title: Suicidal Expression in Adolescents in Nicaragua in Relation to Youth Self-Report (YSR) Syndromes and Exposure to Suicide.
abstract: BACKGROUND
  Suicide and suicidal expressions among young people represent a major public health problem worldwide. Most studies are from high-income countries, and it remains unclear whether prevalence and risk factors show a similar pattern in other settings. This study aims to assess the prevalence of suicidal expressions and serious suicidal expressions (ideation, plans and attempts) among adolescents in Nicaragua, in relation to previously reported risk factors, such as exposure to suicide in significant others (parents, siblings, partners or friends) and mental health problems.
  
  
  METHODS
  368 adolescents aged 15-18 years were randomly selected from public secondary schools in León, Nicaragua. Data was collected using Attitude Towards Suicide (ATTS) and Youth Self-Report questionnaires (YSR). Bivariate and multivariate analyses were conducted.
  
  
  RESULTS
  Suicide ideation prevalence in the past year was 22.6%, suicide plans 10.3%, and suicide attempts 6.5%. Girls were significantly more likely to report suicidal ideation. Multivariate analyses showed that anxious/depressed, somatic complaints and exposure to suicidal behavior in significant others were significantly associated with own serious suicidal expressions.
  
  
  CONCLUSIONS
  The prevalence of serious suicidal expressions among young people in Nicaragua is within the range reported from Western high-income countries. An attempted or completed suicide in someone close, is associated with own suicidal expressions even in the absence of increased mental distress. Furthermore, somatic complaints should alert health care professionals of the possibility of increased suicide risk.
authors.affiliation: Centre for Demography and Health Research. Nicaraguan National Autonomous University, León, Nicaragua.
authors.forename: Claudia María
authors.initials: CM
authors.lastname: Obando Medina
authors.forename: Andres
authors.initials: A
authors.lastname: Herrera
authors.forename: Gunnar
authors.initials: G
authors.lastname: Kullgren