation in clinical work and to prevent suicidal behaviors by increasing health promotion behaviors.