Abstract
Suicidal ideation (SI) represents a manifestation of self-destructive thoughts and behaviors with significant public health implications. This study aimed to determine the prevalence of SI and identify associated risk factors among male and female university students in southern Bangladesh. Data were collected through simple random sampling between April and June 2022 from university students in southern Bangladesh, yielding a final sample of 584 participants (51.5% male, 48.5% female). SI was assessed as the primary outcome variable. Statistical analyses included frequency distributions, chi-square tests, and binary logistic regression to determine prevalence rates and identify associated risk factors. The prevalence of SI was substantially higher among female participants (31.4%) compared to their male counterparts (9.0%). Among female participants, significant risk factors included sleeping <7 hours per night (odds ratio (OR) = 7.670, P = .020), having a positive relationship with a partner (OR = 0.336, P = .018), experiencing mild (OR = 0.073, P < .01) or moderate depression (OR = 0.259, P = .014), and reporting no anxiety (OR = 0.031, P = .002). For male participants, significant associations were found with having no anxiety (OR = 0.014, P = .004) and experiencing moderate anxiety (OR = 0.043, P = .009). Female university students demonstrated a significantly higher risk of SI, underscoring the critical importance of gender-sensitive mental health interventions. Findings suggest that female students should be encouraged to maintain regular sleep patterns and cultivate healthy interpersonal relationships. Mental health screening and support services should be prioritized for both genders, with particular attention to depression and anxiety management.