Peer-reviewed article
Association between unintentional injuries and suicidal ideation of children and adolescents: a longitudinal study
Yulian Yang, Biao Chen, Zhengyan Chen, Jingjing Lu, Xudong Zhou ·
Summary
Written by AI, not yet AICS's view · claude-sonnet-5-5This study followed 24,522 students in grades 5–11 in Anhui, China, across two school surveys, in November 2023 and April 2025. It tested whether earlier unintentional injuries were linked to suicidal ideation at the second survey. All 12 injury types studied were linked to higher odds of later suicidal ideation, even after accounting for socio-demographic characteristics and suicidal ideation at the first survey. The authors suggest broad injury-prevention and early-identification strategies rather than a focus on any single injury type.
Key points
- All 12 types of unintentional injury were significantly associated with suicidal ideation at Wave 2, with adjusted odds ratios from 1.31 to 1.65.
- The strongest associations were for explosion injuries (OR 1.65), injuries from sharp objects (OR 1.62) and poisoning (OR 1.54).
- The weakest association, still significant, was for swallowing a foreign object (OR 1.31).
- Only 3 of 12 injury types (falls, explosions, electric-current exposure) showed significant gender-by-injury interactions, so the pattern was largely similar across sexes.
- The follow-up rate was 84.18%, and all associations remained significant after Benjamini–Hochberg FDR correction.
Limitations
This is an observational study, so it shows association and not that injuries cause suicidal ideation. The abstract does not say how injuries and ideation were measured. The sample comes from one province in China, and grade 12 students were excluded.
Abstract
Purpose This study aims to investigate the prospective association between unintentional injuries and subsequent suicidal ideation among children and adolescents. Methods This study is a two-wave longitudinal school-based cohort derived from repeated surveys administered in Anhui, China, in November 2023 (Wave 1) and April 2025 (Wave 2). As grade 12 students in Wave 1 would graduate by July 2024 and thus be unavailable for follow-up, we included only students in grades 5–11 from Wave 1. We identified 24,522 students who participated in both waves, yielding a follow-up rate of 84.18% (47.08% female). Results Among 12 types of unintentional injuries, after adjustment for socio-demographic characteristics and Wave 1 suicidal ideation, all 12 types were significantly associated with Wave 2 suicidal ideation, with adjusted odds ratios ranging from 1.31 to 1.65; all associations remained significant after Benjamini–Hochberg FDR correction (q < 0.05). The strongest associations were observed for explosion injuries (OR = 1.65, 95% CI = 1.27–2.13, q < 0.001), injuries from sharp objects (OR = 1.62, 95% CI = 1.50–1.75, q < 0.001), and poisoning (OR = 1.54, 95% CI = 1.19–1.99, q = 0.001), while the weakest, though still significant, was for Swallow a foreign object (OR = 1.31, 95% CI = 1.21–1.42, q < 0.001). Formal interaction tests indicated that only 3 of the 12 injury types (fall injuries, explosion injuries, and electric-current exposure) showed statistically significant gender × injury interactions, suggesting that the overall pattern of associations is largely consistent across sexes. Conclusion Previous unintentional injuries are associated with an increased likelihood of subsequent suicidal ideation. Given the consistent pattern of associations and the absence of a clearly dominant injury category, broadly framed injury-prevention and early-identification strategies may be warranted, rather than prioritization of any single injury type.