Sexual abuse and substance abuse increase risk of suicidal behavior in Malaysian youth

Introduction The aim of this study was to determine the association between sexual abuse, substance abuse and socio-demographic factors with suicidal ideation (SI), plans (SP) and deliberate self-harm (DSH) and propose steps to prevent youth suicidal behavior. Methods This was a cross-sectional study of 6786 adolescents aged 1718 years, selected randomly from all Malaysian adolescents to undergo compulsory youth camps located in Selangor, Malaysia (20082009). Participants were assessed using self-administered questionnaires developed to reflect the local cultural setting. However, only 4581 subjects were analyzed after excluding incomplete data. Results The rates of SI, SP and DSH were 7.6%, 3.2% and 6.3%, respectively. The multivariable-adjusted odds ratio showed that sexual abuse was associated with SI 1.99 (95% CI: 1.562.55), SP 1.57 (95% CI: 1.092.27) and DSH 2.26 (95% CI: 1.752.94); illicit drug use was associated with SI 4.05 (95% CI: 2.147.67), SP 2.62 (95% CI: 1.056.53) and DSH 2.06, (95% CI: 1.054.04); for alcohol use DSH was 1.34 (95% CI: 1.001.79). Being female was associated with all suicidal behaviors: SI 2.51 (95% CI: 1.913.30), SP 2.07 (95% CI: 1.393.08) and DSH 1.59 (95% CI: 1.192.11). Discussion Given the well-founded concern of increasing risk of suicidal behavior among youth, preventive efforts should adopt a more comprehensive approach in dealing with sexual abuse and substance abuse, and their sequelae, especially in girls.