Objective: To explore the factors influencing mental health and suicidal behaviors of medical students and provide a scientific basis for improving their mental health and reducing their suicidal behaviors.
Methods: We conducted a questionnaire-based survey among 11 270 medical students in the first and second years at 3 universities in the southern, northern and central regions of a province in China, and 10 340 valid responses were retrieved. Multiple logistic regression was used to analyze the factors affecting anxiety, depression and suicidal behaviors, particularly the impact of family environment on the mental health status of the medical students.
Results: Medical students of the female gender, in their second year in college, with dissatisfaction with their major, coming from poor families, families experiencing domestic violence or dysfunctional family were more likely to develop depression and anxiety; medical students who experienced violence by their parents or guardians and had childhood experience of separation from parents were more likely to develop anxiety (P < 0.05). Female medical students exposure to violence by parents/guardians, anxiety, depression, and family dysfunction were more likely to have suicidal attempts and suicidal ideation; and those who were dissatisfied with their studies, had witnessed violence between parents or had childhood experience separation from parents were also more likely to have suicidal ideation (P < 0.05).
Conclusions: The mental health and suicidal behavior of medical students are affected by various factors involving family conditions, childhood experience, to which parents and relevant agencies should give due attention.
目的: 了解并探讨医学生的心理健康及自杀行为的影响因素，为提高医学生的心理健康水平、降低自杀行为提供科学依据。
方法: 以某省南部、北部和中部三个地区的省属医学院校的一、二年级11270名在校大学生为调查对象，经过对回收的问卷进行核查并摒弃填写质量较差的问卷后保留10 340份有效问卷，并采用多因素Logistic回归分析焦虑、抑郁和自杀行为的影响因素，尤其是家庭环境因素对医学生心理健康状况的影响。
结果: 女生、二年级医学生、对所学专业不满意、家庭经济状况差、父母间有暴力打斗行为、家庭功能存在障碍的医学生更容易发展出抑郁和焦虑情绪; 被父母/监护人殴打、儿童时期有留守经历的医学生也更易出现焦虑情绪(P < 0.05)。同时，女性、被父母/监护人殴打、存在焦虑情绪、存在抑郁情绪、家庭功能存在障碍的医学生更容易出现自杀未遂和自杀意念; 对所学专业不满意、父母间有暴力打斗行为、儿童时期有留守经历者也更易出现自杀意念(P < 0.05)。
结论: 医学生的心理健康与自杀行为受家庭关系、成长经历等多方面的影响，因此应加强父母和相关部门对医学生心理健康与自杀行为的重视。
Keywords: contributing factors; medical students; mental health; suicide.