Association Between the Patterns of Five Unhealthy Behaviors and Suicidal Behaviors Among Adolescents in Six Provinces of China

Chunyu Guo; Yanni Xue; Zhengmei Xia; Yingying Cui; Jie Hu; Xuexue Huang; Yuhui Wan; Jun Fang; Shichen Zhang

doi:10.3389/fpsyt.2022.901537

Association Between the Patterns of Five Unhealthy Behaviors and Suicidal Behaviors Among Adolescents in Six Provinces of China

Front Psychiatry. 2022 Jul 5:13:901537. doi: 10.3389/fpsyt.2022.901537. eCollection 2022.

Authors

Chunyu Guo¹, Yanni Xue², Zhengmei Xia¹, Yingying Cui¹, Jie Hu², Xuexue Huang², Yuhui Wan², Jun Fang^{1

3}, Shichen Zhang⁴

Affiliations

¹ Department of Toxicology, School of Public Health, Anhui Medical University, and Key Laboratory of Environmental Toxicology of Anhui Higher Education Institutes, Hefei, China.
² Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, and MOE Key Laboratory of Population Health Across Life Cycle/Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei, China.
³ Faculty of Pharmaceutical Science, Sojo University, Kumamoto, Japan.
⁴ School of Public Health and Health Management, Anhui Medical College, Hefei, China.

Abstract

Background: In adolescents, multiple unhealthy behaviors frequently occur together and are likely to be associated with suicidal behaviors (SBs), increasing the risk of suicide. This study aimed to clarify the potential patterns of unhealthy behaviors in Chinese adolescents and to examine the associations between the different patterns of unhealthy behaviors and SBs.

Methods: A total of 22,628 middle school students were enrolled in this study. Self-reported unhealthy behaviors and SBs were investigated using questionnaires. Latent class analysis (LCA) was performed based on five unhealthy behaviors [smoking, alcohol use (AU), diet pill use (DPU), screen time (ST), and problematic mobile phone use (PMPU)]. Multivariate logistic regressions were used to examine associations between the different patterns of unhealthy behaviors and SBs.

Results: Four subgroups of unhealthy behaviors were identified by LCA, including high-risk class (smoking/AU/DPU/PMPU/ST), moderate-risk class 1 (DPU/PMPU), moderate-risk class 2 (smoking/AU/ST), and low-risk class. Compared with the low-risk class, moderate-risk class 1, moderate-risk class 2, and high-risk class had higher risks of suicidal ideation, suicide plan, and suicide attempt.

Conclusions: These findings suggested that patterns of unhealthy behaviors were related to SBs in Chinese adolescents. Accordingly, considerations of different classes of unhealthy behaviors may be essential for developing effective preventive programs.

Keywords: adolescent; behaviors; latent class analysis; suicide attempt; suicide ideation; suicide plan.