BACKGROUND: The aim of this study was to describe potential associations between suicidal behaviors and psychoactive substance uses among adolescents.
METHODS: A cross-sectional, national survey representative of adolescents aged 17, living in continental France, was conducted in 2014. A total of 22,023 adolescents answered an anonymous, self-administered questionnaire about their health and their use of psychoactive substances. Suicidal risk was assessed by means of a 4-level indicator [1. No depression, as stipulated by the Adolescent Depression Rating Scale (ADRS); 2. Depression, no suicidal ideation, no suicidal attempts; 3. Depression with suicidal ideation; 4. Depression with suicidal attempts]. Multivariate logistic regressions were conducted to identify the factors significantly related to frequent substance uses.
RESULTS: Three percent of adolescents (1.8% of boys vs. 3.7% of girls) were labeled as suffering from severe depression, 10% stated they had suicidal thoughts during the last year and 3% attempted to commit suicide at least once in their lifetime. The results support the view of a gradient between suicidal risk severity and regular use of tobacco and cannabis. The association with regular alcohol use appears somewhat weaker.
CONCLUSION: Suicidal behaviors and regular substance uses are significantly related but also mediated by adolescents' mental health.