Prevalence and associated factors of suicidal ideation among college students during the COVID-19 pandemic in China: a 3-wave repeated survey

Shun-Wei Liang; Li-Li Liu; Xiao-Dan Peng; Jian-Bin Chen; An-di Huang; Xia-Yong Wang; Jing-Bo Zhao; Fang Fan; Xian-Chen Liu

doi:10.1186/s12888-022-03968-2

Prevalence and associated factors of suicidal ideation among college students during the COVID-19 pandemic in China: a 3-wave repeated survey

BMC Psychiatry. 2022 May 15;22(1):336. doi: 10.1186/s12888-022-03968-2.

Authors

Shun-Wei Liang^#^{1

2}, Li-Li Liu^#¹, Xiao-Dan Peng¹, Jian-Bin Chen^{1

3}, An-di Huang¹, Xia-Yong Wang¹, Jing-Bo Zhao^{4

5}, Fang Fan⁶, Xian-Chen Liu⁷

Affiliations

¹ Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China.
² Mental Health Education and Counseling Center, Guangzhou Academy of Fine Arts, Guangzhou, China.
³ Mental Health Education and Counseling Center, School of Public Health, Southern Medical University, Guangzhou, China.
⁴ Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China. mingtian@smu.edu.cn.
⁵ Mental Health Education and Counseling Center, School of Public Health, Southern Medical University, Guangzhou, China. mingtian@smu.edu.cn.
⁶ School of Psychology, Center for Studies of Psychological Application, Ministry of Education Key Laboratory of Brain, Cognition and Education Sciences, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangdong, China.
⁷ Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, PA, USA.

^# Contributed equally.

Abstract

Objective: The coronavirus disease 2019 (COVID-19) pandemic, a major public health crisis, harms individuals' mental health. This 3-wave repeated survey aimed to examine the prevalence and correlates of suicidal ideation at different stages of the COVID-19 pandemic in a large sample of college students in China.

Methods: Using a repeated cross-sectional survey design, we conducted 3 online surveys of college students during the COVID-19 pandemic at 22 universities in Guandong, China. The 3 surveys were conducted during the outbreak period (T1: 3 February to 10 February 2020, N = 164,101), remission period (T2: 24 March to 3 April 2020, N = 148,384), and normalized prevention and control period (T3: 1 June to 15 June 2020, N = 159,187). Suicidal ideation was measured by the ninth item of the Patient Health Questionnaire-9. A range of suicide-related factors was assessed, including sociodemographic characteristics, depression, anxiety, insomnia, pre-existing mental health problems, and COVID-19-related factors.

Results: The prevalence of suicidal ideation was 8.5%, 11.0% and 12.6% at T1, T2, and T3, respectively. Male sex (aOR: 1.35-1.44, Ps < 0.001), poor self-perceived mental health (aOR: 2.25-2.81, Ps < 0.001), mental diseases (aOR: 1.52-2.09, P < 0.001), prior psychological counseling (aOR: 1.23-1.37, Ps < 0.01), negative perception of the risk of the COVID-19 epidemic (aOR: 1.14-1.36, Ps < 0.001), depressive symptoms (aOR: 2.51-303, Ps < 0.001) and anxiety symptoms (aOR: 1.62-101.11, Ps < 0.001) were associated with an increased risk of suicidal ideation.

Conclusion: Suicidal ideation appeared to increase during the COVID-19 pandemic remission period among college students in China. Multiple factors, especially mental health problems, are associated with suicidal ideation. Psychosocial interventions should be implemented during and after the COVID-19 pandemic to reduce suicide risk among college students.

Keywords: COVID-19 pandemic; College students; Prevalence; Risk factors; Suicidal ideation.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

COVID-19* / epidemiology
China / epidemiology
Cross-Sectional Studies
Depression / epidemiology
Depression / psychology
Humans
Male
Pandemics
Prevalence
Risk Factors
SARS-CoV-2
Students / psychology
Suicidal Ideation