Prevalence of suicidal ideation and its associated factors among school-going adolescents in northern Bangladesh: a cross-sectional study

Adolescent suicidal ideation is a critical public health issue, yet empirical evidence on its prevalence and associated factors among adolescents in northern Bangladesh remains limited. This study estimated the 12-month prevalence of suicidal ideation and examined its associated factors among school-going adolescents in Nilphamari District, Bangladesh. A cross-sectional survey was conducted between May and June 2026 among 365 adolescents aged 13-19 years across eight secondary schools and colleges. Self-administered questionnaires assessed suicidal ideation alongside validated tools for depression (PHQ-9), anxiety (GAD-7), and perceived social support (MSPSS). Factors associated with suicidal ideation were examined using multivariable logistic regression. The 12-month prevalence of suicidal ideation was 30.7% (112/365; 95% CI 26.0%-35.7%). In the primary multivariable model, moderate depression (AOR = 6.05, 95% CI 1.03-35.38; p = 0.046) and moderately severe depression (AOR = 6.86, 95% CI 1.05-44.62; p = 0.044) were associated with higher odds of suicidal ideation compared to minimal depression. However, this association was not statistically significant in a sensitivity analysis using the PHQ-8 score after excluding Item 9 (AOR = 1.06, 95% CI: 0.96-1.17; p = 0.228). Loneliness "often" showed the strongest association with suicidal ideation (AOR = 10.59, 95% CI: 2.53-44.35; p = 0.001). Suicidal ideation was also associated with truancy of 6-9 days (AOR 4.44, 95% CI 1.24-15.90; p = 0.022), truancy of [≥]10 days (AOR 3.77, 95% CI 1.34-10.59; p = 0.012), intentional self-harm (AOR = 2.51, 95% CI: 1.17-5.41; p = 0.018), and physical harm exposure (AOR = 2.63, 95% CI: 1.24-5.57; p = 0.012). Maternal secondary education was associated with lower odds of suicidal ideation (AOR = 0.34, 95% CI: 0.12-0.99; p = 0.048). Suicidal ideation was common among school-going adolescents in northern Bangladesh, affecting nearly one in three participants. Early school-based identification and support for adolescents experiencing mental-health and psychosocial difficulties, together with family engagement and strengthened suicide-prevention services, are warranted.