Table 3.
Results for school absenteeism and self-harm
| References | Self-harm or suicidal acts construct | School absenteeism construct | Subgroups | OR (unless otherwise specified) | 95% confidence interval | P value | aORa | 95% confidence interval | P value |
|---|---|---|---|---|---|---|---|---|---|
| Asante et al. [46] | Suicide attempts in the past 12 months | 3 or more days absent in the past 30 days without permission | 1.52 | 1.22–1.90 | < 0.001 | 1.25 | 0.96–1.62 | > 0.05 | |
| Bailey et al. [73] | Suicide deaths from official records | Contempt of court for truancy | 4.1o | 0.7–14.6 | 0.11 | – | – | – | |
| Bjarnason and Thorlindsson [71] | Suicide attempts ever | How often do you play truant from schoolf | Male | R = 0.25p | – | < 0.001 | R = 0.00p | – | > 0.05 |
| Female | R = 0.22p | – | < 0.001 | R = 0.00p | – | > 0.05 | |||
| Borowsky et al. 1999 [43] | Suicide attempts ever | Skipped school in the past month | 1.94 | 1.75–2.16 | < 0.0001 | – | – | – | |
| Borowsky et al. [61] | Suicide attempt in the past 12 months (at 1 year follow-up) | This school year, how many times have you skipped school?g | Male: Black | – | – | – | – | – | > 0.05u |
| Male: Hispanic | – | – | – | – | – | > 0.05u | |||
| Male: White | – | – | – | 2.9 | – | < 0.01 | |||
| Female: Black | – | – | – | – | – | > 0.05u | |||
| Female: Hispanic | – | – | – | 3.1 | – | < 0.01 | |||
| Female: White | – | – | – | 2.9 | – | < 0.001 | |||
| Brunner et al. [69] | Any lifetime deliberate self-injurious behaviour | Missed 3 or more days in 2 weeks without permission | 2.59 | 2.14–3.13 | < 0.01 | 1.17 | 0.93–1.48 | > 0.05 | |
| Cheng et al. [51] | During the past 12 months, how many times did you actually attempt suicide? (dichotomised) | 6 or more days absent from school in the past 30 days | Ref | – | – | Ref | – | – | |
| 1–5 days absent from school in the past 30 days | 0.71q | 0.32–1.55 | 0.3896 | 0.77 | 0.33–1.78 | 0.5440 | |||
| 0 days absent from school in the past 30 days | 0.33q | 0.19–0.58 | 0.3896 | 0.35 | 0.19–0.65 | 0.0008 | |||
| Cwik et al. [42] | Multiple suicide attempts in the past 90 days (vs single attempt) | Days missed school because feared unsafe (past 30) 0 vs 1 or moreh | 1.06* | 0.34–3.30* | 0.919* | – | – | – | |
| Davaasambuu et al. [48] | Suicide attempt in the past 12 months | Missed class in the past 30 days without permission | 1.94 | 1.60–2.34 | < 0.0001 | 1.31 | 1.03–1.67 | 0.03 | |
| Urban | 2.35 | 1.78–3.11 | < 0.0001 | 1.43 | 1.00–2.04 | 0.05 | |||
| Rural | 1.70 | 1.31–2.22 | < 0.0001 | 1.22 | 0.87–1.71 | 0.24 | |||
| Donath et al. [63] | Lifetime suicide attempt | Truancy ever | – | – | – | 1.56 | 1.50–1.69 | < 0.001 | |
| Epstein and Spirito [52] | Suicide attempts in the past 12 months | Skipped school because felt unsafe past 30 days | – | – | – | 1.78 | 1.36–2.33 | – | |
| Evren et al. [68] | Self-harm behaviour within the past year | Truancy before age 13 | 2.34 | 1.99–2.75 | < 0.001 | – | – | – | |
| Absenteeism in days—none vs 1–14 or more than 15i | 1.74* | 1.37–2.22* | 0.0001* | – | – | – | |||
| Fergusson et al. [49] | Suicide attempt between age 14 and 21 | Any truancy between age 11 and 15 | – | – | – | 4.07* | 2.45–6.74* | < 0.0001* | |
| Larsson and Sund [70] | Self-harm or suicide attempt during 1 year follow-upb | Truancy within the last year, ordinal 1–4, none to more than once a monthj | 2.56* | 1.81–3.62* | 0.0001* | – | – | – | |
| Lewinsohn et al. [66] | Suicide attempts past 12 months | Days missed school past 6 weeksk | 1.5 | 1.2–1.8 | < 0.01 | 1.4 | 1.1–1.7 | < 0.01 | |
| Lewinsohn et al. [67] | Suicide attempts between baseline and 1 year follow-up | Missed school days in the past 6 weeksl | – | – | > 0.05r | – | – | NSu | |
| Lyon et al. [44] | Presentation to hospital with suicide attempt | Truancy | 0.43* | 0.19–0.94* | 0.054* | 51.3s | 5.35–490.2 | 0.0001 | |
| Noble et al. [72] | Lifetime non-suicidal self-injury | Number of days missed school because felt unsafe past 30 days (ordinal) |
Middle school High school |
– – |
– – |
– – |
1.14 0.93 |
– – |
> 0.05 > 0.05 |
| Pages et al. [65] | Lifetime suicide attempt | Often absent from school | Male | – | – | – | 1.6 | 1.03–3.2 | 0.104* |
| 2.48 | 2.14–2.87 | < 0.0001 | – | – | – | ||||
| Pillai et al. [62] | Suicidal ideation, plan or attempt in the past 3 months | 1 or more days absent from school in the past 3 monthsm | 2.61* | 1.20–5.66* | 0.0188* | ||||
| 1–3 days absent from school in the past 3 monthsn | – | – | – | 1.4 | 0.5–4.0 | > 0.05 | |||
| 4–6 days absent from school in the past 3 monthsn | – | – | – | 3.0 | 1.1–7.7 | < 0.05 | |||
| 7 or more days absent from school in the past 3 monthsn | – | – | – | 5.1 | 2.1–12 | < 0.05 | |||
| Randall et al. [56] | One suicide attempt past 12 monthsc | Missed 3 or more days without permission in the past 30 days | – | – | – | 0.79t | 0.24–2.54 | 0.669 | |
| 2 or more suicide attempts past 12 monthsc | – | – | – | 1.70t | 0.61–4.74 | 0.290 | |||
| 1 or more suicide attempts past 12 monthsd | 2.71* | 1.79–4.10* | 0.0001* | ||||||
| Sharma et al. [55] | Suicide attempts in the past 12 months | 3 or more days absent in the past 30 days without giving notice to the school | 0.52 | 0.3–0.88 | < 0.05 | 0.7 | 0.37–1.33 | 0.228* | |
| Taliaferro and Muehlenkamp [60] | Suicide attempt past 12 monthse | During past 30 days, did you miss school due to feeling unsafe? | Male | – | – | – | 1.06 | 0.64–1.74 | > 0.0033v |
| (compared to suicidal ideation only) | Male | – | – | – | 1.23 | 0.82–1.85 | > 0.0033v | ||
| Suicide attempt past 12 monthse | Female | – | – | – | 1.06 | 0.68–1.66 | > 0.0033v | ||
| (compared to suicidal ideation only) | Female | – | – | – | 1.23 | 0.89–1.71 | > 0.0033v | ||
| Xin et al. [64] | Deliberate self-injurious behaviour in the past 12 months | Truancy (not defined) | – | – | – | 1.4 | 1.16–1.69 | < 0.001 | |
| Male | 3.53 | 3.00–4.16 | < 0.05 | 1.48 | 1.16–1.90 | 0.002 | |||
| Female | 3.93 | 3.24–4.77 | < 0.05 | – | – | NSu |
Data is missing where either univariate or multivariate analyses were not reported in the paper and could not be calculated from the data available
*Results calculated from data available within the paper, OR odds ratio, NS non-significant, significance cutoff not reported in paper, Variables are binary unless otherwise stated. Statistically significant results in bold (using P < 0.05 cutoff unless otherwise stated)
aAdjusted for covariates listed in Table 1
bDichotomised to self-harm or suicidal ideation vs no self-harm or suicidal ideation
cMultinomial logistic regression with no suicide attempts vs one suicide attempt vs two or more as outcomes
dDichotomised to no attempts vs one or more attempts
eCompared to no suicidal ideation or attempts
fOrdinal: 1: never; 2 < monthly; 3 monthly; 4 weekly; 5 daily
gUnclear comparator: highest end of scale vs lowest end
hDichotomised to 0 days missed vs 1 or more days missed
iDichotomised to no absenteeism vs 1–14 or more than 15 days absent, not clear over what period measured
jOrdinal converted to binary but not clear where the split has been made
kNot clear what the comparator is—probably binary but not clear where the split has been made
lContinuous variable
mDichotomised to 0 days absent vs 1 or more days
nCategorical exposure variable
oRate ratio—person years until outcome
pStatistic ‘R’ is comparable to standardised beta coefficient in multiple regression
qAdjusted for age and city only
rOnly Chi square analysis reported
sNumber of times less likely to be a risk factor
tRelative risk ratio
uResult not reported due to non-significance
vNS > 0.0033 (Bonferroni correction)