An explanatory model of suicidal ideation based on family functionality and mental health problems: A cross-sectional study of medical students

Abstract

Background: One of the mental health problems with the greatest impact on people's lives is suicidal behavior, a largely preventable public health problem that accounts for almost half of all violent deaths. The aim of the study is to propose a model that can explain and predict suicidal ideation based on mental health problems (stress-anxiety-depression) and family functionality (cohesion, flexibility, and cohesion). Methods: Our study is cross-sectional. The population consisted of medical interns from all over Peru. Non-probability sampling was used. We used Family Cohesion and Adaptability Evaluation Scale (FACES-III), Family Communication Scale, Family Satisfaction Scale, Depression Anxiety and Stress Scales (DASS-21), and the Scale for Suicide Ideation – Worst (SSI-W). Results: A total of 480 participants were included. The prevalence of suicidal ideation was 39Poisson regression analysis adjusted identified that people with anxiety symptoms were more than four times more likely to have suicidal ideation (PR=4.89; 95% CI:1.90-12.64). Also, people with moderate to high levels of family communication were much less likely to have suicidal ideation (PR= 0.07; 95% CI: 0.01-0.41), making it a protective factor. The proposed model presented optimal goodness-of-fit indices (CFI=0.974; TLI=0.974; SRMR=0.055; RMSEA=0.062). In addition, the proposed model can explain the presence of suicidal ideation in 88.3% (R2=0.883). Conclusions: Our model can explain 88.3% of suicidal behavior based on family relationships and mental health problems in medical interns. In addition, the variables that alone were most associated with suicidal behavior were anxious symptoms and family communication as risk factors and protective factors, respectively.