Epidemiological risk factors of suicidal behavior and effects of the components of coping strategies on suicidal behavior in medical students

Abstract

Background: Suicidal behavior in medical students can be triggered by mental stresses and adoption of poor coping strategies, and might have a negative impact on their quality of life. Aims: The aim of this study was to evaluate the prevalence and risk factors of suicidal behavior, and effects of the components of coping strategies on suicidal behavior among medical students. Methods: An institution-based cross-sectional study was conducted on 531 medical students for a period of two months from February to March 2021. Stratified random sampling technique was used to select the study participants. Data was collected using a self-administered questionnaire. Suicide Behaviors Questionnaire-Revised (SBQ-R) scale was used to measure suicidal behavior. Exploratory factor analysis was performed on the Brief-COPE Inventory to classify the coping components. Chi-squared test and multiple logistic regression were used to determine the risk factors and their association with suicidal behavior. Results: A total of 104 respondents (19.6%) had reported an SBQ-R cutoff score of ≥7 and had suicidal behavior. The rate of lifetime suicidal ideation, plan and attempt was 20.3%, 10.3% and 2.3%, respectively, among medical students with one-year prevalence of suicidal ideation at 33%. The mean age of the participants was 21.26 years (standard deviation (SD) = 1.99). The identified risk factors significantly associated with higher suicidal behavior were depression (OR = 9.6), dissatisfaction with academic performances (OR = 4.9) and coping with mental disengagement (OR = 4.6), while coping with supportive strategies (OR = 0.57) was investigated as a preventive factor for the suicidal behavior. Conclusions: The prevalence of suicidal behavior is found to be highly alarming, revealing that depression and poor coping strategies are risk factors among medical students. The analysis recommends that quantification of the problems, treatment at an early stage and proactive student counselling to help them embrace the appropriate coping strategies should be the first steps in prevention of suicidal behavior.

A Moderation Model for Bolstering Resilience to Suicidal Psychopathology

“…Hence, previous studies (Johnson et al, 2011; Brailovskaia et al, 2020; Seo et al, 2022) implied that mental well-being, life satisfaction, ego resiliency, and social support have moderated the influence of depression on suicidal ideation among college students and were especially noteworthy for the diminution and prevention of suicidal ideations, whereas self-efficacy, problem-solving abilities, and psychosocial stress resistance were identified to have weaker evidence as a moderator (Johnson et al, 2011). Recently, multiple researchers (Cheng et al, 2014; Stange et al, 2017) investigated coping flexibility as a resilience construct to depression and stress, as opposed to conventional approaches that concentrate on the effect of a specific coping mechanism, which is not considerably adaptive (Garg et al, 2022; Garg et al, 2023), whereas only two studies have investigated the association between coping flexibility and suicidal psychopathologies (Heffer and Willoughby, 2017; Kato, 2022). Thus, making assumptions about the nature of resilience is challenging because the components analyzed have varied greatly between the studies and the results.…”

“…The suicide epidemic, an intricate and multifaceted phenomenon, is a societal health concern that disproportionately impacts millennials between the ages of 18 and 25 years globally and in India (Naghvi, M., 2019; Singh, 2022; Garg et al, 2023). According to the literature, medical graduates who began to have academic hardships when they started their medical training were more likely to have suicidal thoughts and attempts (Garg et al, 2022; Garg et al, 2023). Among Indian medical students, current research revealed that 37.2% had lifetime suicidal thoughts, 10.9% had made suicide plans at some point in their lives, and 3.3% had attempted it.…”

“…Among those who have attempted suicide in the last 12 months, around 35% to 45% have had suicidal ideation and are making suicidal ideations and attempts significant predictors of suicidal psychopathology (Garg et al, 2023). Furthermore, the literature has established that experiencing daily life stress among medical students (academic pressure, future expectations, interpersonal issues, and financial difficulties) is a persistent and strongest antecedent of psychological distress and suicidal psychopathologies compared with other risk factors (Bae and Lee, 2018; Garg et al, 2022; Song and Bae, 2022; Garg et al, 2023). Considerable research has been conducted to identify the risk variables that triggered suicidal thoughts and behavior in the past few decades; nevertheless, suicidal intervention strategies concentrated on these risk factors have provided upsetting results, and a rising trend has been observed (Sher, 2019; Kessler et al, 2020).…”

What covariates drive medical students to the brink of suicidal ideation, plan, and attempt? A double-centric cross-sectional study in a resource-constrained rural setting in North India

“…[ 3 , 4 ] The literature established that medical students are at higher risk of suicidal ideation and attempt incomparable to other professional academic courses and the general population. [ 5 ] A recent study conducted in India[ 6 ] found that 19.6% of medical students had suicidal behavior while a previous study showed a higher proportion (30%). [ 7 ] Around 230 suicidal deaths were reported among medical students in India during the last decade.…”

“…[ 11 ] A systematic meta-analysis identified an 11.1% pooled prevalence of suicidal ideation among medical students. [ 12 ] A recent work[ 6 ] carried out in India reported a much higher prevalence of 12-month suicidal ideation (33.7%) and lifetime suicidal ideation (20.3%), compared to a previous survey (8–15%). [ 13 ] The variety of related literature based on the suicide-behavior framework proposed that medical students have the propensity of transforming suicidal ideation into an attempt through familiarization with afflictions and medical knowledge of ways of possible self-harm.…”