Abstract

BackgroundThis study aimed to examine suicide ideation, suicide attempts, and suicide risk by examining a large sample of Chinese university students and identify the predictive factors, including depressive and anxiety symptoms, for suicide attempt and suicide risk.MethodsWe recruited 6,836 students (aged 18–30) based on all students enrolled in 2016 from one university using cluster sampling. They completed four questionnaires: the Beck Scale for Suicide Ideation and the Suicidal Behaviors Questionnaire-Revised were used to measure suicide risk, and students’ depressive/anxiety symptoms were estimated using Patient Health Questionnaire and Generalized Anxiety Disorder Scale.ResultsFour major findings emerged. First, 18% of the students showed high suicide ideation, 14.5% showed suicide risk, 18.8% had suicide plans, and 1% had attempted suicide. Second, a weak sense of life’s value was common among university students, as 61.4% of students considered suicide as a way to end or evade problems. Third, the results of the binary logistic regression showed that education, suicide ideation, including the wish to die, attitude toward suicide, specificity/planning of suicide, and deception or concealment of contemplated suicide were predictive factors of suicide attempt and suicide risk. The variable “deterrents to active attempt” was also a predictive factor of suicide risk. Fourth, depressive and anxiety symptoms did not significantly predict suicide attempts or suicide risk. Only 10.8% and 5.6% of the students had self-reported scores above the clinical cut-off points for depression and anxiety, respectively.ConclusionsThis study highlighted the prevalence of suicide risk among Chinese university students. The high risk of suicide may not only be due to affective disorders, but also a weak sense of life’s value or other reasons. Suicide ideation that significantly predicts suicide risk can be used for suicide risk assessment. Universities should provide appropriate life education and suicide prevention and intervention such as teaching instructors gate-keeper skills.

Highlights

  • This study aimed to examine suicide ideation, suicide attempts, and suicide risk by examining a large sample of Chinese university students and identify the predictive factors, including depressive and anxiety symptoms, for suicide attempt and suicide risk

  • Distribution of suicide risk We found that 18% (n=1230) of the students had high suicide ideation (SSI ≥ 6), and 14.5% (n=991) had suicide risk (SBQ-R ≥ 7)

  • This study highlighted the prevalence of suicide risk and its characteristics among Chinese university students

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Summary

Introduction

This study aimed to examine suicide ideation, suicide attempts, and suicide risk by examining a large sample of Chinese university students and identify the predictive factors, including depressive and anxiety symptoms, for suicide attempt and suicide risk. Several studies found that suicide ideation and attempts were more common among Chinese university students than in other countries [5, 6]. A meta-analysis showed that the overall lifetime prevalence of suicide ideation among Chinese university students was 10.7%, higher than the cross-national prevalence among young adults across 17 countries including Africa, the Americas, Asia and the Pacific, Europe and the Middle East (9.2%) [7, 8]. More recent studies found a high incidence rate of suicide ideation (13.2%) and suicide attempts (3.4%) among 730 university students in Jilin province in China [9]. The high lethality is one of the reasons why it is critical to understand suicide ideation

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