Association between lifestyle patterns and suicidality in adolescents: SESSAMO Project

Introduction Adolescent suicidality is a major public health concern. Lifestyle behaviors may be related to suicidality, yet evidence considering their combined effect is limited. This study aimed to examine the association between lifestyle behaviors, summarized through the Global Index of Lifestyle Quality (GILQ), and suicidality in a cohort of Spanish adolescents. Methods This cross-sectional analysis included 2,042 adolescents aged 14–16 years from the SESSAMO project. Lifestyle behaviors (diet, physical activity, sleep quality, screen use, substance use, risky sexual behavior, gambling, and spend time with friends) were assessed. Suicidality was measured using the Columbia Suicide Severity Rating Scale. Multivariate logistic regression models were fitted to assess associations between lifestyle factors, the GILQ, and suicidality, adjusting for potential confounders and depressive symptoms. Results A total of 9.6% of participants reported suicidality. An inverse dose–response association was observed between the GILQ and suicidality. A higher lifestyle score was associated with lower odds of suicidality (OR for extreme quartiles of GILQ adherence=0.40; 95% CI=0.16-0.94). Sleep quality, adequate sleep duration, absence of daytime sleepiness, and higher diet quality showed inverse and statistically significant associations with the presence of suicidality; however, these associations lost statistical significance after adjustment for depressive symptoms. Conclusions A healthy lifestyle was inversely associated with suicidality in this sample of Spanish adolescents, supporting the relevance of lifestyle patterns as potential risk markers. These findings highlight the close interrelationship between lifestyle and mental health and support their integration in prevention strategies.