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

다국어 초록 (Multilingual Abstract)

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.

다국어 초록 (Multilingual Abstract)

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.

참고문헌 (Reference)

1 정혜경, "청소년의 자살충동에 영향을 미치는 예측요인" 한국청소년학회 10 (10): 107-126, 2003

2 홍성철, "사회계층이 자살 사망 위험도에 미치는 영향" 한국보건사회학회 14 : 249-271, 2003

3 손정남, "대학생의 자살생각 관련 요인에 대한 판별분석" 정신간호학회 16 (16): 267-275, 2007

4 노명선, "대학생들의 자살관련행동에 관한 연구" 대한신경정신의학회 46 (46): 35-40, 2007

5 이현지, "대학생 자아정체감과 무망감, 우울이 자살사고의 관계에 관한 연구" 한국청소년학회 14 (14): 243-264, 2007

6 Witte TK, "Variability in suicidal ideation: a better predictor of suicide attempts than intensity or duration of ideation?" 88 : 131-136, 2005

7 Johansson SE, "Unemployment is an important risk factor for suicide in contemporary Sweden: an 11-year follow-up study of a cross-sectional sample of 37,789 people" 111 : 41-45, 1997

8 Sher L, "Triggers for suicidal behavior in depressed older adolescents and young adults: do alcohol use disorders make a difference?" 19 : 91-98, 2007

9 Andrews B, "The relation of depression and anxiety to life-stress and achievement in students" 95 : 509-521, 2004

10 Murphy GE, "The lifetime risk of suicide in alcoholism" 47 : 383-392, 1990

11 Rehkopf DH, "The association between suicide and the socioeconomic characteristics of geographical areas: a systematic review" 36 : 145-157, 2006

12 Rihmer ZZ, "Suicide risk in mood disorders" 20 : 17-22, 2007

13 Lipschitz A, "Suicide prevention in young adults (age 18-30)" 25 : 155-170, 1995

14 Murphy GE, "Suicide in alcoholism" Oxford University 1992

15 Hawton K, "Suicide in Oxford University students, 1976-1990" 166 : 44-50, 1995

16 Beck AT, "Suicide ideation at its worst point: a predictor of eventual suicide in psychiatric outpatients" 29 : 1-9, 1999

17 Mościcki EK, "Suicide attempts in the Epidemiologic Catchment Area Study" 61 : 259-268, 1988

18 Kirmayer LJ, "Suicide attempts among Inuit youth: a community survey of prevalence and risk factors" 94 : 8-17, 1996

19 Jamison KR, "Suicide and bipolar disorder" 61 (61): 47-51, 2000

20 Spann M, "Suicide and African American teenagers: risk factors and coping mechanisms" 36 : 553-568, 2006

21 Fevziye Toros, "Suicide Attempts and Risk Factors among Children and Adolescents" 연세대학교의과대학 45 (45): 367-374, 2004

22 Schweitzer R, "Suicidal ideation and behaviours among university students in Australia" 29 : 473-479, 1995

23 Yen YC, "Suicidal ideation and associated factors among community-dwelling elders in Taiwan" 59 : 365-371, 2005

24 Brener ND, "Suicidal ideation among college students in the United States" 67 : 1004-1008, 1999

25 Langhinrichsen-Rohling J, "Suicidal behavior, negative affect, gender, and self-reported delinquency in college students" 34 : 255-266, 2004

26 Oksuz E, "Socioeconomic factors and health risk behaviors among university students in Turkey: questionnaire study." 46 : 66-73, 2005

27 Gould MS, "Separation/divorce and child and adolescent completed suicide" 37 : 155-162, 1998

28 Nassir Ghaemi S, "Sensitivity and specificity of a new bipolar spectrum diagnostic scale" 84 : 273-277, 2005

29 Xu HL, "Risk factors for suicide attempt among college students at Central South University" 25 : 288-291, 2004

30 Beautrais AL, "Risk factors for suicide and attempted s" 34 : 420-436, 2000

31 Ang RP, "Relationship between academic stress and suicidal ideation: testing for depression as a mediator using multiple regression" 37 : 133-143, 2006

32 D’Zurilla TJ, "Relation between social problem-solving ability and subsequent level of psychological stress in college students" 61 : 841-846, 1991

33 Krishnan KR, "Psychiatric and medical comorbidities of bipolar disorder" 67 : 1-8, 2005

34 Weissman MM, "Prevalence of suicide ideation and suicide attempts in nine countries" 29 : 9-17, 1999

35 Park HS, "Predictors of suicidal ideation among high school students by gender in South Korea" 76 : 181-188, 2006

36 Bush HS, "Personal assessment of stress factors for college students" 55 : 370-375, 1985

37 Westefeld JS, "Perce-ptions concerning college student suicide: data from four universities" 35 : 640-645, 2005

38 Taylor R, "Mental health and socio-economic variations in Australian suicide" 61 : 1551-1559, 2005

39 Steer RA, "Mean Beck Depression Inventory-II scores by severity of major depressive episode" 88 : 1075-176, 2001

40 Dilsaver SC, "High rate of unrecognized bipolar mixed states among destitute Hispanic adolescents referred for “major depressive disorder”" 84 : 179-186, 2005

41 Brent DA, "Familial risk factors for adolescent suicide: a case-control study" 89 : 52-58, 1994

42 Galfalvy HC, "Evaluation of clinical prognostic models for suicide attempts after a major depressive episode" 117 : 244-252, 2008

43 Juon HS, "Epidemiology of suicidal behavior among Korean adolescents" 35 : 663-676, 1994

44 Saunders JB, "Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO Collaborative Project on Early Detection of Persons with Harmful Alcohol Consumption--II" 88 : 791-804, 1993

45 Lee BO, "Development of Korean Version of Alcohol Use Disorders Identification Test (AUDIT-K): Its Reliability and Validity" 4 : 83-92, 2000

46 Kochanek KD, "Deaths: final data for 2002. National Vital Statistics Reports" National Center for Health Statistics 2004

47 Hashim IH, "Cultural and Gender Differences in Perceptions of Stressors and Coping Skills: A Study of Western and African College Students in China" 24 : 182-203, 2003

48 Donovan DM, "Concurrent validity of the Alcohol Use Disorders Identification Test (AUDIT) and AUDIT zones in defining levels of severity among out-patients with alcohol dependence in the COMBINE study" 101 : 1696-1704, 2006

49 Towbes LC, "Chronic stress in the lives of college students: Scale development and prospective prediction of distress" 25 : 199-217, 1996

50 Lejoyeux M, "Characteristics of suicide attempts preceded by alcohol consumption" 12 : 30-38, 2008

51 Rihmer Z, "Bipolar disorders and suicidal behaviour" 4 (4): 21-25, 2002

52 Sajatovic M, "Bipolar disorder: disease burden" 11 : S80-S84, 2005

53 Hawton K, "Attempted suicide in Oxford University students, 1976-1990" 25 : 179-188, 1995

54 Kisch J, "Aspects of suicidal behavior, depression, and treatment in college students: results from the spring 2000 national college health assessment survey" 35 : 3-13, 2005

55 Beck AT, "An inventory for measuring depression" 4 : 561-571, 1961

56 Rudd MD, "An integrative model of suicidal ideation" 20 (20): 16-30, 1990

57 Perkins DF, "An Ecological Risk-Factor Examination of Suicide Ideation and Behavior of Adolescents" 17 : 3-26, 2002

58 Sher L, "Alcoholism and suicidal behavior: a clinical overview" 113 : 13-22, 2006

59 Ellis JB, "Adaptive characteristics and suicidal behavior: a gender comparison of young adults" 31 : 845-854, 2007

60 Dubow EF, "A two-year longitudinal study of stressful life events, social support, and social problem-solving skills: contributions to children’s behavioral and academic adjustment" 62 : 583-599, 1991

61 Rhee MK, "A standardization study of Beck Depression Inventory I-Korean Version (K-BDI)" 4 : 77-95, 1995

62 "2005 Annual report on the morbidity rate of suicide"