Seedat Samhaa, Sengwayo Muhle, Gani Salma, Mashego Lesedi, Ochayon Jordan, Shepard Ashleigh, Vergie Caleb, Masango Mxolisi, Makuapane Lerato P, Wagner Fezile, Wagner Ryan G
Unit for Undergraduate Medical Education, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Analytics and Institutional Research Unit, University of the Witwatersrand, Johannesburg, South Africa.
Front Psychiatry. 2025 Mar 19;16:1492620. doi: 10.3389/fpsyt.2025.1492620. eCollection 2025.
Suicidal ideation is an important mental health concern amongst university students who are exposed to multiple stressors. Furthermore, those studying towards degrees in the field of Health Sciences are exposed to additional and unique stressors. This quantitative cross-sectional study aimed to define the prevalence of suicidal ideation and its determinants amongst undergraduate students within the Faculty of Health Sciences at a large, urban South African University.
An online questionnaire was administered to the 4089 students registered in the Faculty of Health Sciences, with 1211 students submitting responses between March and April 2020. The distribution of this survey coincided with the onset of the national lockdown due to the Covid-19 pandemic. The survey was comprised of validated tools measuring depression (with an included indicator of suicidal ideation), anxiety and resilience. Data analysis was completed using the STATA statistical software (version 14). Both a bivariate analysis and a multivariate logistic regression adjusted for gender were performed.
The total prevalence of suicidal ideation adjusted for gender and race in this sample was found to be 21.8% (CI: 18.6-25.3; p<0.001). Females had significantly higher suicidal ideation than males (24.1% versus 17.8%; p=0.011). In the multivariate model adjusted for gender, having depressive (aOR 10.8; CI: 7.9-14.8; p<0.001) or anxiety (aOR 5.1: CI: 3.8-6.8; P<0.001) symptoms, only sometimes (aOR 2.7: CI 1.8-4.0; p<0.001) or never (aOR 2.7; CI: 1.8-4.0; p<0.001) having anyone to talk to and being of colored race (aOR 2.0; CI: 1.1-3.4; p=0.019) were significantly associated with suicidal ideation, whilst higher resilience (aOR 0.3; CI: 0.3-0.4; p<0.001) was associated with lower levels of suicidal ideation.
The prevalence of suicidal ideation found in this study was higher than that found in the general South African adult population and highlights the need to further investigate and address student mental health, especially students in the field of Health Sciences. Interventions aimed at mitigating the determinants, including depression and anxiety, and promoting the development of protective factors such as resilience and social support may lead to a reduction in suicidal ideation in this population group. Institutional initiatives aimed at improving access to and the quality of mental health services offered to students should be widely advocated for and implemented.
自杀意念是面临多种压力源的大学生群体中一个重要的心理健康问题。此外，攻读健康科学领域学位的学生还会面临额外且独特的压力源。这项定量横断面研究旨在确定南非一所大型城市大学健康科学学院本科学生中自杀意念的患病率及其决定因素。
对健康科学学院注册的4089名学生进行了在线问卷调查，2022名学生在2020年3月至4月期间提交了回复。这项调查的开展时间恰逢因新冠疫情全国实施封锁之时。该调查由经过验证的工具组成，用于测量抑郁（包括自杀意念指标）、焦虑和心理韧性。使用STATA统计软件（版本14）完成数据分析。进行了双变量分析以及针对性别进行调整的多变量逻辑回归分析。
在这个样本中，经性别和种族调整后的自杀意念总患病率为21.8%（置信区间：18.6 - 25.3；p < 0.001）。女性的自杀意念显著高于男性（24.1%对17.8%；p = 0.011）。在针对性别进行调整的多变量模型中，有抑郁（调整后比值比10.8；置信区间：7.9 - 14.8；p < 0.001）或焦虑（调整后比值比5.1：置信区间：3.8 - 6.8；p < 0.001）症状、只是有时（调整后比值比2.7：置信区间1.8 - 4.0；p < 0.001）或从未（调整后比值比2.7；置信区间：1.8 - 4.0；p < 0.001）有倾诉对象以及属于有色人种（调整后比值比2.0；置信区间：1.1 - 3.4；p = 0.019）与自杀意念显著相关，而较高的心理韧性（调整后比值比0.3；置信区间：0.3 - 0.4；p < 0.001）与较低水平的自杀意念相关。
本研究中发现的自杀意念患病率高于南非普通成年人群体，凸显了进一步调查和解决学生心理健康问题的必要性，尤其是健康科学领域的学生。旨在减轻包括抑郁和焦虑在内的决定因素，并促进心理韧性和社会支持等保护因素发展的干预措施，可能会降低该人群中的自杀意念。应广泛倡导并实施旨在改善学生获得心理健康服务的机会和服务质量的机构举措。
