The relationship between the frequency of suicidal ideation and sleep disturbance factors among adolescent earthquake victims in China.
OBJECTIVE
This study aimed to examine the frequency of suicidal ideation (SI) and identify exposure variables, mental health, and sleep-related risk factors of SI among adolescents following the 2013 Ya'an earthquake.


METHODS
Participants consisted of 5563 adolescent students selected through random sampling from 11 primary and high schools in the counties most severely affected by the earthquake. They were asked to complete the Pittsburgh Sleep Quality Index, Children's Revised Impact of Event Scale-13, Short Mood and Feelings Questionnaire, and Screen for Child Anxiety-Related Emotional Disorders. Multinomial logistic analysis was used to identify possible relationships between SI and psychopathology, sleep problems, earthquake exposures or demographic characteristics. The mediation analysis was used to identify direct and indirect effects among sleep problems, psychopathology, earthquake exposures and SI.


RESULTS
Our findings suggest that 29.5% of the sample experienced SI during the past year (12.9% once, 11.9% twice, 2.6% on 3-4 occasions and 2.1% on at least 5 occasions). Multiple sleeping problems, including trouble falling asleep, shorter sleep duration, and daytime dysfunction, showed independent associations with SI. The mediation analysis suggested that depression and anxiety mainly mediated the association of sleep with SI.


LIMITATIONS
This study was cross-sectional and did not include controls. No baseline data were collected prior to the earthquake.


CONCLUSION
SI can be a serious problem among adolescents following a major earthquake, especially those who are older, who live in one-child households, or who are female. Years after a disaster, we found that exposure severity, psychopathology and sleep impairment all contributed to SI, and that earthquake exposure may have disrupted sleep and worsened mood, which in turn may have impacted SI. By enhancing teenagers' sleep management and shaping their activities, post-disaster intervention programs may help prevent SI among Chinese adolescents.
['Tang|Wanjie|W|', 'Xu|Dun|D|', 'Li|Bin|B|', 'Lu|Yi|Y|', 'Xu|Jiuping|J|']
D000293:Adolescent D000367:Age Factors D001007:Anxiety D002648:Child D002681:China D015897:Comorbidity D003863:Depression D055866:Earthquakes D005260:Female D006801:Humans D008297:Male D012737:Sex Factors D012893:Sleep Wake Disorders D013313:Stress Disorders, Post-Traumatic D059020:Suicidal Ideation D017741:Survivors
Suicidal ideation Adolescent Earthquake Sleeping problems Epidemiology