Dear Sir
We have conducted the following study following the suicide attempt of a student. High rates of psychological morbidity have been reported among medical students from all over the world (Dahlin et al. Citation2005), but information in Lebanon is lacking. Lebanon is a mediterranean country with a population of about 4 million, equally divided into Christians and Muslims. On both sides, there are strong religious and cultural sanctions against suicidal behavior and the social stigma attached to suicide is considerable. We studied all first and third-year medical students registered in 2007. We used Paykel's questionnaire measuring suicidal ideation, planning and attempts.
Out of 145 students, we obtained 141 questionnaires. One third of the students expressed suicidal thoughts, 9.9% reported suicide planning, and 4 students (2.8%) reported a suicide attempt (1 male, 3 females). There were no significant differences between years 1 and 3, or between sexes, with a slight female predominance.
These figures are comparable to similar studies elsewhere. They are underestimated due to the reluctance of medical students to express vulnerability, as this may influence their records. Medical students are be affected by several problems including worries about the future, educational constraints, social problems, classmate conflict, exam pressure, and close contact with death. However, other studies include similar powerful sources of stress, without similar rates of suicidal behavior.
We noticed a higher non significant rate of suicidal behavior in females. Female medical students are subjected to sexual discrimination by their patients or their male colleagues, both in university and hospital settings; this may influence their behavior and increase their anxiety scores; They usually seek psychological or psychiatric help, more than males. Lindeman's 40 year-review of suicide in physicians concluded that female doctors were more at risk for suicide than the general population (Lindeman et al. Citation1997).
For social and religious reasons, suicidal behavior is underreported in Lebanon and we think that the true extent of the problem is underestimated.
References
- Dahlin M, Joneborg N, Runeson B. Stress and depression among medical students: A cross-sectional study. Med Educ 2005; 39: 594–604
- Lindeman S, Läärä E, Hirvonen J, Lönnqvist J. Suicide mortality among medical doctors in Finland: Are females more prone to suicide than their male colleagues?. Psychol Med 1997; 27: 1219–1222