Prevalence of suicidal ideation in medical students: A systematic review. Ideación suicida en estudiantes de medicina.

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Francisco Javier Llievanos-Ruiz
Fabiola González Betanzos
Alicia Edith Hermosillo de la Torre
Luis Miguel Sánchez-Loyo

Abstract

It has been pointed out that medical students are a population vulnerable to suicidal behaviors; however, the evidence on the prevalence of suicidal ideation in these students is heterogeneous. The aim of this systematic review was to identify the prevalence of suicidal ideation in medical students, forms of measurement and its relationship with the identified prevalence. A search for articles was carried out in eight of the main scientific databases, a period of 10 years of publications was considered, the confidence intervals of the prevalence of suicidal ideation reported in each study were obtained, grouped according to the period of time that evaluated the instrument used and in each period the mean, variance, standard deviation and confidence interval (95%) of the mean were calculated. The results show that the reported presence of suicidal ideation lifetime was between 15.7 and 35.3%, during the medical career between 3.7 and 11.8%, during the last year between 7 and 35.6% and at present between 1.6 and 43.6%. Conclusion: There is a high variability in the prevalence of suicidal ideation among the different studies reviewed, possibly associated with various methodological biases. This review highlights the need to properly select the instruments to determine the prevalence of suicidal ideation.

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Llievanos-Ruiz, F. J., González Betanzos, F., Hermosillo de la Torre, A. E. ., & Sánchez-Loyo, L. M. (2022). Prevalence of suicidal ideation in medical students: A systematic review.: Ideación suicida en estudiantes de medicina. Uaricha, 19, 1–13. https://doi.org/10.35830/urp.v19i.587
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References

*boalshamat, K., Salman, W., Almehman, R., Maghrabi, A., Alamoudi, K., Najjar, A., & Alshehri, A. (2018). The relationship between loneliness and suicidal ideation in private medical and dental students in Jeddah, Saudi Arabia. Journal International Medicine Dentistry, 5(1), 11-19. https://doi.org/10.18320/JIMD/201805.0111

*Adhikari, A., Dutta, A., Sapkota, S., Chapagain, A., Aryal, A., & Pradhan, A. (2017). Prevalence of poor mental health among medical students in Nepal: a cross-sectional study. BMC medical education, 17(1), 1-7. https://doi.org/10.1186/s12909-017-1083-0

*Ahmed, S. A., Omar, Q. H., & Elamaim, A. A. A. (2016). Forensic analysis of suicidal ideation among medical students of Egypt: a crosssectional study. Journal of forensic and legal medicine, 44, 1-4. https://doi.org/10.1016/j.jflm.2016.08.009

*Alexandrino-Silva, C., Pereira, M. L. G., Bustamante, C., Ferraz, A. C. D. T., Baldassin, S., Andrade, A. G. D., & Alves, T. C. D. T. F. (2009). Suicidal ideation among students enrolled in healthcare training programs: a cross-sectional study. Brazilian Journal of Psychiatry, 31(4), 338-344. https://doi.org/10.1590/S1516-44462009005000006

*Amiri, L., Voracek, M., Yousef, S., Galadari, A., Yammahi, S., Sadeghi, M. R., Eskin, M., & Dervic, K. (2013). Suicidal behavior and attitudes among medical students in the United Arab Emirates. Crisis, 34(2), 116-123. https://doi.org/10.1027/0227-5910/a000170

Blacker, C., Lewis, C., Swintak, C., Bostwick, J., & Rackley S. (2019). Medical Student Suicide Rates: A Systematic Review of the Historical and International Literature. Academic Medicine, 94(2), 274-280. https://doi.org/10.1097/ACM.0000000000002430

Castillejos, M. C., Huertas, P., Martín, P., & Moreno Küstner, B. (2021). Prevalence of Suicidality in the European General Population: A Systematic Review and Meta-Analysis. Archives of Suicide Research, 25(4), 810-828. https://doi.org/10.1080/13811118.2020.1765928

Cao, X.-L., Zhong, B.-L., Xiang, Y.-T., Ungvari, G. S., Lai, K. Y., Chiu, H. F., & Caine, E. D. (2015). Prevalence of suicidal ideation and suicide attempts in the general population of China. The International Journal of Psychiatry in Medicine, 49(4) 296-308. https://doi.org/10.1177/0091217415589306

*Choi, D., Tolova, V., Socha, E., & Samenow, C. P. (2013). Substance use and attitudes on professional conduct among medical students: a single-institution study. Academic Psychiatry, 37(3), 191-195. https://doi.org/10.1176/appi.ap.12060126

*Chow, W. S., Schmidtke, J., Loerbroks, A., Muth, T., & Angerer, P. (2018). The relationship between personality traits with depressive symptoms and suicidal ideation among medical students: A cross-sectional study at one medical school in Germany. International Journal of Environmental Research and Public Health, 15(7), 1462. https://doi.org/10.3390/ijerph15071462

*Coentre, R., Faravelli, C., & Figueira, M. L. (2016). Assessment of depression and suicidal behaviour among medical students in Portugal. International Journal of Medical Education, 7, 354-363. https://doi.org/10.5116/ijme.57f8.c468

Davidson, J. E., Proudfoot, J., Lee, K., & Zisook, S. (2019). Nurse suicide in the United States: Analysis of the Center for Disease Control 2014 National Violent Death Reporting System dataset. Archives of Psychiatric Nursing, 33(5), 16-21. https://doi.org/10.1016/j.apnu.2019.04.006

De Paula, W., Breguez, G. S., Machado, E. L., & Meireles, A. L. (2020). Prevalence of anxiety, depression, and suicidal ideation symptoms among university students: a systematic review. Brazilian Journal of Health Review, 3(4), 8739-8756. https://doi.org/10.34119/bjhrv3n4-119

Dong, M., Zhou, F. C., Xu, S. W., Zhang, Q., Ng, C. H., Ungvari, G. S., & Xiang, Y. T. (2020). Prevalence of suicide‐related behaviors among physicians: A systematic review and meta‐analysis. Suicide and Life‐Threatening Behavior, 50(6), 1264-1275. https://doi.org/10.1111/sltb.12690

*Downs, N., Feng, W., Kirby, B., McGuire, T., Moutier, C., Norcross, W., Norman, M., Young, I., & Zisook, S. (2014). Listening to depression and suicide risk in medical students: the Healer Education Assessment and Referral (HEAR) Program. Academic Psychiatry, 38(5), 547-553. https://doi.org/10.1007/s40596-014-0115-x

*Dutheil F., Aubert C., Pereira B., Dambrun M., Moustafa F., Mermillod M., Baker, J. S., Trousselard, M., Lesage, F. X., & Navel, V. (2019). Suicide among physicians and health-care workers: A systematic review and meta-analysis. PLoS ONE, 14(12), e0226361. https://doi.org/10.1371/journal.pone.0226361

*Dyrbye, L. N., Harper, W., Moutier, C., Durning, S. J., Power, D. V., Massie, F. S., Eacker, A., Thomas, M. R., Satele, D., Sloan, J., & Shanafelt, T. D. (2012). A multi-institutional study exploring the impact of positive mental health on medical students’ professionalism in an era of high burnout. Academic Medicine, 87(8), 1024-1031. https://doi.org/10.1097/ACM.0b013e31825cfa35

*Dyrbye, L. N., West, C. P., Satele, D., Boone, S., Tan, L., Sloan, J., & Shanafelt, T. D. (2014). Burnout among US medical students, residents, and early career physicians relative to the general US population. Academic medicine, 89(3), 443-451. https://doi.org/10.1097/ACM.0000000000000134

*Eskin, M., Voracek, M., Stieger, S., & Altinyazar, V. (2011). A cross-cultural investigation of suicidal behavior and attitudes in Austrian and Turkish medical students. Social psychiatry and psychiatric epidemiology, 46(9), 813-823. https://doi.org/10.1007/s00127-010-0254-7

*Fan, A. P., Kosik, R. O., Mandell, G. A., Tran, D. T. P., Cheng, H. M., Chen, C. H., Su, T. P., & Chiu, A. W. (2012). Suicidal ideation in medical students: who is at risk? Annals of the Academy of Medicine-Singapore, 41(9), 377-382

*Gignon, M., Havet, E., Ammirati, C., Traullé, S., Manaouil, C., Balcaen, T., Loas, G., Dubois, G., & Ganry, O. (2015). Alcohol, cigarette, and illegal substance consumption among medical students: a cross-sectional survey. Workplace health & safety, 63(2), 54-63. https://doi.org/10.1177/2165079915570917

Hawton, K., Agerbo, E., Simkin, S., Platt, B., & Mellanby, R. J. (2011) Risk of suicide in medical and related occupational groups: a national study based on Danish case population-based registers. Journal of Affective Disorders, 134(1-3), 320–326. https://doi.org/10.1016/j.jad.2011.05.044

Instituto Nacional de Estadística y Geografía (2019). Estadísticas a propósito del día mundial para la prevención del suicidio (10 de septiembre). Recuperado de: https://www.inegi.org.mx/contenidos/saladeprensa/aproposito/2019/suicidios2019_Nal.pdf

*Jeon, H. J., Roh, M. S., Kim, K. H., Lee, J. R., Lee, D., Yoon, S. C., & Hahm, B. J. (2009). Early trauma and lifetime suicidal behavior in a nationwide sample of Korean medical students. Journal of Affective Disorders, 119(1-3), 210-214. https://doi.org/10.1016/j.jad.2009.03.002

Ji, Y. D., Robertson, F. C., Patel, N. A., Peacock, Z. S., & Resnick, C. M. (2020). Assessment of Risk Factors for Suicide Among US Health Care Professionals. JAMA Surgery, 155(8), 713-721. https://doi.org/10.1001/jamasurg.2020.1338

Mata, D. A., Ramos, M. A., Bansal, N., Khan, R., Guille, C., Di Angelantonio, E., & Sen, S. (2015). Prevalence of depression and depressive symptoms among resident physicians: a systematic review and meta-analysis. JAMA, 314(22), 2373-2383. https://doi.org/10.1001/jama.2015.15845

*Matheson, K. M., Barrett, T., Landine, J., McLuckie, A., Soh, N. L. W., & Walter, G. (2016). Experiences of psychological distress and sources of stress and support during medical training: a survey of medical students. Academic Psychiatry, 40(1), 63-68. https://doi.org/10.1007/s40596-015-0395-9

*Menezes, R. G., Subba, S. H., Sathian, B., Kharoshah, M. A., Senthilkumaran, S., Pant, S., Arun, M., Kundapur, R., Jain, A., Lobo, S. W., & Shankar, P. R. (2012). Suicidal ideation among students of a medical college in Western Nepal: a cross-sectional study. Legal Medicine, 14(4), 183-187. https://doi.org/10.1016/j.legalmed.2012.02.004

*Merlo, L. J., Curran, J. S., & Watson, R. (2017). Gender differences in substance use and psychiatric distress among medical students: A comprehensive statewide evaluation. Substance Abuse, 38(4), 401-406. https://doi.org/10.1080/08897077.2017.1355871

Millner A. J., Lee M. D., & Nock M. K. (2015). Single-Item measurement of suicidal behaviors: validity and consequences of misclassification. PLoS ONE, 10(10), e0141606. https://doi.org/10.1371/journal.pone.0141606

Milner, A. J., Maheen, H., Bismark, M. M., & Spittal, M. J. (2016). Suicide by health professionals: a retrospective mortality study in Australia, 2001–2012. Medical Journal of Australia, 205(6), 260-265. https://doi.org/10.5694/mja15.01044

Mortier, P., Cuijpers, P., Kiekens, G., Auerbach, R., Demyttenaere, K., Green, J., Kessler, R. C., Nock, M. K., & Bruffaerts, R. (2018). The prevalence of suicidal thoughts and behaviours among college students: A meta-analysis. Psychological Medicine, 48(4), 554-565. https://doi.org/10.1017/S0033291717002215

Nock, M. K., Borges, G., Bromet, E. J., Cha, C. B., Kessler, R. C., & Lee, S. (2008). Suicide and suicidal behavior. Epidemiologic reviews, 30(1), 133-154. https://doi.org/10.1093/epirev/mxn002

Organización Mundial de la Salud (2014). Prevención del suicidio: Un imperativo global. http://www.who.int/mental_health/suicide-prevention/world_report_2014/es/

*Osama, M., Islam, M. Y., Hussain, S. A., Masroor, S. M. Z., Burney, M. U., Masood, M. A., Menezes, R. G., & Rehman, R. (2014). Suicidal ideation among medical students of Pakistan: a cross-sectional study. Journal of forensic and legal medicine, 27, 65-68. https://doi.org/10.1016/j.jflm.2014.08.006

*Pinzón-Amado, A., Guerrero, S., Moreno, K., Landínez, C., & Pinzón, J. (2013). Ideación suicida en estudiantes de medicina: prevalencia y factores asociados. Revista Colombiana de Psiquiatría, 43 (S1), 47-55. https://doi.org/10.1016/j.rcp.2013.11.005

Rotenstein, L., Ramos, M., Torre, M., Segal, J., Peluso, M., Guille, C., Sen, S., & Mata D. (2016). Prevalence of Depression, Depressive Symptoms, and Suicidal Ideation Among Medical Students: A Systematic Review and Meta-Analysis. JAMA, 316(21), 2214-2236. https://doi.org/10.1001/jama.2016.17324

*Schwenk, T. L., Davis, L., & Wimsatt, L. A. (2010). Depression, stigma, and suicidal ideation in medical students. JAMA, 304(11), 1181-1190. https://doi.org/10.1001/jama.2010.1300

Silverman, M. M. (2016). Challenges to Defining and Classifying Suicide and Suicidal Behaviors. En: R. O’Connor y J. Pirkis (eds). The International Handbook of Suicide Prevention (pp.9–35). Wiley Blackwell. https://doi.org/10.1002/9781118903223.ch1

Silverman, M. M., & De Leo, D. (2016). Why there is a need for an international nomenclature and classification system for suicide. Crisis, 37(2), 83-87 https://doi.org/10.1027/0227-5910/a000419

*Sobowale, K., Zhou, A. N., Fan, J., Liu, N., & Sherer, R. (2014). Depression and suicidal ideation in medical students in China: a call for wellness curricula. International Journal of Medical Education, 5, 31-36. https://doi.org/10.5116/ijme.52e3.a465

*Talih, F., Daher, M., Daou, D., & Ajaltouni, J. (2018). Examining burnout, depression, and attitudes regarding drug use among Lebanese medical students during the 4 years of medical school. Academic Psychiatry, 42(2), 288-296. https://doi.org/10.1007/s40596-017-0879-x

*Thompson, D., Goebert, D., & Takeshita, J. (2010). A program for reducing depressive symptoms and suicidal ideation in medical students. Academic Medicine, 85(10), 1635-1639. https://doi.org/10.1097/ACM.0b013e3181f0b49c

*Torres, A. R., Campos, L. M., Lima, M. C. P., & Ramos-Cerqueira, A. T. A. (2018). Suicidal ideation among medical students: prevalence and predictors. The Journal of Nervous and Mental Disease, 206(3), 160-168. https://doi.org/10.1097/NMD.00000000000007344

Turecki, G., & Brent, D. A. (2016). Suicide and suicidal behaviour. The Lancet, 387(10024), 1227-1239. https://doi.org/10.1016/S0140-6736(15)00234-2

Turecki, G., Brent, D. A., Gunnell, D., O’Connor, R. C., Oquendo, M. A., Pirkis, J., & Stanley, B. H. (2019). Suicide and suicide risk. Nature reviews Disease primers, 5(1), 1-22. https://doi.org/10.1038/s41572-019-0121-0

*Van Niekerk, L., Scribante, L., & Raubenheimer, P. J. (2012). Suicidal ideation and attempt among South African medical students. SAMJ: South African Medical Journal, 102(6), 372-373.

Wells, G. A., Shea, B., O'Connell, D., Peterson, J., Welch, V., Losos, M. & Tugwell, P. (2021). The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. Ottawa Hospital Research Institute. http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp

*Zisook, S., Young, I., Doran, N., Downs, N., Hadley, A., Kirby, B., McGuire, T., Moutier, C., Norcross, W., & Tiamson-Kassab, M. (2016). Suicidal ideation among students and physicians at a US medical school: a healer education, assessment and referral (HEAR) program report. OMEGA-Journal of death and dying, 74(1), 35-61. https://doi.org/10.1177/0030222815598045