Prevalence, Risk and Protective Factors and Risk Assessment Tools for Adolescent Suicidal Ideation in low-and middle-income countries: A Scoping Review

Abstract

Background: Suicidal ideation among adolescents constitutes an urgent public-health problem owing to its prevalence, the potential progression to suicidal behaviour, and the vulnerability of the adolescent developmental period. Measurement inconsistency, cultural constraints on disclosure, and heterogeneity in risk and protective factors complicate surveillance and prevention, especially in low- and middle-income countries. This scoping review synthesises evidence on prevalence, multilevel risk and protective factors, and the psychometric performance of common adolescent suicidal ideation instruments, drawing principally from a recent doctoral dissertation examining in-school adolescents in Ogun State, Nigeria, and from contemporary international literature.

Main body: The review first situates the Ogun State empirical estimate, a point prevalence of 3.9% for suicidal ideation among 1,444 in-school adolescents, within global and regional trends, noting heterogeneity in pooled estimates across systematic reviews and meta-analyses. The synthesis organises determinants using a socio-ecological framework, identifying robust individual-level correlates (depression, prior attempt, sleep disturbance), interpersonal drivers (family instability, childhood abuse, parental substance misuse), and societal factors (socioeconomic stressors, stigma and legal sanctions). Protective factors repeatedly documented include strong social support and connectedness, higher self-esteem, purpose in life and adaptive coping strategies. The review evaluates three measurement instruments deployed and psychometrically tested within the same adolescent sample, the Suicidal Ideation Attributes Scale (SIDAS), the Positive and Negative Suicide Ideation Inventory (PANSI) and the Suicide Ideation Scale (SIS), and finds that SIDAS and the PANSI negative subscale display the most favourable structural validity for school-based screening in similar contexts, while SIS demonstrates excellent internal consistency but requires latent-structure reappraisal.

Conclusion: For school-based screening in LMIC settings similar to Ogun State, a pragmatic approach combines brief validated severity measures (SIDAS) with risk-focused subscales (PANSI-NSI) to detect high-risk adolescents efficiently, paired with robust referral pathways. Research priorities include wider cross-national validation of instruments, longitudinal studies for temporal risk modelling, and trials of context-adapted preventive interventions.