Prevalence and Risk Factors Associated with Suicide Ideation and Attempts in Korean College Students

Hong-Seok Lee,Sukil Kim,Inyoung Choi,Kyuong-Uk Lee 대한신경정신의학회 2008 PSYCHIATRY INVESTIGATION Vol.5 No.2

Objective: Suicide is a leading cause of death in college age students. Identification of the associated risk factors has important implications for how to prevent and respond to this population; however, few studies have been performed on this topic in this age group. The purpose of this study was to evaluate the prevalence and risk factors associated with suicide ideation and attempts in college students. Methods: Three hundred sixty-eight college students participated in this cross-sectional observational study. The recent (over two weeks) suicide ideation and lifetime suicide attempts were defined according to Moscicki’s suicide behavior index. Sociodemographic variables were assessed and psychopathology measured using the Beck Depression Inventory, the Bipolar Spectrum Diagnostic Scale and the Alcohol Use Disorders Identification Test. A hierarchical multiple logistic regression analysis was used to identify the significant risk factors related to suicide ideation and attempts. Results: The two-week prevalence of suicidal ideation was 9.8%, and the lifetime prevalence of suicide attempts was 3.3%. The univariate analysis showed that students who had more severe depression (p<0.001), a higher probability for bipolar disorder (p<0.001) and decrement of academic achievement (p<0.005) were more likely to have suicide ideation. Those with factors such as severe depression (p<0.05), a higher probability of bipolar disorder (p<0.001), a low socioeconomic status (p<0.001), who lived alone (p<0.01), and were female (p<0.05) had a higher risk for suicide attempts. The most important predictors of suicide ideation, by the logistic regression analysis, were depression, probability for bipolar disorder and academic achievement, and the risks identified for suicide attempts were socioeconomic status and probability of bipolar disorder. Conclusion: Suicide ideation and attempts were common in college students. The results of this study suggest that early identification and management of mood disorders and other sociodemographic risk factors may have implications for intervention and prevention. Objective: Suicide is a leading cause of death in college age students. Identification of the associated risk factors has important implications for how to prevent and respond to this population; however, few studies have been performed on this topic in this age group. The purpose of this study was to evaluate the prevalence and risk factors associated with suicide ideation and attempts in college students. Methods: Three hundred sixty-eight college students participated in this cross-sectional observational study. The recent (over two weeks) suicide ideation and lifetime suicide attempts were defined according to Moscicki’s suicide behavior index. Sociodemographic variables were assessed and psychopathology measured using the Beck Depression Inventory, the Bipolar Spectrum Diagnostic Scale and the Alcohol Use Disorders Identification Test. A hierarchical multiple logistic regression analysis was used to identify the significant risk factors related to suicide ideation and attempts. Results: The two-week prevalence of suicidal ideation was 9.8%, and the lifetime prevalence of suicide attempts was 3.3%. The univariate analysis showed that students who had more severe depression (p<0.001), a higher probability for bipolar disorder (p<0.001) and decrement of academic achievement (p<0.005) were more likely to have suicide ideation. Those with factors such as severe depression (p<0.05), a higher probability of bipolar disorder (p<0.001), a low socioeconomic status (p<0.001), who lived alone (p<0.01), and were female (p<0.05) had a higher risk for suicide attempts. The most important predictors of suicide ideation, by the logistic regression analysis, were depression, probability for bipolar disorder and academic achievement, and the risks identified for suicide attempts were socioeconomic status and probability of bipolar disorder. Conclusion: Suicide ideation and attempts were common in college students. The results of this study suggest that early identification and management of mood disorders and other sociodemographic risk factors may have implications for intervention and prevention.

Comparison of Clinical Characteristics between Single and Repeated Suicide Attempters Admitted to Emergency Room

Taehoon Koo,Kwanghun Lee,Wan Seok Seo,Jong Hun Lee,Hee-Cheol Kim,Sang Won Lee,Seunghee Won 대한신경정신의학회 2016 신경정신의학 Vol.55 No.3

Objectives This study compares single and repeat suicide attempts, and evaluates the risk factors associated with suicide re-attempts. Methods Two hundred and seventy-nine patients admitted to emergency rooms in four university hospitals in Daegu after suicide attempt were included in this study (n=179 single suicide attempters, n=100 repeated attempters). A structured interview focused on demographic, clinical, suicidal and psychological characteristics was administered to these patients after recovery from physical and psychological impairments. Results Individuals with repeated suicide attempts were younger, more highly educated, had more history of psychiatric treatments, took more psychiatric medications, and had more sustained suicidal ideations, bipolar disorders and personality disorders than individuals with single suicide attempt. Individuals with repeated suicide attempts marked significantly higher scores in the Childhood Trauma Questionnaire, Patient Health Questionnaire-9, and the Barratt Impulsiveness Scale. Multivariate logistic regression showed that below the sixties, history of psychiatric treatments, personality disorders, substance use disorders and sustained suicidal ideations were significantly associated with predictive factors for subsequent suicide attempt. Conclusion Our findings suggest that repeat suicide attempters have different clinical characteristics from single suicide attempters, and some risk factors raise the risk of further suicide attempts. It is necessary for suicidal prevention program planners to be aware of these risk factors, especially for first-time suicide attempters

Clinical Characteristics of Non-Suicidal Self-Injury and Suicide Attempts among Psychiatric Patients in Korea: A Retrospective Chart Review

Yubeen Bae,Yoanna Seong,Seok Hyeon Kim,Sojung Kim 대한신경정신의학회 2020 PSYCHIATRY INVESTIGATION Vol.17 No.4

Objective Limited data exist on non-suicidal self-injury (NSSI) and suicide attempts among psychiatric patients in Korea. In this study, we investigated the clinical characteristics of patients who engaged in NSSI and/or suicide attempts. Methods We performed a retrospective medical chart review of patients with NSSI and/or suicide attempts at the psychiatric department of a university medical center in Seoul between 2017 and 2019. According to their history, patients were allocated to one of three groups: NSSI only, suicide attempts only and NSSI and suicide attempts group. Groups were compared based on sociodemographic characteristics and psychological assessments. Results Overall, 80 patients with NSSI and/or suicide attempts were evaluated. Patients with NSSI and suicide attempts were more likely to be female than the other two groups. Patients with NSSI and suicide attempts were more likely to suffer from Cluster B personality disorder than the other groups. And patients with NSSI and suicide attempts scored significantly higher on novelty-seeking in TCI and RC8, RC9 in MMPI-2. Conclusion Patients with NSSI and/or suicide attempts were more likely to be female, younger, and showed higher levels of psychological disturbances. These findings highlight the importance of early detection and intervention for patients with NSSI.

2017년 자살 관련 지표들과 추이

권준현,양지은,주영준,박은철,장성인 한국보건행정학회 2019 보건행정학회지 Vol.29 No.1

Suicide is a major public health issue that causes over 800,000 deaths each year globally. Korea ranks high in suicide rates, in which around 24.3 per 100,000 individuals are reported to have died by intentional self-harm in 2017 according to Statistics Korea. The aim of this study was to examine the current status and trend of suicide ideation and attempt using data from the following five sources: Korean National Health and Nutrition Examination (KNHANES, ‘07–13, ‘15–17), Korean Community Health Survey (KCHS, ‘08–09, ’13, ’17), Korean Wealth Panel Study (KOWEPS, ‘12–17), Korea Health Panel Survey (KHP, ‘10–13), and Statistics Korea (1983–2017). Suicide ideation and attempts were also further examined based on equalized household income levels. Data published by Statistics Korea were used to show the updated suicide rate and number of deaths by intentional self-harm. The rate of suicide ideation at the recent year was 4.73% (KNHANES, ‘17), 6.96% (KCHS, ‘17), 1.63% (KOWEPS, ‘17), and 5.39% (KHP, ‘13). That of suicide attempts as recent year was 0.71% (KNHANES, ‘17), 0.32% (KCHS, ‘17), and 0.09% (KOWEPS, ‘17). Annual percentage change of suicidal ideation was -15.4% (KNHANES, ‘07–17), -2.5% (KCHS, ‘08–17), -8.6% (KOWEPS, ‘12–17), and -10.9% (KHP, ‘10–13). Annual percentage change of suicide attempts was -4.0% (KNHANES, ‘07–17), -4.4% (KCHS, ‘08–17), and -14.9% (KOWEPS, ‘12–17). Individuals with lower income levels were more likely to experience suicide ideation and attempts. Considering that Korea still shows a high suicide rate despite the continuously decreasing trend of suicide ideation and attempt, continuous observation and appropriate policy implementation regarding suicide related problems are necessary.

자살시도자와 자살 사망자의 자살 방법, 스트레스 요인 및 정신과적 진단

오시현,안지혜,서지효,구혜린,김민정,장혜연,김석주 대한수면의학회 2022 수면·정신생리 Vol.29 No.1

Objectives: Suicide is the major public mental health concerns all over the world. The comparison of suicide attempters and suicide completers could be the fundamental evidence for the suicide prevention. The aim of this study is to explore the differences between suicide attempters and suicide completers in terms of the stressors, suicide methods, and psychiatric diagnosis. Methods: Two types of secondary data were collected for the analyses. Data of the suicide attempters (n = 680) were gathered by intensive reviewing the medical records of Samsung Medical Center, Seoul, Republic of Korea. Data of suicide completers (n = 11,722) were collected by the psychological autopsy data which were gathered by Korean Foundation for Suicide Prevention. Suicidal methods, psychiatric disorders and stressors before suicidal attempt were compared between suicide attempter and completers. Results: Suicide completers were older and male predominant compared to suicidal attempt. Hanging or gas intoxication were more commonly used in the suicide completion, while wrist cutting or drug intoxication were more common in suicide attempters. All types of stressors were found to be high in suicide completers than suicide attempters. However, the proportion of economic and physical stress were greater in suicide completers, while the proportion of family stress were greater in suicide attempters. According to the recorded diagnoses, the rates of depressive disorders, sleep-wake disorders, substance-related disorders were higher in suicide completers, while the rates of anxiety disorders and trauma- and stressor-related disorders, bipolar and related disorders and somatic symptom disorders were higher in suicide attempters. However, after controlling the gender and age, there were no significant differences in diagnosis between suicide attempters and suicide completers. Conclusion: These findings implicate that suicide attempters and completers differed in suicide methods and type of stress. The results suggests that economic stressors, physical illness might raise the risk of suicide completion.

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.

Differences between Impulsive and Non-Impulsive Suicide Attempts among Individuals Treated in Emergency Rooms of South Korea

Meerae Lim,이수정,Jong Ik Park 대한신경정신의학회 2016 PSYCHIATRY INVESTIGATION Vol.13 No.4

ObjectiveaaA considerable proportion of suicide attempts are the result of sudden desires. Understanding such impulsive suicide attempts is necessary for effective interventions. We evaluated the impulsivity of suicide attempters treated in emergency rooms. The aim of the study was to identify the characteristics of impulsive suicide attempts by comparing these individuals to those who attempted to commit suicide in a non-impulsive manner. MethodsaaThis study analyzed suicide attempters who visited the emergency departments of seven selected university hospitals. A total of 269 medical records in which impulsivity of suicide attempt were confirmed were subject to be analyzed. The impulsivity of the suicide attempt was examined using a summative score of items 6 and 15 on the Suicide Intent Scale. ResultsaaA total of 48.0% of the participants were impelled by sudden inclinations to attempt suicide. Impulsive attempters were younger, unmarried and less physical illness than non-impulsive attempters, whereas no significant differences were found on psychiatric history and previous suicide history. Impulsive suicide attempters had suicide ideations that were not as severe (χ2=55.33, p<0.001) or intense (t=-8.38, p<0.001) as their counterparts’. Furthermore, medical results of impulsive suicide attempts were better than non-impulsive suicide attempts (t=-3.77, p<0.001). ConclusionaaThe results suggested that a considerable proportion of suicide attempts were the result of sudden inclinations. Impulsive attempts were made in relatively earlier stages of suicide ideation; consequently, they have less intent than non-impulsive attempts.

자살 예방을 위한 집중관리 대상으로서의 중독

곽문환,강현영,이시진,한갑수,김수진,이의중,이성우 대한임상독성학회 2018 대한임상독성학회지 Vol.16 No.2

Purpose: The Korean government has tried to decrease the suicide death rate over the last decade. Suicide attempts, particularly non-fatal attempts, are the most powerful known risk factor for a completed suicide. An analysis of suicide attempt methods will help establish the effective preventive action of suicide. Fit prevention according to the method of suicide attempt may decrease the incidence of suicide death. Self-poisoning is suggested as a major method of both suicide attempts and suicide death. The aim of this study was to determine if a self-poisoning patient is a suitable target for the prevention of the suicide. Methods: This was retrospective analysis of a prospective cohort, which included patients who presented to the emergency department (ED) after a self-harm or suicide attempt from Jan 2013 to Dec 2017. The proportion of methods in suicide attempts, psychological consultation, and fatality according to the suicide attempt method were analyzed. The types of poison were also analyzed. Results: Poisoning was the most common method of suicide attempts (52.1%). The rate of psychological consultations were 18.8% for all patients and 29.1% for poison patients (p<0.001). The rate of mortality in poisoning was 0.6%. Psychological consultation was performed more frequently in admission cases than discharged cases. The most common materials of poisons was psychological medicines and sedatives that had been prescribed at clinics or hospital. Conclusion: Self-poisoning is a major method of suicide attempt with a high rate of psychiatric consultation, low mortality rate, versus others methods. The prevention of suicide death for suicide attempts may focus on self-poisoning, which is the major method of suicide attempts. A suitable aftercare program for self-poisoning may be an effective method for preventing suicide if an early diagnosis and management of psychiatric disorders through psychiatric consultation can be made, and early connection to social prevention program for non-fatal patients are possible.

청소년 자살시도 경험에 관한 질적 연구 - 자살시도 이전 단계, 자살시도 단계, 자살실패 이후 단계 경험을 중심으로

정주연,박재연 한국청소년학회 2015 청소년학연구 Vol.22 No.7

This research was performed through interviews of adolescent survivors with Suicidal Attempt Experiences based on their Pre-suicide attempt, in thoes day of suicide attempt, after suicide attempt Experiences. Only Seven study participants were chosen among the Adolescent Clients who reported their Suicidal Attempt Experiences in counseling center. The participants had a semi-structured one-on-one interviewing and the data was analyzed by the method of Consensual Qualitative Research (CQR). The analyses included 18 domains; the result summarized as follows. Pre-suicide attempt stage experience was classified into ‘cause of suicide attempt’, ‘inner and extrinsic experience before suicide attempt’, and ‘the time required from the first suicidal ideation to real attempt’. Of these, ‘interpersonal relation’ has great effect on cause of suicide attempt. Suicide attempt stage experience was classified into ‘the first suicide attempt time’, ‘inner experience after suicidal decision’, ‘place of suicide attempt’, ‘instrument’, and ‘method’. ‘There is no will to live.’ is most typical among inner experience of suicide attempt. After failure of suicide stage experience was classified into ‘psychological state after failure’, ‘the most difficult part’, ‘the effort to overcome difficulty’, ‘what kind of support they need’. The result showed that after failure of suicide attempt, the most difficult thing is ‘consciousness of others’ and the most needful help is ‘attention’. Stages of adolescent suicide attempt experience and the meaning of the experiences turned out through this research can contribute to practical strategy arrangements and have very important suggestions in the perspective of adolescent suicide prevention. 본 연구는 자살시도 경험이 있는 생존 청소년의 자살시도 이전, 자살시도 당시, 이후 경험을 바탕으로 수행 되었다. 이를 위해 상담센터에 내원한 청소년 내담자 중 자살시도 경험을 보고 하였던 7명을 선정하여 인터뷰하였다. 반 구조화된 질문을 활용하여 1:1 면담방식으로 진행하였으며, 추출된 자료는 합의적 질적 연구방법(Consensual Qualitative Research: CQR)에 의하여 분석하였다. 분석과정을 통하여 최종 18개의 영역을 도출하였는데, 자살시도 이전 단계경험은 ‘자살시도 원인’, ‘자살시도 직전 내·외적 경험’, ‘처음 자살 생각부터 실제 시도까지 소요시간’ 둥으로 영역이 나누어졌다. 이 중 자살시도의 원인으로는 ‘대인관계’가 가장 많은 영향을 미치고 있었다. 자살시도 단계의 경험은 ‘첫 자살시도 시기’, ‘자살 결심 후 내적 경험’, ‘자살시도 장소’, ‘도구’, ‘방법’, 등의 영역으로 나누어졌는데, 자살시도 단계의 내적 경험 중에는 ‘살아갈 의욕 없음’이 가장 전형적 이었다. 자살 실패 이후 경험으로는 ‘실패 후 심리적 상태’, ‘가장 힘든 점’, ‘힘든 상황을 극복하기 위한 노력’, ‘어떤 도움이 필요한가’, 등의 영역으로 나누어졌는데, 그 결과 실패 이후 가장 힘든 점으로는 ‘타인에 대한 의식’이며, 가장 필요한 도움은 ‘관심’인 것으로 나타났다. 이 연구를 통해 밝혀진 청소년의 자살시도에 대한 단계별 경험과 그 경험이 주는 의미는 청소년 자살 예방적 관점에서 매우 큰 시사점과 실천적 전략을 마련하는데 기여할 수 있을 것이다.

Risk Factors for Suicide Attempts of Korean Elderly : Relative Effects of Individual Traits and Social Quality

Meeae Lee 보안공학연구지원센터 2015 International Journal of Bio-Science and Bio-Techn Vol.7 No.1

The main purpose of this research is to explore risk factors for suicide attempts of Korean elderly persons who are aged 61 and over. Using data from 2011 Elderly Living Condition Survey database, this study focuses on the effects of social quality on suicide attempts. Social quality is estimated by social unkindness, which is operationalized through having experiences of feeling hurt by others’ unkind words or actions. Analysis results show that age, area of residence, ADL functional score, geriatric depression score, communication frequency with children, communication frequency with friends or neighbors, and having experiences of feeling hurt by others’ unkind words or actions are significant predictors. Key findings are that those with experiences of feeling hurt by social unkindness have far higher probability of attempting suicide. This implies that, for those who are exposed and vulnerable to social unkindness, without improving unkind social quality, it is not possible to get lowering those suicide attempts. Based on the analysis results, to prevent suicide attempts among older persons, improvement in social quality through encouraging members of society to activate an act of kindness with each other is needed. Policy makers should take this into account when developing policies to deter suicide attempts among the elderly persons.