Adverse childhood experiences and their impact on suicidal ideation among medical students in Iran

Abstract

Background: Adverse childhood experiences (ACEs) are important predictors of long-term mental health outcomes, including suicidal ideation and suicidal behaviors. Understanding the prevalence and specific types of ACEs, and their relationship with suicide-related attitudes and ideation, is critical for targeted prevention. Methods: A cross-sectional study was conducted between June and September 2024 among 301 students at Qazvin University of Medical Sciences, Iran. Participants completed validated questionnaires assessing socio-demographics, ACEs (ACE-IQ), depression (BDI-II), anxiety (BAI), suicidal attitude, and lifetime suicidal ideation. Logistic regression was used to examine associations between ACE types, suicidal ideation, and suicide attitudes. Results: Overall, 70.8% of participants reported at least one ACE, with emotional neglect (59.8%), emotional abuse (20.6%), and physical abuse (17.3%) being most prevalent. Household dysfunction was significantly associated with suicidal ideation (OR = 2.13, p = 0.048), but no ACE category was linked to suicide attitudes. Positive suicide attitudes were reported by 12% of respondents, and lifetime suicidal ideation by 4.3%. Depression and anxiety scores showed no significant associations with ACEs, suicidal ideation, or suicide attitudes. Conclusion: A high prevalence of adverse childhood experiences was observed among medical students, along with an association between household dysfunction and suicidal ideation. Addressing family instability and fostering resilience in at-risk youth may reduce long-term suicide risk.