Suicidal Ideation and Associated Factors Among Medical Undergraduates in A Medical College of North Kerala

Roshni SS; Remya Ramachandran; Swathi Chalil; KrishnaRaj JS

doi:10.55489/njmr.150420251137

Authors

Roshni SS Department of Community Medicine, Government Medical College Manjeri, Malappuram, India
Remya Ramachandran Department of Community Medicine, Malabar Medical College Hospital and Research Centre, Kozhikode, India
Swathi Chalil Department of Community Medicine, Malabar Medical College Hospital and Research Centre, Kozhikode, India
KrishnaRaj JS Department of Community Medicine, Malabar Medical College Hospital and Research Centre, Kozhikode, India

DOI:

https://doi.org/10.55489/njmr.150420251137

Keywords:

Suicide, Ideation, Medical, Students

Abstract

Background: Suicide is a major global concern, causing over 700,000 deaths annually and ranking as the fourth leading cause of death among 15-29-year-olds. Medical students are at heightened risk, with thoughts of suicide often emerging at the beginning of their medical education. Identifying and addressing this issue by finding out the prevalence of suicidal ideation and associated factors among medical undergraduates was the main aim of our study.

Methodology: A Cross-sectional study was conducted in medical colleges of Kozhikode district, North Kerala using World Mental Health survey initiative version of the World Health Organization Composite International Diagnostic Interview (WHO-CIDI). Students from all academic years who were willing to participate were included through consecutive sampling.

Results: The study found that 28.9% of medical students experienced suicidal ideation after enrolling in medical school. Substance abuse, h/o psychiatric illnesses in students, comorbidities, sleeping difficulties, psychiatric illnesses in family, suicides in family and experiencing stressful events during the course were factors significantly associated with suicidal ideation.

Conclusions: This study observed a high prevalence of suicidal ideation among medical students. And the factors associated were joining MBBS without self-interest, substance abuse, history of psychiatric illness, psychiatric illness in the family, stressful events, co-morbidities and sleeping difficulties.

References

World Health Organization. Suicide; 2025. Available from: https://www.who.int/news-room/fact-sheets/detail/suicide [Accessed 23 June, 2025]

Coentre R, Góis C. Suicidal ideation in medical students: recent insights. Adv Med Educ Pract. 2018 Nov 29;9:873-880. DOI: https://doi.org/10.2147/AMEP.S162626 PMid:30568525 PMCid:PMC6276609 DOI: https://doi.org/10.2147/AMEP.S162626

Chomon RJ. Depression and suicidal ideation among medical students in a private medical college of Bangladesh. A cross sectional web based survey. PLoS One. 2022 Apr 29;17(4):e0265367. DOI: https://doi.org/10.1371/journal.pone.0265367 PMid:35486632 PMCid:PMC9053818 DOI: https://doi.org/10.1371/journal.pone.0265367

Brennan-Wydra E, Chung HW, Angoff N, ChenFeng J, Phillips A, Schreiber J, Young C, Wilkins K. Maladaptive Perfectionism, Impostor Phenomenon, and Suicidal Ideation Among Medical Students. Acad Psychiatry. 2021 Dec;45(6):708-715. DOI: https://doi.org/10.1007/s40596-021-01503-1 PMid:34350548 DOI: https://doi.org/10.1007/s40596-021-01503-1

Varghese SM, Paulson NV, Ajayan P, Abraham JM, Thomas P, Benjamin AI, Matteethra GC. To be or not to be: a cross-sectional study on suicidal ideation, intensity of suicidal ideation and suicide attempts among medical students in Kerala, India. BMJ Public Health. 2025 Jan 11;3(1):e000902. DOI: https://doi.org/10.1136/bmjph-2024-000902. PMID: 40017969; PMCID: PMC11812858. DOI: https://doi.org/10.1136/bmjph-2024-000902

Seo C, Di Carlo C, Dong SX, Fournier K, Haykal KA. Risk factors for suicidal ideation and suicide attempt among medical students: A meta-analysis. PloS one. 2021 Dec 22;16(12):e0261785. DOI: https://doi.org/10.1371/journal.pone.0261785 PMid:34936691 PMCid:PMC8694469 DOI: https://doi.org/10.1371/journal.pone.0261785

Tugnoli S, Casetta I, Caracciolo S, Salviato J. Parental bonding, depression, and suicidal ideation in medical students. Front Psychol. 2022 Aug 4;13:877306. DOI: https://doi.org/10.3389/fpsyg.2022.877306 PMid:35992478 PMCid:PMC9386274 DOI: https://doi.org/10.3389/fpsyg.2022.877306

Abdu Z, Hajure M, Desalegn D. Suicidal behavior and associated factors among students in Mettu University, South West Ethiopia: An institutional based cross-sectional study. Psychol Res Behav Manag. 2020;13:233-243. DOI: https://doi.org/10.2147/PRBM.S240827 PMid:32184684 PMCid:PMC7061437 DOI: https://doi.org/10.2147/PRBM.S240827

Kessler RC, Borges G, Walters EE. Prevalence of and risk factors for lifetime suicide attempts in the National Comorbidity Survey. Arch Gen Psychiatry. 1999 Jul;56(7):617-626. DOI: https://doi.org/10.1001/archpsyc.56.7.617 PMid:10401507 DOI: https://doi.org/10.1001/archpsyc.56.7.617

Kessler RC, Ustün TB. The World Mental Health (WMH) Survey Initiative Version of the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI). Int J Methods Psychiatr Res. 2004;13(2):93-121. DOI: https://doi.org/10.1002/mpr.168. PMID: 15297906 PMCID: PMC6878592 DOI: https://doi.org/10.1002/mpr.168

Desai ND, Chavda P, Shah S. Prevalence and predictors of suicide ideation among undergraduate medical students from a medical college of Western India. Med J Armed Forces India. 2021 Feb;77(Suppl 1):S107-S114. DOI: https://doi.org/10.1016/j.mjafi.2020.11.018 PMID: 33612940 PMCID: PMC7873708 DOI: https://doi.org/10.1016/j.mjafi.2020.11.018

Garg S, Kharb A, Bansal K. 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. Indian J Psychiatry. 2023 Apr;65(4).431-442. DOI: https://doi.org/10.4103/indianjpsychiatry.indianjpsychiatry_400_22 PMid:37325106 PMCid:PMC10263093 DOI: https://doi.org/10.4103/indianjpsychiatry.indianjpsychiatry_400_22

Goyal A, Kishore J, Anand T, Rathi A. Suicidal ideation among medical students of Delhi. Journal of Mental Health and Human Behaviour. 2012 Jan;17(1):60-70.

Garg S, Chauhan A, Singh S, Bansal K. Epidemiological Risk Factors of Suicidal Behavior and Effects of the Components of Coping Strategies on Suicidal Behavior in Medical Students: A North-Indian Institution-Based Cross-Sectional Study. J Neurosci Rural Pract. 2022 Jun 8;13(3):382-392. DOI: https://doi.org/10.1055/s-0042-1744225. PMID: 35946011; PMCID: PMC9357490. DOI: https://doi.org/10.1055/s-0042-1744225

Desalegn GT, Wondie M, Dereje S, Addisu A. Suicide ideation, attempt, and determinants among medical students Northwest Ethiopia: an institution-based cross-sectional study. Ann Gen Psychiatry. 2020 Aug 9;19:44. DOI: https://doi.org/10.1186/s12991-020-00295-2 PMid:32788922 PMCid:PMC7416387 DOI: https://doi.org/10.1186/s12991-020-00295-2

Asfaw H, Yigzaw N, Yohannis Z, Fekadu G, Alemayehu Y. Prevalence and associated factors of suicidal ideation and attempt among undergraduate medical students of Haramaya University, Ethiopia. A cross sectional study. PLoS One. 2020 Aug 12;15(8):e0236398. DOI: https://doi.org/10.1371/journal.pone.0236398 PMid:32785295 PMCid:PMC7423400 DOI: https://doi.org/10.1371/journal.pone.0236398

Wang S, Wei T, Zhu R, Li S, Liu X, Cai Y, et al. Perceived entrapment predicts first-onset suicidal ideation: A longitudinal study among medical students in China. Front public Health. 2023;10:1049975. DOI: https://doi.org/10.3389/fpubh.2022.1049975 PMid:36743178 PMCid:PMC9892625 DOI: https://doi.org/10.3389/fpubh.2022.1049975

Fan AP, Kosik RO, Mandell GA, Tran DT, Cheng HM, Chen CH, Su TP, Chiu AW. Suicidal ideation in medical students: who is at risk? Ann Acad Med Singap. 2012 Sep;41(9):377-382. DOI: https://doi.org/10.47102/annals-acadmedsg.V41N9p377 PMid:23052431 DOI: https://doi.org/10.47102/annals-acadmedsg.V41N9p377

Pinzón-Amado A, Guerrero S, Moreno K, Landínez C, Pinzón J. Suicide ideation among medical students: prevalence and associated factors. Rev Colomb Psiquiatr. 2013;43(Suppl 1):47-55. DOI: https://doi.org/10.1016/j.rcp.2013.11.005 PMid:26574113 DOI: https://doi.org/10.1016/j.rcp.2013.11.005

Coentre R, Faravelli C, Figueira ML. Assessment of depression and suicidal behaviour among medical students in Portugal. Int J Med Educ. 2016 Oct 29;7:354-363. DOI: https://doi.org/10.5116/ijme.57f8.c468 PMid:27794561 PMCid:PMC5116364 DOI: https://doi.org/10.5116/ijme.57f8.c468

Schwenk TL, Davis L, Wimsatt LA. Depression, Stigma, and Suicidal Ideation in Medical Students. JAMA. 2010 Sep 15;304(11):1181-1190. DOI: https://doi.org/10.1001/jama.2010.1300 PMid:20841531 DOI: https://doi.org/10.1001/jama.2010.1300

Nakhostin-Ansari A, Akhlaghi M, Etesam F, Sadeghian MH. Suicidal Ideation and Its Associated Factors in Medical, Dental, and Pharmacy Students: A Cross-Sectional Study during COVID-19 Pandemic. Psychiatry J. 2022 Nov 28;2022:8139351. DOI: https://doi.org/10.1155/2022/8139351 PMid:36478735 PMCid:PMC9722308 DOI: https://doi.org/10.1155/2022/8139351

Mozaffor M, Raheem E, Islam MS, Nurunnabi ASM, Hossain MS, Biswas C, et al. Suicidal behaviors among undergraduate medical students in Bangladesh. Res Dev Med Educ. 2022;11:14. DOI: https://doi.org/10.34172/rdme.2022.014 DOI: https://doi.org/10.34172/rdme.2022.014

Luo JM, Liu EZ, Yang HD, Du CZ, Xia LJ, Zhang ZC, et al. Prevalence and factors associated with suicidal ideation in medical students with migraine. Front psychiatry. 2021 Oct 21;12:683342. DOI: https://doi.org/10.3389/fpsyt.2021.683342 PMid:34744811 PMCid:PMC8566429 DOI: https://doi.org/10.3389/fpsyt.2021.683342