Ai Koyanagi1, Brendon Stubbs2, Hans Oh3, Nicola Veronese4, Lee Smith5, Josep Maria Haro6, Davy Vancampfort7. 1. Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain. Electronic address: a.koyanagi@pssjd.org. 2. Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London, United Kingdom; Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford, United Kingdom. 3. Suzanne Dworak-Peck School of Social Work, University of Southern California, CA, USA. 4. National Research Council, Neuroscience Institute, Aging Branch, Padova, Italy. 5. The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, United Kingdom. 6. Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain. 7. Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium; University Psychiatric Center KU Leuven, KU Leuven, Leuven-Kortenberg, Belgium.
Abstract
BACKGROUND: Data on food insecurity and suicide attempts in adolescence are scarce. Thus, the aim of the current study was to assess the association between food insecurity (hunger) and suicide attempts in adolescents from 44 countries. METHODS: Cross-sectional, school-based data from the Global School-based Student Health Survey were analyzed. Data on past 12-month suicide attempts and past 30-day food insecurity (hunger) were collected. Multivariable logistic regression, meta-analysis, and meta-regression were conducted to assess the associations. RESULTS: The final sample consisted of 179,771 adolescents attending school. The prevalence of moderate (rarely/sometimes hungry) and severe (most of the time/always hungry) food insecurity were 46.7% and 7.0%, respectively. After adjustment for potential confounders, severe food insecurity (vs. no food insecurity, i.e., no hunger) was significantly associated with higher odds for suicide attempts in 31 of the 44 countries studied with the pooled OR (95% CI) being 1.90 (1.77-2.04) (I2 = 45.2%). The associations were similar across country-income levels. However, meta-regression analysis by country showed that stronger associations were related with lower population prevalence of severe food insecurity. The pooled OR (95% CI) for moderate food insecurity (vs. no food insecurity) was 1.26 (1.21-1.32) (I2 = 29.7%). LIMITATIONS: Causality cannot be established due to the cross-sectional study design. CONCLUSIONS: Food insecurity (hunger) is a global problem and is associated with suicide attempts. The identification of children suffering from food insecurity (hunger) and remedying this condition may be important to improve mental health among adolescents worldwide.
BACKGROUND: Data on food insecurity and suicide attempts in adolescence are scarce. Thus, the aim of the current study was to assess the association between food insecurity (hunger) and suicide attempts in adolescents from 44 countries. METHODS: Cross-sectional, school-based data from the Global School-based Student Health Survey were analyzed. Data on past 12-month suicide attempts and past 30-day food insecurity (hunger) were collected. Multivariable logistic regression, meta-analysis, and meta-regression were conducted to assess the associations. RESULTS: The final sample consisted of 179,771 adolescents attending school. The prevalence of moderate (rarely/sometimes hungry) and severe (most of the time/always hungry) food insecurity were 46.7% and 7.0%, respectively. After adjustment for potential confounders, severe food insecurity (vs. no food insecurity, i.e., no hunger) was significantly associated with higher odds for suicide attempts in 31 of the 44 countries studied with the pooled OR (95% CI) being 1.90 (1.77-2.04) (I2 = 45.2%). The associations were similar across country-income levels. However, meta-regression analysis by country showed that stronger associations were related with lower population prevalence of severe food insecurity. The pooled OR (95% CI) for moderate food insecurity (vs. no food insecurity) was 1.26 (1.21-1.32) (I2 = 29.7%). LIMITATIONS: Causality cannot be established due to the cross-sectional study design. CONCLUSIONS: Food insecurity (hunger) is a global problem and is associated with suicide attempts. The identification of children suffering from food insecurity (hunger) and remedying this condition may be important to improve mental health among adolescents worldwide.
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