Factors associated with suicidal ideation in junior high school students with autism spectrum disorder in Japan: A cross-sectional observational study

Abstract

Aim: Suicide is a leading cause of death among adolescents. Several studies have reported higher suicidal ideation (SI) rates in individuals with autism spectrum disorder (ASD) than in those without ASD; however, risk factors for SI remain unclear, especially among adolescents. This study aimed to investigate the factors contributing to SI among junior high school students with ASD in Japan. Methods: We conducted a cross-sectional observational study of junior high school students who visited the Center for Child Health, Behavior, and Development, Ehime University Hospital. Medical records from April 2015 to March 2022 were examined. Participants completed the Strengths and Difficulties Questionnaire (SDQ) and General Health Questionnaire 30 (GHQ30), while their parents completed the Autism Screening Questionnaire, Attention Deficit Hyperactivity Disorder Rating Scale, and Social Responsiveness Scale. SI was assessed using item 28 of the GHQ30: “make away with yourself.” Multiple logistic regression analysis was performed with SI as the dependent variable. Results: Participants were categorized into ASD (n = 84) and non-ASD (n = 166) groups. The prevalence of SI was similar in both groups (p = 0.478). In the ASD group, multiple logistic regression analysis revealed that the SDQ subscales “Peer Problems” and “Emotional Symptoms” were significantly associated with SI (odds ratio [OR]: 1.63, 95% confidence interval [CI]: 1.22–2.19, OR: 1.44, 95% CI: 1.14–1.83). Conclusion: Approximately 40% of junior high school psychiatric outpatients had SI, irrespective of autistic tendencies. Our study suggests the importance of enhancing peer connectedness among students with ASD who experience SI.