Beck’s Depression Inventory II Suicidal Ideation in Medical Students – Prevalence and Associated Factors
Keywords:Suicidal Ideation, Suicide, Medical Students, Prevalence, Depression, Neuroticism
Background: Suicide is the second leading cause of death in 15- to 29-year-olds in Germany. Studies have shown that compared to the general population students are more affected by suicidal ideation, as one major indicator of an attempted suicide. This effect is observed all over the world, interestingly, it is also true for physicians. Therefore, we investigated whether medical students are at an even higher risk than their peers to develop suicidal ideation.
Methods: N=1,103 medical students at a German university completed a self-reporting survey investigating socio-demographic, potential risk, and protective factors. The Beck’s Depression Inventory (BDI)-II Item 9 “Suicidality“ served as the dependent variable.
Results: N=130 students (11.8% of the total sample) reported suicidal ideation within the last two weeks. Stepwise computed logistic regression models including all potential risk factors resulted in 40% explained variance. The most significant independent risk factors were the BDI-score, usage of tranquilizers, feeling lonely, insufficient time for hobbies and prior personal mental health issues, whereas focus enhancing drugs showed to be the only independent protective predictor. The BDI-II score correlated positively with the number of students suffering from suicidal ideation.
Conclusion: The prevalence of suicidal ideation in our sample medical student population exceeds that of the general population greatly, confirming existing data and emphasizing the need to raise awareness and establish prevention programs.
Federal Statistical Office. Registered deaths from suicide. Available from: https://www.destatis.de/EN/Themes/Countries-Regions/International-Statistics/Data-Topic/Population-Labour-Social-Issues/Health/Suicide.html. Last update November 30, 2020; cited January 13, 2021.
Kessler RC, Borges G, Walters EE. Prevalence of and risk factors for lifetime suicide attempts in the National Comorbidity Survey. Arch Gen Psychiatry. 1999;56:617–6. DOI: https://doi.org/10.1001/archpsyc.56.7.617
Lee J-I, Lee M-B, Liao S-C, Chang C-M, Sung S-C, Chiang H-C et al. Prevalence of suicidal ideation and associated risk factors in the general population. J Formos Med Assoc. 2010;109:138–47. DOI: https://doi.org/10.1016/S0929-6646(10)60034-4
Hawton K, van Heeringen K. Suicide. Lancet. 2009;373:1372–1381. DOI: https://doi.org/10.1016/S0140-6736(09)60372-X
Kerby DS. CART analysis with unit-weighted regression to predict suicidal ideation from Big Five traits. Personality and Individual Differences. 2003;35:249–61. DOI: https://doi.org/10.1016/S0191-8869(02)00174-5
Santos HGBD, Marcon SR, Espinosa MM, Baptista MN, Paulo PMC de. Factors associated with suicidal ideation among university students. Rev Lat Am Enfermagem. 2017;25:e2878. DOI: https://doi.org/10.1590/1518-8345.1592.2878
Barrios LC, Everett SA, Simon TR, Brener ND. Suicide ideation among US college students. Associations with other injury risk behaviors. J Am Coll Health. 2000;48:229–33. DOI: https://doi.org/10.1080/07448480009599309
Brener ND, Hassan SS, Barrios LC. Suicidal ideation among college students in the United States. J Consult Clin Psychol. 1999;67:1004–8. DOI: https://doi.org/10.1037/0022-006X.67.6.1004
Schernhammer ES, Colditz GA. Suicide Rates Among Physicians: A Quantitative and Gender Assessment (Meta-Analysis). AJP 2004;161:2295–302. DOI: https://doi.org/10.1176/appi.ajp.161.12.2295
ANEMF. Rapport Santé mentale 2020. Available from: https://www.anemf.org/download/rapport-sante-mentale-2020/. Last updated December 8, 2020; Last cited January 14, 2021.
Atienza-Carbonell B, Balanzá Martínez V. Prevalence of depressive symptoms and suicidal ideation among Spanish medical students. Actas Esp Psiquiatr. 2020;48:154–62.
Tyssen R, Vaglum P, Grønvold NT, Ekeberg O. Suicidal ideation among medical students and young physicians: a nationwide and prospective study of prevalence and predictors. J Affect Disord. 2001;64:69–79. DOI: https://doi.org/10.1016/S0165-0327(00)00205-6
Dyrbye LN, Thomas MR, Massie FS, Power DV, Eacker A, Harper W et al. Burnout and suicidal ideation among U.S. medical students. Ann Intern Med. 2008;149:334–41. DOI: https://doi.org/10.7326/0003-4819-149-5-200809020-00008
Rotenstein LS, Ramos MA, Torre M, Segal JB, Peluso MJ, Guille C et al. Prevalence of Depression, Depressive Symptoms, and Suicidal Ideation Among Medical Students: A Systematic Review and Meta-Analysis. JAMA. 2016;316:2214–236. DOI: https://doi.org/10.1001/jama.2016.17324
Schwenk TL, Davis L, Wimsatt LA. Depression, stigma, and suicidal ideation in medical students. JAMA. 2010;304:1181–190. DOI: https://doi.org/10.1001/jama.2010.1300
Pukas L, Rabkow N, Keuch L, Ehring E, Fuchs S, Stoevesandt D et al. Prevalence and predictive factors for depressive symptoms among medical students in Germany – a cross-sectional study. 2022.
Kühner C, Bürger C, Keller F, Hautzinger M. Reliability and validity of the revised Beck Depression Inventory (BDI-II). Results from German samples. Der Nervenarzt. 2007;78: 651–6. DOI: https://doi.org/10.1007/s00115-006-2098-7
Desseilles M, Perroud N, Guillaume S, Jaussent I, Genty C, Malafosse A et al. Is it valid to measure suicidal ideation by depression rating scales? J Affect Disord. 2012;136: 398–404. DOI: https://doi.org/10.1016/j.jad.2011.11.013
Costa PT, McCrae RR. The Revised NEO Personality Inventory (NEO-PI-R). In: The SAGE Handbook of Personality Theory and Assessment: Volume 2 — Personality Measurement and Testing. SAGE Publications Ltd: 1 Oliver’s Yard, 55 City Road, London EC1Y 1SP United Kingdom, 2008, pp 179–198. DOI: https://doi.org/10.4135/9781849200479.n9
Borkenau P, Ostendorf F. NEO-Fünf-Faktoren-Inventar (NEO-FFI) nach Costa und McCrae : Handanweisung. 1993. https://pub.uni-bielefeld.de/record/1902849. Accessed Jan 17, 2021.
Statistisches Bundesamt. Studierende insgesamt und Studierende Deutsche im Studienfach Medizin (Allgemein-Medizin) nach Geschlecht. Available from: https://www.destatis.de/DE/Themen/Gesellschaft-Umwelt/Bildung-Forschung-Kultur/Hochschulen/Tabellen/lrbil05.html. Last updated 2020; Last cited January 24, 2021.
Griens AMGF, Jonker K, Spinhoven P, Blom MBJ. The influence of depressive state features on trait measurement. J Affect Disord. 2002;70:95–9. DOI: https://doi.org/10.1016/S0165-0327(00)00371-2
Arria AM, O’Grady KE, Caldeira KM, Vincent KB, Wilcox HC, Wish ED. Suicide ideation among college students: a multivariate analysis. Arch Suicide Res. 2009;13:230–46. DOI: https://doi.org/10.1080/13811110903044351
Curran TA, Gawley E, Casey P, Gill M, Crumlish N. Depression, suicidality and alcohol abuse among medical and business students. Ir Med J. 2009;102:249–52.
Chow WS, Schmidtke J, Loerbroks A, Muth T, Angerer P. The Relationship between Personality Traits with Depressive Symptoms and Suicidal Ideation among Medical Students: A Cross-Sectional Study at One Medical School in Germany. I J Environ Res Public Health. 2018;15:1462. DOI: https://doi.org/10.3390/ijerph15071462
MacLean L, Booza J, Balon R. The Impact of Medical School on Student Mental Health. Acad Psychiatry. 2016;40:89–91. DOI: https://doi.org/10.1007/s40596-015-0301-5
Blacker CJ, Lewis CP, Swintak CC, Bostwick JM, Rackley SJ. Medical Student Suicide Rates: A Systematic Review of the Historical and International Literature. Acad Med. 2019;94:274–80. DOI: https://doi.org/10.1097/ACM.0000000000002430
Yeomans Cabrera M, Martínez Líbano J. Suicidal Ideation And Suicidal Thoughts In University Students During The Covid-19 Pandemic: A Systematic Review. Rev Argentina de Clin Psicol. 2021;30(2):390–405.
Levine RE, Breitkopf CR, Sierles FS, Camp G. Complications Associated With Surveying Medical Student Depression: the importance of anonymity. Acad Psychiatry. 2003;27:12–8. DOI: https://doi.org/10.1176/appi.ap.27.1.12
Givens JL, Tjia J. Depressed medical students’ use of mental health services and barriers to use. Acad Med. 2002;77:918–21. DOI: https://doi.org/10.1097/00001888-200209000-00024
Thompson D, Goebert D, Takeshita J. A Program for Reducing Depressive Symptoms and Suicidal Ideation in Medical Students. Acad Med. 2010;85:1635–9. DOI: https://doi.org/10.1097/ACM.0b013e3181f0b49c
How to Cite
Copyright (c) 2023 Lea Keuch, Lilith Pukas, Nadja Rabkow, Emilia Ehring, Tordis Kindt, Carolin Rehnisch, Angelina Pelzer, Patricia Lamlé, Stefan Watzke
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
- The Author retains copyright in the Work, where the term “Work” shall include all digital objects that may result in subsequent electronic publication or distribution.
- Upon acceptance of the Work, the author shall grant to the Publisher the right of first publication of the Work.
- The Author shall grant to the Publisher and its agents the nonexclusive perpetual right and license to publish, archive, and make accessible the Work in whole or in part in all forms of media now or hereafter known under a Creative Commons Attribution 4.0 International License or its equivalent, which, for the avoidance of doubt, allows others to copy, distribute, and transmit the Work under the following conditions:
- Attribution—other users must attribute the Work in the manner specified by the author as indicated on the journal Web site; with the understanding that the above condition can be waived with permission from the Author and that where the Work or any of its elements is in the public domain under applicable law, that status is in no way affected by the license.
- The Author is able to enter into separate, additional contractual arrangements for the nonexclusive distribution of the journal's published version of the Work (e.g., post it to an institutional repository or publish it in a book), as long as there is provided in the document an acknowledgment of its initial publication in this journal.
- Authors are permitted and encouraged to post online a prepublication manuscript (but not the Publisher’s final formatted PDF version of the Work) in institutional repositories or on their Websites prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work. Any such posting made before acceptance and publication of the Work shall be updated upon publication to include a reference to the Publisher-assigned DOI (Digital Object Identifier) and a link to the online abstract for the final published Work in the Journal.
- Upon Publisher’s request, the Author agrees to furnish promptly to Publisher, at the Author’s own expense, written evidence of the permissions, licenses, and consents for use of third-party material included within the Work, except as determined by Publisher to be covered by the principles of Fair Use.
- The Author represents and warrants that:
- the Work is the Author’s original work;
- the Author has not transferred, and will not transfer, exclusive rights in the Work to any third party;
- the Work is not pending review or under consideration by another publisher;
- the Work has not previously been published;
- the Work contains no misrepresentation or infringement of the Work or property of other authors or third parties; and
- the Work contains no libel, invasion of privacy, or other unlawful matter.
- The Author agrees to indemnify and hold Publisher harmless from the Author’s breach of the representations and warranties contained in Paragraph 6 above, as well as any claim or proceeding relating to Publisher’s use and publication of any content contained in the Work, including third-party content.
Enforcement of copyright
The IJMS takes the protection of copyright very seriously.
If the IJMS discovers that you have used its copyright materials in contravention of the license above, the IJMS may bring legal proceedings against you seeking reparation and an injunction to stop you using those materials. You could also be ordered to pay legal costs.
If you become aware of any use of the IJMS' copyright materials that contravenes or may contravene the license above, please report this by email to firstname.lastname@example.org
If you become aware of any material on the website that you believe infringes your or any other person's copyright, please report this by email to email@example.com