Beyond Suicidal Ideation: Identifying High-Risk University Students Through Depression, Sleep Disturbance, and Impulsivity—A Cross-Sectional Secondary Analysis

Background: Suicide prevention strategies in university settings largely rely on detecting explicit suicidal ideation. However, students experiencing severe psychiatric distress may not endorse suicidal thoughts and therefore remain unidentified by ideation-centered screening models. This study aimed to identify and clinically characterize university students with high depressive symptoms, poor sleep quality, and elevated impulsivity who deny suicidal ideation in order to examine whether they re