Tongji Hospital, School of Medicine, Tongji University, Shanghai, China.
School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Front Public Health. 2023 Jan 19;10:1049975. doi: 10.3389/fpubh.2022.1049975. eCollection 2022.
The prevalence of suicidal ideation among medical students is high. Evidence indicates that feelings of entrapment are a predictor of suicidal ideation. In this study, we aimed to (1) investigate the prevalence of first-onset suicidal ideation among Chinese medical students and (2) explore the predictive effects of perceived entrapment on first-onset suicidal ideation.
This longitudinal study was conducted between 2018 and 2019 among 211 newly enrolled medical students in Shanghai. Using an anonymous questionnaire, we collected information on sociodemographic (sex, major, parents' income, and academic performance) and psychological (entrapment, depression, loneliness, defeat, social support, and interpersonal needs) variables as well as suicidal ideation. Participants were divided into four subgroups based on their exposure to entrapment (control, new-onset, reduced, and persistent). The primary outcome, first-onset suicidal ideation, was defined as suicidal ideation absent at baseline but present at follow-up.
In total, 54.98% of participants (116/211) were women, and 76.78% (162/211) majored in clinical medicine. In the follow-up survey, 6.16% of participants (16/211) reported first-onset suicidal ideation, 17.54% (37/211) reported new-onset entrapment, and 12.80% (27/211) reported persistent entrapment during follow-up. Compared with the control group who reported no perceived entrapment at baseline and follow-up, participants who reported new-onset entrapment had the highest risk of new-onset suicidal ideation [odds ratio (OR) = 14.700, 95% confidence interval (CI) = 2.906-74.364; adjusted OR = 8.798; 95% CI = 1.588-48.757; multivariate OR = 8.238, 95% CI = 1.394-48.693).
New-onset entrapment can significantly predict suicidal ideation. Therefore, greater attention is needed for new-onset entrapment, such as intervention for suicidal ideation.
医学生出现自杀意念的情况较为普遍。有证据表明，感到被束缚是自杀意念的一个预测因素。在这项研究中，我们旨在：(1) 调查中国医学生首次出现自杀意念的发生率；(2) 探讨感知到的束缚对首次出现自杀意念的预测作用。
本纵向研究于 2018 年至 2019 年期间在上海的 211 名新入学的医学生中进行。使用匿名问卷收集了社会人口学（性别、专业、父母收入和学业成绩）和心理学（束缚感、抑郁、孤独、挫败感、社会支持和人际需求）变量以及自杀意念的信息。根据束缚感暴露情况（对照组、新发病例组、减轻组和持续组）将参与者分为四组。主要结局指标为首发自杀意念，定义为基线时无自杀意念，随访时出现自杀意念。
共有 54.98%（116/211）的参与者为女性，76.78%（162/211）主修临床医学。在随访调查中，6.16%（16/211）的参与者报告首发自杀意念，17.54%（37/211）报告新发病例束缚感，12.80%（27/211）报告随访期间持续束缚感。与基线和随访时均未报告感知束缚感的对照组相比，报告新发病例束缚感的参与者出现首发自杀意念的风险最高[比值比（OR）=14.700，95%置信区间（CI）=2.906-74.364；调整 OR=8.798；95%CI=1.588-48.757；多变量 OR=8.238，95%CI=1.394-48.693）]。
新发病例束缚感可显著预测自杀意念。因此，需要更加关注新发病例束缚感，如对自杀意念进行干预。
