Severity progression markers of suicide-risk depression among undergraduate students in Brazil
DOI:
https://doi.org/10.15448/1980-6108.2026.1.48528Keywords:
depression, suicide risk, university, students, BrazilAbstract
Aims: Mood disorders are highly prevalent among young undergraduate students and, in more severe cases, can lead to suicide. This study aimed to identify progression markers of depressive symptoms with suicide risk among undergraduate students. Methods: We conducted a cross-sectional survey of 996 undergraduates at a southern Brazilian public university. We calculated the chance of classifying individuals as 'not depressed, no suicide risk', 'depressed, no suicide risk', or 'depressed, suicide risk' according to individual characteristics using multinomial regression. Results: The prevalence of depressive symptoms and suicide risk in the sample were 38.3% and 15.7%, respectively. Severity progression markers included a history of domestic violence in childhood, non-heterosexual sexual orientation, food insecurity, enrollment in a humanities course, dissatisfaction with the course, frequent and heavy use of alcohol, and clinical levels of anxiety and stress. Conclusions: In the university context, researchers can utilize the results of this study to identify cases with an increased risk of suicide early on. In addition to screening for clinically relevant depressive symptoms, assessing the severity progression markers identified in this investigation may help prevent the worsening of cases and, ultimately, suicide itself.
Downloads
References
1. GBD 2019 Mental Disorders Collaborators. Global, Regional, and National Burden of 12 Mental Disorders in 204 Countries and Territories, 1990-2019: A Systematic Analysis for the Global Burden of Disease Study 2019. Lancet Psychiatry. 2022;9(2):137-50. https://doi.org/10.1016/S2215-0366(21)00395-3 DOI: https://doi.org/10.1016/S2215-0366(21)00395-3
2. World Health Organization. Depression and Other Common Mental Disorders: Global Health Estimates. Geneva: WHO; 2017.
3. Pacheco JP, Giacomin HT, Tam WW, Ribeiro TB, Arab C, Bezerra IM, et al. Mental Health Problems Among Medical Students in Brazil: A Systematic Review and Meta-analysis. Braz J Psychiatry. 2017;39(4):369-78. https://doi.org/10.1590/1516-4446-2017-2223 DOI: https://doi.org/10.1590/1516-4446-2017-2223
4. Mortier P, Cuijpers P, Kiekens G, Auerbach RP, Demyttenaere K, Green JG, et al. The Prevalence of Suicidal Thoughts and Behaviours Among College Students: A Meta-analysis. Psychol Med. 2018;48(4):554-65. https://doi.org/10.1017/S0033291717002215 DOI: https://doi.org/10.1017/S0033291717002215
5. Auerbach RP, Alonso J, Axinn WG, Cuijpers P, Ebert DD, Green JG, et al. Mental Disorders Among College Students in the World Health Organization World Mental Health Surveys. Psychol Med. 2016;46(14):2955-70. https://doi.org/10.1017/S0033291716001665 DOI: https://doi.org/10.1017/S0033291716001665
6. Ebert DD, Buntrock C, Mortier P, Auerbach R, Weisel KK, Kessler RC, et al. Prediction of Major Depressive Disorder Onset in College Students. Depress Anxiety. 2019;36(4):294-304. https://doi.org/10.1002/da.22867 DOI: https://doi.org/10.1002/da.22867
7. Horgan A, Kelly P, Goodwin J, Behan L. Depressive Symptoms and Suicidal Ideation Among Irish Undergraduate College Students. Issues Ment Health Nurs. 2018;39(7):575-84. https://doi.org/10.1080/01612840.2017.1422199 DOI: https://doi.org/10.1080/01612840.2017.1422199
8. Tang F, Byrne M, Qin P. Psychological Distress and Risk for Suicidal Behavior Among University Students in Contemporary China. J Affect Disord. 2018;228:101-8. https://doi.org/10.1016/j.jad.2017.12.005 DOI: https://doi.org/10.1016/j.jad.2017.12.005
9. Demenech LM, Oliveira AT, Neiva-Silva L, Dumith SC. Prevalence of Anxiety, Depression and Suicidal Behaviors Among Brazilian Undergraduate Students: A Systematic Review and Meta-analysis. J Affect Disord. 2021;282:147-59. https://doi.org/10.1016/j.jad.2020.12.108 DOI: https://doi.org/10.1016/j.jad.2020.12.108
10. Ernst M, Kallenbach-Kaminski L, Kaufhold J, Negele A, Bahrke U, Hautzinger M, et al. Suicide Attempts in Chronically Depressed Individuals: What are the Risk Factors? Psychiatry Res. 2020;287:112481. https://doi.org/10.1016/j.psychres.2019.112481 DOI: https://doi.org/10.1016/j.psychres.2019.112481
11. Demenech LM, Neiva-Silva L, Brignol SMS, Marcon SR, Lemos SM, Tassitano RM, et al. A Study on the Health and Wellness of Undergraduate Students (SABES-Grad): Methodological Aspects of a Nationwide Multicenter and Multilevel Study Overlapping with the Covid-19 Pandemic. Trends Psychiatry Psychother. 2023;45:e20210367. https://doi.org/10.47626/2237-6089-2021-0367 DOI: https://doi.org/10.47626/2237-6089-2021-0367
12. Demenech LM, Dumith SC, Ferreira LS, Corrêa ML, Soares PSM, Silva PA, et al. How Far Can You Go? Association Between Illicit Drug Use and Academic Migration. J Bras Psiquiatr. 2019;68(1):1-8. https://doi.org/10.1590/0047-2085000000232 DOI: https://doi.org/10.1590/0047-2085000000219
13. Munhoz TN, Nunes BP, Wehrmeister FC, Santos IS, Matijasevich A. A Nationwide Population-based Study of Depression in Brazil. J Affect Disord. 2016;192:226-33. https://doi.org/10.1016/j.jad.2015.12.038 DOI: https://doi.org/10.1016/j.jad.2015.12.038
14. Amorim P. Mini International Neuropsychiatric Interview (MINI): Validation of a Short Structured Diagnostic Psychiatric Interview. Braz J Psiquiatr. 2000;22(3):106-15. https://doi.org/10.1590/S1516-44462000000300003 DOI: https://doi.org/10.1590/S1516-44462000000300003
15. Victora CG, Huttly SR, Fuchs SC, Olinto MT. The Role of Conceptual Frameworks in Epidemiological Analysis: A Hierarchical Approach. Int J Epidemiol. 1997;26(1):224-7. https://doi.org/10.1093/ije/26.1.224 DOI: https://doi.org/10.1093/ije/26.1.224
16. Carpena MX, Dumith SC, Mola CL, Neiva-Silva L. Sociodemographic, Behavioral, and Health-related Risk Factors for Depression Among Men and Women in a Southern Brazilian City. Braz J Psychiatry. 2019;41(5):396-402. https://doi.org/10.1590/1516-4446-2018-0135 DOI: https://doi.org/10.1590/1516-4446-2018-0135
17. Dumith SC, Demenech LM, Carpena MX, Nomiyama S, Neiva-Silva L, Mola CL. Suicidal Thought in Southern Brazil: Who are the Most Susceptible? J Affect Disord. 2020;260:610-6. https://doi.org/10.1016/j.jad.2019.09.046 DOI: https://doi.org/10.1016/j.jad.2019.09.046
18. Acharya L, Jin L, Collins W. College Life is Stressful Today – Emerging Stressors and Depressive Symptoms in College Students. J Am Coll Health. 2018;66(7):655-64. https://doi.org/10.1080/07448481.2018.1451869 DOI: https://doi.org/10.1080/07448481.2018.1451869
19. Mortier P, Demyttenaere K, Auerbach RP, Cuijpers P, Green JG, Kiekens G, et al. First Onset of Suicidal Thoughts and Behaviours in College. J Affect Disord. 2017;207:291-9. https://doi.org/10.1016/j.jad.2016.09.033 DOI: https://doi.org/10.1016/j.jad.2016.09.033
20. Cluver L, Orkin M, Boyes ME, Sherr L. Child and Adolescent Suicide Attempts, Suicidal Behavior, and Adverse Childhood Experiences in South Africa: A Prospective Study. J Adolesc Health. 2015;57(1):52-9. https://doi.org/10.1016/j.jadohealth.2015.03.001 DOI: https://doi.org/10.1016/j.jadohealth.2015.03.001
21. Oginni OA, Mosaku KS, Mapayi BM, Akinsulore A, Afolabi TO. Depression and Associated Factors Among Gay and Heterosexual Male University Students in Nigeria. Arch Sex Behav. 2018;47(4):1119-32. https://doi.org/10.1007/s10508-017-0987-4 DOI: https://doi.org/10.1007/s10508-017-0987-4
22. Santos HGBD, Marcon SR, Espinosa MM, Baptista MN, Paulo PMC. Factors Associated with Suicidal Ideation Among University Students. Rev Lat Am Enfermagem. 2017;25:e2878. https://doi.org/10.1590/1518-8345.1592.2878 DOI: https://doi.org/10.1590/1518-8345.1592.2878
23. Chang CJ, Fehling KB, Selby EA. Sexual Minority Status and Psychological Risk for Suicide Attempt: A Serial Multiple Mediation Model of Social Support and Emotion Regulation. Front Psychiatry. 2020;11:385. https://doi.org/10.3389/fpsyt.2020.00385 DOI: https://doi.org/10.3389/fpsyt.2020.00385
24. Shayo FK, Lawala PS. Does Food Insecurity Link to Suicidal Behaviors Among In-school Adolescents? Findings from the Low-income Country of sub-Saharan Africa. BMC Psychiatry. 2019;19(1):227. https://doi.org/10.1186/s12888-019-2212-6 DOI: https://doi.org/10.1186/s12888-019-2212-6
25. Davison KM, Marshall-Fabien GL, Tecson A. Association of Moderate and Severe Food Insecurity with Suicidal Ideation in Adults: National Survey Data from three Canadian Provinces. Soc Psychiatry Psychiatr Epidemiol. 2015;50(6):963-72. https://doi.org/10.1007/s00127-015-1018-1 DOI: https://doi.org/10.1007/s00127-015-1018-1
26. Ariño DO, Bardagi MP. Relação entre Fatores Acadêmicos e a Saúde Mental de Estudantes Universitários. Psicol Pesq. 2018;12(3):44-52. https://doi.org/10.24879/2018001200300544 DOI: https://doi.org/10.24879/2018001200300544
27. Flesch BD, Houvèssou GM, Munhoz TN, Fassa AG. Episódio Depressivo Maior entre Universitários do Sul do Brasil. Rev Saúde Pública. 2020;54:11. https://doi.org/10.11606/s1518-8787.2020054001540 DOI: https://doi.org/10.11606/s1518-8787.2020054001540
28. Lamis DA, Ballard ED, May AM, Dvorak RD. Depressive Symptoms and Suicidal Ideation in College Students: The Mediating and Moderating Roles of Hopelessness, Alcohol Problems, and Social Support. J Clin Psychol. 2016;72(9):919-32. https://doi.org/10.1002/jclp.22295 DOI: https://doi.org/10.1002/jclp.22295
29. Gerber M, Ludyga S, Mücke M, Colledge F, Brand S, Pühse U. Low Vigorous Physical Activity is Associated with Increased Adrenocortical Reactivity to Psychosocial Stress in Students with High Stress Perceptions. Psychoneuroendocrinology. 2017;80:104-13. https://doi.org/10.1016/j.psyneuen.2017.03.004 DOI: https://doi.org/10.1016/j.psyneuen.2017.03.004
30. Wiener CD, Moreira FP, Zago A, Souza LM, Branco JC, Oliveira JF, et al. Mood Disorder, Anxiety, and Suicide Risk Among Subjects with Alcohol Abuse and/or Dependence: A Population-based Study. Braz J Psiquiatr. 2018;40:1-5. https://doi.org/10.1590/1516-4446-2016-2170 DOI: https://doi.org/10.1590/1516-4446-2016-2170
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Lauro Miranda Demenech, Mariana Corrêa, Raimundo Bittencourt de Almeida , Thales Rodrigues de Almeida, Rafael Clain-Martins, Lucas Neiva-Silva, Samuel Carvalho Dumith

This work is licensed under a Creative Commons Attribution 4.0 International License.








