Factors associated with suicidal ideation in medical students, a literature review

Authors

  • Citlalli Anahí Zempoalteca Buenavista Universidad Autónoma del Estado de Hidalgo https://orcid.org/0009-0001-9439-8616
  • Alfonso Reyes Garnica Universidad Autónoma del Estado de Hidalgo

Keywords:

suicidal ideation, Suicidal behaviour, Medicine, Students, University

Abstract

Suicidal ideation in medical students is a behavior that has a direct impact on the academic performance and well-being of university students. Therefore, it is imperative to identify risk and protective factors that can have a positive influence on the regulation of such behavior, with the purpose of reducing suicide rates. The purpose of the present narrative review is to identify risk factors associated with suicidal ideation in medical students, as well as to describe their potential to modify the turnaround between suicidal behaviors. A literature review of descriptive studies conducted in medical students of basic cycles, clinical fields and medical internships at a global level was carried out. The factors associated with the generation of suicidal behaviors are presented grouped under the scheme proposed in the Volitional Motivational Model in three phases: the pre-motivational phase, the motivational phase and the volitional phase. It was found that approximately 25% of medical students had reported suicidal ideation, the most associated factors being academic dissatisfaction and depressive symptoms. Therefore, it is imperative to develop positive coping strategies among future health professionals.

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References

[1] Reeves K, Vasconez G, Weiss S. Characteristics of Suicidal Ideation: A Systematic Review. Arch. Suicide Res. 2022; 26(4): 1736-56

[2] Al-Halabía S, Sáiza PA, Buróna P, Garrido M, Benabarrea A, Jiménez E. Validación de la versión en español de la Columbia-Suicide Severity Rating Scale (Escala Columbia para Evaluar el Riesgo de Suicidio). Rev. Psiq. Salud Mental. 2016; 9(3): 134-42.

[3] American Psychiatric Association. Sección III: Afecciones que necesitan más estudios. En: Manual diagnóstico y estadístico de los trastornos mentales (DSM-5), 5a Ed. Buenos Aires, Argentina: Editorial Médica Panamericana; 2014: 801-3.

[4] Organización Mundial de la Salud(OMS). Clasificación Internacional de Enfermedades Undécima Revisión (CIE-11). Ginebra: Organización Mundial de la Salud; 2022.

[5] Organización Mundial de la Salud. Suicidio. Organización Mundial de la Salud: 2025. [Citado el 3 de septiembre, 2025]. Disponible en: https://www.who.int/es/news-room/fact-sheets/detail/suicide

[6] GBD 2021 Suicide Collaborators. Global, regional, and national burden of suicide, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021. Lancet Public Health. 2025;10 (3): e189-e202.

[7] Wang S, Wei T, Zhu R, Li S, Lui X, Cai Y et al. Perceived entrapment predictsfirst-onset suicidal ideation: A longitudinalstudy among medical students in China. Frontiers. Public Healt. 2023; 10: 1049975.

[8] Kumar V, Mateen A, Aziz T, Singh AK, Singh AK, Mahto M, et al. Prevalence and Various Risk Factors Associated with Suicidal Ideation Thoughts in Medical Students from a Medical College in Northern India. Ann. Afr. Med. 2025; 24(2): 468-73.

[9] Oskouei AH, Sardarzehi R, Zarchi MSZ, Serjouie F, Zavareh SAT, Kianimoghadam AS, et al. Structural equation modeling of suicidal ideation among medical students in Iran: the role of perfectionism, repetitive negative thinking and feelings of loneliness. BMC Psychiatry. 2025; 25(1): 823

[10] Rex M, Waern M, Carlström E, Joneken I, Tell S, Brezicka T, et al. Person-centred suicide prevention: key elements from the perspective of people living with suicidality. Int. J. Qual. Stud. Health Well-being. 2025; 20(1): 2549752

[11] King CA, Harness J, Arango A, Czyz E. Suicide Prevention in Youth. Curr. Psychiatry Rep. 2025; 27(9): 500-8

[12] Centers for Disease Control and Prevention. Youth Risk Behavior Survey Data Summary & Trends Report: 2013–2023. U.S. Department of Health and Human Services; 2024.

[13] Zhao M, Xin Y, Bai X, Zhang S, Liu H, Xu W, et al. Risk factors for suicidality among college students: A systematic review and meta analysis. J. Affect. Disord. 2025; 382: 567-78.

[14] Shen Y, Chan BSM, Huang C, Cui X, Liu J, Lu J, et al. Suicidal behaviors and attention deficit hyperactivity disorder (ADHD): a cross sectional study among Chinese medical college students. BMC Psychiatry. 2021; 21(1): 258.

[15] Li J, Zhang Y, Siu Man Chan B, Tan SN, Lu J, Luo X, et al. Associations between anxiety, depression, and risk of suicidal behaviors in Chinese medical college students. Front. Psychiatry. 2022; 13: 1012298.

[16] Peng B, Hu N, Guan L, Chen C, Chen Z, Yu H. Family functioning and suicidal ideation in college students: a moderated mediation model of depression and acceptance. Front. Public Health. 2023; 11: 1137921.

[17] Nakhostin-Ansari A, Akhlaghi M, Etesam F, Sadeghian MH. Suicidal Ideation and Its Associated Factors in Medical, Dental, and Pharmacy Students: A Cross-Sectional Study during COVID-19 Pandemic. Psychiatry J. 2022; 2022: 8139351.

[18] Hossein Sadeghian M, Etesam F, Nakhostin-Ansari A, Akbarpour S, Akhlaghi M. Association Between Hopelessness And Suicidal Ideation In Iranian Medical Students: A Cross-Sectional Study. Health Psychol Res. 2021; 9(1): 27579.

[19] Desai ND, Chavda P, Shah S. Prevalence and predictors of suicide ideation among undergraduate medical students from a medical college of Western India. Med. J. Armed Forces India. 2021; 77(Suppl 1): S107-S114.

[20] Gui Z, Ren X, Li X, Zhou C, Sun L. Parents' parenting styles differences are associated with lifetime suicidal ideation: Evidence from Chinese medical college students. J. Health Psychol. 2022; 27(10): 2420-34.

[21] Desalegn GT, Wondie M, Dereje S, Addisu A. Suicide ideation, attempt, and determinants among medical students Northwest Ethiopia: an institution-based cross-sectional study. Ann. Gen. Psychiatry. 2020; 19: 44.

[22] Nordin T, Degerstedt F, Granholm Valmari E. A Scoping Review of Masculinity Norms and Their Interplay With Loneliness and Social Connectedness Among Men in Western Societies. Am. J. Mens Health. 2024; 18(6): 15579883241304585.

[23] O'Connor RC, Kirtley OJ. The integrated motivational-volitional model of suicidal behaviour. Philos. Trans. R. Soc. Lond. B. Biol. Sci. 2018; 373(1754): 20170268

[24] van Ballegooijen W, Littlewood DL, Nielsen E, Kapur N, Gooding P. The temporal relationships between defeat, entrapment and suicidal ideation: ecological momentary assessment study. BJPsych. Open. 2022; 8(4): e105

[25] Marcon G, Massaro Carneiro Monteiro G, Ballester P, Cassidy RM, Zimerman A, Brunoni AR, et al. Who attempts suicide among medical students? Acta Psychiatr Scand. 2020; 141(3): 254-64.

[26] Peng J, Ren L. Gender differences in the network of suicidal ideation, interpersonal needs and depressive symptoms among Chinese college students. Sci. Rep. 2025; 15: 10507.

[27] Capdevila-Gaudens P, García-Abajo JM, Flores-Funes D, García-Barbero M, García-Estañ J. Depression, anxiety, burnout and empathy among Spanish medical students. PLoS One. 2021; 16(12): e0260359.

[28] Schad A, Layton RL, Ragland D, Cook JG. Mental health in medical and biomedical doctoral students during the 2020 COVID-19 pandemic and racial protests. Elife. 2022; 11: e69960.

[29] Suárez DE, Cardozo AC, Villarreal ME, Trujillo EM. Non-Heterosexual Medical Students Are Critically Vulnerable to Mental Health Risks: The Need to Account for Sexual Diversity in Wellness Initiatives. Teach Learn Med. 2021; 33(1): 1-9.

[30] Franklin JC, Ribeiro JD, Fox KR, Bentley KH, Kleiman EM, Huang X, et al. Risk factors for suicidal thoughts and behaviors: A meta analysis of 50 years of research. Psychol. Bull. 2017; 143(2): 187-232.

[31] Bernal M, Haro JM, Bernert S, Brugha T, de Graaf R, Bruffaerts R, et al; ESEMED/MHEDEA Investigators. Risk factors for suicidality in Europe: results from the ESEMED study. J. Affect. Disord. 2007; 101(1-3): 27-34.

[32] Oh H, Landré B, Yon DK, Frajerman A, Gyasi RM, Jacob L. Physical activity and suicidal behavior in medical students from the United States. J Affect Disord. 2024; 367658-67.

[33] Kumar V, Mateen A, Aziz T, Singh AK, Singh AK, Mahto M, et al. Prevalence and Various Risk Factors Associated with Suicidal Ideation Thoughts in Medical Students from a Medical College in Northern India. Ann. Afr. Med. 2025; 24(2): 468-73.

[34] Schwenk TL, Davis L, Wimsatt LA. Depression, stigma, and suicidal ideation in medical students. JAMA. 2010 Sep 15;304(11):1181-90.

[35] Pinzón-Amado A, Guerrero S, Moreno K, Landínez C, Pinzón J. Ideación suicida en estudiantes de medicina: prevalencia y factores asociados. Rev. Colomb. Psiquiatr. 2013; 43(Suppl 1): 47-55.

[36] Çelikkol Sadiç Ç. An examination of levels of depression, the probability of suicide, and autistic traits in medical faculty students: Across-sectional study. Medicine (Baltimore). 2024; 103(46): e40607.

[37] Li J, Zhang Y, Siu Man Chan B, Tan SN, Lu J, Luo X, et al. Associations between anxiety, depression, and risk of suicidal behaviors in Chinese medical college students. Front Psychiatry. 2022; 13: 1012298.

[38] Pitanupong J, Sa-I A, Sathaporn K, Jiraphan A, Ittasakul P, Karawekpanyawong N. The personality traits with depression and suicidal ideation among Thai medical students: a university-based multiregional study. BMC Psychol. 2024; 12(1): 223.

[39] Shen Y, Chan BSM, Huang C, Cui X, Liu J, Lu J, Patel M, Verrico CD, Luo X, Zhang XY. Suicidal behaviors and attention deficit hyperactivity disorder (ADHD): a cross-sectional study among Chinese medical college students. BMC Psychiatry. 2021 May 18;21(1):258.

[40] Wen LY, Zhang L, Zhu LJ, Song JG, Wang AS, Feng Y, et al. Latent class analysis on mental health and associated factors in medical and non-medical college students. J. Affect. Disord. 2025; 388: 119593.

[41] Atienza-Carbonell B, Balanzá-Martínez V. Prevalence of depressive symptoms and suicidal ideation among Spanish medical students. Actas Esp. Psiquiatr. 2020; 48(4): 154-62.

[42] Herrera J, Nuñez M. ¿Qué efectos tiene en nuestro cerebro el maltrato? UNAM, Global Revista: 2023 [Citado el 11 de septiembre, 2025]. Disponible en: https://unamglobal.unam.mx/global_revista/que-efectos-tiene-en-nuestro-cerebro-el-maltrato/

[43] Tugnoli S, Casetta I, Caracciolo S, Salviato J. Parental bonding, depression, and suicidal ideation in medical students. Front Psychol. 2022; 13: 877306.

[44] Salmerón-Ruiz MA, García de Ribera C, Sebastián Barberán V, Eddy Ives L, Álvarez-Pitti J. Impact of digital media on development and physical health. An. Pediatr. (Engl. Ed). 2025; 102(6): 503876.

[45] Wang X, Peng P, Liu Y, Yang WF, Chen S, Wang Y. Workplace violence inflicted by patients or their family members/visitors and its relationship with suicidal ideation among undergraduate medical students during clinical training in China. Ann. Med. 2023; 55(2): 2295027.

[46] Instituto Nacional de Estadística y Geografía (INEGI). Encuesta Nacional de Seguridad Pública Urbana (ENSU). INEGI: 2025. [Citado el 13 de septiembre, 2025]. Disponible en: https://www.inegi.org.mx/contenidos/saladeprensa/boletines/2025/ensu/ENSU20205_07_RR.pdf

[47] Escobar-Padilla B, Márquez-González H, Consejo y Chapela C, López-Sepúlveda AC, Sepúlveda Vildósola AC. Social Violence Increases the Risk of Suicidal Ideation Among Undergraduate Medical Students. Arch. Med. Res. 2019; 50(8): 577-86.

[48] Garg S, Kharb A, Bansal K. What covariates drive medical students to the brink of suicidal ideation, plan, and attempt? A double centric cross-sectional study in a resource-constrained rural setting in North India. Indian J. Psychiatry. 2023; 65(4): 431-42

[49] Pelissier C, Viale M, Berthelot P, Poizat B, Massoubre C, Tiffet T, Fontana L. Factors Associated with Psychological Distress in French Medical Students during the COVID-19 Health Crisis: A Cross-Sectional Study. Int J Environ Res Public Health. 2021; 18(24): 12951

[50] Hosseinzadeh Oskouei A, Sardarzehi R, Zamani Zarchi MS, Tavallaei Zavareh SA, Shams J, Kianimoghadam AS, et al. The mediating role of feelings of hopelessness and repetitive negative thinking in the relationship between perfectionism and depressive symptoms among medical students with suicidal ideation. Front. Psychiatry. 2025; 16: 1560653.

[51] Atreya A, Nepal S, Menezes RG, Marhatta A, Ghimire S, Shah P. Suicidal Ideation Among Medical and Nursing Students. J. Nepal Health Res. Counc. 2023; 20(4): 852-8.

[52] Asfaw H, Yigzaw N, Yohannis Z, Fekadu G, Alemayehu Y. Prevalence and associated factors of suicidal ideation and attempt among undergraduate medical students of Haramaya University, Ethiopia. A cross sectional study. PLoS One. 2020; 15(8): e0236398.

[53] Seo EH, Yang HJ, Kim SG, Yoon HJ. Ego-resiliency moderates the risk of depression and social anxiety symptoms on suicidal ideation in medical students. Ann. Gen. Psychiatry. 2022; 21(1): 19.

[54] Koushik M, Veeramani P, Vaishali LPM, Charumathi B, Jain T. Suicidal ideation and its associated risk factors among students of a medical college in Chennai-A cross-sectional study. J. Family Med. Prim. Care. 2025; 14(1): 62-9.

[55] van Ballegooijen W, Littlewood DL, Nielsen E, Kapur N, Gooding P. The temporal relationships between defeat, entrapment and suicidal ideation: ecological momentary assessment study. BJPsych. Open. 2022; 8(4): e105.

[56] Nguyen T, Pu C, Waits A, Tran TD, Ngo TH, Huynh QTV, et al. Transforming stress program on medical students' stress mindset and coping strategies: a quasi-experimental study. BMC Med Educ. 2023; 23(1): 587.

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Published

2026-01-30

How to Cite

Zempoalteca Buenavista, C. A., & Reyes Garnica, A. (2026). Factors associated with suicidal ideation in medical students, a literature review. Mexican Journal of Medical Research ICSA, 14(28). Retrieved from https://repository.uaeh.edu.mx/revistas/index.php/MJMR/article/view/16185