Suicidal ideation among students enrolled in healthcare training programs: a cross-sectional study

Alexandrino-Silva, Clóvis; Pereira, Maira Lazarini Guimarães; Bustamante, Carlos; Ferraz, André Corrêa de Toledo; Baldassin, Sergio; Andrade, Arthur Guerra de; Alves, Tania C. T. Ferraz

doi:10.1590/s1516-44462009005000006

Cited by 50 publications

(49 citation statements)

References 37 publications

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“…Previous studies in other countries that used BDI to measure depression in medical students yielded similar results (5-35.1%) to the current research 1 , 5 , 10 , 13 - 15 , 53 - 58 . Recent, high-quality studies have reported a lower prevalence of depression that previous studies 59 .…”

Section: Discussionsupporting

confidence: 82%

“…There are no published studies about depression or suicidal behaviour in Portuguese non-medical university students. Studies from other countries have found high rates of depression in other university students, namely, business, nursing and pharmacy students 10 , 11 , 61 , 66 . One possible explanation is that medical students maintain this high prevalence of depression and suicidal behaviour after completing their medical degree and throughout their professional lives, making the medical profession one of the professions with the highest rates of depression and suicidality 23 , 67 …”

Section: Discussionmentioning

confidence: 99%

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Assessment of depression and suicidal behaviour among medical students in Portugal

2016

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ObjectivesTo examine depression and suicidal behaviour and associated factors in a sample of medical students in Portugal. MethodsWe conducted a cross-sectional study design of 456 native Portuguese medical students from the 4th and 5th year at the University of Lisbon. Participants answered a self-report survey including questions on demographic and clinical variables. Statistical analyses were conducted using the chi-square test, with a Monte Carlo simulation when appropriate. ResultsDepression among medical students was 6.1% (n=28) and suicidal behaviour 3.9% (n=18). Higher depression scores were noted in female medical students (χ2=4.870,df=2,p=0.027), students who lived alone (χ2=8.491,df=3,p=0.037), those with poor physical health (χ2=48.269,df=2,p<0.001), with poor economic status (χ2=8.579,df=2,p=0.014), students with a psychiatric diagnosis (χ2=44.846,df=1,p=0.009), students with a family history of psychiatric disorders (χ2=5.284,df=1,p=0.022) and students with high levels of anxiety (χ2=104.8, df=3, p<0.001). Depression scores were also higher in students with suicidal ideation (χ2=85.0,df=1,p<0.001), suicidal plan (χ2=47.9,df=1,p<0.001) and suicidal attempt (χ2=19.2,df=1,p<0.001). Suicidal behaviour was higher in medical students who lived alone (χ2=16.936,df=3,p=0.001), who had poor physical health (χ2=18,929,df=2,p=0.001), poor economic status (χ2=9.181,df=2,p=0.01), who are/were in psychopharmacology treatment (χ2=30.108,df =1,p<0.001), and who had high alcohol use (χ2=7.547,df=2,p=0.023), severe depression (χ2=88.875,df=3,p<0.001) and high anxiety levels (χ2=50.343,df=3,p<0.001). The results also revealed that there were no differences between students in the 4th and 5th years of medical school regarding rate of depression and suicidal behaviour.ConclusionsSince depression and suicidal behaviour are mental health problems affecting a significant proportion of medical students, medical schools should implement programs that promote mental health wellness, physical health and economic status between other factors.

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Assessment of depression and suicidal behaviour among medical students in Portugal

2016

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“…For example, the TDI item assessing suicidal ideation was given the highest weight (raw score) as those that tap sadness. In accordance with clinical research, a depressive syndrome with suicidal ideation is more serious, and this item alone indicates higher intensity of depression 21,22,24,25. Also, items tapping self-shame had higher weight, in accordance with the growing body of literature that has attached great importance to the emotion of self-shame in generating depressive symptoms 93–102.…”

Section: Discussionsupporting

confidence: 80%

“…These established measures, developed according to classical test theory (CTT), have shown some psychometric limitations, mainly inherent in the theory assumptions 14–20. First, their traditional method of scoring (ie, to compute a raw total score by summing responses to individual items), by weighing each item equally, assumes that each item or symptom on the scale represents a comparable level of psychiatric severity, so that a score of 4 (always) could be obtained for endorsement of “suicidal thoughts” but also for endorsement of “feeling blue,” although feeling blue should be considered a “less severe” item on the spectrum, whereas suicidal thoughts is clearly a “more severe” symptom 21–25…”

Section: Introductionmentioning

confidence: 99%

Building a new Rasch-based self-report inventory of depression

Balsamo¹,

Giampaglia²,

Saggino³

2014

NDT

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This paper illustrates a sequential item development process to create a new self-report instrument of depression refined with Rasch analysis from a larger pool of potential diagnostic items elicited through a consensus approach by clinical experts according to the latest edition of the Diagnostic and Statistical Manual of Mental Disorders criteria for major depression. A 51-item pool was administered to a sample of 529 subjects (300 healthy community-dwelling adults and 229 psychiatric outpatients). Item selection resulted in a 21-item set, named the Teate Depression Inventory, with an excellent Person Separation Index and no evidence of bias due to an item–trait interaction (χ2=147.71; df =168; P=0.48). Additional support for the unidimensionality, local independence, appropriateness of the response format, and discrimination ability between clinical and nonclinical subjects was provided. No substantial differential item functioning by sex was observed. The Teate Depression Inventory shows considerable promise as a unidimensional tool for the screening of depression. Finally, advantages and disadvantages of this methodology will be discussed in terms of subsequent possible mathematical analyses, statistical tests, and implications for clinical investigations.

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“…(2006) indicated that medical school itself, regardless of culture, generates a level of stress which may contribute to poor mental health. These symptoms are often severe enough to cause clinical symptoms (Dahlin et al, 2005), worsen the quality of life (Hassed et al, 2009) and trigger suicidal thoughts (Alexandrino-Silva et al, 2009) in these students. Similar findings have emerged from Europe (Dahlin et al, 2005, Guthrie et al, 1988) and the US (Levine et al, 2006, Clark & Zedlow, 1988, Dyrbie et al, 2006b).…”

Section: Introductionmentioning

confidence: 99%

Does ragging play a role in medical student depression — Cause or effect?

Castaldelli-Maia

Martins

Bhugra

et al. 2012

Journal of Affective Disorders

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Background Medical students have depressive symptoms rates different than the general population. In this study we set out to look at which are the environmental factors related to one medical school in Brazil that could be correlated with these symptoms. Methods We assessed depressive symptoms using Beck’s Depression Inventory. 465 and 267 students were recruited in 2001 and 2006 respectively. We explored possible social and environmental causes using a small group of qualitative data. Results Nearly 15% scored above the cut off for the threshold in the two samples. Males who were in the pre-clinical stage in 2006 had a trend of increase in depressive symptoms than males in the same cycle in 2001 (aOR= 7.36 [95%CI= 0.85-63.5] p=0.07). Qualitative data confirmed that factors such as ragging and low social involvement were correlated with depressive symptoms in pre-clinical stage males. Limitations Low response rates especially in the latter groups may affect the findings. Dropout students were not accessed. We also had very limited number of interviews as resources did not permit more detailed exploration with larger number of teachers and students in the qualitative study. Conclusions Despite the correlation between ragging and depressive symptoms, none causal relationship could be done. Future qualitative and quantitative research on this topic is needed. The correlation of depression with low social involvement was already described in other studies.

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Suicidal ideation among students enrolled in healthcare training programs: a cross-sectional study

Cited by 50 publications

References 37 publications

Assessment of depression and suicidal behaviour among medical students in Portugal

Assessment of depression and suicidal behaviour among medical students in Portugal

Building a new Rasch-based self-report inventory of depression

Does ragging play a role in medical student depression — Cause or effect?

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