Table 1.
Characteristics of included studies
| Study | Country | Year of training | Number of students | Instrument and cutoff used | Prevalence of suicidal ideation | Other significant findings |
|---|---|---|---|---|---|---|
| Adhikari et al (2017)23 | Nepal | First to fourth | 343 | Question if they had seriously considered committing suicide while in medical school | 4.7% | No difference between females and males. Clinical years and depressed students with high rates |
| Sun et al (2017)26 | China | First to fifth | 2,198 | Questions about lifetime suicidal ideation, 12-month suicidal ideation, suicide plan, and suicide attempt | Lifetime suicidal ideation: 17.9% 12-month suicidal ideation:8.2% | Suicide plan: 5.2% Suicide attempt: 4.3% Male, mother’s education, and parenting style |
| Torres et al (2017)25 | Brazil | First to sixth | 475 | Item 9 of BDI | Current suicidal ideation: 7.2% | Living alone, thoughts of abandoning the course, moderate or severe depressive symptoms, and probable obsessive–compulsive disorder associated with suicidal ideation |
| Ahmed et al (2016)27 | Egypt | First year, pre-clinical and clinical years | 612 | BSI Scale | 12.75% (BSI>24) | Lifetime suicide plan: 3.59% 48 hours suicide plan: 2.78% |
| Coentre et al (2016)28 | Portugal | Fourth and fifth | 456 | 3 questions about medical school time of suicidal ideation, suicide plan, and suicide attempt | Medical school suicidal ideation: 3.7% | Medical school suicide plan: 1.1% Medical school suicide attempt: 0.7% |
| Wege et al (2016)36 | Germany | First | 389 | 1 question about lifetime suicidal ideation | Lifetime suicidal ideation: 7.4% | Expected financial difficulties associated with suicidal ideation |
| Youssef et al (2016)38 | Pakistan | Second | 114 | KADS-6 | Current suicidal ideation: 24.6% | No statistically significant difference between genders |
| MacLean et al (2015)31 | USA | Not specified | 385 | 3 questions about suicidal ideation (12 months and lifetime) and suicide attempts | Past 12 months suicidal ideation: 11.7% Lifetime suicidal ideation: 29.9% | Lifetime suicide attempt: 1.8% |
| Dyrbye et al (2014)32 | USA | First and second | 4,402 | 1 question about past 12 months suicidal ideation | Past 12 months suicidal ideation: 9.4% | Medical students were not more likely to have experienced recent suicidal ideation |
| Osama et al (2014)29 | Pakistan | First to fifth | 331 | 4 questions about suicidal ideation | Past 12 months suicidal ideation: 35.6% | Lifetime suicide plan: 13.9%; Lifetime suicide attempt: 4.8% |
| Miletic et al (2014)30 | Serbia | First, third, and sixth | 1,296 | SBQ | Lifetime suicidal ideation: 2.9% | Lifetime suicide plan: 0.5% Lifetime suicide attempt: 0.6% |
| Sobowale et al (2014)9 | China | Second and third | 348 | Item 9 of PHQ-9 | Current suicidal ideation: 7.5% | |
| Amiri et al (2012)24 | United Arab Emirates | First to sixth | 115 | Questions about suicidal ideation and suicide attempt (lifetime, past 12 months, and current) | Lifetime suicidal ideation: 17.5% Past 12 months: 7% Current: 1.8% | Lifetime suicide attempts: 1.8% |
| Fan et al (2012)33 | Taiwan-China | First and second | 435 | 1 question about current suicidal ideation | Current suicidal ideation: 11.5% | Suicidal ideation higher in second year compared to first year. Students of lower socioeconomic status with noninflammatory joint pain, with headache, with sleep disorders and depressed more likely to have experienced suicidal ideation |
| Goyal et al (2012)37 | India | First year to internship | 265 | 7 questions about lifetime suicidal ideation and suicide attempt | Lifetime suicidal ideation: 53.6% | Lifetime suicide attempt: 2.7% Suicidal ideation was higher in first year, associated with “impulsive or reckless behavior in difficult situations”, feeling of being “better off dead” and “it’s all too much to manage” Suicidal ideation higher among females and nonworking mothers |
| Menezes et al (2012)10 | Nepal | Second and third | 206 | 4 questions about past 12 months suicidal ideation included in the GHQ-28 3 questions about lifetime suicidal ideation, suicidal plan, and suicidal attempt | Past 12 months suicidal ideation: 10.7% Lifetime suicidal ideation: 18.4% | Lifetime suicide plans: 1% Lifetime suicide attempt: 1% Factors associated with suicidal ideation were primarily dissatisfaction with academic performance, being in the clinical semesters, having history of drug abuse, and feeling neglected by parents |
| van Niekerk et al (2012)34 | South Africa | First to fifth | 874 | 1 question about lifetime suicidal ideation | Lifetime suicidal ideation: 32.3% | Lifetime suicide attempt: 6.2% Suicidal ideation three times higher than the general age-matched population Suicidal ideation had a strong association with suicide attempt |
Abbreviations: BDI, Beck Depression Inventory; BSI, Beck’s Suicidal Ideation Scale; GHQ-28, General Health Questionnaire; KADS-6, Kutcher Adolescent Depression Scale; PHQ-9, item 9 of the Patient Health Questionnaire; SBQ, Suicide Behaviors Questionnaire.