Factors associated with single and multiple suicide attempts in adolescent school children in Morocco: A national cross-sectional survey

The study aimed to assess factors associated with multiple suicide attempts (MSA) in adolescents with a history of suicide attempts in Morocco. National cross-sectional data from the Global School-Based Student Health Survey (GSHS) in Morocco in 2016 were analysed. Students who reported to have a history of past 12-month suicide attempts were included in the final sample (n = 931). In multiple logistic regression, students with MSA were compared with students with a single suicide attempt (SSA). Results indicated that among the subsample of school adolescents (median age = 15 years), 55.8% had attempted suicide once, and 44.2% multiple times in the past 12 months. Compared to students who attempted suicide once, students with MSA more often had anxiety-induced sleep disturbance and were more frequently bullied. Compared to participants without psychosocial distress, students with three or more psychosocial distress factors had higher odds of MSA. Further, compared to students without health risk behaviours, students with three or more health risk behaviours had a higher odd of MSA. Psychosocial distress (anxiety-induced sleep disturbance and frequently being bullied) and multiple health risk behaviours increased the odds of MSA, suggesting the potential relevance of these variables in identifying multiple suicide attempters among adolescents in Morocco.