Suicidal ideation is a spectrum of contemplations, wishes, and preoccupations with suicide. Its prevalence is ambiguous in Iraq, especially among the youth. We aim to survey the prevalence of suicidal ideation among Iraqi students and explore its risk factors. We surveyed Iraqi undergraduate medical students (n = 496) using two psychometric tools, the PHQ-9 and Beck's SSI-C. We also explored potential risk factors, including the students' attributes, socio-demographics, and history of mental illnesses. The current study included males (23.8%) and females (76.2%) in their early twenties (21.73 ± 0.11). Concerning PHQ-9 and SSI-C, most students had either moderate (28%) or mild depression (27.8%), while those with suicidal ideation accounted for an alarming 64.9%. The strongest association existed between the SSI-C and PHQ-9 scores (p = 0.001, OR = 4.70). Other associations existed with the personal history of mental illness (p < 0.001, OR = 2.87) and the family history of suicidality (p = 0.006, OR = 2.28). Path analysis highlighted four suicidal ideation predictors, including the PHQ-9 score (standardized estimate = 0.41, p < 0.001), personal history of mental illness (0.16, p < 0.001), previous psychiatric consultation (0.12, p = 0.002), and family history of suicidality (0.11, p = 0.005). Suicidal ideation is highly prevalent among Iraqi students. Univariable testing, multivariable analyses, and structural modeling yielded congruent results. The students' inherent rather than inherited attributes influenced the phenomenon the most, which is in harmony with Durkheim's theory on the social roots of suicide. We encourage psychiatrists and psychology counselors to be vigilant concerning these risk factors among potential suicidal ideation victims.
Keywords: neurotic disorders; patient health questionnaire-9; prevalence studies; scale for suicide ideation; structural equation modeling.