Suicidal ideation and associated factors in 2821 school-going adolescents in Uganda

In Uganda, a country facing a myriad of socio-economic challenges, understanding the burden of suicidal thoughts and identifying associated factors among school-going adolescents is crucial for developing targeted public and school health interventions. This study examines the prevalence of suicidal ideation and associated factors among school-going Ugandan adolescents.

In total, 2821 adolescents (1273 boys; 16.3 ± 1.0 years) completed the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder -7 (GAD-7), Childhood Trauma Questionnaire-Short Form (CTQ-SF), Physical Activity Vital Sign and questions on food security, health and socio-economic status. Binary logistic regressions were used to detect variables independently associated with suicidal ideation.

Suicidal ideation in the past 2 weeks (PHQ-9 item 9 score ≥ 1) was present in 32.9 % (n = 927). In separate multivariable logistic regressions, which included all variables that were statistically significant in the univariate analyses, female sex (adjusted odds ratio, AOR = 1.65, 95 %CI = 1.36-1.99), living in a post-conflict setting (AOR = 1.48, 95 %CI = 1.19-1.84), a poor self-reported health status (AOR = 2.83, 95 %CI = 2.35-3.42), severe depressive symptoms (AOR = 3.82, 95 %CI = 2.33-6.25), severe anxiety symptoms (AOR = 3.94, 95 %CI = 2.72-5.70), a history of abuse (AOR = 2.36, 95 %CI = 1.94-2.88) and a history of neglect (AOR = 1.50, 95 %CI = 1.21-1.87) remained significantly associated with suicidal ideation.

Suicidal ideation is highly prevalent among Ugandan school-going adolescents. These findings highlight the urgent need for comprehensive, school-based mental health strategies that include routine screening, psychosocial support, and clearly defined referral pathways, particularly for girls and those residing in post-conflict regions where trauma exposure and service limitations are pronounced.