See discussions, stats, and author profiles for this publication at: https://www.researchgate.

net/publication/350789543

SUICIDAL IDEATION AND SUICIDAL THOUGHTS IN UNIVERSITY

STUDENTS DURING THE COVID-19 PANDEMIC: A SYSTEMATIC REVIEW

Article in Revista Argentina de Clinica Psicologica · April 2021

DOI: 10.24205/03276716.2020.4038

CITATIONS
READS
0
61

2 authors:

María Mercedes Yeomans Cabrera

Jonathan Martínez Líbano
Universidad de las Américas (Chile)
Universidad de las Américas (Chile)
3 PUBLICATIONS 2 CITATIONS
2 PUBLICATIONS 0 CITATIONS

Some of the authors of this publication are also working on these related projects:

Education in Confinament View project

All content following this page was uploaded by María Mercedes Yeomans Cabrera on 10 April 2021.

The user has requested enhancement of the downloaded file.

Revista Argentina de Clínica Psicológica
2021, Vol. XXX, N°2, 390-405 390
DOI: 10.24205/03276716.2020.4038

SUICIDAL IDEATION AND SUICIDAL THOUGHTS IN

UNIVERSITY STUDENTS DURING THE COVID-19
PANDEMIC: A SYSTEMATIC REVIEW
Jonathan Martínez-Líbano1,2*, María Mercedes Yeomans Cabrera3,4

Abstract: Suicidal ideation and suicidal thinking are relevant phenomena to study given their
high incidence among university students in higher education, even more so if during the
academic period students are affected by a pandemic such as COVID-19. Consequently,
this systematic review's objective was to determine the prevalence of suicidal ideation
and suicidal thinking in university students during the COVID-19 pandemic and, as a
secondary objective, to establish possible risk factors. The search was performed following
the PRISMA model in the Web of Science, Scopus, PubMed, and Medline search engines
between January 2020 and January 2021, and the Newcastle- Ottawa Scale (NOS) was used
to evaluate the methodological quality of the studies. Regarding the results, at the end of
the search, nine relevant studies were identified for analysis: four on suicidal thoughts,
four on suicidal ideation, and one on suicide as a continuous variable. In conclusion, it
was possible to stipulate that the average prevalence of suicidal ideation and suicidal
thoughts were 17.8% for the university population. Likewise, the risk factors associated
with the appearance of suicidal thoughts and ideation in university students during the
COVID-19 pandemic were ethnographic, psychological, contextual and health factors.
Keywords: suicidal ideation, suicidal thinking, mental health, university students, COVID- 19
pandemic.

INTRODUCTION 2019). Suicide deaths are almost equally divided

Suicidal ideation is often an indicator of mental between male and female students (Farrell et al.,
health problems and a significant risk factor for 2017). However, knowledge of students'
suicide (Pereira & Cardoso, 2015). There is long- distinguishing characteristics with mental illness
standing concern about mental health and suicide risk who die by suicide may help us in clinical
among college students (McLaughlin & Gunnell, management (Farrell et al., 2017). Although a
2020). Since getting into higher education is a time of systematic review of mental health problems in the
transition that coincides with the typical onset of general population was recently conducted (Xiong et
severe mental illness (Farrell, Kapur, While, al., 2020), background information on the
Appleby, & Windfuhr, 2017), it may lead college prevalence of suicidal ideation and suicidal
students to be at an increased risk for suicidal thoughts in college students has not been accurately
tendencies (Yi et al., 2020). Suicide is a leading determined. Besides, there are scarce studies about
cause of death in this population (Hedman- the way this population has developed during the
Robertson, 2018); among college students aged 18 to COVID-19 pandemic. Consequently, the following
22 years, 6.6% reported severe suicidal thoughts, systematic review's objective was to determine the
2.2% reported suicide plans, and 1.1% reported prevalence of suicidal ideation and suicidal
attempting suicide in the past year (SAMHSA, thoughts during the

1 Facultad de Salud y Ciencias Sociales, Universidad de Las Américas, Chile

2 Escuela de Ciencias Sociales y Jurídicas, Universidad Viña del Mar, Chile
3 Facultad de Comunicaciones y Artes, Universidad de Las Américas, Chile
4 Facultad de Educación, Universidad de Las Américas, Chile
*Corresponding autor: [email protected]

REVISTA ARGENTINA
2021, Vol. XXX, N°2, 390- DE CLÍNICA
 391 Jonathan Martínez-Líbano, María Mercedes Yeomans Cabrera

COVID-19 pandemic in college students and, as a 2010). The American Psychiatric Association
secondary objective, to establish associated risk proposed two new diagnostic entities called suicidal
factors. behavior disorder and nonsuicidal self-injury in the
chapter "Conditions for Further Study" in the fifth
LITERATURE REVIEW version of the Diagnostic and Statistical Manual of
Suicidal behavior is a significant public health Mental Disorders (DSM-V) (American Psychiatric
problem (Freeman et al., 2017). According to Association, 2014). A fundamental limitation to
various studies, suicide is the thirteenth leading progress in the field is incomplete or inaccurate
cause of death worldwide (Lozano et al., 2012). models of suicide and suicide risk (May & Klonsky,
Each year, more than 800,000 people die by suicide 2016). Although suicide is a public health problem, it
worldwide, and it is estimated that between 10 and can be prevented through timely, low-cost, data-
20 million more people attempt suicide (World driven interventions (Organización Mundial de la
Health Organization, 2014). Suicidal behavior is Salud, 2020).
defined as the desire or act that intentionally causes
harm or leads to death to oneself, encompasses MATERIALS AND METHODS
suicidal ideation, and the suicide attempt until it A systematic review was conducted, identifying
reaches its goal: consummated suicide (Alvarado & articles published in the Web of Science, Scopus,
Velez, 2016). Several factors can lead a person to PubMed, and Medline databases between January
have the capacity to commit suicide, including 2019 and January 2021, written in English and
genetic predispositions, courage in the face of Spanish.
death, greater tolerance to physical pain, and
familiarity and access to lethal means, which is a Search strategy
central component of modern theories of suicide The literature search was performed according to
(Klonsky & May, 2015; O’Connor & Kirtley, 2018; the preferred reporting protocol for systematic
Van Orden et al., 2010). Suicide-related behaviors can reviews and meta-analyses PRISMA (Moher,
be classified as ideations (i.e., thoughts), Liberati, Tetzlaff, Altman, & Group, 2009; Page et
communications, and behaviors (Van Orden et al., al., 2020; Urrútia & Bonfill, 2013). Title, abstract,
Identificatio

n = 34 records identified n = 4 Web of Science

n = 6 Scopus n = 20 Pubmed n = 4 Medline
Additional records identified through manual searching (n=0)
Screenin

Records after duplicates removed (n = 22)

Records excluded n = 5
Titles and abstractcs screened (n = 22)
Eligibility

Full-text articles assessed for eligibility (n = 17 )

Full-text articles excluded, with reasons (n =8 )

6 articles removed for studying desing 2 articles removed for studying other pol

Studies included in qualitative synthesis (n = 9)

Includ

Figure 1. PRISMA flow chart.

REVISTA ARGENTINA
2021, Vol. XXX, N°2, 390- DE CLÍNICA
and keyword fields were searched in each of the students. Of these, 12 were eliminated due to
databases. The following keywords combined with duplicates. Five articles were excluded by reading the
Boolean operators (OR/AND) were used: (["COVID- title and abstract; finally, eight were eliminated by
19 "OR "SARS-CoV-2" OR "Coronavirus"] AND reading the full text. Thus, nine articles that met the
["suicide" OR "suicide ideation" OR "suicide inclusion criteria were selected for the systematic
thoughts"] AND ["university students" OR review.
"undergraduate Students" OR "college students"]).
The search strategy for study selection is shown in Study Characteristics
Figure 1. The study characteristics and findings of this
review are summarized in Table 1. The nine articles'
Study selection and eligibility criteria sample sizes ranged between 1,000 and 69,054
The titles and abstracts of each article were participants, with a total of 106,814 higher
reviewed, then the full text was reviewed to education students. All studies had a cross-
determine eligibility. Studies were eligible for sectional study design. The 9 studies were
inclusion if: 1) they followed a cross-sectional study conducted in various countries around the world
design; 2) the population was in college students; 3) Greece (n = 2), France (n = 1), Bangladesh (n = 1),
application of clinical and non-clinical instruments; Libya (n = 1), USA (n = 1), Poland (n = 1), China
4) positive and negative outcomes; 5) field studies; (n = 1), and Indonesia, Taiwan, and Thailand (n =
6) English and Spanish language texts; 7) data in the 1).
articles were during COVID-19 pandemic. The
following exclusion criteria were used, 1) studies Evaluation of methodological quality
not under COVID-19 pandemic; 2) subjects who The results of the evaluation of the
were not university students; 3) academic notes, methodological quality of the studies are presented in
letters to the editor or reflections; 4) longitudinal Table 2. The overall quality of the included studies
studies. was moderate, with a total of 6 to 7 points. There
were four studies with seven points (Kaparounaki
Data extraction et al., 2020; M E Patsali et al., 2020; Tasnim, Islam,
A data extraction form was used to include Hossain, Sikdera, & Potenza, 2020; Xin, Luo, She,
relevant data: (1) Lead author, (2) Country, (3) Yu, Li, et al., 2020), and five studies with six points
Study design, (4) Sample size, (5) Measurement (Elhadi et al., 2020; Pramukti et al., 2020; Wang et
instrument, (6) Prevalence, (7) Associated risk al., 2020; Wathelet et al., 2020). Results are shown
factors. in Table 2.

Quality Assessment Measuring tools

The Newcastle-Ottawa Scale (NOS), adapted for Various scales were used in the studies (n = 11) in
cross-sectional studies, was used to assess the the following proportions: The Patient Health
studies' quality (Epstein et al., 2018). The scale Questionnaire (PHQ-9) (n = 3); State-Trait Anxiety
consists of three dimensions: selection, Inventory (STAI) (n=3); Center for Epidemiologic
comparability, and outcome. Seven categories Studies-Depression (CES-D) (n = 2); Depression
assess: the sample's representativeness, sample size Anxiety and Stress Scales-21 (DASS-21) (n = 2); The
justification, comparability between respondents Generalized Anxiety Disorder (GAD-7) (n = 2); Beck
and non-respondents, exposure determinations, Depression Inventory (BDI) (n = 1); The Depressive
comparability based on study design or analysis, Symptom Index Suicidality Subscale (DSI-SS) (n = 1);
outcome assessment, statistical analysis The Impact of Event Scale-Revised (IES-R) (n = 1);
appropriateness. A total of nine points may be Perceived Stress Scale (PSS) (n = 1); Risk Assessment
awarded if the study meets certain criteria, with a Suicidality Scale (RASS) (n = 1); Self-harm or suicidal
maximum of four points assigned for the selection ideation (SH-SI) (n = 1).
dimension, a maximum of two points assigned for
the comparability dimension, and a maximum of Risk factors associated with university students
three points assigned for the outcome dimension Within the risk factors for the occurrence of
(Epstein et al., 2018). suicidal ideation and thoughts we found
ethnographic factors, psychological factors,
RESULTS contextual factors, and health factors in the
Search Results following proportions: depression (n = 5); anxiety (n
In total, 34 publications were identified on the = 5); female gender (n = 3); stress (n = 3); age (n =
suicide subject, suicidal thoughts, and suicidal 2); COVID-19 compatible symptoms (n = 2); history
ideation in the COVID-19 pandemic in university of suicide attempts (n = 2); non-binary gender (n =
1); problems with income or housing (n = 1);

REVISTA ARGENTINA
2021, Vol. XXX, N°2, 390- DE CLÍNICA
 393 Jonathan Martínez-Líbano, María Mercedes Yeomans Cabrera

psychiatric history (n = 1); social isolation (n = 1); news (n = 1); studies of law, literature, pedagogy,
poor quality of information received (n = 1); sleep political science and related studies, as well as
disorders (n = 1); smoking (n = 1); past suicidal technical but not health sciences (n = 1); beliefs of
thoughts (n = 1); family history of suicide (n = 1); conspiracy theories (n = 1); fear of civil war (n =
living with a Relative with Covid-19 (n = 1); living 1).
alone (n = 1); low support (n = 1); overexposure to
Table 1. Summary of the study sample's characteristics, study design, evaluation tools used, prevalence
rates, and associated risk factors.
Main Study Sample Type of
Country Design Students Instrument Measurement Prevalence Risk factors
Author
Female or non-binary
gender, problems with
income or housing,
IES-R / PSS
Wathelet et Suicidal psychiatric history,
France Transversal 69.054 / STAI / 11,4%
al., 2020 thoughts symptoms compatible
BDI.
with COVID-19, social
isolation, low quality of
the information received.
Sleep disorders, smoking,
past suicidal thoughts,
Tasnim, et Suicidal history of suicide
Bangaldesh Transversal 3.331 DASS-21 12,8%
al., 2020 ideation attempts, family history
of suicide, depression,
anxiety, and stress.
Year of study, age,
psychological stress due to
civil war, living with
Elhadi et al., GAD-7 / Suicidal family or friends with
Libia Transversal 3.500 22,7%
2020 PHQ-9 ideation COVID-19, internal
displacement due to
conflict, and living with
family or alone.
Woman, presence of
Wang et al., PHQ-9 / Suicidal
EEUU Transversal 2.031 18% Anxiety and Depression,
2020 GAD-7 thoughts
Increased stress
Debowska DASS / DSI- Not young adult students
Poland Transversal 7.228 Suicidal
et al., 2020 SS specified (18-24 years old)
Kaparounaki STAI / CES- Suicidal Presence of high levels of
Greece Transversal 1.000 20,2%
et al., 2020 D / RASS thoughts anxiety and depression
Presence of depressive
symptoms and emotional
Xin et al., PHQ-9 / Suicidal distress, perceived risk of
China Transversal 24.378 12,9%
2020 SH-SI ideation infection, and mental
health variables were
significant.
Low Perceived Support,
Indonesian, Sadness and depressed
Pramukti et Suicidal
Taiwanese, Transversal 1.985 STAI 26,7% mood, High Anxiety due
al., 2020 thoughts
and Thai to overexposure to
information

REVISTA ARGENTINA
2021, Vol. XXX, N°2, 390- DE CLÍNICA
 394 Jonathan Martínez-Líbano, María Mercedes Yeomans Cabrera
Female gender History of
self-harm. History of
suicide attempts.
Following studies of law,
Patsali et al., Suicidal It increases literature, pedagogy,
Greece Transversal 1.535 CES-D
2020 ideation by 2.59% political science and
related studies, and
technical sciences, but
not health. Beliefs in
conspiracy theories.
Own elaboration

Table 2. Results of Study quality appraisal of the included studies

Total
Study Selection Comparability Outcome
Score
Non- Ascertainme Based on Assessme
Representativen Sample Statstic
Responde nts of Desing and nt of Quality
ess of the sample Size al Test
nts exposure analysis Outcome
Wathelet
6 * * ** * * satisfactory
et al., 2020
Tasnim, et
7 * * ** * * * good
al., 2020
Elhadi et
6 * * ** * * satisfactory
al., 2020
Wang et
6 * * ** * * satisfactory
al., 2020
Debowska
6 * * ** * * satisfactory
et al., 2020
Kaparouna
ki et al., 7 * * ** * * * good
2020
Xin et al.,
7 * * ** * * * good
2020
Pramukti
6 * * ** * * satisfactory
et al., 2020
Patsali et
7 * * ** * * * good
al., 2020

Own elaboration can be concluded that there is a diverse prevalence in

the studies consulted, from 11.4% to 26.7%,
The Patient Health Questionnaire (PHQ); State- obtaining an average of 17.8% prevalence of
Trait Anxiety Inventory (STAI); Center for suicidal ideation and thoughts. These results are
Epidemiologic Studies-Depression (CES-D); associated with other studies where the prevalence is
Depression Anxiety and Stress Scales-21 (DASS-21); similar without the effect of the COVID-19
The Generalized Anxiety Disorder (GAD-7); Beck pandemic, the indicators of suicidal ideation range
Depression Inventory (BDI); The Depressive from 8% to 25% (Villalobos-Galvis, 2009), 14.9%
Symptom Index Suicidality Subscale (DSI-SS); The (Rudd, 1989); 9.9% (Blasco et al., 2019); 21%
Impact of Event Scale-Revised (IES-R); Perceived (Sivertsen et al., 2019) in similar populations. From
Stress Scale (PSS) Risk Assessment Suicidality Scale the results described above, it cannot be asserted that
(RASS)Self-harm or suicidal ideation (SH-SI) the percentage of suicidal ideation or thoughts was
elevated in college students during the COVID- 19
DISCUSSION pandemic. This may be since suicidal ideation is
The review conducted explored suicidal ideation transient and dynamic, increasing and decreasing
and thoughts in university students during the considerably over days (Siddaway, Holm-Denoma,
COVID-19 pandemic. At the end of this review, it Witte, & Ruscio, 2021). Nevertheless, the results

REVISTA ARGENTINA
2021, Vol. XXX, N°2, 390- DE CLÍNICA
 395 Jonathan Martínez-Líbano, María Mercedes Yeomans Cabrera
present many factors associated with the risk of and immaturity, generate stumbling blocks that can
suicidal ideation, which is reviewed below in four translate into moments of distress, loneliness, and
categories: ethnographic factors, psychological frustration, all risk factors for committing a suicidal
factors, contextual factors, and health factors. act or engaging in suicidal behaviors (Cortés, 2013).
However, it is essential to point out that age is not a
1. Ethnographic Factors determining factor, considering that in some
Among the risk factors presented in studies of countries, the highest suicide rate is found in adults of
suicidal ideation and suicidal thoughts during the the third and fourth ages (Ordóñez Monak, Franco
COVID-19 pandemic is gender. Concerning the Agudelo, & González Ortiz, 2013).
female and non-binary genders, they are at higher
risk. This study's results are consistent with 2. Psychological factors
previous studies, which indicate that females are From the psychological point of view, it has been
more likely to have suicidal thoughts (Boiett et al., established that students with a previous psychiatric
2020; Villalobos-Galvis, 2009). Similarly, concerning history may be subject to a high presentation of
the non-binary gender, some studies report that this suicidal ideation and thoughts; this is evidenced both
group of people may experience discrimination. This in research focused on the period of the covid-19
has been associated with a higher probability of pandemic, as well as in previous research (Coentre,
suicide attempts and depressive symptoms; the latter Faravelli, & Figueira, 2016).
would be due to a more significant perceived In addition to personal psychiatric history,
burden and frustrated belonging beyond the effects of family history of psychiatric disorders (Boiett et al.,
childhood trauma and sociodemographic variables 2020), and family history of suicide and suicidal
(Wyman Battalen et al., 2020). Likewise, bisexual behavior in a family member (Villalobos-Galvis,
sexual orientations are significantly associated with 2009) are essential factors in the suicidal ideation of a
suicidal ideation (Lytle, Blosnich, De Luca, & subject. This could be due to both genetic and
Brownson, 2018). However, the above contrasts contextual factors, which should be scrutinized.
with other research where there is evidence that Past suicidal thoughts and suicidal ideation, such
there are no gender differences in suicidal ideation as the subject's history of suicide attempts, are
and suicidal thoughts (Dachew, Bifftu, Tiruneh, & central elements in the appearance of new and
Anlay, 2018; McAuliffe, Corcoran, Keeley, & Perry, repeated thoughts (McAuliffe et al., 2003;
2003; Naderi & Esmaili, 2009; Schweitzer, Sarmiento & Aguilar, 2011), especially when people
McLean, & Klayich, 1995), so the gender factor feel overwhelmed by stressors (Denneson et al.,
should be deepened in new studies, considering that 2015). The research reviewed shows that mood
society has a permanent evolution. There is evidence disorders, among others, depression, are the most
of a difference because male university students may recurrent risk in college students and are highly
have a higher risk of death by suicide (Farrell et al., associated with suicidal ideation and thoughts
2017; Granato, Smith, & Selwyn, 2015; McLaughlin (Eisenberg, Gollust, Golberstein, & Hefner, 2007;
& Gunnell, 2020), which is associated with the fact Hayes et al., 2020; Mikaella E Patsali et al., 2020;
that, apparently, the male gender uses suicide as a Ross, Dehay, & Deiling, 2020). Mood disorders are a
form of escape from pain (Lester, Wood, Williams, & cross-cutting factor regardless of gender (Miranda-
Haines, 2004). In summary, the female and non- Mendizabal et al., 2019). This is since, at a cognitive
binary genders present a greater tendency to level, the person experiences profound hopelessness
suicidal ideation, while the male gender tends to about the future, accompanied by death's perception
commit suicide. This tendency could be related to as the only way out (Echeburúa, Psicología, Vasco,
how the genders proceed, where women tend to be & Ehu, 2015).
more reflective (Bahamón Muñetón, Vianchá Anxiety and distress, identified among the risks
Pinzón, Alarcón Alarcón, & Bohórquez Olaya, that occur in college students, are negative feelings
2012); on the contrary, men tend to be more that increase the likelihood of suicidal thoughts and
impulsive and concrete (Peñas-Lledó, Fernández, & ideation considerably (Dachew et al., 2018;
Waller, 2004). From a hetero ethnographic perspective, Eisenberg et al., 2007; Johnson & Hayes, 2003;
young adult students (18-24 years old) have been Kaparounakia Chrysi K. et al., 2020; Ross et al.,
prone to suicidal thoughts and ideation, even before 2020). On the one hand, people suffering from
the COVID-19 pandemic (Farrell et al., 2017). In anxiety present fears of loss of control and
this specific group of young people, there is an emotional intensity; these symptoms are also
increased burden of individual pressures or associated with panic attacks connected to cognitive
responsibilities. This, together with inexperience concerns, such as feeling a loss of sanity or control
and, in more extreme cases, the fear of

REVISTA ARGENTINA
2021, Vol. XXX, N°2, 390- DE CLÍNICA
 396 Jonathan Martínez-Líbano, María Mercedes Yeomans Cabrera
dying (Capron et al., 2012). This, in turn, can lead to cultural, or economic and have different impacts on
anxiety disorders, which can severely affect different groups (The Australian Curriculum, 2021).
people's lives, impairing health, work, family, and From this perspective, COVID-19 is a disease that has
personal relationships. Among these disorders are wreaked havoc in all areas of life, not only because
generalized anxiety disorders, panic disorder, of its high mortality rate but also because of its
phobias, social anxiety disorder, obsessive- political, social, educational, and economic
compulsive disorder, and post-traumatic stress consequences (Martínez-Líbano, 2020).
disorder (American Psychological Association, From the political perspective, public policies
2016). have seen the need to restrict personal freedoms
Although the medical impacts of COVID-19 are (Tisdell, 2020), implementing curfews, quarantines,
notable, the pandemic's interpersonal, financial, and and military support in the streets, among other
social consequences are likely to have a more measures (Yen-Hao Chu, Alam, Larson, & Lin, 2020).
significant and more sustained effect on Many criticize the political action, indicating that
psychological health (Madigan et al., 2020), both in the measures have been insufficient, late, or
the short and long term (C. L. Park et al., 2021). motivated by intentions unrelated to the pandemic,
Research on the psychological effects of COVID-19 which has caused great political tension in different
has found elevated levels of anxiety, depression, countries and among them (Wenham, 2021). On the
and sleep disturbance in the general population other hand, there is a series of negative feelings
(Huang & Zhao, 2020). There is now considerable towards the political class since before the
empirical evidence on the effects of COVID-19 on the coronavirus, which has devalued the democratic
psychological health of the population (Gruber et al., structures regarding the pandemic crisis's response
2020a). These include increased family and (Flinders, 2020). Moreover, the way countries
occupational stress, increased health anxiety due to relate to each other has been disrupted by the
fear of illness or contagion (Asmundson et al., pandemic's rapid spread and will probably never be
2020), as well as job loss and financial insecurity, the same again (Brown & Wang, 2020).
fear of lack of essential supplies, fear of infection, From a social perspective, the confinement,
loss of resources, supports and interpersonal social isolation and interruption of daily life during
connection, and possible separation and/or death of the COVID-19 period have impacted the population to
loved ones (Gruber et al., 2020b). a great extent (Tasnim et al., 2020), becoming an
epidemic that affects all aspects of human life
3. Contextual Factors (Nguyen, Nguyen, & Le, 2021). In this sense, COVID-
The pandemic has brought a decline in the 19, has been characterized by presenting three
quality of life and mental health of people traumatic components: (i) fears of present and
worldwide, and students in higher education future infections, (ii) widespread economic impact,
institutions would not be exempt from such and (iii) disruption and isolation from routine (Kira
consequences (Kaparounaki et al., 2020). Many et al., 2020). Thus, the confinement generated by
factors can lead college students to be particularly this pandemic meant, for many people, a radical
vulnerable and predisposed to suicidal ideation, change in lifestyle, avoiding contact with friends
creating a public health crisis (Tasnim et al., 2020): and family and, in addition, stopping activities not
life instability and existing mental and physical related to work (Corvo & Caro, 2020).
health problems (Gurung & Stone, 2020), From the same social perspective, another risk
uncertainty about the future and loss of autonomy factor was isolation. Several authors report that
(Gruber et al., 2020b), the sudden transition to social isolation has historically been implicated as a
online learning (Besser, Flett, & Zeigler-Hill, 2020), factor that directly and fundamentally influences
high levels of stress and burnout (Humphrey, 2013), suicidal ideation and behavior (Masuda, Kurahashi, &
feelings of tension, fear of infection, insomnia and Onari, 2013; Trout, 1980). The low quality of the
low mood (Yang, Tu, & Dai, 2020), increased information received and the low tolerance to
psychological distress (Hamza, Ewing, Heath, & uncertainty increase the possibility of suicidal
Goldstein, 2020), increased moderate depression to ideation and thoughts (Zerach & Levi‐Belz, 2019).
severe depression, self-harm, and suicidal ideation The subjective feeling of loneliness has a significant
and emotional distress due to COVID-19 (Xin, Luo, impact on people (Calati et al., 2019). However,
She, Yu, Wang, et al., 2020), among others. other research has reported that social isolation has
When we speak of contextual factors, we refer affected young people to a lesser extent due to their
to characteristics of the environment that affect more significant social network interaction (Orben,
behavior; these factors can be personal, social, Tomova, & Blakemore, 2020). These have been
positively associated with psychological well-

REVISTA ARGENTINA
2021, Vol. XXX, N°2, 390- DE CLÍNICA
 397 Jonathan Martínez-Líbano, María Mercedes Yeomans Cabrera
being (Doo-Hun & Ghee-Young, 2020). On the other students. This is since in homes with drug use, the
hand, when referring to the psychological and absence of family warmth, lack of communication
psychosocial implications of covid on students, we with parents, and permanent family discord have
found a need to present emotional containment been observed (Larraguibel, González, Martínez, &
plans to the entire school community; they will Valenzuela, 2000).
serve to deal with the social crisis context; it was
also found that the psychological and pedagogical 4. Health Factors
impact of social restriction and online education In this review, sleep disorders were associated
should be analyzed. Strategies should be sought to with increased suicidal thoughts and suicidal
mitigate the psychological impact of confinement ideation, coinciding with other studies in which
at home—this includes providing access to sleep quality (Fekih-Romdhane et al., 2021; Soares et
accessible, friendly platforms that minimize al., 2020) and insomnia have been identified as risk
technical issues (Yeomans Cabrera & Silva Fuentes, factors for suicidal ideation (Chu et al., 2016).
2020). However, depending on the student, the Insomnia directly impacts the mood of the sufferer,
decrease in face-to-face contact for youth may be manifesting itself with irritability, fatigue,
less detrimental due to widespread access to digital headache, appetite alterations, accident proneness,
forms of social interaction through social or difficulty in attending and concentrating on
networking technologies (Orben et al., 2020). simple tasks, which increases the risk of suicidal
On the other hand, stress and stressful life ideation, even in pre-pandemic contexts (Escobar,
events (such as living in a pandemic like COVID-19) Quijano, & Calvo, 2017). Because it is during sleep that
are situations that elevate suicidal ideation and are all physical and psychological functions of the
phenomena that occur together regularly human being are restored and regulated (Balk, de
(Brailovskaia, Teismann, & Margraf, 2020; Jonge, Oerlemans, & Geurts, 2019), good quality
Rodríguez-hidalgo et al., 2020). The person, feeling sleep is of utmost importance for the body's proper
overwhelmed by various stressors and life changes, functioning. It is a fact that not sleeping brings
perceives suicide as a solution to his or her harmful consequences for people (Cirelli & Tononi,
problems (Denneson et al., 2015). 2008), since the brain activity that develops during
It adds the low social support perceived in sleep allows the body to function (Fernandez &
university students, which is an essential element in Lüthi, 2020). Poor sleep quality affects people's
the appearance of suicidal ideation and thoughts; this health (Bernert, Turvey, Conwell, & Joiner, 2014;
same idea has been manifested in contexts outside Leng et al., 2015), affecting moods and cognitive
covid (Dachew et al., 2018; Soares et al., 2020). functions (Belenky et al., 2003). All people require
Besides, a connection has been found between a minimum number of hours of sleep (Lowe, Safati,
suicidal thoughts and the negative view of social & Hall, 2017), However, sleep deprivation caused
support, such as exaggerating their perception of by different factors I all sectors (Chen et al., 2006;
conflict in interpersonal relationships (Arria et al., Costa, Accattoli, Garbarino, Magnavita, & Roscelli,
2009). 2013; Hoyos et al., 2020), including health and
In this review, financial distress is identified as contextual factors (Magnavita & Garbarino, 2017).
another contextual risk factor. This is in line with
other research where it is referred that financial Study implications
difficulty promotes suicidal ideation and thoughts This article is the first systematic review that
(Dachew et al., 2018). This same factor has a examines and summarizes the existing literature
statistically significant influence on the risk of associated with suicidal ideation and thoughts, the
depression (Areas et al., 2012) and increases the risk COVID-19 pandemic in the college student
of having mental health problems in general population, and the associated risk factors. Thus, a
(Eisenberg et al., 2007). Stressful events often precedent is established to develop studies that will
precede suicidal behaviors, and debt can be seen as a contribute to the prevention of suicide and promote
continuous source of stress (Bebbington, Jenkins, mental health in the university population.
Mcmanus, & Dennis, 2011), leading to suicidal
behavior (Chen et al., 2006). Limitations
Similarly, other contextual factors affect the There are certain limitations in this systemic
individual's mind, such as tobacco and substance use review; all the studies reviewed were conducted
(Dachew et al., 2018; Fekih-Romdhane, ElKhouni, through self-reports, leading to social desirability
Sassi, & Cheour, 2021), and alcohol dependence responses. Also, as they were online studies, there
(Decou & Skewes, 2016), which can increase suicidal
thoughts and ideation in college

REVISTA ARGENTINA
2021, Vol. XXX, N°2, 390- DE CLÍNICA
 398 Jonathan Martínez-Líbano, María Mercedes Yeomans Cabrera
may be a population that could not access the with studies conducted before the COVID-19
evaluation. All the studies were cross-sectional, so they pandemic. Among the risk factors found in the
were measured at a specific point in time. However, appearance of suicidal thoughts and behaviors in
it is difficult to extrapolate these results to the higher education students during the pandemic
general population, so causal inferences cannot be there are ethnographic, psychological, contextual, and
made. Also, most of the studies had a higher number health factors. Ethnographic factors include being
of women in the samples, so that this situation could female and non-binary. Psychological factors include
interfere with the data analysis. Concerning the scales depression, anxiety, stress, suicidal thoughts in the
used to evaluate suicidal ideation and suicidal past, family history of suicide attempts, own suicide
thoughts, although they are validated internationally attempts. Contextual factors include academic
(Hall et al., 2021; Lamela, Soreira, Matos, & Morais, performance problems and financial problems.
2020; S. H. Park et al., 2020), progress is required in Finally, health factors include sleep problems and
the application of much more specific scales such as smoking. It is necessary to emphasize this problem
the psychache scale (Holden, Mehta, Cunningham, & since students' mental health and future
Mcleod, 2001) and the suicidal behaviors professionals should also be a responsibility of
questionnaire revised scale (SBQR) (Linehan, 1996); university institutions.
These scales
have demonstrated superior performance in the
accurate identification of suicide and its REFERENCIAS
subcomponents, as evidenced in various [1] Alvarado, A., & Velez, L. (2016). Factores de
investigations (Liang et al., 2020; Troister, D’Agata, riesgo biopsicosociales predisponentes para
& Holden, 2015). The use of non-specific scales la conducta suicida en adolescentes de
could be the reason for not finding other risk factors dos unidades educativas fiscales de
identified by the literature associated with the Guayaquil, para promover factores
occurrence of suicidal ideation and thoughts in protectores (Universidad de Guayaquil.
college students, such as low self-esteem (Man & Facultad de Ciencias Médicas. Carrera de
Rrez, 2002; Thompson, 2010), hopelessness Medicina). Universidad de Guayaquil.
(Boduszek & Dhingra, 2016; Chioqueta & Stiles, Facultad de Ciencias Médicas. Carrera de
2007), stressful situations in the student's life Medicina. Retrieved from
(Brailovskaia et al., 2020), alcohol dependence http://repositorio.ug.edu.ec/handle/redug/3 6267
(Decou & Skewes, 2016), academic and financial [2] American Psychiatric Association. (2014).
problems (McLaughlin & Gunnell, 2020), and DSM V.pdf. Manual Diagnóstico y
dissatisfaction with academic performance Estadístico de Los Tratornos Mentales, p.
(Madadin et al., 2020). 1000. Retrieved from
All of the above should continue to motivate the https://www.bibliopsi.org/docs/guia/DSM
study of the effects of the pandemic in different V.pdf
populations around the world and, by the way, [3] American Psychological Association. (2016).
continue to delve into the mental health of higher Beyond worry: How psychologists help with
education students, who will be the ones called to anxiety disorders. American Psychological
lead the future of our society in the coming years. Association, 19, 1–2. Retrieved from
http://www.apa.org/helpcenter/anxiety.aspx
Future studies [4] Areas, U., Mojs, E., WarchoŁ-Biedermann, K.,
Further studies are needed to investigate the GŁowacka, M. D., Strzelecki, W., Ziemska, B.,
relationship between sleep quality and suicidal & Marcinkowski, J. T. (2012). Social and health
ideation, gender and suicidal ideation, and the care needs of elderly people living in the
Covid-19 pandemic's impact on suicide rates. countryside in poland. Annals of Agricultural
and Environmental Medicine, 19(4), 770–774.
CONCLUSIÓN [5] Arria, A. M., Grady, K. E. O., Caldeira, K. M.,
We can conclude that little research addresses Kathryn, B., Wilcox, H. C., Wish, E. D., …
suicidal ideation and thoughts in college students Wish,
during the COVID-19 pandemic period around the E. D. (2009). Suicide Ideation Among
world and none in Latin America. According to this College Students : A Multivariate
study, between 11.4% to 26.7% of the university Analysis Suicide Ideation Among College
population could present suicidal ideation and Students : A Multivariate
suicidal thoughts during the COVID-19 pandemic (x=̄ Analysis. 1118.
17.8%). This percentage is high and correlates https://doi.org/10.1080/1381111090304435 1

REVISTA ARGENTINA
2021, Vol. XXX, N°2, 390- DE CLÍNICA
 399 Jonathan Martínez-Líbano, María Mercedes Yeomans Cabrera
[6] Asmundson, G. J. G., Paluszek, M. M., Landry, Proximal Factors in Spanish University
C. A., Rachor, G. S., McKay, D., & Taylor, S. Students. Suicide an Life-Threatening
(2020). Do pre-existing anxiety-related and Behavior, 49(3), 881–898.
mood disorders differentially impact COVID- https://doi.org/https://doi.org/10.1111/sltb.
19 stress responses and coping? Journal of 12491
Anxiety Disorders, 74(July). [14] Boduszek, D., & Dhingra, K. (2016). Construct
https://doi.org/10.1016/j.janxdis.2020.10227 1 Validity of the Beck Hopelessness Scale (
[7] Bahamón Muñetón, M. J., Vianchá Pinzón, M. BHS ) Among University Students : A
A., Alarcón Alarcón, L. L., & Bohórquez Olaya, Multitrait – Multimethod Approach. 28(10),
C. I. (2012). Estilos individuales de 1325–1330.
Aprendizaje: implicaciones en la conducta [15] Boiett, E., Bert, F., Savatteri, A., Scattaglia, M.,
vocacional. Pensamiento Psicológico, 10(1), Ferrara, M., Langiano, E., … Siliquini, R. (2020).
129–144. Retrieved from Prevalence and predictors of stress, suicidal
http://www.scielo.org.co/scielo.php?script=s thoughts and depression in Italian university
ci_arttext&pid=S1657-89612012000100009 students. European Journal of Public Health,
[8] Balk, Y. A., de Jonge, J., Oerlemans, W. G. M., (30).
https://doi.org/https://doi.org/10.1093/eurp
& Geurts, S. A. E. (2019). Physical recovery, ub/ckaa165.055
mental detachment and sleep as predictors of
injury and mental energy. Journal of Health [16] Brailovskaia, J., Teismann, T., & Margraf, J.
Psychology, 24(13). (2020). Positive Mental Health, Stressful Life
https://doi.org/10.1177/1359105317705980 Events, and Suicide Ideation: A 2-Year Follow-
[9] Bebbington, P. E., Jenkins, R., Mcmanus, S., & Up Study. Crisis, 41(5), 383–388.
Dennis, M. S. (2011). Personal debt and https://doi.org/10.1027/0227-5910/a000652
suicidal ideation. (April). [17] Brown, K., & Wang, R. C. (2020). POLITICS
https://doi.org/10.1017/S003329171000126 1 AND SCIENCE: THE CASE OF CHINA AND
[10] Belenky, G., Wesensten, N. J., Thorne, D. R., THE CORONAVIRUS. Asian
Thomas, M. L., Sing, H. C., Redmond, D. P., … Affairs, 51(2).
Balkin, T. J. (2003). Patterns of performance https://doi.org/10.1080/03068374.2020.175
degradation and restoration during sleep 2567
restriction and subsequent recovery: A sleep [18] Calati, R., Ferrari, C., Brittner, M., Oasi, O.,
dose-response study. Journal of Sleep Olié, E., Carvalho, A. F., & Courtet, P. (2019).
Research, 12(1). Suicidal thoughts and behaviors and social
https://doi.org/10.1046/j.1365- isolation : A narrative review of the literature
2869.2003.00337.x population. Journal of Affective Disorders,
[11] Bernert, R. A., Turvey, C. L., Conwell, Y., & 245(September 2018), 653–667.
Joiner, T. E. (2014). Association of poor https://doi.org/10.1016/j.jad.2018.11.022
subjective sleep quality with risk for death by [19] Capron, D. W., Fitch, K., Medley, A., Blagg, C.,
suicide during a 10-year period a longitudinal, Mallott, M., & Joiner, T. (2012). Role of anxiety
population-based study of late life. JAMA sensitivity subfactors in suicidal ideation and
Psychiatry, 71(10). suicide attempt history. Depression and
https://doi.org/10.1001/jamapsychiatry.2014 Anxiety, 29(3), 195–201.
.1126 https://doi.org/10.1002/da.20871
[12] Besser, A., Flett, G. L., & Zeigler-Hill, V. [20] Chen, E. Y. H., Chan, W. S. C., Wong, P. W.
(2020). Adaptability to a sudden transition to C., Chan, S. S. M., Chan, C. L. W., Law, Y. W.,
online learning during the COVID-19 … Yip,
pandemic: Understanding the challenges for P. S. F. (2006). Suicide in Hong Kong: A case-
students. Scholarship of Teachingand control psychological autopsy study.
Learning in Psychology. Advance Online Psychological Medicine, 36(6), 815–825.
Publication. https://doi.org/10.1017/S003329170600724 0
https://doi.org/10.1037/stl0000198 [21] Chioqueta, A. P., & Stiles, T. C. (2007). The
[13] Blasco, M. J., Vilagut, G., Almenara, J., Roca, Relationship Between Psychological Buffers ,
M., Piqueras, J. A., Gabilondo, A., … Alonso, J. Hopelessness , and Suicidal Ideation
(2019). Suicidal Thoughts and Behaviors: Identification of Protective Factors. 28(2),
Prevalence and Association with Distal and 67– 73. https://doi.org/10.1027/0227-
5910.28.2.67
[22] Chu, C., Hom, M. A., Rogers, M. L., Ringer, F.
B., Hames, J. L., Suh, S., & Joiner, T. E. (2016).
REVISTA ARGENTINA
2021, Vol. XXX, N°2, 390- DE CLÍNICA
 400 Jonathan Martínez-Líbano, María Mercedes Yeomans Cabrera
Is Insomnia Lonely ? Exploring Thwarted 23(10).
Belongingness as an Explanatory Link https://doi.org/https://doi.org/10.1080/136
between Insomnia and Suicidal Ideation in 9118X.2019.1574860
a Sample of South Korean University [32] Echeburúa, E., Psicología, F. De, Vasco, P., &
Students. 12(5). Ehu, U. P. V. (2015). Las múltiples caras del
[23] Cirelli, C., & Tononi, G. (2008). Is sleep suicidio en la clínica psicológica The many
essential? PLoS Biology, Vol. 6. faces of suicide in the psychological clinic.
https://doi.org/10.1371/journal.pbio.006021 6 Terapia Psicológica, 33, 117–126.
[24] Coentre, R., Faravelli, C., & Figueira, M. L. https://doi.org/http://dx.doi.org/10.4067/S0
(2016). Assessment of depression and 718-48082015000200006
suicidal behaviour among medical [33] Eisenberg, D., Gollust, S. E., Golberstein, E., &
students in Portugal. 354–363. Hefner, J. L. (2007). Prevalence and Correlates
https://doi.org/10.5116/ijme.57f8.c468 of Depression , Anxiety , and Suicidality
[25] Cortés, A. (2013). Conducta suicida Among University Students. 77(4), 534–542.
adolescencia y riesgo. Revista Cubana de https://doi.org/10.1037/0002-9432.77.4.534
Medicina General Integral, 30(1), 132–139. [34] Elhadi, M., Buzreg, A., Bouhuwaish, A.,
Khaled, A., Alhadi, A., Msherghi, A., …
[26] Corvo, E., & Caro, W. De. (2020). COVID-19 Khaled,
and Spontaneous Singing to Decrease
Loneliness , Improve Cohesion , and Mental A. (2020). Psychological Impact of the Civil
Well-Being : An Italian Experience. War and COVID-19 on Libyan Medical
Psychological Trauma:Theory, Research, Students: A Cross-Sectional Study. Frontiers in
Practice, and Policy, 12, 247–248. Retrieved Psychology, 11, 570435.
from https://psycnet.apa.org/fulltext/2020- https://doi.org/10.3389/fpsyg.2020.570435
44059-001.pdf [35] Epstein, S., Roberts, E., Sedgwick, R., Finning, K.,
[27] Costa, G., Accattoli, M. P., Garbarino, S., Ford, T., Dutta, R., & Downs, J. (2018). Poor
Magnavita, N., & Roscelli, F. (2013). Sleep school attendance and exclusion:
disorders and work: Guidelines for health A systematic review protocol on educational
surveillance, risk management and prevention risk factors for self-harm and suicidal
[I disturbi del sonno in ambito lavorativo: behaviours. BMJ Open, 8(12), 1–5.
Indirizzi di sorveglianza sanitaria, prevenzione e https://doi.org/10.1136/bmjopen-2018-
gestione del rischio]. Medicina Del Lavoro, 023953
104(4). [36] Escobar, F., Quijano, M., & Calvo, J. (2017).
[28] Dachew, B. A., Bifftu, B. B., Tiruneh, B. T., Evaluación del Insomnio como Factor de
& Anlay, D. Z. (2018). Suicidal thoughts among Riesgo para Suicidio. Revista de La Facultad de
university students in Ethiopia. Annals of Ciencias Médicas, 74(1), 37–45.
General Psychiatry, 17(1), 1–5. [37] Farrell, S., Kapur, N., While, D., Appleby, L., &
https://doi.org/10.1186/s12991-017-0172-0 Windfuhr, K. (2017). Suicide in a national
[29] Decou, C. R., & Skewes, M. C. (2016). student mental health patient population,
Symptoms of Alcohol Dependence 1997-2012. Crisis, 38(2), 82–88.
Predict Suicide Ideation Among https://doi.org/10.1027/0227-5910/a000412
Alaskan Undergraduates. [38] Fekih-Romdhane, F., ElKhouni, C., Sassi, H., &
https://doi.org/10.1027/0227-5910/a000373 Cheour, M. (2021). The Role of Personal
[30] Denneson, L. M., Teo, A. R., Ganzini, L., Factors and Learning Environment in Suicidal
Helmer, D. A., Bair, M. J., & Dobscha, S. K. Ideation Among Tunisian Medical Students.
(2015). Military Veterans’ Experiences with Crisis, 42, 20–31.
Suicidal Ideation: Implications for https://doi.org/https://doi.org/10.1027/022 7-
Intervention and Prevention. Suicide and Life- 5910/a000678
Threatening Behavior, 45(August), 399–414. [39] Fernandez, L. M. J., & Lüthi, A. (2020). Sleep
https://doi.org/10.1111/sltb.12136 spindles: Mechanisms and functions.
[31] Doo-Hun, C., & Ghee-Young, N. (2020). The Physiological Reviews, 100(2).
influence of social media use on attitude https://doi.org/10.1152/physrev.00042.2018
toward suicide through psychological well- [40] Flinders, M. (2020). Democracy and the
being, social isolation, and social support. Politics of Coronavirus: Trust, Blame and
Information, Communication & Society, Understanding. Parliamentary Affairs.
https://doi.org/10.1093/pa/gsaa013
[41] Freeman, A., Mergl, R., Kohls, E., Székely, A.,

REVISTA ARGENTINA
2021, Vol. XXX, N°2, 390- DE CLÍNICA
 401 Jonathan Martínez-Líbano, María Mercedes Yeomans Cabrera
Gusmao, R., Arensman, E., … Rummel-Kluge, Latent Classes. 67(1), 104–114.
C. (2017). A cross-national study on gender [49] Hedman-Robertson, A. S. (2018).
differences in suicide intent. BMC Psychiatry, Undergraduate Students’ exposure,
17(1), 1–11. https://doi.org/10.1186/s12888- knowledge, utilization, and intended use of
017-1398-8 the national suicide prevention lifeline. Crisis,
[42] Granato, S. L., Smith, P. N., & Selwyn, C. N. 39(2), 110–118.
(2015). Acquired capability and masculine https://doi.org/10.1027/0227-5910/a000480
gender norm adherence: Potential pathways to [50] Holden, R. R., Mehta, K., Cunningham, E. J., &
higher rates of male suicide. Psychology of Mcleod, L. D. (2001). Development and
Men and Masculinity, 16(3), 246–253. Preliminary Validation of a Scale of Psychache.
https://doi.org/10.1037/a0038181 Canadian Journal of Behavioural Science,
[43] Gruber, J., Prinstein, M. J., Clark, L. A., 33(4), 224–232. Retrieved from
Rottenberg, J., Abramowitz, J. S., Albano, A. https://recursos-
M., … Weinstock, L. M. (2020a). Mental electronicos.udla.cl:2145/doi/10.1037/h0087 144
Health and Clinical Psychological Science in the [51] Hoyos, C. M., Gordon, C., Terpening, Z.,
Time of COVID-19: Challenges, Opportunities, Norrie, L., Lewis, S. J. G., Hickie, I. B., &
and a Call to Action. American
Psychologist. Naismith, S. L. (2020). Circadian rhythm and
sleep alterations in older people with lifetime
https://doi.org/10.1037/amp0000707 depression: A case-control study. BMC
[44] Gruber, J., Prinstein, M. J., Clark, L. A., Psychiatry, 20(1).
Rottenberg, J., Abramowitz, J. S., Albano, A. https://doi.org/10.1186/s12888-020-02606-z
M., … Weinstock, L. M. (2020b). Mental [52] Huang, Y., & Zhao, N. (2020). Generalized
Health and Clinical Psychological Science in anxiety disorder, depressive symptoms and
the Time of COVID-19: Challenges, sleep quality during COVID-19 outbreak in
Opportunities, and a Call to Action. American China: a web-based cross-sectional survey.
Psychologist. Psychiatry Research, 288, 1–3. Retrieved
https://doi.org/10.1037/amp0000707 from
[45] Gurung, R. A. R., & Stone, A. M. (2020). https://pubmed.ncbi.nlm.nih.gov/32325383/
Scholarship of Teaching and Learning in [53] Humphrey, K. R. (2013). Using a Student-Led
Psychology Learning During the Pandemic. Support Group to Reduce Stress and Burnout
Cholarship of Teaching and Learning in Among BSW Students. Social Work with
Psychology. Advance Online Publication. Groups, 36(1), 73–84.
Retrieved from https://doi.org/10.1080/01609513.2012.712 905
https://psycnet.apa.org/record/2020-78359- 001 [54] Johnson, C. V., & Hayes, J. A. (2003). Troubled
[46] Hall, B. J., Patel, A., Lao, L., Liem, A., spirits: Prevalence of predictors of religious
Mayawati, and spiritual concerns among university
E. H., & Tjipto, S. (2021). Structural validation students and counseling center clients.
of The Patient Health Questionnaire-9 (PHQ- Journal of Counseling Psychology, 50(4),
9) among Filipina and Indonesian female 409– 419. https://doi.org/10.1037/0022-
migrant domestic workers in Macao: 0167.50.4.409
STRUCTURAL VALIDATION OF PHQ-9. [55] Kaparounaki, C. K., Patsali, M. E., Mousa, D.-P.
Psychiatry Research, 295(June 2020), 113575. V, Papadopoulou, E. V. K., Papadopoulou, K. K.
https://doi.org/10.1016/j.psychres.2020.113 575 K., & Fountoulakis, K. N. (2020, August).
[47] Hamza, C. A., Ewing, L., Heath, N. L., & University students’ mental health amidst the
Goldstein, A. L. (2020). When Social Isolation COVID-19 quarantine in Greece. Psychiatry
Is Nothing New: A Longitudinal Study Research, Vol. 290, p. 113111.
Psychological Distress During COVID-19 https://doi.org/10.1016/j.psychres.2020.113 111
Among University Students With and Without [56] Kaparounakia Chrysi K., Patsalia, M. E.,
Preexisting Mental Health Concerns. Mousaa, D.-P. V., Papadopouloua, E. V. K.,
Canadian Psychology. Papadopouloua, K. K. K., & Fountoulakis, K. N.
https://doi.org/10.1037/cap0000255 (2020). University students’ mental health
[48] Hayes, J. A., Petrovich, J., Janis, R. A., Yang, Y., amidst the COVID-19 quarantine in Greece.
Castonguay, L. G., & Locke, B. D. (2020). Psychiatry Research Journal, (January).
Suicide Among College Students in
Psychotherapy : Individual Predictors
and

REVISTA ARGENTINA
2021, Vol. XXX, N°2, 390- DE CLÍNICA
 402 Jonathan Martínez-Líbano, María Mercedes Yeomans Cabrera
[57] Kira, I. A., Shuwiekh, H. A. M., Alhuwailah, Neuroscience and Biobehavioral Reviews, Vol.
A., Ashby, J. S., Sous, M., Sous, F., … Jamil, 80.
H. J. (2020). Traumatology The Effects of https://doi.org/10.1016/j.neubiorev.2017.07. 010
COVID-19 and Collective Identity Trauma ( [66] Lozano, R., Naghavi, M., Foreman, K., Lim, S.,
Intersectional Discrimination ) on Social Shibuya, K., & Aboyans, V. (2012). Global and
Status and Well- Being. Traumatology. regional mortality from 235 causes of death
Retrieved from for 20 age groups in 1990 and 2010: a
https://psycnet.apa.org/fulltext/2020-87181- systematic analysis for the Global Burden of
001.pdf Disease Study. The Lancet, 380(9859), 2095–
[58] Klonsky, E. D., & May, A. M. (2015). The 2128.
Three- Step Theory (3ST): A New Theory of https://doi.org/https://doi.org/10.1016/S014 0-
Suicide Rooted in the “Ideation-to-Action” 6736(12)61728-0
Framework. International Journal of Cognitive [67] Lytle, M. C., Blosnich, J. R., De Luca, S. M., &
Therapy, 8(2). Brownson, C. (2018). Association of Religiosity
https://doi.org/https://doi.org/10.1521/ijct.2 With Sexual Minority Suicide Ideation and
015.8.2.114 Attempt. American Journal of Preventive
[59] Lamela, D., Soreira, C., Matos, P., & Morais, A.
(2020). Systematic review of the factor Medicine, 54(5), 644–651.
https://doi.org/10.1016/j.amepre.2018.01.0 19
structure and measurement invariance of the [68] Madadin, M., Menezes, R. G., Alassaf, M. A.,
patient health questionnaire-9 (PHQ-9) and Almulhim, A. M., Abumadini, M. S., Alnemer,
validation of the Portuguese version in F. A., … Alramadhan, A. K. (2020). Crisis :
community settings. Journal of Affective The Journal of Crisis Suicidal Ideation
Disorders, 276(June), 220–233. Among Medical • Students in Dammam ,
https://doi.org/10.1016/j.jad.2020.06.066 Saudi Arabia.
[60] Larraguibel, M., González, P., Martínez, V., & [69] Madigan, S., Racine, N., Cooke, J. E., Korczak,
Valenzuela, R. (2000). Factores de riesgo de la D. J., Madigan, S., Racine, N., … Korczak, D. J.
conducta suicida en niños y adolescentes.
Revista Chilena de Pediatria, 71(3).
https://doi.org/http://dx.doi.org/10.4067/S0 (2020). Canadian Psychology / Psychologie
370-41062000000300002 canadienne and Future Directions and Future
[61] Leng, Y., Cappuccio, F. P., Wainwright, N. W. Directions.
J., Surtees, P. G., Luben, R., Brayne, C., & CanadianPsychology/Psychologiecanadienne.
Khaw, K. T. (2015). Sleep duration and risk of Retrieved from
fatal and nonfatal stroke: A prospective study https://psycnet.apa.org/fulltext/2020-80476-
and meta-analysis. Neurology, 84(11). 001.pdf
https://doi.org/10.1212/WNL.000000000000 [70] Magnavita, N., & Garbarino, S. (2017). Sleep,
1371 health and wellness at work: A scoping
[62] Lester, D., Wood, P., Williams, C., & Haines, J. review. International Journal of
(2004). Motives for suicide - A study of Environmental Research and Public Health,
Australian suicide notes. Crisis, 25(1), 33–34. Vol. 14.
https://doi.org/10.1027/0227-5910.25.1.33 https://doi.org/10.3390/ijerph14111347
[63] Liang, J., Kõlves, K., Lew, B., Leo, D. De, Yuan, [71] Man, A. F. De, & Rrez, B. I. B. G. (2002).
L., & Talib, M. A. (2020). Coping Strategies and The
Relationship Between Level of Self-Esteem
and
Suicidality : A Cross-Sectional Study From Suicidal Ideation With Stability of Self-
Esteem
China. FRONTIERS IN PSYCHOLOGY, as Moderator. 235–238.
11(March), 1–6. [72] Martínez-Líbano, J. (2020). Salud mental en
https://doi.org/10.3389/fpsyt.2020.00129 estudiantes chilenos durante confinamiento
[64] Linehan, M. M. (1996). Suicidal behaviors por Covid-19 : revisión bibliográfica Mental
questionnaire (University of Washington). neurocognitive consequences of sleep
University of Washington. Retrieved from restriction: A meta-analytic review.
https://wbma.cc/wp-
content/uploads/2018/01/Suicidal_Beh_Que
st_pre_assessment.pdf
[65] Lowe, C. J., Safati, A., & Hall, P. A. (2017). The

REVISTA ARGENTINA
2021, Vol. XXX, N°2, 390- DE CLÍNICA
 403 Jonathan Martínez-Líbano, María Mercedes Yeomans Cabrera
Health in Chilean Students during
Confinement by Covid-19 : literature review.
Revista Educación Las Américas, 2.
https://doi.org/https://doi.org/10.35811/rea
.v10i2.126 Cada
[73] Masuda, N., Kurahashi, I., & Onari, H. (2013).
Suicide Ideation of Individuals in Online
Social Networks. PLoS ONE, 8(4), 1–8.

REVISTA ARGENTINA
2021, Vol. XXX, N°2, 390- DE CLÍNICA
 404 Jonathan Martínez-Líbano, María Mercedes Yeomans Cabrera
https://doi.org/10.1371/journal.pone.00622 62 https://doi.org/10.4324/9780203509241-9
[74] May, A. M., & Klonsky, E. D. (2016). [83] Ordóñez Monak, I. A., Franco Agudelo, S. A.,
“Impulsive” Suicide Attempts: What Do We & González Ortiz, J. O. (2013). Caracterización
Really Mean? Personality Disorders: Theory, sociodemográfica de los suicidas adultos
Research, and Treatment, 7(3), 293–302. mayores de 60 años: Bogotá 2003-2007.
https://doi.org/10.1037/per0000160 Revista Colombiana de Psiquiatria, 43(SUPPL.
[75] McAuliffe, C., Corcoran, P., Keeley, H. S., & 1). https://doi.org/10.1016/j.rcp.2013.11.006
Perry, I. J. (2003). Risk of suicide ideation [84] Organización Mundial de la Salud. (2020).
associated with problem-solving ability and Suicidio. Retrieved from Suicido website:
attitudes toward suicidal behavior in https://www.who.int/es/news-room/fact-
University Students. Crisis, 24(4), 160–167. sheets/detail/suicide
https://doi.org/10.1027//0227- 5910.24.4.160 [85] Page, M., McKenzie, J., Bossuyt, P., Boutron,
[76] McLaughlin, J. C., & Gunnell, D. (2020). Suicide I., Hoffmann, T., Mulrow, C., … Moher, D.
Deaths in University Students in a UK City (2020). Updating guidance for reporting
between 2010 and 2018 - Case Series. Crisis: systematic reviews: development of the
PRISMA 2020 statement. (September).
The Journal of Crisis Intervention and https://doi.org/https://doi.org/10.31222/osf.
Suicide Prevention, 1–8.
https://doi.org/10.1027/0227-5910/a000704 io/jb4dx
[77] Miranda-Mendizabal, A., Castellví, P., Alayo, [86] Park, C. L., Finkelstein-Fox, L., Russell, B. S.,
I., Vilagut, G., Blasco, M. J., Torrent, A., … Fendrich, M., Hutchison, M., & Becker, J.
Alonso, J. (2019). Gender commonalities and (2021). Americans’ distress early in the
differences in risk and protective factors of COVID-19 pandemic: Protective resources and
suicidal thoughts and behaviors: A cross- coping strategies. Psychological Trauma :
sectional study of Spanish university students. Theory, Research, Practice and Policy.
Depression and Anxiety, 36(11), 1102–1114. https://doi.org/10.1037/tra0000931
https://doi.org/10.1002/da.22960 [87] Park, S. H., Song, Y. J. C., Demetriou, E. A.,
[78] Moher, D., Liberati, A., Tetzlaff, J., Altman, D. Pepper, K. L., Thomas, E. E., Hickie, I. B., &
G., & Group, T. P. (2009). Preferred Reporting Guastella, A. J. (2020). Validation of the 21-
Items for Systematic Reviews and Meta- item Depression, Anxiety, and Stress Scales
Analyses : The PRISMA Statement. PLoS Med, (DASS-21) in individuals with autism spectrum
6(7). disorder. Psychiatry Research, 291(February),
https://doi.org/10.1371/journal.pmed.10000 97 113300.
[79] Naderi, F., & Esmaili, E. (2009). Collet-Lester https://doi.org/10.1016/j.psychres.2020.113 300
Fear of Death Scale Validation and Gender- [88] Patsali, M E, Mousa, D.-P. V., Papadopoulou,
Based Comparison of Death Anxiety, Suicide E. V. K., Papadopoulou, K. K. K., Kaparounaki,
Ideation and Life Satisfaction in University C. K., Diakogiannis, I., & Fountoulakis, K. N.
Students. Journal of Applied Sciences, 9, (2020). University students’ changes in mental
3308–3316. health status and determinants of behavior
[80] Nguyen, T. M., Nguyen, G., & Le, H. (2021). during the COVID-19 lockdown in Greece.
Traumatology The Influence of COVID-19 Psychiatry Research, 292.
Stress on Psychological Well-Being https://doi.org/10.1016/j.psychres.2020.113 298
Among Vietnamese Adults : The Role of [89] Patsali, Mikaella E, Mousa, D.
Self- Compassion and Gratitude. V, Papadopoulou, E. V. K., Papadopoulou, K.
[81] O’Connor, R. C., & Kirtley, O. J. (2018). The K. K., Kaparounaki, C. K., & Diakogiannis, I.
integrated motivational–volitional model of (2020). University students ’ changes in
suicidal behaviour. Philosophical Transactions mental health status and determinants of
of the Royal Society B, 373. behavior during the COVID-19 lockdown in
[82] Orben, A., Tomova, L., & Blakemore, S. (2020). Greece. Psychiatry Research, 292(July),
The effects of social deprivation on adolescent 113298.
development and mental health. The Lancet https://doi.org/10.1016/j.psychres.2020.113 298
Child & Adolescent Health, 4(8), 634–640. [90] Peñas-Lledó, E., Fernández, J. D., & Waller, G.
(2004). Association of anger with bulimic and

REVISTA ARGENTINA
2021, Vol. XXX, N°2, 390- DE CLÍNICA
 405 Jonathan Martínez-Líbano, María Mercedes Yeomans Cabrera
other impulsive behaviours among non- ideation to action theoretical models of
clinical women and men. European Eating suicidal thoughts and behavior. Psychological
Disorders Review, 12(6). Assessment.
https://doi.org/10.1002/erv.588 https://doi.org/10.1037/pas0000889
[91] Pereira, A., & Cardoso, F. (2015). Suicidal [100]Sivertsen, B., Hysing, M., Knapstad, M.,
ideation in university students: Prevalence Harvey, A. G., Reneflot, A., Lønning, K. J.,
and association with school and gender. & O’Connor, R. C. (2019). Suicide attempts and
Paideia, 25(62), 299–306. non-suicidal self-harm among university
https://doi.org/10.1590/1982- students: prevalence study. BJPsych Open,
43272562201503 5(2). https://doi.org/doi:10.1192/bjo.2019.4
[92] Pramukti, I., Strong, C., Sitthimongkol, Y., [101] Soares, F. C., Hardman, C. M., Rangel Junior, J.
Setiawan, A., Pandin, M. G. R., Yen, C.-F., … Ko, F. B., Bezerra, J., Petribu, K., Mota, J., … Lima,
N.-Y. (2020). Anxiety and Suicidal Thoughts R. A. (2020). Secular trends in suicidal ideation
During the COVID-19 Pandemic: Cross- and associated factors among adolescents.
Country Comparative Study Among Brazilian Journal of Psychiatry, 42(5), 475–
Indonesian, Taiwanese, and Thai University 480. https://doi.org/10.1590/1516-4446-
Students. Journal of Medical Internet 2019-0783

Research, 22(12), e24487. [102] Tasnim, R., Islam, S., Hossain, S. S., Sikdera, T.,
https://doi.org/10.2196/24487 & Potenza, M. (2020). Suicidal ideation among
[93] Rodríguez-hidalgo, A. J., Dios, I., Holden, R. R., Bangladeshi university students early during the
Rodriguez-Hidalgo, A. J., Pantaleon, Y., Dios, I., COVID-19 pandemic: Prevalence estimates
& Falla, D. (2020). Fear of COVID-19, Stress, and correlates. CHILDREN AND YOUTH
and Anxiety in University Undergraduate SERVICES REVIEW, 119.
Students: A Predictive Model for Depression. https://doi.org/10.1016/j.childyouth.2020.10 5703
FRONTIERS IN PSYCHOLOGY, 11(November). [103] The Australian Curriculum. (2021). Contextual
https://doi.org/10.3389/fpsyg.2020.591797 factors. Retrieved April 1, 2021, from Glossary
[94] Ross, S. G., Dehay, T., & Deiling, M. (2020). website:
Crisis : The Journal of Crisis The Suicide https://www.australiancurriculum.edu.au/f- 10-
Prevention for College Student curriculum/health-and-physical-
Gatekeepers Program A Pilot Study. education/Glossary/?term=contextual+factor s#
[95] Rudd, D. (1989). The Prevalence of Suicidal [104] Thompson, A. H. (2010). The suicidal process
Ideation among College Students. Suicide an and self-esteem. Crisis, 31(6), 311–316.
Life-Threatening Behavior, 19(2), 173–183. https://doi.org/10.1027/0227-5910/a000045
https://doi.org/https://doi.org/10.1111/j.194 3- [105]Tisdell, C. A. (2020). Economic, social and
278X.1989.tb01031.x political issues raised by the COVID-19
[96] SAMHSA. (2019). National Suicide Prevention pandemic. Economic Analysis and Policy, 68,
Lifeline. Retrieved. 17–28.
[97] Sarmiento, C., & Aguilar, J. (2011). Predictores https://doi.org/10.1016/j.eap.2020.08.002
familiares y personales de la ideación suicida en [106]Troister, T., D’Agata, M. T., & Holden, R. R.
adolescentes. Psicología y Salud, 21(55), 25– (2015). Suicide risk screening: Comparing the
30. Retrieved from Beck Depression Inventory-II, Beck
https://psicologiaysalud.uv.mx/index.php/psi Hopelessness Scale, and Psychache Scale in
cysalud undergraduates. Psychological Assessment,
[98] Schweitzer, R., McLean, J., & Klayich, M. 27(4), 1500–1506.
(1995). Suicidal Ideation and Behabiours https://doi.org/10.1037/pas0000126
among University Students in Australia. [107] Trout, D. L. (1980). The Role of Social Isolation
Australian & New Zealand Journal of in Suicide. Suicide and Life‐Threatening
Psychiatry, 29(3), 473–479. Behavior, Vol. 10, pp. 10–23.
https://doi.org/https://doi- https://doi.org/10.1111/j.1943-
org.recursosbiblioteca.unab.cl/10.3109/0004 278X.1980.tb00693.x
8679509064956 [108] Urrútia, G., & Bonfill, X. (2013). La
[99] Siddaway, A. P., Holm-Denoma, J., Witte, T. K., declaración prisma: un paso adelante en la
& Ruscio, J. (2021). Reexamining the latent mejora de las publicaciones de la revista
structure of suicidal thoughts using española de salud
taxometric analysis: Implications for testing

REVISTA ARGENTINA
2021, Vol. XXX, N°2, 390- DE CLÍNICA
 405 Jonathan Martínez-Líbano, María Mercedes Yeomans Cabrera
pública. Rev Esp Salud Pública, 99–102. Psychological Correlates of Mandatory
[109] Van Orden, K. A., Witte, T. K., Cukrowicz, K. Quarantine During the Initial COVID-19
C., Braithwaite, S. R., Selby, E. A., & Joiner, T. Outbreak in China. American Psychologist,
E. (2010). The Interpersonal Theory of Suicide. 75(5), 607–617. Retrieved from
Psychological Review, 117(2), 575–600. https://psycnet.apa.org/fulltext/2020-51214-
https://doi.org/10.1037/a0018697 002.pdf
[110]Villalobos-Galvis, F. H. (2009). Situation [118] Xiong, J., Lipsitz, O., Nasri, F., Lui, L. M. W.,
affecting the suicidal behavior in college and Gill, H., Phan, L., … McIntyre, R. S. (2020).
university students in San Juan de Pasto, Impact of COVID-19 pandemic on mental
Colombia. Salud Mental, 32(2), 165–171. health in the general population: A systematic
Retrieved from https://www-scopus- review. Journal of Affective Disorders,
com.recursosbiblioteca.unab.cl/record/displa y.uri? 277(June), 55– 64.
eid=2-s2.0- https://doi.org/10.1016/j.jad.2020.08.001
77953919731&origin=resultslist&sort=plf- [119]Yang, D., Tu, C., & Dai, X. (2020). The Effect
f&src=s&st1=&st2=&sid=ed0636afacddca09e of the 2019 Novel Coronavirus Pandemic on
72a629096c0467c&sot=b&sdt=b&sl=73&s=TI College Students in Wuhan. Psychological
TLE-ABS- Trauma: Theory, Research, Practice, and

KEY+%28%22suicide+ideation%22+AND+%22 Policy, 12, 6–14. Retrieved from

university+st https://psycnet.apa.org/fulltext/2020-41745-
[111] Wang, X., Hegde, S., Son, C., Keller, B., Smith, 001.pdf
A., & Sasangohar, F. (2020). Investigating [120] Yen-Hao Chu, I., Alam, P., Larson, H. J., & Lin,
Mental Health of US College Students During L. (2020). Social consequences of mass
the COVID-19 Pandemic: Cross-Sectional quarantine during epidemics: A systematic
Survey Study. Journal of Medical Internet review with implications for the COVID-19
Research, 22(9), e22817. response. Journal of Travel Medicine, Vol. 27.
https://doi.org/10.2196/22817 https://doi.org/10.1093/JTM/TAAA192
[112] Wathelet, M., Duhem, S., Vaiva, G., Baubet, T., [121] Yeomans Cabrera, M. M., & Silva Fuentes, A.
Habran, E., Veerapa, E., … D’Hondt, F. (2020). (2020). Pedagogical and Psychosocial
Factors Associated With Mental Health Implications of Quarantine by Covid-19 on
Disorders Among University Students in ChileanStudents. Revista Educación Las
France Confined During the COVID-19 Américas, 10, 106–117.
Pandemic. JAMA NETWORK OPEN, 3(10). https://doi.org/10.35811/rea.v10i0.78
https://doi.org/10.1001/jamanetworkopen.2 [122] Yi, S., Chang, E. C., Chang, O. D., Seward, N. J.,
020.25591 Mcavoy, L. B., Emmaleigh, R., … Hirsch, J. K.
[113]Wenham, C. (2021). What went wrong in the (2020). Crisis : The Journal of Crisis Coping and
global governance of covid-19? The BMJ, Vol. Suicide in College Students Does Being
372. https://doi.org/10.1136/bmj.n303 Optimistic Matter ? Crisis: The Journal of Crisis
[114]World Health Organization. (2014). Mental Intervention and Suicide Prevention.
health—Suicide prevention. https://doi.org/http://dx.doi.org/10.1027/02
[115] Wyman Battalen, A., Mereish, E., Putney, J., 27-5910/a000662
Sellers, C. M., Gushwa, M., & McManama [123] Zerach, G., & Levi‐Belz, Y. (2019). Intolerance
O’Brien, K. H. (2020). Associations of of Uncertainty Moderates the Association
Discrimination, Suicide Ideation Severity and Between Potentially Morally Injurious Events
Attempts, and Depressive Symptoms among and Suicide Ideation and Behavior Among
Sexual and Gender Minority Youth. Crisis. Combat Veterans. Journal of Traumatic Stress,
https://doi.org/10.1027/0227-5910/a000718 32(3), 424–436.
[116] Xin, M., Luo, S., She, R., Yu, Y., Li, L., Wang, https://doi.org/https://doi.org/10.1002/jts.2 2366
S.,
… Lau, J. T.-F. (2020). Negative cognitive and
psychological correlates of mandatory
quarantine during the initial COVID-19
outbreak in China. The American Psychologist,
75(5), 607–617.
https://doi.org/10.1037/amp0000692
[117] Xin, M., Luo, S., She, R., Yu, Y., Wang, S.,
Lin, D., … Lau, J. T. (2020). Negative Cognitive
and
REVISTA ARGENTINA
2021, Vol. XXX, N°2, 390- DE CLÍNICA

View publication