청소년의 자살시도 및 자살사고에 영향을 미치는 심리사회적 요인

김경민,윤보현,박수희,김도형,시영화,송제헌,이지선 대한우울조울병학회 2014 우울조울병 Vol.12 No.3

Objectives : Suicide in adolescence rapidly increases after age of 15, and it is most common cause of death at that age period. The aim of this study was to examine the psychosocial factors influencing suicidal attempts or suicidal ideation in adolescents. Method : A total of 4338 school adolescents (male 2,216, female 2,122) in Jeollanam-do province were involved. Suicidal attempt or suicidal ideation groups were divided according to a respondent answered ‘yes’ to the question about experience of suicidal attempt or thought. We evaluated sociodemographic factors using self-reporting questionnaire. Students were asked to complete the Beck Suicidal Ideation Inventory (BSII), Beck Depression Inventory (BDI), Global Assessment of Recent Stress (GARS), Dysfunctional Impulsivity Scale (DIS), Self-Esteem Scale (SES) and Resilience Test (RT) to assess the psychosocial factors affecting suicidal attempt or ideation. Results : Of the 4338 students, 220 (5%) reported past suicidal attempts and 1193 (27%) reported their experiences of suicidal ideation. Girls more significantly reported suicidal attempts and suicidal ideations than boys. Age differences were found that middle school students more reported only suicidal attempts than high school students. The scores of BDI, BSII, GARS, DIS and SES were significantly higher in the suicidal attempt group than those of suicidal ideation group, and also the scores of the suicidal ideation group were higher than those of the control group. Multivariate multinomial logistic regression analysis revealed that gender, family satisfaction, depression, stress and self-esteem were significantly associated with both suicidal attempt and ideation. School grade, socioeconomic status and impulsivity were also significantly correlated with suicidal attempt. Middle-school students, high socioeconomic status and depression were reported as the risk factors of suicidal attempt in the suicidal ideation group. Conclusion : Because so many adolescents commonly think about suicide, it is very important to understand characteristic of high suicide risk adolescents and manage them appropriately. We found some factors associated with adolescent suicide. Depression is the strongest predictor for suicide. Gender, school grade, socioeconomic status and family satisfaction were also correlated of suicide. In addition, self-esteem and resilience reported as the protective factors against suicide. This study suggests that the intensive and multidimensional approaches in the area of school education and adolescent suicide prevention program are necessary due to various psychosocial factors influencing suicidal ideation and attempts.

Relationship Between Current Sleep Duration and Past Suicidal Ideation or Attempt Among Korean Adolescents

Jang, Sung-In,Lee, Kwang-Sig,Park, Eun-Cheol The Korean Society for Preventive Medicine 2013 Journal of Preventive Medicine and Public Health Vol.46 No.6

Objectives: To comprehensively examine the relationship between current sleep duration and past suicidal idea or attempt among Korean adolescents. Methods: Data came from the 2009 Korea Youth Risk Behavior Web-based Survey with 75 066 participants (with the participation rate of 97.6%) in 800 middle and high schools. Binary logistic regression was conducted by gender and depressed mood to identify significant factors for suicidal ideation/attempt. The dependent variable was the log odds of suicidal ideation/attempt, while the independent/control variables were sleep duration and other demographic, socio-economic and health-related factors. Results: A negative association between sleep duration and suicidal ideation or attempt was weaker for those with depressed mood than for those without such experience in Korea for Year 2009. The odds ratio of suicidal ideation/attempt regarding less than 4 hours of sleep compared to 6 to 7 hours of sleep, was smaller in a group with depressed mood than in a group without such experience, for example, 1.64 (95% confidence interval [CI], 1.29 to 2.08) vs. 2.06 (95% CI, 1.34 to 3.17) for men's suicidal ideation, 2.50 (95% CI, 1.69 to 3.69) vs. 3.89 (95% CI, 1.74 to 8.66) for men's suicidal attempt. A negative association between age (or self-rated health) and suicidal ideation/attempt was also weaker for those with depressed mood than for those without such experience in the nation for the year. Conclusions: There was a negative association between sleep duration and suicidal ideation/attempt in Korea for Year 2009 and this association was weaker for those with depressed mood than for those without such experience. Based on the findings of this study, adolescents' better mental health and longer, more comfortable sleep might help to prevent their suicidal ideation and attempt in Korea.

지역사회 거주 노인의 정신건강 및 기능장애와 자살시도의 관련성: 지역사회건강조사를 기반으로

정진영 사단법인 대한보건협회 2020 대한보건연구 Vol.46 No.2

Objective:This study was aimed to analyze the relationship between the mental health and physical dysfunction and suicidal attempt among community dwelling elderly(65 years or more). Method:This study was conducted on 129,277 persons over the age of 65 who participated in the Community Health Survey(CHS) for 2013 and 2017. The study participants were classified no suicidal ideation group(111,344 people), suicidal ideation only(17,487 people), suicidal attempt(446 people) based on their response to suicidal ideation and suicidal attempt. Related factors to suicidal ideation and suicidal attempt were analyzed using complex sample logistic regression analysis. All analyses used SAS ver 9.4 with 0.05 of significance level. Results:Related factors to suicidal attempt were depressive symptom, stress, and counselling due to suicidal ideation in both sexes, pain/discomfort in elderly men, and 2 or more falling, limitation of daily activity in elderly women. Conclusion:Few studies have performed to analyze related factors on suicidal attempt simultaneously. These results will develop the understanding of the elderly who attempted suicide and contribute to the selection of suicide high risk groups. 목적:본 연구는 지역사회에서 거주하는 노인(65세 이상)을 대상으로 자살생각자 중 자살시도에 영향을 미치는 요인을 탐색하고자 실시되었다. 방법:2013년, 2017년 지역사회건강조사(Community Health Survey, CHS) 참여자 129,277명을 대상으로 하였다. 자살생각 및 자살시도 응답결과를 바탕으로 비자살생각군(none, 111,344명), 자살시도 경험이 없는 자살생각군(suicidal ideation only, 17,487명), 자살시도군(suicidal attempt, 446명)으로 분류하였다. 자살시도 관련요인 분석은 성별을 층화하여 복합표본 로지스틱회귀분석(Complex sample logistic regression analysis)을 실시하였다. 통계분석은 SAS ver 9.4를 사용하였고, 유의수준(significance level)은 0.05로 하였다. 결과:남녀 모두의 자살시도 관련요인은 우울, 스트레스, 자살생각으로 인한 상담이었으며, 남성 노인에게만 영향을 미치는 요인은 통증/불편감, 여성 노인에게만 영향을 미치는 요인은 2회 이상의 낙상경험, 일상활동 제한으로 분석되었다. 결론:본 연구결과 자살생각과 자살시도 관련 요인은 달랐으며, 성별 차이도 관찰되었다. 본 연구는 자살을 시도하는 노인에 대한 이해를 넓히고 자살의 고위험군을 선별하는데 기여할 수 있을 것이다.

Relationship Between Current Sleep Duration and Past Suicidal Ideation or Attempt Among Korean Adolescents

장성인,이광식,박은철 대한예방의학회 2013 Journal of Preventive Medicine and Public Health Vol.46 No.6

Objectives: To comprehensively examine the relationship between current sleep duration and past suicidal idea or attempt among Korean adolescents. Methods: Data came from the 2009 Korea Youth Risk Behavior Web-based Survey with 75 066 participants (with the participation rate of 97.6%) in 800 middle and high schools. Binary logistic regression was conducted by gender and depressed mood to identify significant factors for suicidal ideation/attempt. The dependent variable was the log odds of suicidal ideation/attempt, while the independent/control variables were sleep duration and other demographic, socio-economic and health-related factors. Results: A negative association between sleep duration and suicidal ideation or attempt was weaker for those with depressed mood than for those without such experience in Korea for Year 2009. The odds ratio of suicidal ideation/attempt regarding less than 4 hours of sleep compared to 6 to 7 hours of sleep, was smaller in a group with depressed mood than in a group without such experience, for example, 1.64 (95% confidence interval [CI], 1.29 to 2.08) vs. 2.06 (95% CI, 1.34 to 3.17) for men’s suicidal ideation, 2.50 (95% CI, 1.69 to 3.69) vs. 3.89 (95% CI, 1.74 to 8.66) for men’s suicidal attempt. A negative association between age (or self-rated health) and suicidal ideation/attempt was also weaker for those with depressed mood than for those without such experience in the nation for the year. Conclusions: There was a negative association between sleep duration and suicidal ideation/attempt in Korea for Year 2009 and this association was weaker for those with depressed mood than for those without such experience. Based on the findings of this study, adolescents’ better mental health and longer, more comfortable sleep might help to prevent their suicidal ideation and attempt in Korea.

A study of job stress, suicidal ideation and suicide attempts in display manufacturing workers: a cross-sectional study

안승환,이용진,장은철,권순찬,민영선,류승훈 대한직업환경의학회 2020 대한직업환경의학회지 Vol.32 No.-

Background: This study aimed to investigate the association between job stress and suicide ideation/attempts among display manufacturing workers. Methods: Data were collected from 836 workers in a display manufacturing company who participated in health screenings from May 22 to June 16, 2017. The data included general characteristics, night work, job tenure, previous physician-diagnosed chronic diseases, suicidal ideation/suicide attempts, and job stress. We investigated suicidal ideation/suicide attempts that covered the past year by using a self-reported questionnaire. Job stress was measured using the 43-item Korean Occupational Stress Scale. Multiple logistic regression analysis was used to investigate the association between job stress and suicidal ideation/ suicide attempts. The mediator effect of depression on suicidal ideation/suicide attempts was tested using a series of logistic regression by applying Baron and Kenny's mediation method. Results: In the model adjusting for variables (e.g., age, body mass index, smoking, alcohol consumption, regular exercise, shift work, job tenure, chronic disease and depression), physical environment (OR: 3.60, 95% CI: 1.08–12.02), lack of reward (OR: 5.31, 95% CI: 1.54–18.34), and occupation climate (OR: 7.36, 95% CI: 2.28–23.72) were correlated with suicidal ideation/suicide attempts in women. However, all subscales of job stress were not significantly correlated with suicidal ideation/suicide attempts in men. In mediation analysis, job instability and occupational climate were correlated with suicidal ideation/suicide attempts and were mediated by depression in men workers. Conclusions: In women workers, the experiences of suicidal ideation/suicide attempts were significantly correlated with the physical environment, lack of reward, and occupational climate that were subscales of job stress. In men workers, depression rather than job stress was correlated with experiences of suicidal ideation/suicide attempts.

응급실에 내원한 자살기도 환자에 관한 연구

김승열,송화식,김갑득,이경규 대한응급의학회 1999 대한응급의학회지 Vol.10 No.4

This study was designed to investigate clinical characteristics and outcome of patient with suicidal attempt. A retrospective analysis by chart review of 130 cases of patients with suicidal attempt who visited emergency department of Dankook University Hospital from January 1998 to December 1998. The results were as follows ; 1. The ratio of patients with suicidal attempt to total patients who visited emergency department was 0.7%. The highest suicidal attempt rates were among aged 20-39. The gender ratio is similar. 2. Suicidal attempt were more common in summer, July, Friday, evening. 3. The most common place of suicidal attempt was home. 4. Drug ingestion was the most common method of suicidal attempt. Drug used for suicidal attempt were agricultural drug including organic phosphorus and carbamate, and therapeutic drug. 5. Common motives of suicidal attempt were marriage conflict, family conflict. 6. The intensity of will to die was more strong in old aged male. 7. Suicidal attempt associated with alcohol drinking was 39.2%. 8. Common symptoms or signs of intoxication were neurological and gastrointestinal.

Predictors of Suicide Attempts in Clinically Depressed Korean Adolescents

권아혜,송정은,육기환,전덕인,정명훈,홍나래,홍현주 대한정신약물학회 2016 CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE Vol.14 No.4

We examined predictors of suicide attempts in clinically depressed adolescents in Korea and gender differences in suicidal behavior. In total, 106 adolescents diagnosed with depressive disorder were recruited in South Korea. We assessed various variables that might affect suicide attempts, and used a structured interview for the diagnosis of depression and comorbidities and to evaluate suicidality. Demographic and clinical characteristics of the subjects were compared between suicide attempt and non-suicide attempt groups and we examined significant predictors of suicide attempts. Gender differences in suicidal ideation and suicidal behavior were also analyzed. Among 106 depressed participants, 50 (47.2%) adolescents were classified in the suicide attempt group. Generally, the suicide attempt and non-suicide attempt group shared similar clinical characteristics. The suicide attempt group had more females, more major depressive disorder diagnoses, more depressive episodes, and higher suicidal ideation than the non-suicide attempt group. Suicidal ideation was the only significant predictor of suicidal attempt, regardless of gender. Higher suicidal ideation frequency scores and more non-suicidal self-injurious behaviors were shown in the female suicide attempt group than the male suicide attempt group. It is recommended that suicidal ideation be assessed regularly and managed rigorously to decrease suicide risks in depressive adolescents.

한국 성인 자살관념자의 자살시도 연관 요인

최윤철,김현석,이상신 한국정신신체의학회 2022 정신신체의학 Vol.30 No.2

Objectives:The study aimed to identify factors associated with suicidal attempt in Korean adults experiencing thoughts of suicide. Methods:This study analyzed outcomes of suicidal behavior in the Korea National Health and Nutrition Examination Survey (KNHANES) 2015, 2017, and 2019. This survey was administered by the Korea Centers for Disease Control and Prevention (KCDC). The suicidal idea group was divided into individuals who had attempted suicide (n=92) and those who had not (n=831). Complex samples crosstabs analysis was conducted to compare the two groups’ sociodemographic, psychiatric, and clinical characteristics. In addition, factors related to attempted suicide were investigated using complex samples logistic regression analysis. Results:The attempted suicide group had significantly higher rates of depression, recent psychiatric counseling, and suicidal plan (p<0.001) than the non-attempting group. In addition, the groups differed significantly in the frequency of binge drinking and smoking (p<0.05). Adjusted multivariate analysis revealed that the presence of a suicidal plan (Odds ratio [OR]=8.46, 95% Confidential Intervals [CI]=4.72-15.00), daily binge drinking (OR=3.14, 95% CI=1.26-7.84), psychiatric counseling within the past year (OR=3.03, 95% CI=1.75-5.23), low income level (OR=2.89, 95% CI=1.17-7.10), and history of depression (OR=2.39, 95% CI=1.29-4.42) were significantly associated with suicidal attempt. Conclusions:Factors associated with suicidal attempt among suicidal ideators in the general Korean population were identified across all sociodemographic, psychiatric, and clinical variables. Assessment of and intervention in suicidal plan, binge drinking, income level, and depression might prevent progression to suicidal attempt among those contemplating suicide. 연구목적자살관념이 있는 한국성인에서 자살시도와 연관된 요인을 규명하고자 하였다. 방 법질병관리청에서 매년 실시하는 국민건강영양조사 중 자살행동을 조사한 2015, 2017, 2019년도 결과를 분석하였고, 만 19세 이상 성인을 대상으로 하였다. 자살관념자를 자살시도군(n=92)과 비자살시도군(n=831)으로나누었고, 복합표본 교차분석으로 두 군의 사회인구학적, 정신의학적, 임상적 특성을 비교하였다. 복합표본 로지스틱 회귀분석으로 자살관념자에서 자살시도와 연관된 인자를 조사하였다. 결 과자살관념자 중 자살시도군에서는 비자살시도군에 비해 우울증 진단 병력, 자살시도 전 정신의학적 상담 경험, 자살계획이 유의하게 많았다(p<0.001). 또한 두 군은 소득 수준, 폭음 빈도, 흡연 빈도에서 유의한 차이를보였다(p<0.05). 다변량 분석 모형(Adjusted model)에서 자살계획이 있는 경우(Odds ratio [OR]=8.46, 95% Confidential Intervals [CI]=4.72-15.00), 매일 폭음을 하는 경우(OR=3.14, 95% CI=1.26-7.84), 최근 1년 동안정신의학적 상담 경험이 있는 경우(OR=3.03, 95% CI=1.75-5.23), 소득 수준이 낮은 경우(OR=2.89, 95% CI= 1.17-7.10), 평생 우울증을 진단받은 적이 있는 경우(OR=2.39, 95% CI=1.29-4.42)가 자살시도와 통계적으로 유의한 연관성이 있었다. 결 론우리나라 일반인구의 자살관념자에서 사회인구학적, 정신의학적, 임상적 변수 모두에 걸쳐서 자살시도의 위험요인이 나타났다. 자살관념이 있는 환자들에서 자살계획, 문제음주, 소득수준, 우울증 병력 등을 평가하고 개입하는 것이 자살시도로의 이환을 방지해 줄 가능성이 있다.

청소년 자살생각, 자살시도의 영향요인 분석: 스트레스, 외로움, 절망감의 상호작용효과

채민정 한국청소년상담복지개발원 2024 청소년상담연구 Vol.32 No.1

본 연구는 청소년들의 자살생각과 자살시도를 연속적인 과정으로 두고 자살생각에 영향을 주는 요인과 자살시도에 영향을 주는 요인을 단계적으로 분석하여 자살생각을 하는 청소년들 중에서 어떠한 청소년들이 자살시도에 이르는지 살펴보고자 하였다. 이를 위해 2022년 청소년건강행태조사 자료를 활용하여 전체집단 51,850명, 자살생각 집단 7,350명, 자살시도 집단 1,213명을 대상으로 인구사회학적 변인과 심리적 변인을 투입하여 로지스틱회귀분석을 수행하였다. 분석결과 청소년 자살생각에 영향을 주는 인구사회학적 변인으로 성별, 학년, 경제적 상태가, 심리적 변인으로는 스트레스, 외로움, 절망감이 도출되었으며, 자살생각을 가진 청소년들의 자살시도에 영향을 주는 요인으로 학업성적과 절망감이 도출되었다. 또한 자살생각에 대한 스트레스와 외로움, 외로움과 절망감, 절망감과 스트레스의 상호작용효과가 유의했으며, 자살시도에 대한 외로움과 절망감의 상호작용효과가 유의했다. 본 연구의 결과를 통해 청소년 자살생각에서 자살시도로 이어지는 과정에서 단계별로 영향을 주는 요인과 심리적 요인 간 상호작용효과의 차이를 확인하였다. 이러한 연구결과에 기반하여, 청소년의 자살생각을 예방하는 개입과 자살시도를 예방하는 개입의 차별화가 필요함을 논의하였다. The purpose of this study was to examine factors that impacting suicidal ideation and suicide attempts among adolescents, based on the hypothesis that suicidal ideation is closely associated with suicidal attempts. Using the data from the 2022 Korean Youth Health Behavior Survey, this study performed a logistic regression analysis on sociodemographic variables and psychological variables. Participants in this study were 51,850 adolescents in total, consisting of 7,350 in the suicidal ideation group and 1,213 in the suicide attempts group. From the Logistic regression analysis, gender, grade level, and economic status were identified as sociodemographic variables that impacted suicidal ideation, and stress, loneliness, and helplessness were identified as psychological variables that impacted suicidal ideation. Also, academic performance and helplessness were the variables that impacted suicidal attempts among those with suicidal ideation. Additionally, the interaction effects of stress and loneliness, loneliness and hopelessness, and hopelessness and stress on suicidal ideation were significant, and the interaction effects of loneliness and hopelessness on suicidal attempts were significant as well. These findings clearly show that there exist risk factors and interaction effects of some psychological variables in the process from suicidal ideation to suicidal attempts. Based on these findings, the importance of differentiated interventions to prevent suicidal ideation and to prevent suicide attempts in adolescents was discussed.

Factors Affecting Suicide Attempters Visiting Emergency Departments: Through a Focus on Acquired Capability with Rehearsal for Suicide, Negative Urgency, and Social Support

한소리,이영숙,김지선,김은지,허인수,이주영,윤희정,심세훈 대한우울조울병학회 2020 우울조울병 Vol.18 No.2

This study examines how acquired capability for suicide, negative urgency, and social support effectuate a suicide attempt. Sixty-three adults having visited an emergency room due to a suicide attempt were studied. The results can be summarized as follows. First, there were no significant sex differences in acquired capability for suicide, negative urgency, and social support. Second, the correlation among suicidal ideation, acquired capability for suicide, negative urgency, social support, and suicide attempts was examined. Results showed that suicide attempts were significantly and positively correlated with suicide ideation, acquired capability for suicide, and negative urgency. However, social support and suicide attempts did not significantly correlate. Third, results of hierarchical regression analysis indicated that acquired capability for suicide and negative urgency significantly predicted suicide attempts even when suicide ideation was controlled, but social support did not significantly explain attempts. In other words, study results imply that suicide attempts increase when acquired capability for suicide and negative urgency are high. Study results offer empirical data for understanding the intrinsic characteristics of individuals attempting suicide.