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Lageborn CT, Bjureberg J, Song J, Runeson B, Möller J, Ljung R, Dahlin M. Risk of suicide and self-harm in university students entering different university programs - a national register-based cohort study in Sweden. Soc Psychiatry Psychiatr Epidemiol 2023; 58:1139-1149. [PMID: 37149517 PMCID: PMC10366015 DOI: 10.1007/s00127-023-02484-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 04/26/2023] [Indexed: 05/08/2023]
Abstract
PURPOSE It is not known whether the elevated suicide risk in certain occupations, such as health care professionals, is partly attributable to a selection of individuals with prior vulnerability. We aimed to determine the risk of suicide and self-harm already in students entering different university programs. METHODS We used national registers to identify 621,218 Swedish residents aged 18-39 years with registration for a university program 1993-2013. Outcomes were suicide and self-harm within three years. We applied logistic regression analyses to calculate odds ratios (OR) and 95% confidence intervals (CI) of risk of suicide and self-harm, with the Education program category as a reference. Results were adjusted for sex, age, time period and for history of hospitalization due to mental disorder or self-harm, as a measure of previous vulnerability. In the second step, we stratified results by sex. RESULTS There was a higher risk of suicide (OR 2.4) in female nursing students and natural science students (OR 4.2) and of self-harm in female and male Nursing/Health care students (OR range 1.2 -1.7). Subcategorization into nursing students only strengthened the association with self-harm for both sexes. Prior vulnerability did not fully explain the increased risk. CONCLUSION The elevated risk of suicide in nursing and health care occupations partly has its onset in vulnerability factors present before or emerging during university studies. Increased efforts in identifying and treating mental disorders and preventing self-harm in university students could be an important step in preventing future suicides.
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Affiliation(s)
- Christine Takami Lageborn
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Health Care Services, Region Stockholm, Norra Stockholms Psykiatri, Vårdvägen 1, 112 81, Stockholm, Sweden.
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
| | - Johan Bjureberg
- Centre for Psychiatry Research, Karolinska Institutet and Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
- Department of Psychology, Stanford University, Stanford, CA, USA
| | - Jie Song
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Bo Runeson
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Health Care Services, Region Stockholm, Norra Stockholms Psykiatri, Vårdvägen 1, 112 81, Stockholm, Sweden
| | - Jette Möller
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Rickard Ljung
- Institute of Environmental Medicine, Unit of Epidemiology, Karolinska Institutet, Stockholm, Sweden
| | - Marie Dahlin
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Health Care Services, Region Stockholm, Norra Stockholms Psykiatri, Vårdvägen 1, 112 81, Stockholm, Sweden
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Frajerman A, Chevance A, Chaumette B, Morvan Y. Prevalence and factors associated with depression and suicidal ideation among French students in 2016: A national study. Psychiatry Res 2023; 326:115263. [PMID: 37295352 DOI: 10.1016/j.psychres.2023.115263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 05/21/2023] [Accepted: 05/22/2023] [Indexed: 06/12/2023]
Abstract
Depression is one of the leading causes of morbidity worldwide and increases the risk of suicide. Students are known as a population at risk for depression. This study aimed to evaluate the prevalence of 12 months major depressive episode (MDE) and suicidal thoughts in French students and investigate associated factors. A questionnaire was sent by email to a representative sample of the French student population between April 28th and June 27th 2016. MDE was assessed using the Composite International Diagnostic Interview Short Form (CIDI-SF). The response rate was 18.7% (N= 18,875). Prevalence of 12 months MDE was 15.8%, and suicidal thoughts was 9%. Factors associated with MDE were being a woman, study field (law/eco, human/social sciences, and medical), having failed midterms exams or dropout, refusal or stop social scholarship, and subjective financial difficulties. Factors associated with suicidal thoughts were study field (human/social sciences), having failed midterms exams or dropout, and important subjective financial difficulties. The use of CIDI-SF allows comparison with the 2017 French national study, and showed more MDE in students than in the general population. This is the only national study on French students before COVID 19 pandemic.
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Affiliation(s)
- Ariel Frajerman
- Institute of Psychiatry and Neurosciences de Paris, INSERM UMR 1266, Pathophysiology of Psychiatric Diseases, University of Paris, 75014 Paris, France; Institute of Psychiatry GDR 3557 of Psychiatry, 75014 Paris, France; MOODS Team, INSERM U1178, CESP, Université Paris-Saclay, Faculté de Médecine Paris- Saclay, Le Kremlin Bicêtre, F-94275, France; Service Hospitalo-Universitaire de Psychiatrie de Bicêtre, Mood Center Paris Saclay, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Saclay, Hôpital de Bicêtre, F-94275, France.
| | - Astrid Chevance
- Center for Research and Epidemiology and Statistics, Université de Paris, Inserm UMR 1153 Hôtel Dieu, Paris; Service d'épidémiologie clinique, Hôpitaux Paris Centre, APHP, Paris
| | - Boris Chaumette
- Institute of Psychiatry and Neurosciences de Paris, INSERM UMR 1266, Pathophysiology of Psychiatric Diseases, University of Paris, 75014 Paris, France; Institute of Psychiatry GDR 3557 of Psychiatry, 75014 Paris, France; PEPIT, GHU Paris Psychiatrie et Neurosciences, 75014 Paris, France; Department of Psychiatry, McGill University, Montreal, Canada
| | - Yannick Morvan
- Université Paris Nanterre, UFR SPSE, laboratoire CLIPSYD, UR4430; Inserm U1018, CESP, Equipe Psychiatrie du développement et trajectoires
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Rutkowska A. Remote Interventions to Support Students' Psychological Well-Being during the COVID-19 Pandemic: A Narrative Review of Recent Approaches. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14040. [PMID: 36360919 PMCID: PMC9656822 DOI: 10.3390/ijerph192114040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 10/20/2022] [Accepted: 10/22/2022] [Indexed: 06/16/2023]
Abstract
The COVID-19 pandemic has negatively affected students' mental health, and it is important to implement mental health management strategies. The purpose of this study was to present current findings on the implementation of remote mental health interventions in students during the pandemic. The PubMed and Web of Science electronic databases were searched and, from a total of 174 articles, 106 records were excluded according to the inclusion criteria and 23 were assessed as full texts. After the full-text screening, 12 studies were included in the review. The included publications were randomized clinical trials focused on remote mental support interventions among students from 10 countries, representing both genders, and were in the average age range of 17-55 years with an overall number of 892 participants. The included studies covered the effectiveness of strictly psychotherapeutic programs, such as cognitive-behavioral therapy (CBT) and dialectical behavior therapy (DBT), as well as other techniques such as mindfulness, laughter therapy, the brain wave modulation technique (BWM-T), and physical activity-based interventions. This narrative review provides an overview of studies with a wide range of types of remote mental health support interventions. Each of the forms of intervention analyzed in this review resulted in positive changes in students' mental health, which indicates hope for widespread help via various forms of intervention implemented remotely.
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Affiliation(s)
- Anna Rutkowska
- Department of Physical Education and Physiotherapy, Opole University of Technology, 45-758 Opole, Poland
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4
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Midlife suicide: A systematic review and meta-analysis of socioeconomic, psychiatric and physical health risk factors. J Psychiatr Res 2022; 154:233-241. [PMID: 35961179 DOI: 10.1016/j.jpsychires.2022.07.037] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 07/09/2022] [Accepted: 07/20/2022] [Indexed: 10/16/2022]
Abstract
Suicide is an increasing contributing cause of mortality in middle-aged adults; however, knowledge to guide prevention is limited. This first systematic review and meta-analysis of studies on midlife suicide has provided an overview of published research on this issue and synthesized the evidence on socioeconomic and physical and mental health factors associated with this mortality. Using PRISMA guidelines MEDLINE, Embase, PsycINFO, Scopus and Web of Science were searched for English-language publications that involved persons aged 35 to 65, used individual-level data, and reported prevalence of exposure(s) or relative risks. The search identified 62 studies on midlife suicides and associated factors (28 for SES, 22 for psychiatric disorder and 23 for physical illness). All studies were from high income countries, and most (80.6%) used data from population registries. Meta-analyses showed that the pooled prevalence of exposure in suicide decedents was 57.8% for psychiatric disorder, 56.3% for low income, 43.2% for unemployment, and 27.3% for physical illness. The associated pooled risk ratio was 11.68 (95% confidence intervals: 5.82-23.47) for psychiatric illness of any type, 12.59 (8.29-19.12) for mood disorders, 3.91 (2.72-5.59) for unemployment, 3.18 (2.72-3.72) for being separated or divorced, 2.64 (2.26-3.10) for cancer, 2.50 (0.96-6.38) for central nervous system illness, and 2.26 (1.16-4.41) for low income. In conclusion, midlife suicide is strongly associated with socioeconomic difficulties and physical and psychiatric illnesses that are common in this age population. Future investigations should consider the interactions between risk factors, the intersectionality of sex and ethnicity, and include data from low- and middle-income countries.
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Edlund K, Johansson F, Lindroth R, Bergman L, Sundberg T, Skillgate E. Body image and compulsive exercise: are there associations with depression among university students? Eat Weight Disord 2022; 27:2397-2405. [PMID: 35179726 PMCID: PMC9556381 DOI: 10.1007/s40519-022-01374-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 01/29/2022] [Indexed: 10/31/2022] Open
Abstract
PURPOSE Mental health problems among university students have been reported to be significantly increasing and suggested to be associated with college drop-out. Body dissatisfaction and compulsive exercise are both constructs relevant for mental health problems in general and eating disorders in particular. This study examined associations between body dissatisfaction, compulsive exercise and self-reported symptoms of depression among Swedish university students. METHODS Participants (n = 4262) are students in an ongoing cohort study, and data from the baseline assessment were used. Four linear regression models were built to explore the associations between body dissatisfaction, compulsive weight control exercise and depressive symptoms. RESULTS Our findings showed that females reported higher levels of body dissatisfaction than males. Body dissatisfaction and compulsive exercise were associated with self-reported symptoms of depression in this non-clinical population. Results showed that compulsive exercise was negatively associated with reported symptoms of depression, while body dissatisfaction was positively associated with symptoms of depression. CONCLUSION In line with previous research, there was a gender difference in body dissatisfaction where females displayed higher levels of dissatisfaction than males. Body dissatisfaction was positively associated with reported symptoms of depression, suggesting support of previous research indicating body dissatisfaction to increase mental health problems. Compulsive exercise was negatively associated with symptoms of depression suggesting a behavior negatively reinforced, supporting both constructs to be of interest for reported symptoms of depression in a non-clinical population of Swedish university students. LEVEL OF EVIDENCE III, cohort study. TRIAL REGISTRATION http://clinicaltrials.gov/ID : NCT04465435.
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Affiliation(s)
- Klara Edlund
- Musculoskeletal and Sports Injury Epidemiology Center, Department of Health Promotion Sciences, Sophiahemmet University, Sophiahemmet Högskola, Box 5605, 114 86, Stockholm, Sweden. .,Unit of Intervention and Implementation Research on Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
| | - Fred Johansson
- Musculoskeletal and Sports Injury Epidemiology Center, Department of Health Promotion Sciences, Sophiahemmet University, Sophiahemmet Högskola, Box 5605, 114 86, Stockholm, Sweden.,Unit of Intervention and Implementation Research on Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | | | - Louise Bergman
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Tobias Sundberg
- Musculoskeletal and Sports Injury Epidemiology Center, Department of Health Promotion Sciences, Sophiahemmet University, Sophiahemmet Högskola, Box 5605, 114 86, Stockholm, Sweden.,Unit of Intervention and Implementation Research on Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Eva Skillgate
- Musculoskeletal and Sports Injury Epidemiology Center, Department of Health Promotion Sciences, Sophiahemmet University, Sophiahemmet Högskola, Box 5605, 114 86, Stockholm, Sweden.,Unit of Intervention and Implementation Research on Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
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6
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Rutkowska A, Cieślik B, Tomaszczyk A, Szczepańska-Gieracha J. Mental Health Conditions Among E-Learning Students During the COVID-19 Pandemic. Front Public Health 2022; 10:871934. [PMID: 35655450 PMCID: PMC9152265 DOI: 10.3389/fpubh.2022.871934] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 04/21/2022] [Indexed: 12/20/2022] Open
Abstract
Aim The COVID-19 pandemic has forced the education system to undergo changes, which have also affected universities. E-learning became the main form of education, reducing interpersonal contacts, which could affect the mental wellbeing of students. The aim of this study was to investigate the prevalence of depressive symptoms and the level of perceived stress during e-learning among Polish students and to identify the factors for predicting higher levels of depression symptoms. Methods The study included 753 participants with a mean age of 22.47 (±4.02) years. The Perception of Stress Questionnaire (PSQ) and Beck Depression Inventory (BDI-II) were used to measure the severity of stress and level of depression. Furthermore, our own survey was used to assess the impact of e-learning on various aspects of life. To examine how much stress can explain a statistically significant amount of variance in depression, three-step hierarchical multiple regression was used. In addition, our own questionnaire was used to assess the impact of e-learning on education, social contacts and technical abilities. Results A total of 58% of the students characterized by an increased level of stress. 56% show symptoms of depression and 18% of the participants had suicidal thoughts. The most significant predictor of depression is high stress levels and factors related to e-learning: isolation from friends and acquaintances, negative impact on level of knowledge, reduced motivation to learn, and worsening grades. This predictors may explain about 66% of the variance of depression. Conclusion Universities should implement interventions and educational programmes, providing ad hoc assistance in the form of individual or group meetings with a psychologist (also in a remote form) and organizing workshops and webinars on strategies for managing stress.
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Affiliation(s)
- Anna Rutkowska
- Department of Physical Education and Physiotherapy, Opole University of Technology, Opole, Poland
| | - Błazej Cieślik
- Department of Kinesiology and Health Prevention, Jan Dlugosz University in Częstochowa, Częstochowa, Poland
| | - Agata Tomaszczyk
- Descartes' Error Student Research Association, Faculty of Physical Education and Physiotherapy, Opole University of Technology, Opole, Poland
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7
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Edlund K, Sundberg T, Johansson F, Onell C, Rudman A, Holm LW, Grotle M, Jensen I, Côté P, Skillgate E. Sustainable UNiversity Life (SUN) study: protocol for a prospective cohort study of modifiable risk and prognostic factors for mental health problems and musculoskeletal pain among university students. BMJ Open 2022; 12:e056489. [PMID: 35379630 PMCID: PMC8980731 DOI: 10.1136/bmjopen-2021-056489] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Mental health problems and musculoskeletal pain are common health problems among young adults including students. Little is known about the aetiology and prognosis of these problems in university students. We aim to determine the role of personal, sociodemographic, academic and environmental factors for risk and prognosis of symptoms of depression, anxiety and stress as well as musculoskeletal pain in university students. The constructs that will be studied are based on the biopsychosocial model and psychopathology associated with disabling pain. This model acknowledges illness to consist of interrelated mechanisms categorised into biological, psychological, environmental and social cues. METHODS AND ANALYSIS This cohort study aims to recruit around 5000 Swedish full-time students. Data will be collected using five online surveys during one academic year. A subgroup (n=1851) of the cohort, recruited before the COVID-19 pandemic, receive weekly text messages with three short questions assessing mood, worry and pain, sent through the web-based platform SMS-track . Statistical analyses will include Kaplan-Meier estimates, Cox regression analyses, multinomial logistic regression analyses and generalised estimating equations. We will assess effect measure modification when relevant and conduct sensitivity analyses to assess the impact of lost to follow-up. PROTOCOL AMENDMENTS Due to opportunity and timing of the study, with relevance to the outbreak of the COVID-19 pandemic, this study further aims to address mental health problems, musculoskeletal pain and lifestyle in university students before and during the pandemic. ETHICS AND DISSEMINATION The Sustainable UNiversity Life study was approved by the Swedish ethics authority (2019-03276; 2020-01449). Results will be disseminated through peer-reviewed research papers, reports, research conferences, student theses and stakeholder communications. TRIAL REGISTRATION NUMBER NCT04465435.
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Affiliation(s)
- Klara Edlund
- Department of Health Promotion Science, Sophiahemmet University, Stockholm, Sweden
- Unit of Intervention Research on Worker Health, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Tobias Sundberg
- Department of Health Promotion Science, Sophiahemmet University, Stockholm, Sweden
- Unit of Intervention Research on Worker Health, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Fred Johansson
- Department of Health Promotion Science, Sophiahemmet University, Stockholm, Sweden
- Unit of Intervention Research on Worker Health, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Clara Onell
- Department of Health Promotion Science, Sophiahemmet University, Stockholm, Sweden
- Unit of Intervention Research on Worker Health, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Ann Rudman
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Department of Health and Welfare, Dalarna University, Falun, Sweden
| | - Lena W Holm
- Department of Health Promotion Science, Sophiahemmet University, Stockholm, Sweden
- Unit of Intervention Research on Worker Health, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Margreth Grotle
- Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway
| | - Irene Jensen
- Unit of Intervention Research on Worker Health, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Pierre Côté
- Communication and Research Unit for Musculoskeletal Health (Formi), Oslo University Hospital, Oslo, Norway
- Centre for Disability Prevention and Rehabilitation, Faculty of Health Sciences, Ontario Tech University, Oshawa, Ontario, Canada
| | - Eva Skillgate
- Department of Health Promotion Science, Sophiahemmet University, Stockholm, Sweden
- Unit of Intervention Research on Worker Health, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
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8
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Prihanto JB, Wahjuni ES, Nurhayati F, Matsuyama R, Tsunematsu M, Kakehashi M. Health Literacy, Health Behaviors, and Body Mass Index Impacts on Quality of Life: Cross-Sectional Study of University Students in Surabaya, Indonesia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413132. [PMID: 34948741 PMCID: PMC8702043 DOI: 10.3390/ijerph182413132] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 12/07/2021] [Accepted: 12/08/2021] [Indexed: 11/17/2022]
Abstract
University student life is an important transformation stage with many potential factors that can impact negatively on the Quality of Life (QOL) and the adoption of unhealthy behaviors. Health literacy (HL), Health Behaviors (HBs), and Body Mass Index (BMI) have been found to be essential components in influencing QOL, in addition to socioeconomic determinants. To identify the influential factors of QOL, we performed a cross-sectional survey in a university, and 955 undergraduate students were enrolled as respondents. We measured two different aspects of HL, i.e., Comprehensive Health Literacy (CHL) and Functional Health Literacy (FHL). Overall, QOL scores in four domains did not differ, regarded as medium with averages ranging from 57.00–63.98, and no significant difference between male and female students. In multivariate analysis, CHL had a significant positive influence on all domains, while FHL only affected the psychological and environmental domains with negative associations. Academic performance had a significant positive association with physical and psychological domains. Students from education majors had higher QOL in the psychological and social domains. Moreover, students with normal or underweight BMI status had better psychological QOL, and physical exercise had a positive association with the social relationship and environmental domains. The findings confirmed that CHL and FHL had significant associations with QOL domains in different ways that should be addressed accordingly. Public health practitioners should carefully empower students to use both CHL and FHL as decision-making skills by incorporating them into related curricula.
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Affiliation(s)
- Junaidi Budi Prihanto
- Department of Health Informatics, Graduate School of Biomedical and Health Science, Hiroshima University, Hiroshima 734-8553, Japan; (R.M.); (M.T.); (M.K.)
- Department of Sport Education, Faculty of Sport Science, State University of Surabaya, Surabaya 60213, Indonesia; (E.S.W.); (F.N.)
- Correspondence:
| | - Endang Sri Wahjuni
- Department of Sport Education, Faculty of Sport Science, State University of Surabaya, Surabaya 60213, Indonesia; (E.S.W.); (F.N.)
| | - Faridha Nurhayati
- Department of Sport Education, Faculty of Sport Science, State University of Surabaya, Surabaya 60213, Indonesia; (E.S.W.); (F.N.)
| | - Ryota Matsuyama
- Department of Health Informatics, Graduate School of Biomedical and Health Science, Hiroshima University, Hiroshima 734-8553, Japan; (R.M.); (M.T.); (M.K.)
| | - Miwako Tsunematsu
- Department of Health Informatics, Graduate School of Biomedical and Health Science, Hiroshima University, Hiroshima 734-8553, Japan; (R.M.); (M.T.); (M.K.)
| | - Masayuki Kakehashi
- Department of Health Informatics, Graduate School of Biomedical and Health Science, Hiroshima University, Hiroshima 734-8553, Japan; (R.M.); (M.T.); (M.K.)
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Borderline Personality Symptoms: What Not to Be Overlooked When Approaching Suicidal Ideation among University Students. Healthcare (Basel) 2021; 9:healthcare9101399. [PMID: 34683078 PMCID: PMC8535964 DOI: 10.3390/healthcare9101399] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 09/29/2021] [Accepted: 10/18/2021] [Indexed: 11/17/2022] Open
Abstract
Suicidal ideation is a serious condition antecedent to suicidal attempts and is highly related not only to depression but also other psychosocial factors. This study aimed to examine the predictive effects of these potential factors for suicidal ideation among young adult university students. A cross-sectional survey was conducted on a sample of university students in Thailand. An online questionnaire employed the perceived stress scale-10 (PSS-10), the patient health questionnaire-8 (PHQ-8), the multidimensional scale of perceived social support (MSPSS), and a screening instrument for borderline personality disorder. An ordinal regression analysis was applied to determine the predictive effects of the independent variables. Of 336 students, the mean age was 20.26 ± 1.3 years, 80.4% of whom were female; 14.3% had suicidal ideation. The significant predictors of suicidal thoughts were perceived stress (AOR 1.11, 95% CI 1.01 to 1.22); depressive symptoms (AOR 1.16, 95% CI 1.05 to 1.22); borderline personality symptoms (AOR 1.19, 95% CI 1.01 to 1.40); and perceived social support (AOR 0.97, 95% CI 0.94 to 1.00). Not only did depressive symptoms contribute to suicidal ideation but they also constituted important variables. Therefore, they should be included in intervention plans to prevent suicidality among university students.
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10
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McLaughlin JC, Gunnell D. Suicide Deaths in University Students in a UK City Between 2010 and 2018 - Case Series. CRISIS 2020; 42:171-178. [PMID: 32722926 DOI: 10.1027/0227-5910/a000704] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background: There are longstanding concerns over the mental health and suicide risk of university students in the UK and internationally. Aims: This study aimed to identify risk factors for suicide among students attending universities in a UK city. Method: Suicide deaths between January 2010 and July 2018 were identified from university records. An audit tool was used to collate data from university records and coroners' inquest files. Results: A total of 37 student deaths were identified. Only 10.8% of the students had disclosed a mental health issue at university entry. There was strong statistical evidence that students who died by suicide were more likely to have been male, experiencing academic difficulties (repeated years, changing course, and suspension of studies were all associated with a 5-30-fold increased risk), and in need of financial support compared with other students. Limitations: The coroners' records were only available for around half of the deaths. Healthcare records were not available. Conclusion: Markers of academic and financial difficulty should be considered as flags to identify students at heightened risk. Whilst the relative risk associated with academic difficulties is high, the absolute risk is low. Improved disclosure of mental health issues at university registration could facilitate targeted support for vulnerable students.
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Affiliation(s)
- Joanna C McLaughlin
- Public Health Department, Bath and North East Somerset Council, Bath, UK.,Bristol Medical School, University of Bristol, UK.,Public Health England South West Centre, Bristol, UK
| | - David Gunnell
- Bristol Medical School, University of Bristol, UK.,National Institute of Health Research Biomedical Research Centre at the University Hospitals Bristol NHS Foundation Trust and the University of Bristol, UK
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11
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The incidence of suicide in University students in England and Wales 2000/2001-2016/2017: Record linkage study. J Affect Disord 2020; 261:113-120. [PMID: 31610312 DOI: 10.1016/j.jad.2019.09.079] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 09/11/2019] [Accepted: 09/30/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND There are growing concerns about the mental health and risk of suicide amongst university students. AIM To investigate trends in the incidence and characteristics of university student suicides in England & Wales for the academic years 2000/01 to 2016/17. METHOD Record linkage between Office for National Statistics mortality data and Higher Education Statistics Agency data for England and Wales. Poisson regression and chi-squared tests were used to investigate secular trends and the characteristics of students dying by suicide. RESULTS There were 1330 student suicide deaths from 2000/01 to 2016/17; the annual incidence in 2015/16-2016/17 was 4.7 per 100,000 students. There was evidence of a rise in incidence since 2009/10 (incidence rate ratio per year 1.04 ((95%CI 1.00-1.07) p = 0.029). Incidence in 2012/13 to 2016/17 was less than half the rate in the general population of a similar age. Incidence was higher in males than females and amongst undergraduates vs. postgraduates. There was some evidence of a reduced risk amongst black compared to white students (RR 0.53 (95%CI 0.32-0.88). Incidence was highest in January and lowest during the summer holidays (July-September). LIMITATIONS There was no age/sex or sociodemographic breakdown of the overall student population for 2000/01 to 2011/12. CONCLUSION Rates of suicide are considerably lower amongst students than the general population. In keeping with trends in young people in the wider population, the incidence of student suicide has increased since 2009/10. To inform prevention, research is needed to understand reasons for the rise in suicide in young people.
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Mental Health Services for Canadian University Student-Athletes: An Exploratory Survey. JOURNAL OF CLINICAL SPORT PSYCHOLOGY 2019. [DOI: 10.1123/jcsp.2018-0048] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
University student-athletes are equally vulnerable to mental health challenges compared to their non-athlete peers, but they access mental health services with less frequency. This study sought to explore the mental health issues experienced by Canadian student-athletes in order to address the question: how can Canadian universities better meet the mental health needs of student-athletes? An electronic survey was distributed to student-athletes at a large Canadian university. Data from 113 respondents were analyzed using descriptive statistics and content analysis. Stress and pressure were reported as the most prevalent contributors to mental health issues, and 47% of respondents indicated that there was a time in which they wanted to seek services for their mental health, but chose not to. Respondents identified mental health education for coaches and designating a healthcare professional within the athletic department as beneficial resources. Findings from this study can inform local and national mental health service planning for student-athletes.
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Winzer R, Lindberg L, Guldbrandsson K, Sidorchuk A. Effects of mental health interventions for students in higher education are sustainable over time: a systematic review and meta-analysis of randomized controlled trials. PeerJ 2018; 6:e4598. [PMID: 29629247 PMCID: PMC5885977 DOI: 10.7717/peerj.4598] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Accepted: 03/20/2018] [Indexed: 11/20/2022] Open
Abstract
Background Symptoms of depression, anxiety, and distress are more common in undergraduates compared to age-matched peers. Mental ill health among students is associated with impaired academic achievement, worse occupational preparedness, and lower future occupational performance. Research on mental health promoting and mental ill health preventing interventions has shown promising short-term effects, though the sustainability of intervention benefits deserve closer attention. We aimed to identify, appraise and summarize existing data from randomized control trials (RCTs) reporting on whether the effects of mental health promoting and mental ill health preventing interventions were sustained at least three months post-intervention, and to analyze how the effects vary for different outcomes in relation to follow-up length. Further, we aimed to assess whether the effect sustainability varied by intervention type, study-level determinants and of participant characteristics. Material and Methods A systematic search in MEDLINE, PsycInfo, ERIC, and Scopus was performed for RCTs published in 1995-2015 reporting an assessment of mental ill health and positive mental health outcomes for, at least, three months of post-intervention follow-up. Random-effect modeling was utilized for quantitative synthesis of the existing evidence with standardized mean difference (Hedges' g) used to estimate an aggregated effect size. Sustainability of the effects of interventions was analyzed separately for 3-6 months, 7-12 months, and 13-18 months of post-intervention follow-up. Results About 26 studies were eligible after reviewing 6,571 citations. The pooled effects were mainly small, but significant for several categories of outcomes. Thus, for the combined mental ill health outcomes, symptom-reduction sustained up to 7-12 months post-intervention (standardized mean difference (Hedges' g) effect size (ES) = -0.28 (95% CI [-0.49, -0.08])). Further, sustainability of symptom-reductions were evident for depression with intervention effect lasting up to 13-18 months (ES = -0.30 (95% CI [-0.51, -0.08])), for anxiety up to 7-12 months (ES = -0.27 (95% CI [-0.54, -0.01])), and for stress up to 3-6 months (ES = -0.30 (95% CI [-0.58, -0.03])). The effects of interventions to enhance positive mental health were sustained up to 3-6 months for the combined positive mental health outcomes (ES = 0.32 (95% CI [0.05, 0.59])). For enhanced active coping, sustainability up to 3-6 months was observed with a medium and significant effect (ES = 0.75 (95% CI [0.19, 1.30])). Discussion The evidence suggests long-term effect sustainability for mental ill health preventive interventions, especially for interventions to reduce the symptoms of depression and symptoms of anxiety. Interventions to promote positive mental health offer promising, but shorter-lasting effects. Future research should focus on mental health organizational interventions to examine their potential for students in tertiary education.
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Affiliation(s)
- Regina Winzer
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.,Department of Living Conditions and Lifestyles, The Public Health Agency of Sweden, Solna, Sweden
| | - Lene Lindberg
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.,Center for Epidemiology and Community Medicine, Stockholm County Council, Stockholm, Sweden
| | - Karin Guldbrandsson
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.,Department of Living Conditions and Lifestyles, The Public Health Agency of Sweden, Solna, Sweden
| | - Anna Sidorchuk
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.,Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden
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