The Relationship Between Body Mass Index And Suicidal Ideation And Suicide Attempt Among Adolescents In Low-and Middle-income Countries

Background: Suicide has become a serious public health problem worldwide,causing serious harm to families and society.In previous studies,it has been found that body weight may affect suicidal ideation and suicide attempts.However,most of the existing studies on suicide are conducted in high-income countries,while there are very few studies on adolescents in low-and middle-income countries(LMIC).At the time,about 79% of all suicides in 2016 occurred in LMIC.The relationship between the weight of adolescents in LMIC and suicidal ideation and suicide attempts remains unclear.Therefore,we conducted a study on 104,907 adolescents aged 12-15 years in 45 LMIC.Method: We analyzed data from the Global School Student Health Survey(GSHS).The subjects of the survey were 104907 adolescents aged 12-15 years.They were divided into underweight,normal weight,and overweight according to their body mass index.They reported their suicide ideation and suicide attempt by using selfadministered questionnaire.We use SAS and Stata software for data analysis.Multivariate logistics regression model was used to calculate odds ratios and 95% confidence intervals,and meta-analysis was conducted based on countries and regions.Results: The combined reporting rates of underweight and overweight for 12-15 yearold adolescents in 45 low-and middle-income countries were 19.1% and 22.1% respectively.The combined reporting rates of underweight and overweight for 12-15 year-old adolescents were 15.9% and 22.7% in 29 low-and middle-income countries respectively.The reporting rates of suicidal ideation and suicide attempts among adolescents aged 12-15 in 45 low-and middle-income countries were 16.2% and 17.6%,respectively.The results of the meta-analysis showed that being overweight was associated with an increased risk of suicidal ideation(OR = 1.12;95% CI = 1.05-1.18)and suicide attempt(OR = 1.11;95% CI = 1.03-1.19).Subgroup analysis showed that the association between overweight and suicidal ideation/attempted suicide was only in women,but not significant in men.Conclusion: Adolescents who were overweight in LMIC had a higher risk of reporting suicidal ideation and attempted suicide compared with normal-weight adolescents,but this relationship was only observed in females.