Suicide and Self-Injury
Prevalence and correlates of adolescent self-injurious thoughts and behaviors: population-based study in rural Burkina Faso
Tracie I. Ebalu, B.S.
PhD student
University of Pittsburgh
Pittsburgh, Pennsylvania
Jaclyn C. Kearns, M.A.
PhD Candidate
University of Rochester
Rochester, New York
Lucienne Ouermi, Ph.D.
PhD
Centre de Recherche en Santé de Nouna
Ouagadougou, Oubritenga, Burkina Faso
Mamadou Bountogo, Ph.D.
PhD
Centre de Recherche en Santé de Nouna
Nouna, Naouri, Burkina Faso
Ali Sié, Ph.D.
PhD
Centre de Recherche en Santé de Nouna
Nouna, Naouri, Burkina Faso
Till Bärnighausen, M.D., M.S., Other
Professor
Institute of Global Health
Heidelberg, Baden-Wurttemberg, Germany
Guy Harling, M.P.H., Ph.D.
Associate Professor
Institute for Global Health
London, England, United Kingdom
Worldwide, suicide is the second leading cause of death among youth aged 15-29 years especially in low and middle-income countries (LMIC), which contain 90% of the world’s youth and account for 75% of suicide deaths. Despite this burden, nearly all studies of youth suicide have been conducted in high-income countries. As a result, the prevalence and correlates of youth self-injurious thoughts and behaviors (SITBs) in LMIC are poorly understood. Even within sub-Saharan Africa, research on SITBs is unequally distributed, with lowest income countries, including Burkina Faso, especially underrepresented.
In this study we investigated: (1) lifetime prevalence of passive suicide ideation, active suicide ideation, and non-suicidal self-injury (NSSI); (2) potential correlates of youth SITBs including demographics, adverse environmental factors, psychiatric symptoms, and interpersonal-social experiences. Participants comprised 1,538 adolescents aged 12-20 years old living in rural and semirural northwestern Burkina Faso.
After accounting for sampling and non-response, weighted prevalence estimates for SITBs were: 15.6% for lifetime NSSI, 15.1% for lifetime life not worth living, 5% for lifetime passive ideation, and 2.3% for lifetime active suicide ideation. Using chi-square tests, we found that females were significantly more likely to report that their life was not worth in their lifetime compared to males (p > 0.001), but not other SITBs. Lifetime NSSI and past 12-month NSSI frequency were significantly associated with mental health symptoms (e.g., depressive symptoms) and interpersonal-social experiences (e.g., unwanted sexual experience) (all p’s > 0.05). Lifetime passive suicide ideation and lifetime life not worth living were significantly associated with mental health symptoms (e.g., depressive symptoms) and interpersonal-social experiences (e.g., lack of perceived social belongingness).
In conclusion, our findings indicate that there is high prevalence of SITBs among youth in Burkina Faso, especially of NSSI and life not worth living. Also, interpersonal social factors, experience of violence, and psychiatric symptoms emerged as the strongest predictors of SITBs. Our results suggest the need for not only increased assessment of SITBs, but also multi-faceted prevention initiatives to target correlates such as mental health symptoms and interpersonal-social experiences. These efforts should take into account Burkina Faso’s unique social-cultural context given that most youth suicide prevention and mental health initiatives are school-based.