The study team, led by Pius Agbalugo Odunze of the Department of Community Medicine at Gombe State University and the State Specialist Hospital Gombe, recruited 419 undergraduate students from six randomly selected faculties. Rather than relying on paper-based surveys distributed in lecture halls, the researchers used an electronic questionnaire shared through departmental WhatsApp groups, an approach that reflects how Nigerian students actually communicate and that allowed rapid, anonymous participation across a broad range of academic disciplines. Participants had a mean age of 22.8 years, with a standard deviation of 3.6 years, and 226 of them, or 53.9 percent, were male.

Depression was measured using the first eight items of the Patient Health Questionnaire-9, a widely validated instrument known as the PHQ-8 when used in this truncated form. The PHQ items map directly onto the diagnostic criteria for depressive disorders in major classification systems, asking respondents how often over the preceding two weeks they experienced problems such as depressed mood, loss of interest or pleasure, sleep disturbance, fatigue, appetite changes, difficulty concentrating, psychomotor slowing, and feelings of worthlessness. Each item is scored from zero to three, and a total score of ten or more was used as the threshold for probable depression, a cut-off with strong sensitivity and specificity for major depressive disorder in prior validation work.

Suicidal ideation was assessed separately using item 9 of the PHQ-9, the question that asks about thoughts of being better off dead or of hurting oneself in some way. Keeping this item distinct from the depression score is methodologically important, because it allowed the investigators to model suicidal ideation as its own outcome rather than treating it as an automatic byproduct of depressive symptoms. Overall, 111 students, or 26.5 percent of the sample, screened positive for depression, while 143 students, or 34.1 percent, reported suicidal ideation. The fact that suicidal thoughts were more prevalent than probable depression in this sample immediately signals that self-harm risk among these students is not confined to those with diagnosable mood disorders.

To identify which factors independently predicted each outcome, the researchers moved beyond simple descriptive statistics. Candidate variables were selected on the basis of epidemiological relevance and previous literature, and then refined using ten-fold cross-validated Least Absolute Shrinkage and Selection Operator regression, commonly known as LASSO. LASSO is a regularisation technique that penalises model complexity, effectively shrinking the coefficients of weak predictors toward zero and thereby guarding against overfitting in datasets where the number of events limits how many predictors can be reliably estimated. This is particularly relevant in psychiatric epidemiology, where spurious associations proliferate when analysts test many variables against a modest number of positive cases. The final multivariable logistic regression models were analysed in jamovi version 2.7.35 and R version 4.6.1, with adjusted odds ratios and 95 percent confidence intervals reported and statistical significance set at p less than 0.05.

The results paint a precise picture of who is most at risk. For depression, two factors emerged as independent predictors: being in the 300 level of study, which roughly doubled the odds of screening positive with an adjusted odds ratio of 2.30 and a confidence interval of 1.10 to 4.81, and having a history of chronic medical illness, which nearly tripled the odds, with an adjusted odds ratio of 3.09 and a confidence interval of 1.88 to 5.07. The 300-level finding is notable because it coincides with the academic stage at which coursework typically intensifies and the horizon of graduation and employment begins to loom, a period many educators describe as the pressure point of an undergraduate degree. The chronic illness result aligns with a substantial international literature showing that living with long-term conditions such as diabetes, sickle cell disease, or HIV imposes a psychological toll that compounds academic stress.

For suicidal ideation, the predictors were more numerous and, in one case, startlingly strong. Students who screened positive for depression had more than sixteen-fold higher odds of reporting suicidal thoughts, with an adjusted odds ratio of 16.74 and a confidence interval of 9.21 to 30.42, making depression by far the dominant predictor of self-harm risk in this population. A history of chronic medical illness again played a role, raising the odds by 89 percent, with an adjusted odds ratio of 1.89 and a confidence interval of 1.04 to 3.41. Most strikingly, a history of physical or sexual abuse more than doubled the odds of suicidal ideation, with an adjusted odds ratio of 2.02 and a confidence interval of 1.03 to 3.96. This finding underscores that trauma, even when it occurred years before university enrolment, casts a long shadow over mental health in early adulthood and operates partly through pathways distinct from current depressive symptoms.

The public health implications extend well beyond a single campus. Depression and suicidal ideation among university students frequently exceed prevalence rates observed in the general population, and the consequences are well documented: poorer academic performance, dropout, reduced employability, and, in the most tragic cases, death. In low- and middle-income countries, where mental health services are chronically underfunded and psychiatrists are scarce, universities often represent the last institutional safety net available to young adults. The Gombe State University data suggest that this safety net is being tested. The authors argue that students in the 300 level, those living with chronic medical conditions, and those with histories of physical or sexual abuse should be prioritised for targeted mental health interventions, an approach that concentrates scarce clinical resources on the students most likely to need them.

Equally important is the study’s call for systemic change. The researchers recommend that routine mental health screening, timely referral pathways, and trauma-informed support services be integrated into university health systems so that at-risk students are identified and managed early rather than crisis by crisis. The use of a brief, freely available instrument such as the PHQ, delivered through ubiquitous smartphone channels, demonstrates that such screening need not be expensive or logistically burdensome. A departmental WhatsApp group, the same tool used here for data collection, could just as easily distribute a two-minute wellbeing check each semester. The methodological rigour of the study, including the use of cross-validated LASSO for predictor selection and a prespecified analytical plan, lends confidence that the identified risk factors are genuine rather than statistical artefacts, though the cross-sectional design means the associations cannot establish temporal causality.

For Nigeria, and for North-Eastern Nigeria in particular, the study fills an evidentiary gap that has hindered advocacy and planning. Regional data are essential for persuading governments and university administrators to fund counselling centres, train non-specialist providers, and embed mental health education in curricula. The finding that a history of abuse independently predicts suicidal ideation also carries a message for policy beyond campus walls: prevention of childhood violence is, in a very literal sense, suicide prevention. As universities across sub-Saharan Africa grapple with rising enrolments and shrinking per-student resources, the Gombe State University study provides both a warning and a practical template. The warning is that more than one student in three may be contemplating ending their life. The template is that with a validated questionnaire, a smartphone, and a commitment to act on the results, institutions can find these students before it is too late.

Subject of Research: Prevalence and predictors of depression and suicidal ideation among undergraduate students in North-Eastern Nigeria

Article Title: Prevalence and predictors of depression and suicidal ideation among undergraduate students in Gombe State University, North-Eastern Nigeria

Article References: Prevalence and predictors of depression and suicidal ideation among undergraduate students in Gombe State University, North-Eastern Nigeria. (n.d.). https://doi.org/10.1007/s44192-026-00580-8

Image Credits: AI Generated

DOI: 10.1007/s44192-026-00580-8

Keywords: depression, suicidal ideation, undergraduate students, mental health screening, chronic medical illness, physical or sexual abuse, PHQ-9, Nigeria, Gombe State, low- and middle-income countries, logistic regression, student mental health