Citation

Sourander A, Silwal S, Osokina O, Hinkka-Yli-Salomäki S, Hodes M, Skokauskas N. J. Am. Acad. Child Adolesc. Psychiatry 2024; ePub(ePub): ePub.

Copyright

(Copyright © 2024, American Academy of Child Adolescent Psychiatry, Publisher Lippincott Williams and Wilkins)

DOI

10.1016/j.jaac.2024.03.015

PMID

38575059

Abstract

OBJECTIVE: War profoundly impacts people's lives, causing death, displacement and psychological trauma but limited research has investigated adolescents' suicidality in this context. We compared suicidality or self-harm behavior among adolescents in regions that were, and were not, affected by Russia's initial invasion of Ukraine in 2014.

METHOD: This cross-sectional study comprised 2,752 school students aged 11-17 years from war-affected Donetsk region and non-war Kirovograd region. Data collection occurred from 2016-17 using self-report tools to assess suicidality or self-harm behavior, psychopathology including post-traumatic stress disorder (PTSD), depression and anxiety, and war trauma exposure.

RESULTS: Adolescent girls in war-affected region reported more suicide attempts (9.5% vs 5.1%, adjusted odds ratio [aOR] 1.8, 95% confidence interval [CI] 1.2-2.8), suicidal ideation (39.3% vs 19.6%, aOR 2.6, 95% CI 2.01-3.3) or self-harm behavior (19.6% vs 13.1%, aOR 1.6, 95% CI 1.2-2.1) and boys reported more suicidal ideation (17.0% vs 9.8%, aOR 1.7, 95% CI 1.2-2.4). Boys and girls with PTSD, depression or anxiety showed increased risks for any suicidality or self-harm. A dose-effect relationship was observed in the relationship between war trauma exposure and suicidality or self-harm. The association was strongest for those who had been exposed to 5 or more different war trauma exposures (aOR 3.2, 95% CI 2.2-4.8).

CONCLUSION: War trauma exposure and psychopathology were strongly associated with suicidality or self-harm behavior, with a greater impact in girls than boys. The high prevalence of suicidality found in this study emphasizes the need for intervention at large scale for adolescents living in war situations.

Language: en

Keywords

adolescents; self-harm; suicidal ideation; suicide attempts; war; war adolescents.