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Saeed F, Ghalehnovi E, Saeidi M, Ali beigi N, Vahedi M, Shalbafan M, Kamalzadeh L, Nazeri Astaneh A, Jalali Nadoushan AH, Shoib S. Factors associated with suicidal ideation among medical residents in Tehran during the COVID-19 pandemic: A multicentric cross-sectional survey. PLoS One 2024; 19:e0300394. [PMID: 38489343 PMCID: PMC10942077 DOI: 10.1371/journal.pone.0300394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 02/26/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND The mental health of medical residents, challenged by their intensive training, is of utmost concern. In light of reported suicides among Iranian medical residents in 2021, this study investigates the factors behind suicidal ideation among medical residents during the COVID-19 pandemic in Tehran. METHODS This study conducted a cross-sectional online survey among medical residents in various specialties in Tehran, Iran, amidst the COVID-19 pandemic. Suicidal ideation was assessed using the Beck Scale for Suicidal Ideation (BSSI), while depression, anxiety, and stress were measured using the DASS-21. It also collected demographic and clinical data from the participants. The data were analyzed using descriptive statistics, the Chi-square test, and multiple linear regression to examine the prevalence and determinants of suicidal ideation among medical residents. RESULTS The study enrolled 353 medical residents and found that 34.3% of them had suicidal ideation, with 10.2% indicating a high risk. The study also found high levels of depression, anxiety, and stress among the participants. The variables that significantly predicted suicidal ideation were depression, history of alcohol/substance use, personal history of suicide attempts, history of self-mutilation, family history of suicide attempts, number of shifts in a month, death of close persons because of COVID-19, and income. Depression was the strongest predictor of suicidal ideation. CONCLUSION These findings underscore the urgent need for effective interventions and support systems to address the mental health needs of medical residents in Iran. The strategies should prioritize destigmatizing mental health, promoting access to mental health services, fostering a supportive training environment, and enhancing income opportunities.
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Affiliation(s)
- Fahimeh Saeed
- Psychosis Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | | | - Mahdieh Saeidi
- Research Center for Addiction and Risky Behaviors, Iran University of Medical Sciences, Tehran, Iran
| | - Neda Ali beigi
- Psychosis Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mohsen Vahedi
- Department of Biostatistics and Epidemiology, Pediatric Neurorehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mohammadreza Shalbafan
- Department of Psychiatry, Mental Health Research Center, Psychosocial Health Research Institute (PHRI), School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Leila Kamalzadeh
- Department of Psychiatry, Geriatric mental health research center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Nazeri Astaneh
- Psychosis Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Amir Hossein Jalali Nadoushan
- Department of Psychiatry, Mental Health Research Center, Psychosocial Health Research Institute (PHRI), School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Sheikh Shoib
- Psychosis Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
- Department of Health Services, Srinagar, Kashmir, India
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Valladares-Garrido D, Zila-Velasque JP, Santander-Hernández FM, Guevara-Morales MA, Morocho-Alburqueque N, Failoc-Rojas VE, Pereira-Victorio CJ, Vera-Ponce VJ, León-Figueroa DA, Valladares-Garrido MJ. Association between love breakup and suicidal ideation in Peruvian medical students: a cross-sectional study during the COVID-19 pandemic. Front Psychiatry 2024; 14:1287036. [PMID: 38348360 PMCID: PMC10859463 DOI: 10.3389/fpsyt.2023.1287036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 12/08/2023] [Indexed: 02/15/2024] Open
Abstract
Objective We aimed to determine the association between a major romantic breakup and suicidal ideation in medical students from three universities in Peru. Methods A cross-sectional study was conducted during the first pandemic wave in 2021 on medical students from three universities in northern Peru. The outcome was suicidal ideation, measured with question nine of the Patient Health Questionnaire-9 (PHQ-9). Generalized Anxiety Disorder Scale-7 (GAD-7) and Insomnia Severity Index (ISI) were also used to assess mental health symptoms. The exposure was the experience of a major love breakup during the pandemic. In addition, its association with other covariates (age, sex, family members infected with COVID-19, deceased family members with COVID-19, insomnia, and anxiety, among others) was examined. Results and discussions Out of 370 students, 19.5% reported a major love breakup during the pandemic (95%CI: 15.5-23.8), and 34.3% had suicidal ideation (95%CI: 29.4-39.4). Having a major love breakup was associated with a higher prevalence of suicidal ideation (PR: 1.49, 95%CI: 1.32-1.67, p < 0.001). Moderate insomnia (PR: 2.56, 95%CI: 1.70-3.87, p < 0.001) and anxiety symptoms (PR: 1.94, 1.10-3.44, p = 0.023) were also associated with suicidal ideation. Conclusion Our study provides evidence of a significant association between a major love breakup and suicidal ideation. This finding emphasizes the need for further research to better understand this association and inform the development of effective suicide prevention policies in medical education.
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Affiliation(s)
- Danai Valladares-Garrido
- Escuela de Medicina, Universidad Cesar Vallejo, Trujillo, Peru
- Oficina de Salud Ocupacional, Hospital Santa Rosa, Piura, Peru
| | - J. Pierre Zila-Velasque
- Facultad de Medicina, Universidad Nacional Daniel Alcides Carrion, Pasco, Peru
- Red Latinoamericana de Medicina en la Altitud e Investigación (REDLAMAI), Pasco, Peru
| | - Flor M. Santander-Hernández
- Escuela de Medicina, Universidad Cesar Vallejo, Piura, Peru
- Sociedad Científica de Estudiantes de Medicina, Universidad Cesar Vallejo, Piura, Peru
| | - Miguel A. Guevara-Morales
- Escuela de Medicina, Universidad Cesar Vallejo, Piura, Peru
- Sociedad Científica de Estudiantes de Medicina, Universidad Cesar Vallejo, Piura, Peru
| | - Noelia Morocho-Alburqueque
- Escuela de Medicina Humana, Facultad de Ciencias de la Salud, Universidad Nacional de Piura, Piura, Peru
| | - Virgilio E. Failoc-Rojas
- Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima, Peru
| | | | - Víctor J. Vera-Ponce
- Instituto de Investigación en Ciencias Biomédicas, Universidad Ricardo Palma, Lima, Peru
- Universidad Tecnológica del Perú, Lima, Peru
| | | | - Mario J. Valladares-Garrido
- Facultad de Medicina Humana, Universidad de San Martín de Porres, Chiclayo, Peru
- South American Center for Education and Research in Public Health, Universidad Norbert Wiener, Lima, Peru
- Oficina de Epidemiología, Hospital Regional Lambayeque, Chiclayo, Peru
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Fadakar H, Kim J, Saunders LC, Kamel MM, Kianpoor M, Moghadam AH, Hayati D, Ramadhan N, Maragha T, Meyer M, Jang K, Krausz RM. Suicidality among university students in the Eastern Mediterranean region: A systematic review. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0002460. [PMID: 37862288 PMCID: PMC10588889 DOI: 10.1371/journal.pgph.0002460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 09/12/2023] [Indexed: 10/22/2023]
Abstract
The prevalence of suicide attempts and suicidal ideation among university students is a global concern. Cultural values, social determinants, religion, and especially growing stress all play an important role in this. This systematic review aimed to identify potential protective and risk factors thought to be associated with suicidal ideation among students in the Eastern Mediterranean region and highlight the importance of developing an effective health care response. MEDLINE, CINAHL, Embase, PsycINFO, WHO Global Health Library, IMEMR, Web of Science Core Collections and Farsi and Arabic databases were searched for papers in English, Farsi, and Arabic. A combination of validated filters, free text keywords, and Mesh and Non-Mesh terms were used to retrieve relevant literature. A total of 2774 papers were found after the search, 257 selected for full-text review, and 72 papers included in the final review. Family and peer support play a potential protective role in the development of suicidal ideation among university students, while adverse life events, bullying, depression, anxiety, and other mental health conditions were identified as risk factors. Suicidality was likely under-reported due to stigma around social and cultural factors. Factors involving religion and culture may act as both protective and risk factors and require more in-depth investigation. The student population in the Eastern Mediterranean region face many challenges. The common theme of suicidality emerged as an indicator of an imbalance of resources and stress, which needs to be addressed proactively, given a most likely underreporting of suicidal ideation and attempts due to stigma.
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Affiliation(s)
- Hasti Fadakar
- Faculty of Medicine, Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Jane Kim
- Faculty of Medicine, Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Lauren C. Saunders
- Faculty of Medicine, Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
- School of Environmental and Life Sciences, University of Newcastle, Ourimbah, Australia
| | - Mostafa M. Kamel
- Faculty of Medicine, Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
- Faculty of Medicine, Department of Psychiatry, Tanta University, Tanta, Egypt
| | - Mohsen Kianpoor
- Faculty of Medicine, Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Arash Hoseyni Moghadam
- Faculty of Medicine, Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Dianah Hayati
- Faculty of Medicine, Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Noor Ramadhan
- Faculty of Medicine, Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Tala Maragha
- Faculty of Medicine, Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Maximilian Meyer
- Faculty of Medicine, Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
- University of Basel Psychiatric Clinics, University of Basel, Basel, Switzerland
| | - Kerry Jang
- Faculty of Medicine, Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Reinhard M. Krausz
- Faculty of Medicine, Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
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Valladares-Garrido D, Zila-Velasque JP, Santander-Hernández FM, Guevara-Morales MA, Morocho-Alburqueque N, Failoc-Rojas VE, Pereira-Victorio CJ, Vera-Ponce VJ, León-Figueroa DA, Valladares-Garrido MJ. Association between Love Breakup and Suicidal Ideation in Peruvian Medical Students: A Cross-Sectional Study during the COVID-19 Pandemic. RESEARCH SQUARE 2023:rs.3.rs-3085268. [PMID: 37503178 PMCID: PMC10371140 DOI: 10.21203/rs.3.rs-3085268/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
Objective We aimed to determine the association between a major romantic breakup and suicidal ideation in medical students from three universities in Peru. Methods A cross-sectional study was conducted during the first pandemic wave in 2021 on medical students from three universities in northern Peru. The outcome was suicidal ideation, measured with question nine of the PHQ-9. The exposure was the experience of a major love breakup during the pandemic. In addition, its association with other covariates (age, sex, family members infected with COVID-19, deceased family members with COVID-19, insomnia, and anxiety, among others) was examined. Results and discussions Out of 370 students, 19.5% reported a major love breakup during the pandemic (95%CI: 15.5-23.8), and 34.3% had suicidal ideation (95%CI: 29.4-39.4). Having a major love breakup was associated with a higher prevalence of suicidal ideation (PR: 1.49, 95%CI: 1.32-1.67). Moderate insomnia (PR: 2.56, 95%CI: 1.70-3.87) and anxiety symptoms (PR: 1.94, 1.10-3.44) were also associated with suicidal ideation. Conclusion Our study provides evidence of a significant association between a major love breakup and suicidal ideation. This finding emphasizes the need for further research to better understand this association and inform the development of effective suicide prevention policies in medical education.
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Sun Y, Yang J, Li M, Liu T. The Association Between Neuroticism and Nomophobia: Chain Mediating Effect of Attachment and Loneliness. Int J Ment Health Addict 2022. [DOI: 10.1007/s11469-022-00897-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/16/2022] Open
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Zhang L, Yang Y, Li M, Zhou X, Zhang K, Yin X, Liu H. The prevalence of suicide ideation and predictive factors among pregnant women in the third trimester. BMC Pregnancy Childbirth 2022; 22:266. [PMID: 35351009 PMCID: PMC8966184 DOI: 10.1186/s12884-022-04590-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 03/17/2022] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Pregnancy is a period for women undergo major physical and psychological changes. Suicide is a cause of maternal death and suicidal ideation is a key factor in suicidal behavior. The purpose of this study was to investigate the prevalence of suicidal ideation in the third trimester and associated predictors including psychological factors such as attachment. METHODS A cross-sectional study included 432 pregnant women in the third trimester of pregnancy was conducted in a tertiary hospital. The Edinburgh Postpartum Depression Scale (EPDS) was used to assess prenatal depression and suicidal ideation. The Zung Self-Rating Anxiety Scale (SAS) and Experience of Close Relationship (ECR) scale were used to assess anxiety and attachment respectively. RESULTS The results showed that the EPDS scale screened 6.71% of pregnant women with suicidal ideation. Compared with those without suicidal ideation, pregnant women with suicidal ideation had a higher prevalence of insecure attachment, higher scores on the two dimensions of attachment (attachment avoidance and attachment anxiety), and higher prevalence of prenatal depression and anxiety. Binary logistic regression showed that marital satisfaction was a protective factor for suicidal ideation, while prenatal depression, prenatal anxiety and attachment anxiety were risk factors for suicidal ideation. CONCLUSIONS The suicidal ideation among pregnant women was high, which should be given more attention. In the process of preventing and intervening suicidal ideation, in addition to the emotional state of pregnant women, their psychological factors such as attachment anxiety should also be considered.
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Affiliation(s)
- Ling Zhang
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, 238000, China
| | - Yating Yang
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, 238000, China
| | - Mengdie Li
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, 238000, China
| | - Xiaoqin Zhou
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, 238000, China
| | - Kai Zhang
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, 238000, China
| | - Xuai Yin
- Department of Obstetric and Gynecology, Chaohu Hospital of Anhui Medical University, Hefei, 238000, China
| | - Huanzhong Liu
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, 238000, China.
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Risk factors for suicidal ideation and suicide attempt among medical students: A meta-analysis. PLoS One 2021; 16:e0261785. [PMID: 34936691 PMCID: PMC8694469 DOI: 10.1371/journal.pone.0261785] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 12/09/2021] [Indexed: 11/19/2022] Open
Abstract
Background Medical training poses significant challenge to medical student wellbeing. With the alarming trend of trainee burnout, mental illness, and suicide, previous studies have reported potential risk factors associated with suicidal behaviours among medical students. The objective of this study is to provide a systematic overview of risk factors for suicidal ideation (SI) and suicide attempt (SA) among medical students and summarize the overall risk associated with each risk factor using a meta-analytic approach. Methods Systemic search of six electronic databases including MEDLINE, Embase, Education Source, Scopus, PsycInfo, and CINAHL was performed from database inception to March 19, 2021. Studies reporting original quantitative or epidemiological data on risk factors associated with SI and SA among undergraduate medical students were included. When two or more studies reported outcome on the same risk factor, a random-effects inverse variance meta-analysis was performed to estimate the overall effect size. Results Of 4,053 articles identified, 25 studies were included. Twenty-two studies reported outcomes on SI risk factors only, and three studies on both SI and SA risk factors. Meta-analysis was performed on 25 SI risk factors and 4 SA risk factors. Poor mental health outcomes including depression (OR 6.87; 95% CI [4.80–9.82] for SI; OR 9.34 [4.18–20.90] for SA), burnout (OR 6.29 [2.05–19.30] for SI), comorbid mental illness (OR 5.08 [2.81–9.18] for SI), and stress (OR 3.72 [1.39–9.94] for SI) presented the strongest risk for SI and SA among medical students. Conversely, smoking cigarette (OR 1.92 [0.94–3.92]), family history of mental illness (OR 1.79 [0.86–3.74]) and suicidal behaviour (OR 1.38 [0.80–2.39]) were not significant risk factors for SI, while stress (OR 3.25 [0.59–17.90]), female (OR 3.20 [0.95–10.81]), and alcohol use (OR 1.41 [0.64–3.09]) were not significant risk factors for SA among medical students. Conclusions Medical students face a number of personal, environmental, and academic challenges that may put them at risk for SI and SA. Additional research on individual risk factors is needed to construct effective suicide prevention programs in medical school.
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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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