PREVALENCE AND RISK FACTORS OF SUICIDAL THOUGHTS AMONG SECONDARY SCHOOL ADOLESCENTS IN RIVERS STATE, NIGERIA: URBAN AND RURAL COMPARISON.

Introduction: Suicidal behavior remains a major public health problem all over the world. Suicide thoughts entail thoughts of engaging in self-injurious behavior with the intent to die.

Objectives: This study investigates the prevalence and risk factors associated with suicidal thoughts among secondary school adolescents in both urban and rural areas of Rivers State, Nigeria.

Methods: Using a comparative cross-sectional study design, data were collected from 1680 adolescents (839 in rural and 841 in urban) via an interviewer-administered questionnaire. Data was analyzed with SPSS version 25.

Results: The findings revealed that 26.5% of the adolescents reported having suicidal thoughts, with a slightly higher prevalence in rural areas (26.9%) compared to urban areas (26.0%). Multivariate logistic regression analysis identified significant risk factors (p<0.05), including older age (middle and late adolescence), polygamous family structure, divorced or separated parents, single-parent families, academic difficulties, and dissatisfaction with daily activities. Specific factors such as being an orphan, having a family history of mental health issues, and experiencing loneliness were more significant in urban areas, whereas being in senior classes, living with the father alone, experiencing sexual abuse, and lacking social support were prominent in rural areas. Factorization of the three major grouped associated risk factors (environmental, psychosocial, and intra-personal) revealed intra-personal factors to be prevalent in adolescents with suicidal thoughts in rural secondary schools and psychosocial factors in the urban region.

Conclusion: Early identification and tailored public health interventions can help reduce the prevalence of suicidal thoughts and prevent progression to more severe suicidal behaviors.