Open Access Open Badges Research article

Suicidal expressions among young people in Nicaragua and Cambodia: a cross-cultural study

Claudia Obando Medina1, Bhoomikumar Jegannathan2, Kjerstin Dahlblom3 and Gunnar Kullgren4*

Author Affiliations

1 Centre for Demography and Health Research, Nicaraguan National Autonomous University, León, Nicaragua

2 Center for Child and Adolescent Mental Health (CCAMH), Takhmau, Cambodia

3 Department of Public Health and Clinical Medicine, Division of Epidemiology and Global Health, Umeå University, SE-901 85 Umeå, Sweden

4 Department of Clinical Sciences, Division of Psychiatry, Umeå University, SE-901 87 Umeå, Sweden

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BMC Psychiatry 2012, 12:28  doi:10.1186/1471-244X-12-28

Published: 31 March 2012



Whereas prevalence of suicidal expressions among young people is fairly similar in different countries, less is known about associated risk factors. This study compares young people in Nicaragua and Cambodia to examine if the pattern of association between mental health problems and suicidal expressions differs.


368 and 316 secondary school students, from each country respectively, participated. Self-reported suicidal expressions, exposure to suicidal behavior in significant others and mental health problems among the students were measured using Attitude Towards Suicide (ATTS) and the Youth Self-Report (YSR) questionnaires.


Prevalence of serious suicidal expressions (plans and attempts) during recent year, did not differ between countries. Cambodian young people scored significantly higher on all eight YSR-syndromes, except for withdrawn/depressed. In Nicaragua, all YSR-syndromes were significantly associated with serious suicidal expressions in both genders compared to Cambodia where only one syndrome showed an association in each gender; Withdrawn/depressed among girls and Somatic complaints among boys. Associations between being exposed to suicide among significant others and serious suicidal expressions also differed between Cambodia and Nicaragua.


While the magnitude of serious suicidal expressions is similar between these structurally similar but culturally different countries, determinants behave differently. Qualitative studies are warranted to further explore cultural specific determinants for suicidal expressions among young people.

Suicidal expressions; Adolescents; Young People Cross-cultural comparison; Nicaragua and Cambodia