Suicidal ideation in medical students: recent insights

Figures & data

Figure 1 Flow chart of systematic identification of articles following PRISMA guidelines.

Abbreviation: PRISMA, Preferred Reporting Items for Systematic reviews and Meta-Analysis.

Table 1 Characteristics of included studies

Study	Country	Year of training	Number of students	Instrument and cutoff used	Prevalence of suicidal ideation	Other significant findings
Adhikari et al (2017)^Citation23	Nepal	First to fourth	343	Question if they had seriously considered committing suicide while in medical school	4.7%	No difference between females and males. Clinical years and depressed students with high rates
Sun et al (2017)^Citation26	China	First to fifth	2,198	Questions about lifetime suicidal ideation, 12-month suicidal ideation, suicide plan, and suicide attempt	Lifetime suicidal ideation: 17.9% 12-month suicidal ideation:8.2%	Suicide plan: 5.2% Suicide attempt: 4.3% Male, mother’s education, and parenting style
Torres et al (2017)^Citation25	Brazil	First to sixth	475	Item 9 of BDI	Current suicidal ideation: 7.2%	Living alone, thoughts of abandoning the course, moderate or severe depressive symptoms, and probable obsessive–compulsive disorder associated with suicidal ideation
Ahmed et al (2016)^Citation27	Egypt	First year, pre-clinical and clinical years	612	BSI Scale	12.75% (BSI>24)	Lifetime suicide plan: 3.59% 48 hours suicide plan: 2.78%
Coentre et al (2016)^Citation28	Portugal	Fourth and fifth	456	3 questions about medical school time of suicidal ideation, suicide plan, and suicide attempt	Medical school suicidal ideation: 3.7%	Medical school suicide plan: 1.1% Medical school suicide attempt: 0.7%
Wege et al (2016)^Citation36	Germany	First	389	1 question about lifetime suicidal ideation	Lifetime suicidal ideation: 7.4%	Expected financial difficulties associated with suicidal ideation
Youssef et al (2016)^Citation38	Pakistan	Second	114	KADS-6	Current suicidal ideation: 24.6%	No statistically significant difference between genders
MacLean et al (2015)^Citation31	USA	Not specified	385	3 questions about suicidal ideation (12 months and lifetime) and suicide attempts	Past 12 months suicidal ideation: 11.7% Lifetime suicidal ideation: 29.9%	Lifetime suicide attempt: 1.8%
Dyrbye et al (2014)^Citation32	USA	First and second	4,402	1 question about past 12 months suicidal ideation	Past 12 months suicidal ideation: 9.4%	Medical students were not more likely to have experienced recent suicidal ideation
Osama et al (2014)^Citation29	Pakistan	First to fifth	331	4 questions about suicidal ideation	Past 12 months suicidal ideation: 35.6%	Lifetime suicide plan: 13.9%; Lifetime suicide attempt: 4.8%
Miletic et al (2014)^Citation30	Serbia	First, third, and sixth	1,296	SBQ	Lifetime suicidal ideation: 2.9%	Lifetime suicide plan: 0.5% Lifetime suicide attempt: 0.6%
Sobowale et al (2014)^Citation9	China	Second and third	348	Item 9 of PHQ-9	Current suicidal ideation: 7.5%
Amiri et al (2012)^Citation24	United Arab Emirates	First to sixth	115	Questions about suicidal ideation and suicide attempt (lifetime, past 12 months, and current)	Lifetime suicidal ideation: 17.5% Past 12 months: 7% Current: 1.8%	Lifetime suicide attempts: 1.8%
Fan et al (2012)^Citation33	Taiwan-China	First and second	435	1 question about current suicidal ideation	Current suicidal ideation: 11.5%	Suicidal ideation higher in second year compared to first year. Students of lower socioeconomic status with noninflammatory joint pain, with headache, with sleep disorders and depressed more likely to have experienced suicidal ideation
Goyal et al (2012)^Citation37	India	First year to internship	265	7 questions about lifetime suicidal ideation and suicide attempt	Lifetime suicidal ideation: 53.6%	Lifetime suicide attempt: 2.7% Suicidal ideation was higher in first year, associated with “impulsive or reckless behavior in difficult situations”, feeling of being “better off dead” and “it’s all too much to manage” Suicidal ideation higher among females and nonworking mothers
Menezes et al (2012)^Citation10	Nepal	Second and third	206	4 questions about past 12 months suicidal ideation included in the GHQ-28 3 questions about lifetime suicidal ideation, suicidal plan, and suicidal attempt	Past 12 months suicidal ideation: 10.7% Lifetime suicidal ideation: 18.4%	Lifetime suicide plans: 1% Lifetime suicide attempt: 1% Factors associated with suicidal ideation were primarily dissatisfaction with academic performance, being in the clinical semesters, having history of drug abuse, and feeling neglected by parents
van Niekerk et al (2012)^Citation34	South Africa	First to fifth	874	1 question about lifetime suicidal ideation	Lifetime suicidal ideation: 32.3%	Lifetime suicide attempt: 6.2% Suicidal ideation three times higher than the general age-matched population Suicidal ideation had a strong association with suicide attempt

Abbreviations: BDI, Beck Depression Inventory; BSI, Beck’s Suicidal Ideation Scale; GHQ-28, General Health Questionnaire; KADS-6, Kutcher Adolescent Depression Scale; PHQ-9, item 9 of the Patient Health Questionnaire; SBQ, Suicide Behaviors Questionnaire.

AdhikariADuttaASapkotaSChapagainAAryalAPradhanAPrevalence of poor mental health among medical students in Nepal: a cross-sectional studyBMC Med Educ201717123229183315

 PubMed Web of Science ®Google Scholar

SunLZhouCXuLLiSKongFChuJSuicidal ideation, plans and attempts among medical college students in china: the effect of their parental characteristicsPsychiatry Res201724713914327889604

 PubMed Web of Science ®Google Scholar

TorresARCamposLMLimaMCPRamos-CerqueiraATASuicidal ideation among medical students: prevalence and predictorsJ Nerv Ment Dis201820616016828837427

 PubMed Web of Science ®Google Scholar

AhmedSAOmarQHAbo ElamaimAAForensic analysis of suicidal ideation among medical students of Egypt: a crosssectional studyJ Forensic Leg Med2016441427589377

 PubMed Web of Science ®Google Scholar

CoentreRFaravelliCFigueiraMLAssessment of depression and suicidal behaviour among medical students in PortugalInt J Med Educ2016735436327794561

 PubMed Web of Science ®Google Scholar

WegeNMuthTLiJAngererPMental health among currently enrolled medical students in GermanyPublic Health20161329210026880490

 PubMed Web of Science ®Google Scholar

YoussefMDaudSShafiqueMMGender difference in depression and suicidal ideation of medical studentsPJMHS201610310531056

 Google Scholar

MacleanLBoozaJBalonRThe impact of medical school on student mental healthAcad Psychiatry2016401899125749920

 PubMed Web of Science ®Google Scholar

DyrbyeLNWestCPSateleDBurnout among U.S. medical students, residents, and early career physicians relative to the general U.S. populationAcad Med20148944345124448053

 PubMed Web of Science ®Google Scholar

OsamaMIslamMYHussainSASuicidal ideation among medical students of Pakistan: a cross-sectional studyJ Forensic Leg Med201427656825287803

 PubMed Web of Science ®Google Scholar

MileticVLukovicJARatkovicNAleksicDGrgurevicADemographic risk factors for suicide and depression among Serbian medical school studentsSoc Psychiatry Psychiatr Epidemiol201550463363825205334

 PubMed Web of Science ®Google Scholar

SobowaleKZhouNFanJLiuNShererRDepression and suicidal ideation in medical students in China: a call for wellness curriculaInt J Med Educ20145313625341209

 PubMedGoogle Scholar

AmiriLVoracekMYousefSSuicidal behavior and attitudes among medical students in the United Arab EmiratesCrisis201334211612323195458

 PubMedGoogle Scholar

FanAPKosikROMandellGASuicidal ideation in medical students: who is at risk?Ann Acad Med Singapore201241937738223052431

 PubMed Web of Science ®Google Scholar

GoyalAKishoreJAnandTRathiASuicidal ideation among medical students of DelhiJ Ment Heal Hum Behav20121716070

 Google Scholar

MenezesRGSubbaSHSathianBSuicidal ideation among students of a medical college in Western Nepal: a cross-sectional studyLeg Med2012144183187

 Web of Science ®Google Scholar

van NiekerkLScribanteLRaubenheimerPJSuicidal ideation and attempt among South African medical studentsS Afr Med J20121026 Pt 237222668910

 PubMed Web of Science ®Google Scholar