How are depression and suicidal ideation associated with multiple health risk behaviours among adolescents? A secondary data analysis using the 2016 Korea Youth Risk Behavior Web‐based Survey

Abstract

Accessible summary What is known on the subject? Adolescents who partake in one health risk behaviour (HRB) easily adopt other HRBs, simultaneously or subsequently. Multiple HRBs might threaten adolescents’ future health in adulthood. Adolescents with psychological problems have higher rates of smoking, alcohol use, early sexual initiation and activity, and illicit substance use compared with others. What does this paper add to existing knowledge? A considerable number of Korean adolescents with mental health problems were engaged in multiple HRBs. For those with mental health problems, more than half of the Korean adolescents with multiple HRBs tended to use alcohol and cigarettes concurrently. Korean adolescents who felt depressed and had suicidal ideation were more likely to engage in a greater number of HRBs. Substance abuse is the most prevalent problem that is combined with other HRBs among those with depression and suicidal ideation compared to those who exhibited other HRBs. What are the implications for practice? When mental health nurses working in schools and community centres for mental health identify Korean adolescents with significant depression and suicide ideation levels, they should also assess adolescents’ engagement in multiple HRBs. Population‐based campaigns and policy changes that emphasize both psychological health and risky behaviour reduction among adolescents should be provided simultaneously to students and school nurses. Abstract IntroductionThere is limited understanding about whether poor mental health is associated with certain combinations of multiple health risk behaviours (HRBs) such as smoking, drinking, early sexual activity and substance abuse. AimTo determine the prevalence of multiple HRBs and to identify associations between poor mental health and multiple HRBs as the number of HRBs increases. MethodsThis cross‐sectional study was conducted using the 2016 Korea Youth Risk Behavior Web‐based Survey (N = 65,528). Descriptive statistics and multinomial logistic regression analyses were conducted using the complex sample data. ResultsOverall, 28.6% and 13.9% of Korean adolescents were involved in one or multiple HRBs, respectively. Adolescents who were depressed (OR = 1.43–4.47, 95% CI = 1.37–1.49 to 3.23–6.20) and/or who had suicidal ideation (OR = 1.33–3.19, 95% CI = 1.25–1.42 to 2.25–4.51) were more likely to engage in multiple HRBs. DiscussionA considerable numbers of Korean adolescents are engaged in multiple HRBs. When adolescents self‐reported depression and suicidal ideation, they were more likely to engage in a greater number of HRBs than single HRB. Implications for practiceTailored interventions to decrease multiple HRBs should be designed and provided by considering adolescents’ mental health status and needs.

Relationships between neighborhood collective efficacy and adolescent suicidal ideation

“…The prevalence estimates of adolescent suicidal behaviors differ considerably depending on the study sampling frame (school‐based vs. household‐based; Gould et al, 2003). The 12‐month prevalence of suicidal ideation, which was identified by use of the household‐based nationwide sample of adolescents in this study, is lower than that reported in studies using a school‐based nationwide sample of South Korean adolescents (12.1%–23.4%) (Kang et al, 2015; Kim, 2014; Kim et al, 2020). In addition, the prevalence rate in this study was lower than in the pooled 12‐month prevalence of suicidal ideation (14.0%) in 82 countries analyzed in the World School‐based Student Health Survey (Biswas et al, 2020).…”

“…Female gender and older age are known risk factors for suicidal ideation (Choi et al, 2015; Nam, 2013; Sohn, 2014). The most‐studied personal factors in previous studies were depression, anxiety, hostility, impulsivity, low self‐esteem, smoking cigarettes, and alcohol use (Choi et al, 2015; Hong et al, 2016; Kang et al, 2015; Kim et al, 2020; Kim & Jeon, 2012; Kim & Kim, 2013; Nam, 2013; Oh et al, 2016; Sohn, 2014). Major family‐related factors have included family economic status, family discord, child maltreatment, parent‐child communication, and parent support.…”

Effect of Subjective Economic Status During the COVID-19 Pandemic on Depressive Symptoms and Suicidal Ideation Among South Korean Adolescents

“…According to a review 13 , 27 , 28 of factors related to depressive symptoms and suicidal ideation in adolescents, we considered sex, school grade, self-rated academic performance, cohabitation with family, subjective health status, smartphone dependency, current alcohol consumption, and current smoking as covariates. Self-rated academic performance was measured through responses to the question: “During the past year, how was your academic performance?” The response options were high, mid-high, middle, mid-low, and low.…”

Association Between the Patterns of Five Unhealthy Behaviors and Suicidal Behaviors Among Adolescents in Six Provinces of China

“…Unhealthy behaviors are not only associated with poor healthy conditions of future life for adolescents, but also related to mental health problems that cannot be ignored for the healthy development of young people. For example, both cigarette smoking and alcohol drinking are associated with affective temperament and psychiatric distress, including anxiety and depression, and some suicidal ideation in adolescents ( 8 , 12 , 13 ). In a previous study, it was reported that affective temperament types were independently associated with lifetime suicide attempts ( 14 ).…”