Suicidal thoughts and behaviors: Prevalence and association with distal and proximal factors in Spanish university students

Objective
We report on the prevalence of suicidal thoughts and behaviors in Spanish university students and their risk and protective factors (distal/proximal; individual/environmental).
Methods
First‐year university students completed an online survey including Self‐Injurious Thoughts and Behaviors Interview (SITBI) items, the screening version of the Columbia‐Suicide Severity Rating Scale (C‐SSRS) along with adversities and positive relationships during childhood/adolescence, recent stressful experiences, and lifetime mental disorders. Nested logistic regression models were estimated and areas under the curve (AUC) compared.
Results
A total of 2,118 students completed the survey (mean age = 18.8 [SD = 1.4] years; 55.4% female). Twelve‐month prevalence of suicide ideation (SI) was 9.9%, plans, 5.6%, and attempts, 0.6%. Risk factors of 12‐month SI were as follows: parental psychopathology (OR = 1.7, 95% CI 1.2–2.5); sexual assault (OR = 5.6, 95% CI 1.4–22.1); lifetime mood disorder (OR = 5.2, 95% CI 3.5–7.7); and lifetime anxiety disorder (OR = 1.7, 95% CI: 1.1–2.5). Childhood positive relationships protected from SI were as follows: peers/others (OR = 0.6, 95% CI 0.4–0.9 for the second highest tertile) and family (OR = 0.4, 95% CI 0.3–0.7 for the highest tertile). AUC of the final model was 0.82 (SE = 0.015).
Conclusion
Our results indicate a high prevalence of SI among Spanish university students and identify protective and risk factors from a comprehensive conceptual model.