Associations between somatic symptoms and suicidal behavior: a cohort study in Chinese adolescents

Somatic complaints and suicidal behavior are prevalent in adolescents. However, longitudinal data examining the associations between somatic symptoms and suicidal behaviors in Chinese adolescents are limited. The present study aims to investigate the cross-sectional and longitudinal associations between somatic symptoms and suicidal behavior in a large cohort of Chinese adolescents.

A total of 6,934 Chinese teenagers were assessed at baseline and one year later. Somatic symptoms were assessed using the somatic complaints subscale of the Youth Self-Report. A self-administered questionnaire was utilized to measure suicidal behavior (suicidal ideation or suicide attempt), depressive symptoms, and adolescent and family covariates. Logistic regression models were utilized to examine the relationships between somatic symptoms and suicidal behavior.

Both cross-sectional and longitudinal data analyses showed that the prevalence rates of suicidal behavior were significantly increased with the severity of somatic symptoms (score range 0-14). After adjusting for demographic characteristics and depressive symptoms, somatic symptom scores of 4-5 and ≥ 6 were associated with increased odds of suicidal behavior at baseline (AOR = 1.93 and 2.32) and at one-year follow-up (AOR = 1.33 and 1.59). Adolescents with no suicidal behavior at baseline but somatic symptom scores of ≥ 6 were 1.70 times more likely to report newly incident suicidal behavior within the year of follow-up.

Somatic symptoms independently predict suicidal behavior in adolescents. This finding underscores the need to assess and manage somatic complaints for suicide prevention among adolescents.