Suicide risk assessment among students at the beginning, in the middle and at the end of the medicine course of a university in the city of Rio de Janeiro – Brazil
DOI:
https://doi.org/10.11606/issn.1679-9836.v101i4e-177013Keywords:
Suicidal risk factors, Medical students, Suicidal ideation, Suicidal BehaviorsAbstract
Objective: The purpose of this study is to assess the risk of suicide and the existence of suicidal behavior among academics in the early, intermediate and final stages of a private medical school, and also to analyze risk factors possibly associated with suicidal ideation in this population. Methods: This is a cross-sectional study with 376 medical students. All the participants answered a self-fillable questionnaire through the electronic platform Google Forms composed of 3 sections: questions about personal issues; questions of the Suicide Behavior Questionnaire Revised (SBQ-R); and of the Positive and Negative Suicide Ideation (PANSI) Inventory. Results: 34% of the students were in the 1st year of graduation, 34% in the 3rd year, and 32%, in the 6th year. 71.8% of the population is female and 39.6% are between 21 and 24 years old. In the suicide risk classification according to PANSI, 31.7% of the students were in the medium risk group and 5.3% in high risk group. In the analysis per year, the 3rd year showed a greater percentage of high risk (70.0%). According to the SBQ-R classification of suicide risk, 37.2% of students out of the total population revealed suicidal behavior. Among the analyzed variables, sexual orientation, history of childhood bullying, domestic conflict, presence of mental disorders in family, use of illicit drugs, history of sexual violence and self-reported anxiety were considered as risk factors for suicide. The highlighted results revealed the same pattern when analyzed per year of college. Conclusion: The survey population has increased rates of suicidal negative ideation and behavior compared to the general population. Therefore, it is necessary to implement programs in colleges to promote a greater state of well-being and reduce stressful aspects in academics.
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References
American Psichiatric Association. Practice guideline for the assessment and treatment of patients with suicidal behaviors [cited 2019 April 10]. Available from: https://psychiatryonline.org/pb/assets/raw/sitewide/practice _guidelines/guidelines/suicide.pdf
World Health Organization. The Ottawa charter for health promotion [cited 2019 April 12]. Available from: https://www.who.int/healthpromotion/conferences/previous/ottawa/en/
Brasil. Ministério da Saúde. Secretaria de Vigilância em Saúde. Perfil epidemiológico das tentativas e óbitos por suicídio no Brasil e a rede de atenção à saúde. Bol Epidemiol. 2017;48(30):1-14 [citado 12 abr. 2019]. Disponível em: https://www.gov.br/saude/pt-br/centrais-de-conteudo/apresentacoes/2017/2017-025-perfil-epidemiologico-das-tentativas-e-obitos-por-suicidio-no-brasil-e-a-rede-de-aten-ao-a-sa-de-pdf
Pereira AS, Willhelm AR, Koller SH, Almeida RMM de. Fatores de risco e proteção para tentativa de suicídio na adultez emergente. Ciênc Saúde Coletiva. 2018;23(11):3767-77. doi: http://dx.doi.org/10.1590/1413-812320182311.29112016
Ramôa AFAS, Soares C, Castanheira J, Sequeira J, Fernandes N, Azenha S. Comportamentos suicidários: caracterização e discussão de fatores de vulnerabilidade. Rev Port Med Geral Fam. 2017;33(5):321-32. doi: https://doi.org/10.32385/rpmgf.v33i5.12260
Claumann GS, Pinto AA, Silva DAS, Pelegrini A. Prevalência de pensamentos e comportamentos suicidas e associação com a insatisfação corporal em adolescentes. J Bras Psiquiatr. 2018;67(1):3-9. doi: http://dx.doi.org/10.1590/0047-2085000000177
Schwenk TL, Davis L, Wimsatt LA. Depression, stigma, and suicidal ideation in medical students. JAMA. 2010;304(11):1181-90. doi: https://doi.org/10.1001/jama.2010.1300
Center C, Davis M, Detre T, Ford DE, Hansbrough W, Hendin H, et al. Confronting depression and suicide in physicians: a consensus statement. JAMA. 2003;289(23):3161-66. doi: http://dx.doi.org/10.1001/jama.289.23.3161
Schernhammer ES, Colditz GA. Suicide rates among physicians: a quantitative and gender assessment (meta-analysis). Am J Psychiatry. 2004;161(12):2295-302. doi: https://doi.org/10.1176/appi.ajp.161.12.2295
Schernhammer E. Taking their own lives — the high rate of physician suicide. N Engl J Med. 2005;352(24):2473-6. doi: https://doi.org/10.1056/NEJMp058014
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(21):2214-36. doi: https://doi.org/10.1001/jama.2016.17324
Fan AP, Kosik RO, Mandell GA, Tran DTP, Cheng HM, Chen CH, et al. Suicidal ideation in medical students: who is at risk? Ann Acad Med Singap. 2012;41(9):377-82. .Available from: http://www.annals.edu.sg/pdf/41VolNo9Sep2012/V41N9p377.pdf
Downs N, Feng W, Kirby B, McGuire T, Moutier C, Norcross W, et al. Listening to depression and suicide risk in medical students: the Healer Education Assessment and Referral (HEAR) Program. Acad Psychiatry. 2014;38(5):547-53. doi: https://doi.org/10.1007/s40596-014-0115-x
Coentre R, Góis C. Suicidal ideation in medical students: recent insights. Adv Med Educ Pract. 2018;9:87380. doi: https://doi.org/10.2147/AMEP.S162626
Van Niekerk L, Scribante L, Raubenheimer PJ. Suicidal ideation and attempt among South African medical students. S Afr Med J. 2012;102(6):372-3. doi: https://doi.org/10.7196/SAMJ.5503
Santa ND, Cantilino A. Suicídio entre médicos e estudantes de medicina: revisão de literatura. Rev Bras Educ Med. 2016;40(4):772-80. doi: https://dx.doi.org/10.1590/1981-52712015v40n4e00262015
Menezes RG, Subba SH, Sathian B, Kharoshah MA, Senthilkumaran S, Pant S, et al. Suicidal ideation among students of a medical college in Western Nepal: a cross-sectional study. Legal Med. 2012;14(4):183-7. doi: https://doi.org/10.1016/j.legalmed.2012.02.004
Adhikari A, Dutta A, Sapkota S, Chapagain A, Aryal A, Pradhan A. Prevalence of poor mental health among medical students in Nepal: a cross-sectional study. BMC Med Educ. 2017;17(1):232. doi: https://doi.org/10.1186/s12909-017-1083-0
El-Masry R, Ghreiz S, Helal R, Audeh A, Shams T. Perceived stress and burnout among medical students during the clinical period of their education. Ibnosina J Med Biomed Sci. 2013;5(4):179-88. doi: http://dx.doi.org/10.4103/1947-489X.210543
Dyrbye LN, Thomas MR, Shanafelt TD. Medical student distress: causes, consequences, and proposed solutions. Mayo Clin Proc. 2005;80(12):1613-22. doi: http://dx.doi.org/10.4065/80.12.1613
Rodríguez JAR, Oduber JA. Ideación suicida y grupo de iguales: análisis en una muestra de adolescentes venezolanos. Universitas Psychol. 2015;14(3):1129-40. doi: http://dx.doi.org/10.11144/Javeriana.upsy143.isgi
Katz JL, Silva TPS, Katz, CT. Funcionamento familiar e tentativa de suicídio em adolescentes. Cad Bras Saúde Mental. 2017;9(22):70-82. doi: https://doi.org/10.5007/cbsm.v9i22.69090
Gobbi G, Atkin T, Zytynski T, Wang S, Askari S, Boruff J, et al. Association of cannabis use in adolescence and risk of depression, anxiety, and suicidality in young adulthood: a systematic review and meta-analysis. JAMA Psychiatr. 2019;76(4):426-34. doi: https://doi.org/10.1001/jamapsychiatry.2018.4500
Lemos KM, Neves NMBC, Kuwano AY, Tedesqui G, Bitencourt AGV, Neves FBCS, et al. Uso de substâncias psicoativas entre estudantes de medicina de Salvador (BA). Arch Clin Psychiatr (São Paulo). 2007;34(3):118-24. doi: http://dx.doi.org/10.1590/S0101-60832007000300003
Mesquita EM de, Nunes AJ, Cohen C. Avaliação das atitudes dos estudantes de medicina frente ao abuso de drogas por colegas do meio acadêmico. Arch Clin Psychiatr. 2008;35:8-12. doi: http://dx.doi.org/10.1590/S010160832008000700003
Schwartz RH. Cocaine and marijuana use by medical students before and during medical school. Arch Intern Med. 1990;150(4):883-6. doi: https://doi.org/10.1001/archinte.1990.00390160125024
Vieira PC, Aerts DRGC, Freddo SL, Bittencourt A, Monteiro L. Uso de álcool, tabaco e outras drogas por adolescentes escolares em município do Sul do Brasil. Cad Saúde Pública. 2008;24(11):2487-98. doi: http://dx.doi.org/10.1590/S0102-311X2008001100004
Dvorak RD, Lamis DA, Malone PS. Alcohol use, depressive symptoms, and impulsivity as risk factors for suicide proneness among college students. J Affect Disord. 2013;149(1-3):326-34. doi: https://doi.org/10.1016/j.jad.2013.01.046
Ponte Feijão IE, de Carvalho Sampaio HA, Sabry MOD, Carioca AAF, Yum MEM, de Oliveira Lima JW. Prática de binge alcoólico entre estudantes universitários. Rev Bras Promoção Saúde. 2012;25(4):462-8. Disponível em: https://www.redalyc.org/articulo.oa?id=40824829010
Pinheiro MA, Torres LF, Bezerra MS, Cavalcante RC, Alencar RD, Donato AC, et al. Prevalência e fatores associados ao consumo de álcool e tabaco entre estudantes de medicina no nordeste do Brasil. Rev Bras Educ Méd. 2017;41(2):231-9. doi: https://doi.org/10.1590/1981-52712015v41n2rb20160033
Calbo AS, Busnello FB, Rigoli MM, Schaefer LS, Kristensen CH. Bullying na escola: comportamento agressivo, vitimização e conduta pró-social entre pares. Contextos Clín (Porto Alegre). 2009;2(2):73-80. doi: https://doi.org/10.4013/ctc.2009.22.01
Brent DA, Bridge J, Johnson BA, Connolly J. Suicidal behavior runs in families: a controlled family study of adolescent suicide victims. Arch Gen Psychiatry. 1996;53(12):1145-52. doi: https://doi.org/10.1001/archpsyc.1996.01830120085015
Prieto DYC. Indicadores de proteção e de risco para suicídio por meio de escalas de auto-relato [tese]. Brasília: Universidade de Brasília; 2007. Disponível em: http://repositorio.unb.br/handle/10482/1781
Teixeira-Filho FS, Rondini CA. Ideações e tentativas de suicídio em adolescentes com práticas sexuais hetero e homoeróticas. Saúde Soc. 2012;21(3):651-67. doi: http://dx.doi.org/10.1590/S0104-12902012000300011
Assis SG, Gomes R, Pires TO. Adolescência, comportamento sexual e fatores de risco à saúde. Rev Saúde Pública (São Paulo). 2014;48(1):43-51. doi: http://dx.doi.org/10.1590/S0034-8910.2014048004638
Arnarsson A, Sveinbjornsdottir S, Thorsteinsson EB, Bjarnason T. Suicidal risk and sexual orientation in adolescence: a population-based study in Iceland. Scand J Public Health. 2015;43(5):497-505. doi: https://doi.org/10.1177/1403494815585402
Rosiek A, Rosiek-Kryszewska A, Leksowski L, Leksowski K. Chronic stress and suicidal thinking among medical students. Int J Environ Res Public Health. 2016;13(2):212. doi: https://doi.org/10.3390/ijerph13020212
Rodrigues MES, Silveira TB, Jansen K, Cruzeiro ALS, Ores L, Pinheiro RT, et al. Risco de suicídio em jovens com transtornos de ansiedade: estudo de base populacional. Psico-USF (Rio Grande do Sul). 2012;17(1):53-62. doi: http://dx.doi.org/10.1590/S1413-82712012000100007
Vasconcelos TC, Dias BRT, Andrade LR, Melo GF, Barbosa L, Souza E. Prevalência de sintomas de ansiedade e depressão em estudantes de medicina. Rev Bras Educ Med. 2015;39(1):135-42. doi: https://doi.org/10.1590/1981-52712015v39n1e00042014
Duarte DG, Neves MC, Albuquerque MR, Neves FS, Corrêa H. Sexual abuse and suicide attempt in bipolar type I patients. Rev Bras Psiquiatr (São Paulo). 2015;37(2):180-2. doi: http://dx.doi.org/10.1590/1516-4446-2014-1624
Plunkett A, O’Toole B, Swanston H, Oates RK, Shrimpton S, Parkinson P. Suicide risk following child sexual abuse. Ambul Pediatr. 2001;1(5):262-6. doi: https://doi.org/10.1367/15394409(2001)001<0262:SRFCSA>2.0.CO;2
Thompson D, Goebert D, Takeshita J. A program for reducing depressive symptoms and suicidal ideation in medical students: Acad Med. 2010;85(10):1635-9. doi: https://doi.org/10.1097/ACM.0b013e3181f0b49c
Dyrbye LN, Thomas MR, Shanafelt TD. Medical student distress: causes, consequences, and proposed solutions. Mayo Clin Proc. 2005;80(12):1613-22. doi: https://doi.org/10.4065/80.12.1613
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