Suicidal Ideation and Behavior Among Mexican University Students Before and During the COVID-19 Pandemic

Abstract

Objective

The COVID-19 pandemic has affected the mental health of populations around the world, but few longitudinal studies of its impact on suicidal thoughts and behaviors have been published especially from low- and middle-income countries.

Methods

This is a prospective cohort study of 1,385 first-year students from 5 Universities in Mexico followed-up for 1 year. We report 1-year cumulative incidence of suicidal thoughts and behaviors before (September 19, 2019–March 29, 2020) and during the COVID-19 period (March 30, 2020–June 30, 2020), focusing on those in the COVID-19 period with risk conditions and positive coping strategies during the pandemic.

Results

There was an increase in the incidence of suicidal ideation during the COVID-19 period compared to the pre-COVID-19 period (RR 1.65, 95%CI 1.08–2.50). This increase was mostly found among students with heightened sense of vulnerability (RR 1.95), any poor coping behavior (RR 2.40) and a prior mental disorder (RR 2.41). While we found no evidence of an increased risk of suicidal planning or attempts, there was evidence that those without lifetime mental health disorders were at greater risk of suicidal plans than those with these disorders especially if they had poor coping strategies (RR 3.14).

Conclusion

In the short term, how students deal with the pandemic, being at high risk and having poor coping behavior, increased the new occurrence of suicidal thoughts and behaviors. Studies with longer follow-up and interventions to reduce or enhance these behaviors are needed.

HIGHLIGHTS

• Suicidal ideation increased during the COVID-19 period

• Those with heightened sense of vulnerability and poor coping were more affected

• Studies with longer follow-up are needed

Keywords:

• COVID-19
• longitudinal
• Mexico
• suicidal ideation
• suicide attempt

ACKNOWLEDGMENTS

The survey was carried out in conjunction with the WHO World Mental Health International College Surveys Initiative (WHO WMH-ICS). The authors thank the WHO WMH-ICS collaborators and staff for assistance with instrumentation.

ETHICAL APPROVAL

The recruitment, consent, and data collection procedures were approved by the Research Ethics Committee of the National Institute of Psychiatry in Mexico City, Mexico.

DISCLOSURE STATEMENT

No potential conflict of interest was reported by the author(s).

DATA AVAILABILITY STATEMENT

There is no data set associated with the paper.

Additional information

Funding

This study was supported by the National Council on Science and Technology [CONACyT; CB-2016-01-285548] and the Fundacion Miguel Aleman A.C (awarded to CB). DG is part-funded by the NIHR Biomedical Research Center at University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol.

Notes on contributors

Guilherme Borges

Guilherme Borges, Ricardo Orozco, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico City, Mexico;

Ricardo Orozco

Guilherme Borges, Ricardo Orozco, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico City, Mexico;

David Gunnell

David Gunnell, Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, Bristol, UK; National Institute of Health Research Biomedical Research Centre at the University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, Bristol, UK;

Raúl A. Gutiérrez-García

Raúl A. Gutiérrez-García, Universidad De La Salle Bajío, Campus Salamanca, Guanajuato, Mexico;

Yesica Albor

Yesica Albor, Universidad Cuauhtémoc, plantel Aguascalientes, Aguascalientes, Mexico;

Guillermo E. Quevedo Chávez

Guillermo E. Quevedo Chávez, Universidad la Salle Cancun, Cancun, Mexico;

Praxedis Cristina Hernández Uribe

Praxedis Cristina Hernández Uribe, Universidad Autónoma Metropolitana, Mexico City, Mexico;

Sergio Cruz Hernández

Sergio Cruz Hernández, Universidad Autónoma de Baja California, Mexicali, Mexico;

María Anabell Covarrubias Díaz Couder

María Anabell Covarrubias Díaz Couder, Universidad La Salle Noroeste, Ciudad Obregon, Mexico;

Jordi Alonso

Jordi Alonso, Health Services Research Unit, IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain; CIBER en Epidemiología y Salud Pública (CIBERESP), Girona, Spain; Pompeu Fabra University (UPF), Barcelona, Spain;

Maria-Elena Medina-Mora

Maria-Elena Medina-Mora, Corina Benjet*, Centro de Investigacion en Salud Mental Global, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico City, Mexico.

Corina Benjet

Maria-Elena Medina-Mora, Corina Benjet*, Centro de Investigacion en Salud Mental Global, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico City, Mexico.