Prevalence and psychosocial and occupational predictors of suicidal behaviors among medical residents in Iran.

BACKGROUND: Medical residency is a demanding period often associated with elevated psychological distress and increased risk of suicidal behaviors (SB). This study aimed to assess the prevalence and identify key predictors of suicidal behaviors among medical residents. METHODS: This online survey was conducted in 2025 with 270 medical residents from Kermanshah University of Medical Sciences, Iran. The samples were selected through census, where the questionnaire link was sent to the samples via the most widely used social media in Iran (WhatsApp and Telegram). Data were collected using validated questionnaires including Suicidal Behaviors Questionnaire-Revised (SBQ-R), General Health Questionnaire (GHQ-28), Suicide Resilience Inventory-25 (SRI-25), and a resercher made questionnaire on occupational-academic problems. Logistic regression was used to identify predictors of suicidal behaviors. RESULTS: Nearly one-third of residents reported suicidal behaviors. Suicidal behavior was significantly higher among those had substance use (OR = 3.89, 95% CI: 1.32–7.49, P < 0.01), chronic disorders (OR = 2.78, 95% CI: 1.02–7.57, P < 0.05), and female gender (OR = 3.24, 95% CI: 1.19–8.63, P < 0.05). Higher occupational-academic problems (OR = 1.24, 95% CI: 1.06–1.44, P < 0.01), lower resilience (OR = 0.96, 95% CI: 0.93–0.99, P < 0.05), and higher problems in mental health (OR = 1.06, 95% CI: 1.01–1.10, P < 0.05), were associated with a higher likelihood of suicidal behaviors. The model explained up to 56% of the variance in suicidal behaviors. CONCLUSIONS: The findings emphasize the urgent need for comprehensive mental health strategies in residency programs, combining individual resilience training with systemic reforms addressing workload, gender-specific challenges, and substance use. Institutional policies must focus on reducing stigma and improving access to mental health resources to safeguard resident well-being.