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医科学生自杀行为的流行病学危险因素及应对策略各组成部分对自杀行为的影响:印度一项基于机构的横断面研究

Epidemiological risk factors of suicidal behavior and effects of the components of coping strategies on suicidal behavior in medical students: An institution-based cross-sectional study in India.

作者信息

Garg Sunny, Chauhan Alka, Singh Sanjeet, Bansal Kirti

机构信息

Department of Psychiatry, Bhagat Phool Singh Government Medical College for Women, Khanpur Kalan, Sonipat, Haryana, India.

Department of Community Medicine, Bhagat Phool Singh Government Medical College for Women, Khanpur Kalan, Sonipat, Haryana, India.

出版信息

Indian J Psychiatry. 2022 Jul-Aug;64(4):377-386. doi: 10.4103/indianjpsychiatry.indianjpsychiatry_407_21. Epub 2022 Jul 13.

Abstract

BACKGROUND

Suicidal behavior in medical students can be triggered by mental stresses and adoption of poor coping strategies, and might have a negative impact on their quality of life.

AIMS

The aim of this study was to evaluate the prevalence and risk factors of suicidal behavior, and effects of the components of coping strategies on suicidal behavior among medical students.

METHODS

An institution-based cross-sectional study was conducted on 531 medical students for a period of two months from February to March 2021. Stratified random sampling technique was used to select the study participants. Data was collected using a self-administered questionnaire. Suicide Behaviors Questionnaire-Revised (SBQ-R) scale was used to measure suicidal behavior. Exploratory factor analysis was performed on the Brief-COPE Inventory to classify the coping components. Chi-squared test and multiple logistic regression were used to determine the risk factors and their association with suicidal behavior.

RESULTS

A total of 104 respondents (19.6%) had reported an SBQ-R cutoff score of ≥7 and had suicidal behavior. The rate of lifetime suicidal ideation, plan and attempt was 20.3%, 10.3% and 2.3%, respectively, among medical students with one-year prevalence of suicidal ideation at 33%. The mean age of the participants was 21.26 years (standard deviation (SD) = 1.99). The identified risk factors significantly associated with higher suicidal behavior were depression (OR = 9.6), dissatisfaction with academic performances (OR = 4.9) and coping with mental disengagement (OR = 4.6), while coping with supportive strategies (OR = 0.57) was investigated as a preventive factor for the suicidal behavior.

CONCLUSIONS

The prevalence of suicidal behavior is found to be highly alarming, revealing that depression and poor coping strategies are risk factors among medical students. The analysis recommends that quantification of the problems, treatment at an early stage and proactive student counselling to help them embrace the appropriate coping strategies should be the first steps in prevention of suicidal behavior.

摘要

背景

医学生的自杀行为可能由精神压力和采用不良应对策略引发,并且可能对他们的生活质量产生负面影响。

目的

本研究的目的是评估医学生自杀行为的患病率和风险因素,以及应对策略的组成部分对自杀行为的影响。

方法

2021年2月至3月期间,对531名医学生进行了一项基于机构的横断面研究,为期两个月。采用分层随机抽样技术选择研究参与者。使用自填式问卷收集数据。自杀行为问卷修订版(SBQ-R)量表用于测量自杀行为。对简易应对方式问卷进行探索性因素分析,以对应对成分进行分类。采用卡方检验和多元逻辑回归确定风险因素及其与自杀行为的关联。

结果

共有104名受访者(19.6%)报告SBQ-R截止分数≥7且有自杀行为。在有自杀意念一年患病率为33%的医学生中,终生自杀意念、计划和尝试的发生率分别为20.3%、10.3%和2.3%。参与者的平均年龄为21.26岁(标准差(SD)=1.99)。与较高自杀行为显著相关的已确定风险因素是抑郁(OR=9.6)、对学业成绩不满意(OR=4.9)和应对精神脱离(OR=4.6),而应对支持性策略(OR=0.57)被调查为自杀行为的预防因素。

结论

发现自杀行为的患病率令人高度警觉,表明抑郁和不良应对策略是医学生中的风险因素。分析建议,对问题进行量化、早期治疗以及积极的学生咨询以帮助他们采用适当的应对策略,应是预防自杀行为的首要步骤。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e80b/9435614/aca66e1e9b64/IJPsy-64-377-g002.jpg

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