To investigate the prevalence and clinical correlates of suicidal behavior and self-harm in adolescents diagnosed with depressive disorders, focusing on the independent association of smoking status.
Approach:
Study Design: A cross-sectional study enrolling 2,343 adolescents aged 12–18 years with depressive disorders, conducted at two hospitals in Foshan City from January to December 2025.
Assessment: Suicidal behavior and self-harm were assessed through clinical interviews, and multivariable binary logistic regression models were used to identify independent associations.
Key Findings:
The prevalence of self-harm was 76.0% and suicidal behavior was 44.2% among participants.
Current smokers had 2.74 times higher odds of suicidal behavior compared to never smokers.
Past quitters had 2.32 times higher odds of suicidal behavior compared to never smokers.
Current smoking was associated with a 2.31 times increased risk of self-harm.
Education level showed a borderline association with self-harm, with each additional year of schooling corresponding to a 10% lower odds.
Interpretation:
Smoking status was the only variable significantly associated with both suicidal behavior and self-harm after adjusting for various demographic and clinical factors.
Limitations:
The study's cross-sectional design limits causal inferences.
The exploratory nature of the education level association requires cautious interpretation.
Conclusion:
Smoking is associated with suicidal behavior and self-harm in adolescents with depressive disorders.
