Suicidal ideation, risk factors, and communication with parents. An HBSC study on school children in Estonia, Lithuania, and Luxembourg.

BACKGROUND: Suicide is a leading cause of death among youth. In the year 2002, Lithuania had the 2nd, Luxembourg the 5th, and Estonia the 9th highest suicide rates among 15- to 19-year-olds across 90 countries worldwide. Suicidal ideation is a significant precursor to suicide. AIMS: To report on the prevalence of and associations between suicidal ideation, smoking, alcohol consumption, physical fighting, bullying, and communication with parents among 15-year-old schoolchildren. METHODS: The survey analyzes data from the 2005/2006 HBSC study from Estonia, Lithuania, and Luxembourg (N = 4,954). The risk factors were calculated through multinomial logistic regression analyses. RESULTS: The overall prevalence of suicidal ideation in the preceding year was 17%. Suicidal thoughts were associated with communication difficulties with parents (OR from 2.0 to 4.6) and other risk factors, especially multiple risks (OR for 4-5 concurrent risk factors from 4.5 to 13.6). Parent-child communication had a significant mediating effect by decreasing the odds for suicidality and multiple risks. LIMITATIONS: The prevalence estimates were obtained by self-reports. The causal relationships need further investigation. CONCLUSION: The risk factors studied, particularly multiple risks, were associated with higher odds for suicidal ideation. Good parent-child communication is a significant resource for decreasing suicidal ideation among adolescents.

Suicidal thoughts and depressive feelings amongst Estonian schoolchildren: effect of family relationship and family structure.

Depressive feelings and suicidal ideation in a non-clinical sample of adolescents in Estonia were analysed in the context of family structure, mutual relationships amongst family members and schoolchildren's preferences regarding intimate personal contacts with particular family members. Data from the WHO collaborative study 'Health Behaviour in School-aged Children 2005/2006' (HBSC) were used. A representative sample of schoolchildren aged 11, 13 and 15 years completed the semi-structured questionnaire. The analyses included only adolescents living in households with at least one birth parent. The subjects were 4,389 schoolchildren (2,178 boys and 2,211 girls), who were divided into three groups based on: (1) suicidal thoughts, with or without depressive feelings; (2) depressive feelings; and (3) neither suicidal thoughts nor depressive feelings. Multinomial logistic regression was used. The proportion of depressive feelings increased with age for both boys and girls. Girls expressed depressive feelings more frequently than boys from ages 13 and 15 years, and suicidal thoughts from age 15 years. Self-reported satisfaction with relationships in the family reduced the likelihood of depressive feelings and suicidal thoughts. Good communication with the parents reduced the likelihood of suicidal thoughts in all age groups. Adolescents who were satisfied with their family relationships suffered less frequently from depressive feelings and suicidal thoughts. The best environment for an adolescent was a family with both birth parents. Of the adolescents in 'non-intact' families, those with a step-parent in the family showed suicidal thoughts more frequently than those in single-parent families. Associations between family-related variables and suicidal thoughts were significant even after adjusting for family economic deprivation score.

Children's Depression Inventory in Estonia. Single items and factor structure by age and gender.

The aim of study was to estimate the score of symptoms of depression with the Children's Depression Inventory (CDI) among Estonian schoolchildren aged 7-13-year-old, according to age and gender differences, and to identify the components in factor analysis characterising self-reported childhood symptoms of depression. The applicability of the CDI in 7-year-old children was also estimated. The number of subjects in the study was 725 (342 girls and 383 boys), and the mean age was 10.2 (SD 1.7). The mean total score of the CDI for the whole sample was 9.96 (SD = 6.3, range 0-39, median 9.0). The mean scores of symptoms of depression among children did not differ by gender or age. There were no significant differences in the CDI mean scores between 7-year-old compared to older schoolchildren in the present study. Factor analysis obtained five factors: anhedonia, ineffectiveness, negative self-esteem, negative mood and interpersonal problems. Significant gender and age differences were found: girls reported more symptoms of anhedonia and negative self-esteem, and boys reported more symptoms of ineffectiveness. Younger children reported more symptoms of anhedonia and ineffectiveness, and older children negative self-esteem. The study serves as baseline data before intervention of the EC project "European Alliance Against Depression".

Factors predicting suicide among Russians in Estonia in comparison with Estonians: case-control study.

AIM: To explore differences between suicide victims among Russian immigrants in Estonia and native Estonians, according to socio-demographic background, substance use pattern, and recent life events to find out immigration-specific factors predicting suicide. METHODS: The psychological autopsy study included 427 people who committed suicide in 1999 and 427 randomly selected controls matched by region, gender, age, and nationality. RESULTS: The only variable that differed significantly between Russian and Estonian suicide cases was substance use pattern. Logistic regression models showed that factors associated with suicide for both nationalities were substance dependence and abuse (Russians: odds ratio [OR], 12.9; 95% confidence interval [95% CI], 4.2-39.2; Estonians: OR, 8.1; 95% CI, 3.9-16.4), economical inactivity (Russians: OR 5.5; 95% CI, 1.3-22.9; Estonians: OR, 3.1; 95% CI, 1.3-7.1), and recent family discord (Russians: OR, 3.2; 95% CI, 1.1-9.9; Estonians: OR, 4.5; 95%, CI, 2.1-9.8). The variables that remained significant in the final model were having no partner (Estonians: OR, 3.0; 95% CI, 1.6-5.5), being unemployed (Estonians: OR, 5.5; 95% CI, 2.0-15.4), and being an abstainer (Estonians: OR, 6.7; 95% CI, 2.5-17.6) for Estonians, and somatic illness (Russians: OR, 4.1; 95% CI, 1.4-11.7), separation (Russians: OR, 32.3; 95% CI, 2.9-364.1), and death of a close person (Russians: OR, 0.2; 95% CI, 0.04-0.7) for Russians. CONCLUSION: Although the predicting factors of suicide were similar among the Estonian Russians and Estonians, there were still some differences in the nature of recent life events. Higher suicide rate among Estonian Russians in 1999 could be at least partly attributable to their higher substance consumption.