Epidemiology of Suicidal Ideation, Planning, and Attempts in School-Going Adolescents in the Wasit Governorate: An Updated Wide-Scale Study

Background Suicide represents a serious global public health challenge and a leading cause of mortality and morbidity in adolescents. This study aimed to investigate the occurrence and some determinants of suicidal ideation, planning, and attempts among school-going adolescents in the Wasit Governorate, Iraq. Methodology This was an updated, wide-scale cross-sectional study targeting public governmental middle- and high-school students aged 13 to 18 years. Schools and students were selected using a standardized two-stage cluster sampling design. A pretested Arabic Version of the Iraqi Global School-Based Student Health Survey questionnaire was used in addition to demographic and psychosocial variables, including parental socio-economic status and history of suicidal behaviors among family members and friends. All procedures were performed under ethical standards. The survey data analysis was performed using the primary sampling unit (PSU) and finite population correction (FPC) methods with a baseline univariate analysis and multivariate logistic regression to measure the associated factors. Results A total of 1810 students from 42 middle and high schools were included, with a mean age of 15.98 years. Boys formed 50.27% of the study population. The overall 12-month prevalence of suicidal ideation, planning, and attempts was 23.87% (95% CI: 19.65-28.67), 21.90% (95% CI: 18.04-26.32), and 22.37% (95% CI: 18.60-26.65), respectively. In the univariate analysis, suicidal behavior, and thoughts had significant associations with gender, social status, residency, parental conflict, and the presence of suicidal behavior history in family and friends. In the multivariate full-model analysis, the risk factors for suicide attempts were girls (adjusted odds ratio or AOR 1.64; 95% CI; 1.05-2.58), exposure to suicide attempts in family members (AOR 3.36, 95% CI: 1.60-7.06) and friends (AOR 1.99, 95% CI: 1.26-3.15). Suicidal ideation (AOR 11.81, 95% CI: 7.59-18.40) and planning (AOR 8.06, 95% CI: 4.30-15.10) were the most important associated risk factors for suicide attempts. Conclusion Suicidal ideation, planning, and attempts are alarmingly prevalent among school-going adolescents in Wasit, particularly among girls and those with a history of suicide attempts in friends and family members. Suicidal ideation and planning strongly relate to suicide attempts. Multi-level and collaborative efforts toward preventing the onset of ideation, planning, and attempts are crucial.