title: Explaining gender differences in non-fatal suicidal behaviour among adolescents: a population-based study.
abstract: BACKGROUND
  While suicide is the second leading cause of death among young people in most industrial countries, non-fatal suicidal behaviour is also a very important public health concern among adolescents. The aim of this study was to investigate gender differences in prevalence and emotional and behavioural correlates of suicidal behaviour in a representative school-based sample of adolescents.
  
  
  METHODS
  A cross-sectional design was used to assess suicidal behaviour and various areas of emotional and behavioural problems by using a self-report booklet including the Youth Self-Report. One hundred sixteen schools in a region of Southern Germany agreed to participate. A representative sample of 5,512 ninth-grade students was studied. Mean age was 14.8 years (SD 0.73); 49.8% were female.
  
  
  RESULTS
  Serious suicidal thoughts were reported by 19.8% of the female students and 10.8% of the females had ever attempted suicide. In the male group, 9.3% had a history of suicidal thoughts and 4.9% had previously attempted suicide. Internalizing emotional and behavioural problems were shown to be higher in the female group (difference of the group means 4.41) while externalizing emotional and behavioural problems slightly predominated in male students (difference of the group means -0.65). However, the total rate of emotional and behavioural problems was significantly higher in the adolescent female group (difference of the group means 4.98). Using logistic regression models with suicidal thoughts or attempted suicide as dependent variables, the pseudo-R2 of gender alone was only 2.7% or 2.3%, while it was 30% or 23.2% for emotional and behavioural problems measured by the YSR syndrome scales. By adding gender to the emotional and behavioural problems only an additional 0.3% of information could be explained.
  
  
  CONCLUSIONS
  The findings suggest that gender differences in non-fatal suicidal behaviour among adolescents can to a large extent be explained by the gender differences in emotional and behavioural problems during this age.
authors.affiliation: Department of Child and Adolescent Psychiatry, Centre of Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany. michael.kaess@unimelb.edu.au
authors.forename: Michael
authors.initials: M
authors.lastname: Kaess
authors.forename: Peter
authors.initials: P
authors.lastname: Parzer
authors.forename: Johann
authors.initials: J
authors.lastname: Haffner
authors.forename: Rainer
authors.initials: R
authors.lastname: Steen
authors.forename: Jeanette
authors.initials: J
authors.lastname: Roos
authors.forename: Martin
authors.initials: M
authors.lastname: Klett
authors.forename: Romuald
authors.initials: R
authors.lastname: Brunner
authors.forename: Franz
authors.initials: F
authors.lastname: Resch
mesh_terms: D000293:Adolescent; D000296:Adolescent Psychiatry; D000342:Affective Symptoms; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D012737:Sex Factors; D059020:Suicidal Ideation; D013406:Suicide, Attempted / Q000639:trends*