A narrative review of suicide and suicidal behavior in medical students

Abstract

Studies across different countries have consistently demonstrated high rates of several psychiatric disorders among medical students. These findings, in turn, may be correlated with the higher than expected rate of suicide in student doctors. We aimed to provide a narrative review of the literature concerning suicidality in medical students worldwide. A narrative review is not a systematic review. Using Pub Med, we identified articles including our defined search terms: ((suicide) OR self-harm) (attempted suicide, deliberate self-harm AND medical students) OR future doctors. Particular credence was given to review articles and original research conducted this decade. We find that medical student suicide is likely related to a number of social and environmental factors. Structural systems in medical schools may play a role, for example, curricula, accommodation, social support, and academic pressures. Interpersonal factors that may be implicated include social isolation, the competitive nature of learning, and being away from home at an early age. There may also be endemic factors unique to medical training, which may contribute to higher rates of depression and suicidality; these include simulation training, working with cadavers, and witnessing trauma throughout placements. The socio-cultural environment, for example, the role of ragging, expectations from teachers, and patients, may place extra pressure on vulnerable individuals. Rates have been shown to be higher among females, which raises further discussion on the nature of gender roles and gender role expectations within medicine. As the medical workforce of the future, today's students require a considerable emotional and financial investment. It is, therefore, crucial that educators and supervisors understand the needs of this student body while delivering the essential skills to be a doctor in a sensitive nonstigmatizing manner.

Screening of minor psychiatric disorders and burnout among a sample of medical students in St. Petersburg, Russia: a descriptive study

“…The psychological adaptation of medical students and young doctors is of interest in many countries [ 1 – 6 ]. Research consistently shows a high prevalence of mental disorders and psychological stress among medical students [ 3 , 7 – 9 ], significantly higher than in the general population [ 10 , 11 ]. The incidence of depression and anxiety in a sample of Russian medical students was 4 and 6 times higher, respectively, than in students of other disciplines [ 12 ].…”

“…The incidence of depression and anxiety in a sample of Russian medical students was 4 and 6 times higher, respectively, than in students of other disciplines [ 12 ]. Also, of particular concern is the increasing prevalence of suicidal ideation in medical students [ 6 , 9 , 13 , 14 ].…”

“…It is therefore relevant to study this phase as well as to develop prevention and psychohygiene strategies. Medical-training currently requires significant emotional and financial investment, so it is critical that faculty and managers provide help and support to these future physicians [ 9 ]. Mental health promotion for medical students calls for evidence-based interventions and psychosocial support [ 4 ].…”

Managing depression in India: Opportunities for a targeted smartphone app

“…Depression in India is more prevalent in females than in males (Poongothai et al, 2009;Watson et al, 2020). Domestic violence, financial insecurity, and lack of education are significant contributors to depression in women (Bhattacharya et al, 2018;Chandra et al, 2009).…”

Stress and Resilience among Medical Students during Pandemic

“…They should take the guidance of local mental health experts to do this in a methodical way. National bodies of Psychiatrists and Psychologists should come out with timely recommendations and guidelines for such evaluations [31].…”