자살 임박 시기 알코올 사용과 자살 기도의 특성 = Higher Blood Alcohol Concentration Levels at the Time of Attempting Suicide Predict Poorer Medical Outcomes

다국어 초록 (Multilingual Abstract)

Objective：The aim of this study was to analyze the clinical characteristics of individuals who used alcohol at the time of attempting suicide.
Methods：We divided 143 individuals who attempted suicide by consuming drugs into two groups on the basis of their blood alcohol concentration level: drinker group(n=79) and non-drinker group(n=64). We compared epidemio¬logical characteristics and suicidal behavior between the groups by using the Suicidal Intent Scale(SIS) and the Risk Rescue Rating Scale(RRRS). In addition, we administered the Glasgow Coma Scale(GCS) and the Acute Physiology and Chronic Health Evaluation-II(APACHE-II) to evaluate the medical lethality of the individuals who attempted sui¬cide. We used Student’s t-test, Pearson’s correlation analysis, and multiple linear regression to analyze the data.
Results：The drinker group scored lower on the SIS’s planning subscale than the non-drinker group did(p=0.022). The drinker group’s blood alcohol concentration levels were negatively correlated with the rescue potential of their suicidal attempt(p=0.031) and the APACHE-II score(p=0.003). Higher blood alcohol concentration levels predicted poorer medical outcomes measured by the APACHE-II(p=0.004).
Conclusion：Our findings support the notion that alcohol use increases suicidal impulsivity, decreases rescue po¬tential, and worsens medical outcomes. Therefore, suicide prevention programs need to include education and counseling about the risks associated with alcohol use.

목차 (Table of Contents)

• 서론
• 대상 및 방법
• 결과
• 고찰

참고문헌 (Reference)

1 이현경, "우리나라 성인의 문제음주와 우울 및 자살생각과의 연관성" 한국알코올과학회 12 (12): 155-168, 2011

2 최호선, "법의부검으로 확인된 자살례에 있어서 음주와의 상관관계에 관한 연구" 대한법의학회 36 (36): 63-67, 2012

3 보건복지부, "대한민국 자살현황 연간보고서" 2011

4 Rudd MD, "Warning signs for suicide?" 33 : 99-100, 2003

5 Rudd MD, "Warning signs for suicide:theory, research, and clinical applications" 36 : 255-262, 2006

6 Chan B, "The use of Glasgow Coma Scale in poisoning" 11 : 579-582, 1993

7 Oquendo MA, "The biology of impulsivity and suicidality" 23 : 11-25, 2000

8 Nemtsov A, "Suicides and alcohol consumption in Russia, 1965-1999" 71 : 161-168, 2003

9 Rihmer Z, "Suicide risk in mood disorders" 20 : 17-22, 2007

10 Baca-Garcia E, "Suicide attempts and impulsivity" 255 : 152-156, 2005

11 Borges G, "Suicide attempts and alcohol consumption in an emergency room sample" 57 : 543-548, 1996

12 OECD, "Society at a glance 2014: Organisation for Economic Co-operation and Development"

13 Weisman AD, "Risk-rescue rating in suicide assessment" 26 : 553-560, 1972

14 Finkelstein Y, "Risk of Suicide Following Deliberate Self-poisoning" 72 : 570-575, 2015

15 Brown GK, "Risk factors for suicide in psychiatric outpatients: a 20-year prospective study" 68 : 371-377, 2000

16 Scocco P, "Prevalence of suicide ideation, plans, and attempts and related risk factors in Italy: results from the European Study on the Epidemiology of Mental Disorders--World Mental Health study" 49 : 13-21, 2008

17 Beautrais AL, "Prevalence and comorbidity of mental disorders in persons making serious suicide attempts: a case-control study" 153 : 1009-1014, 1996

18 Sam KG, "Poisoning severity score, APACHE II and GCS: effective clinical indices for estimating severity and predicting outcome of acute organophosphorus and carbamate poisoning" 16 : 239-247, 2009

19 Misson H, "Factor analyses of the Suicidal Intent Scale(SIS) and the Risk-Rescue Rating Scale(RRRS):toward the identification of homogeneous subgroups of suicidal behaviors" 121 : 80-87, 2010

20 Moscicki EK, "Epidemiology of completed and attempted suicide: Toward a framework for prevention" 1 : 310-323, 2001

21 Diaz FJ, "Dimensions of suicidal behavior according to patient reports" 253 : 197-202, 2003

22 De Leo D, "Definitions of suicidal behavior: lessons learned from the WHO/EURO multicentre Study" 27 : 4-15, 2006

23 Beck RW, "Cross-validation of the Suicidal Intent Scale" 34 : 445-446, 1974

24 Beck AT, "Classification of suicidal behaviors: I. Quantifying intent and medical lethality" 132 : 285-287, 1975

25 Beck AT, "Assessment of suicidal intention: the Scale for Suicide Ideation" 47 : 343-352, 1979

26 DeJong TM, "Apples to oranges?: a direct comparison between suicide attempters and suicide completers" 124 : 90-97, 2010

27 Razvodovsky Y, "Alcohol consumption and suicide rate in belarus" 18 : 64-, 2006

28 Sher L, "Alcohol consumption and suicide" 99 : 57-61, 2006

29 Powell K, "Alcohol consumption and nearly lethal suicide attempts" 32 : 30-41, 2002

30 Hufford MR, "Alcohol and suicidal behavior" 21 : 797-811, 2001

31 Brent DA, "Age- and sex-related risk factors for adolescent suicide" 38 : 1497-1505, 1999

32 Nordentoft M, "Absolute risk of suicide after first hospital contact in mental disorder" 68 : 1058-1064, 2011

33 Knaus WA, "APACHE II: a severity of disease classification system" 13 : 818-829, 1985

34 Mann JJ, "A current perspective of suicide and attempted suicide" 136 : 302-311, 2002

35 통계청, "2013년 사망원인통계"