Iran Journal of Nursing

Introduction
Suicide and suicidal thoughts in adolescents have become a worrying psychosocial problem. Considering that adolescents are one of the most vulnerable groups affected by suicide, their mental health is important. Given the increasing prevalence of suicide and the negative consequences of suicidal thoughts, especially at a younger age, early identification of suicide ideation is necessary to reduce suicide rate and its risk factors. The results of a study comparing 49 developing countries reported that the overall prevalence of suicidal ideation in adolescents was 15.3%, where the highest prevalence was seen in the African region (19.8%). 
In Iran, most of studies have reported the suicide rate, and a few have investigated the prevalence of suicidal ideation in adolescents. According to the results of a systematic review study, there is no accurate statistics of the prevalence of suicidal ideation among adolescent students in Iran, and the studies have mainly investigated the relationship between suicidal ideation and other factors in adolescents. Since the phenomenon of suicide in adolescents is costly for the country’s health system and considering that it is not based on the norms ​​and culture of the country, a detailed investigation of suicidal thoughts in this age group seems necessary. Therefore, the present study aims to investigate the suicidal ideation in adolescents from schools located in the west of Tehran, Iran.

Methods
In this descriptive cross-sectional study, 256 boys and girls from second-grade high schools in the west of Tehran were selected by a convenience sampling method in 2022. The data collection tools were a sociodemographic form and the Beck scale for suicidal ideation (BSSI), as a self-report tool with 19 items and three subscales: desire for death (5 items), preparation for suicide (7 items) and actual suicide desire (4 items). The items are rated on a 3-point Likert scale from 0 to 2. The total score ranges from 0 to 38. The collected data were analyzed in SPSS v.16 software using descriptive and inferential statistics (independent t-test, analysis of variance)

Results 
The mean age of the participants was 17.33±0.67 years. The mean BSSI score was 3.19±5.66. Most of participants had low-risk suicidal ideation (87.2%). In the dimension of desire for death, the highest mean of BSSI was related to the item “lack of interest in life” (0.61±0.62) and the lowest score was in the item “desire to commit suicide” (0.14±0.36). In the dimension of preparation for suicide, the highest mean of BSSI was in the item “accepting thoughts about suicide” (1.38±0.49) and the lowest score was in the item “lack of control over suicidal ideation” (0.50±0.50). In the dimension of actual suicide desire, the highest mean of BSSI was related to the item “courage or ability to commit suicide” (1.21±0.53) and the lowest score was in the item “preparing a means to commit suicide” (0.41±0.50). Among the sociodemographic factors, suicidal ideation had a statistically significant relationship only with the grade point average (P=0.004).

Conclusion 
Based on the results, psychiatrists, or nurses working in medical centers are recommended to design and implement programs to educate and provide psychiatric services to high school students in Iran to reduce their suicidal ideation by considering their sociodemographic factors. The relevant authorities should provide the necessary facilities for their implementation in treatment and counseling centers so that they can take effective and useful steps to improve the mental and physical health of adolescents. On the other hand, the results of this study can be a basis for further comprehensive research for improving the knowledge and clinical practice of psychiatrists in providing services to reduce suicidal ideation in adolescents. It is necessary that psychiatric nurses receive in-service training in the field of suicidal ideation in adolescents by holding workshops or using online educational programs.

Ethical Considerations
Compliance with ethical guidelines
This study was approved by the ethical committee of Iran University of Medical Sciences (Code: IR.IUMS.REC.1401.728). All ethical principles were considered in this study. The participants were informed about the study objectives and methods and were assured of the confidentiality of their information. They  were free to leave the study at any time, and if  desired, the research results would be available to them. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Funding
This study was extracted from the master’s thesis of Arman Naeemi at the Department of Psychiatric Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran.

Authors' contributions
Conceptualization: Arman Naeemi and Marjan Mardani-Hamooleh; Investigation: Marjan Mardani-Hamooleh and Nazanin Esmaeeli; Data analysis: Shima Haghani; Project administration, editing & review: Marjan Mardani-Hamoleh.

Conflict of interest
The authors declared no conflict of interest.

Acknowledgments
The authors would like to thank all participants for their cooperation in this study.


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