Association between self-esteem and suicide risk in adolescents from five schools in northern Peru: A cross-sectional study

Evidence on the association between self-esteem and suicide risk (SR) among adolescents in Latin America is limited. To address this gap, we examined this association in secondary school students from northern Peru. We performed an analytical cross-sectional study based on secondary data collected in 2022 from 1,314 adolescents attending 5 secondary schools. SR was assessed using the Plutchik Suicide Risk Scale, while self-esteem was measured with the Rosenberg Self-Esteem Scale. Prevalence ratios (PRs) and corresponding 95% confidence intervals (CIs) were calculated through Poisson regression with robust variance, both in crude and adjusted models. The study population comprised 54.2% males, with the majority (69%) in middle adolescence. Low self-esteem was identified in 44.7% of participants, while 29.4% presented average self-esteem. Overall, 33.3% of adolescents reported SR (95% CI: 30.8–36.0). In crude analyses, both average and low self-esteem were associated with a higher prevalence of SR compared with high self-esteem (PR = 2.30 and PR = 4.11, respectively). In adjusted models, average self-esteem was associated with a 42% higher prevalence (PR = 1.42) and low self-esteem with a 67% higher prevalence (PR = 1.67). One in three adolescents presented an SR, underscoring the need to integrate school- and community-based programs that promote self-esteem within suicide prevention.