Psychological distress and risk for suicidal behavior among university students in contemporary China

Abstract Background Psychological distress and suicidal behavior are important mental health problems among university students and warrant research to inform strategies for effective prevention in this young population. The present study aimed to assess psychological distress and suicidal behavior and to unravel their associations among university students. Methods A total of 5972 undergraduate students, randomly selected from six universities in central China, comprised the sample. The Chinese version of the Symptom Checklist-90-revised (SCL-90-R) was used to assess various psychological symptoms. Logistic regression analysis was used to examine the relationship between psychological distress and risk for suicidal behavior. Results 40.7% of the university students reported positive in a least one of the 9 psychological symptom dimensions assessed by the SCL-90-R. 7.6% of the students reported suicidal behavior in the previous twelve months. The risk of suicidal behavior was significantly associated with psychological symptoms of all types, but there were notable differences by sex. For male students, depression and phobic anxiety increased the risk of suicidal behavior. Meanwhile, depression and obsessive-compulsiveness were positively associated with suicidal behavior in female students. Furthermore, increasing risk of suicidal behavior was associated with increasing positive symptom total (PST) score and a statistically significant trend was observed. Limitations Data collected from a cross-sectional survey does not allow any examination of causal inference. Conclusions Psychological distress and suicidal behavior were both common among university students; and psychological distress was highly associated with suicidal behavior. The findings underscore the importance of mental health care for university students.