수면정신생리 (Sleep Medicine and Psychophysiology)

  • 제21권2호
  • /
  • Pages.61-68
  • /
  • 2014
  • /
  • 1225-7354(pISSN)
  • /
  • 2713-8631(eISSN)
대한수면의학회 (KOREAN ACADEMY OF SLEEP MEDICINE)
권호 표지
DOI QR코드

DOI QR Code

일 도시지역 청소년의 자살사고 유병률과 위험인자에 대한 연구

Prevalence and Related Risk Factors of Suicidal Ideation in Urban Adolescents

  • 이태호 (가천대학교 의학전문대학원) ;
  • 이유진 (서울대학교 의과대학 정신과학교실)
  • Lee, Tae Ho (Gachon University School of Medicine) ;
  • Lee, Yu Jin (Department of Psychiatry, Seoul National University College of Medicine)
  • 투고 : 2014.10.27
  • 심사 : 2014.11.26
  • 발행 : 2014.12.31
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

목 적 : 본 연구에서는 한국의 청소년을 대상으로 자살사고 고위험군의 비율과 청소년에서 자살사고와 관련된 예측인자에 대해서 조사해 보았다. 방 법 : 일 도시지역 중고등학생 3,691명(남자 2,159명, 여자 1,532명, 평균연령 $15.31{\pm}1.46$)을 대상으로 하였다. 대상자들은 사회인구학적 정보를 비롯한 학급성적, 신체적 혹은 정신 질환유무, 평일 평균수면시간, 평일과 주말 사교육시간, 주관적인 상담의 필요성, Beck 우울척도(Beck depression inventory, 이하 BDI), Reynolds 자살생각척도(Reynolds' suicide ideation questionnaire, 이하 SIQ)에 대한 자가보고식 설문지를 작성하였다. 결 과 : 전체 대상자 중 168명(4.6%)이 SIQ 62점 이상의 자살사고 고위험군으로 분류되었다. 다중로지스틱 회귀분석에서는 여성(p = 0.002), 더 어린나이(p < 0.001), 낮은 학교성적(p = 0.043), 높은 BDI 척도 점수(p < 0.001)가 자살사고 고위험군의 예측인자로 나타났다. 자살사고 고위험군에서는, 더 어린나이(p = 0.045)와 높은 BDI 점수(p < 0.001)가 높은 SIQ 점수와 연관된 것으로 나타났다. 결 론 : 본 연구 결과는 여성, 어린나이, 낮은 학교성적, 우울감이 청소년 자살사고의 고위험군의 예측인자였고, 특히 자살사고 고위험군 중에서는 어린나이와 우울감이 심한 청소년들에게 더 많은 관심을 기울여야함을 보여주었다. 따라서 청소년 자살을 예방하기 위해서는, 이러한 위험요인을 가지고 있는 청소년들에 대해 적극적인 관심과 개입이 필요할 것으로 생각된다.

Objective: The aim of the present study is to assess the prevalence and related risk factors of suicide ideation among middle and high school students in an urban area. Methods: We surveyed 3,691 middle and high school students (2,159 male, 1,532 female, 11-19 years of age) using a self-report questionnaire that covered basic socio-demographic data, academic achievements, presence of physical or psychiatric illness, sleep duration on weekdays, time spent at private academies on weekdays and weekends, and subjective needs for counseling. The Beck Depression Inventory (BDI) and Reynolds' Suicidal Ideation Questionnaire (SIQ) were included in the survey. Results: The prevalence of students with high suicide ideation ($SIQ{\geq}62$) was 4.6%. In a logistic regression model, female sex (p = 0.002), younger age (p < 0.001), poor academic achievement (p = 0.043) and higher score of BDI (p < 0.001) were associated with a higher SIQ score. In addition, younger age (p = 0.045) and a higher BDI score (p < 0.001) were associated with a higher SIQ score adolescents having high suicide ideation ($SIQ{\geq}62$). Conclusion: Related risk factors of suicide ideation in adolescents were female sex, younger age, poor academic achievement, and a depressive mood. It would be especially helpful to pay more attention to younger adolescents and a depressive mood as a high-risk group. The understanding of these factors will be helpful for providing an effective suicide screening and prevention program for adolescents.

키워드

참고문헌

  1. American Academy of Sleep Medicine, The international classification of sleep disorders, 2nd edition;2005.
  2. An H, Ahn JH, Bhang SY. The association of psychosocial and familial factors with adolescent suicidal ideation: A populationbased study. Psychiatry Res 2010;177:318-322. https://doi.org/10.1016/j.psychres.2010.03.007
  3. Brausch AM, Muehlenkamp JJ. Body image and suicidal ideation in adolescents. Body Image 2007;4:207-212. https://doi.org/10.1016/j.bodyim.2007.02.001
  4. Centers for Disease Control and Prevention. Youth risk behavior surveillance-United States, 2001. MMWR Surveill Summ 2002;51:1-62.
  5. Centers for Disease Control and Prevention. Youth risk behavior surveillance-United States, 2003. MMWR Surveill Summ 2004;53:1-96.
  6. Centers for Disease Control and Prevention. Youth risk behavior surveillance-United States, 2005. MMWR Surveill Summ 2006;55:1-108.
  7. Centers for Disease Control and Prevention. Youth risk behavior surveillance-United States, 2007. MMWR Surveill Summ 2008;57:1-131.
  8. Centers for Disease Control and Prevention. Youth risk behavior surveillance-United States, 2009. MMWR Surveill Summ 2010;59:1-142.
  9. Cho SJ, Jeon HJ, Kim JK, Suh TW, Kim SU, Hahm BJ, et al. Prevalenceof Suicide Behaviors (Suicidal Ideation and Suicide Attempt) and Risk Factors of Suicide Attempts in Junior and High School Adolescents. J Korean Neuropsychiatr Assoc 2002;41:1142-1155.
  10. Christiansen E, Larsen KJ. Young people's risk of suicide attempts after contact with a psychiatric department-a nested case-control design using Danish register data. J Child Psychol Psychiatry 2012;53:16-25. https://doi.org/10.1111/j.1469-7610.2011.02405.x
  11. Crow S, Eisenberg ME, Story M, Neumark-Sztainer D. Suicidal behavior in adolescents: relationship to weight status, weight control behaviors, and body dissatisfaction. Int J Eat Disord 2008;41:82-87. https://doi.org/10.1002/eat.20466
  12. Dearden KA, De La Cruz NG, Crookston BT, Novilla MLB, Clark M. Adolescents at Risk: Depression, Low Academic Performance, Violence, and Alcohol Increase Bolivian Teenagers' Risk of Attempted Suicide. Int Electron J Health Educ 2005;8:104-119.
  13. Dervic K, Akkaya-Kalayci T, Kapusta ND, Kaya M, Merl E, Vogel E, et al. Suicidal ideation among Viennese high school students. Wien Klin Wochenschr 2007;119:174-180. https://doi.org/10.1007/s00508-006-0753-4
  14. Eaton DK, Lowry R, Brener ND, Galuska DA, Crosby AE. Associations of body mass index and perceived weight with suicide ideation and suicide attempts among US high school students. Arch Pediatr Adolesc Med 2005;159:513-519. https://doi.org/10.1001/archpedi.159.6.513
  15. Fitzgerald CT, Messias E, Buysse DJ. Teen sleep and suicidality: results from the youth risk behavior surveys of 2007 and 2009. J Clin Sleep Med 2011;7:351-356.
  16. Hahn HM, Yum TH, Shin YW, Kim KH, Yoon DJ, Chung KJ. A standardization study of Beck Depression Inventory in Korea. J Korean Neuropsychiatr Assoc 1986;25:487-502.
  17. Hawton K, Arensman E, Wasserman D, Hulten A, Bille-Brahe U, Bjerke T, et al. Relation between attempted suicide and suicide rates among young people in Europe. J Epidemiol Community Health 1998;52;191-194. https://doi.org/10.1136/jech.52.3.191
  18. Hesketh T, Ding QJ, Jenkins R.Suicide ideation in Chinese adolescents. Soc Psychiatry Psychiatr Epidemiol 2002;37:230-235. https://doi.org/10.1007/s00127-002-0536-9
  19. Jacobson CM, Marrocco F, Kleinman M, Gould MS. Restrictive emotionality, depressive symptoms, and suicidal thoughts and behaviors among high school students. J Youth Adolesc 2011;40:656-665. https://doi.org/10.1007/s10964-010-9573-y
  20. Kandel DB, Raveis VH, Davies M. Suicidal ideation in Adolescence: Depression, Substrance Use, and Other Risk Factors. J Youth Adolesc 1991;20:289-309. https://doi.org/10.1007/BF01537613
  21. Keane EM, Dick RW, Bechtold DW, Manson SM. Predictive and concurrent validity of the Suicidal Ideation Questionnaire Among American Indian Adolescents. J Abnorm Child Psychol 1996;24:735-747. https://doi.org/10.1007/BF01664737
  22. Koplin B, Agathen J. Suicidality in children and adolescents: a review. Curr Opin Pediatr 2002;14:713-717. https://doi.org/10.1097/00008480-200212000-00013
  23. Korea Centers for Disease Control and Prevention (2011). Using guidelines for Korea Youth Health Risk Behavior Web-based Survey (KYHRBWS). raw data. Seoul: Author.
  24. Lee YJ, Cho SJ, Cho IH, Kim SJ. Insufficient sleep and suicidality in adolescents. Sleep 2012;35:455-460.
  25. McKnight-Eily LR, Eaton DK, Lowry R, Croft JB, Presley-Cantrell L, Perry GS. Relationships between hours of sleep and healthrisk behaviors in US adolescent students. Prev Med 2011;53:271-273. https://doi.org/10.1016/j.ypmed.2011.06.020
  26. Nock MK, Green JG, Hwang I, McLaughlin KA, Sampson NA, Zaslavsky AM, et al. Prevalence, Correlates, and Treatment of Lifetime Suicidal Behavior Among Adolescents. JAMA Psychiatry 2013;9:1-11.
  27. Park E. The Influencing factors on Suicide Attempt among Adolescents in South Korea. J Korean Acad Nurs 2008;38:465-473. https://doi.org/10.4040/jkan.2008.38.3.465
  28. Park HJ, Kim HN, Kim IB, Jeon SA. Reliability of the Beck Depression Inventory in adolescence. J Korean Acad Fam Med 2000;21:244-253.
  29. Park HS, Schepp KG, Jang EH, Koo HY. Predictors of suicidal ideation among high school students by gender in South Korea. J Sch Health 2006;76:181-188. https://doi.org/10.1111/j.1746-1561.2006.00092.x
  30. Peter T, Roberts LW, Buzdugan R. Suicidal ideation among Canadian youth: a multivariate analysis. Arch Suicide Res 2008;12:263-275. https://doi.org/10.1080/13811110802100882
  31. Pisani AR, Schmeelk-Cone K, Gunzler D, Petrova M, Goldston DB, Tu X, et al. Associations between suicidal high school students' help-seeking and their attitudes and perceptions of social environment. J Youth Adolesc 2012;41:1312-1324. https://doi.org/10.1007/s10964-012-9766-7
  32. Reynolds WM. Suicidal ideation questionnaire. Odessa: Psychological Assessment Resources;1988.
  33. Statistics Korea. Adolescent statistics in 2011. Daejeon: Statistics Korea; 2010.
  34. Ursoniu S, Putnoky S, Vlaicu B, Vladescu C. Predictors of suicidal behavior in a high school student population: a cross-sectional study. Wien Klin Wochenschr 2009;121:564-573. https://doi.org/10.1007/s00508-009-1218-3
  35. Waldrop AE, Hanson RF, Resnick HS, Kilpatrick DG, Naugle AE, Saunders BE. Risk Factors for Suicidal Behavior Among a National Sample of Adolescents: Implications for Prevention. J Trauma Stress 2007;20:869-879. https://doi.org/10.1002/jts.20291
  36. Wang RH, Lai HJ, Hsu HY, Hsu MT. Risk and Protective Factors for Suicidal Ideation Among Taiwanese Adolescents. Nurs Res 2011;60:413-421. https://doi.org/10.1097/NNR.0b013e3182337d83
  37. Wichstrom L. Predictors of Adolescent Suicide Attempts: A Nationally Representative Longitudinal Study of Norwegian Adolescents. J Am Acad Child Adolesc Psychiatry 2000;39:603-610. https://doi.org/10.1097/00004583-200005000-00014
  38. Wilburn VR, Smith DE. Stress, self-esteem, and suicidal ideation in late adolescents. Adolescence 2005;40:33-45.
  39. Wolitzky-Taylor KB, Ruggiero KJ, McCart MR, Smith DW, Hanson RF, Resnick HS, et al. Has Adolescent Suicidality Decreased in the United States? Data From Two National Samples of Adolescents Interviewed in 1995 and 2005. J Clin Child Adolesc Psychol 2010;39:64-76.
  40. Wong MM, Brower KJ, Zucker RA. Sleep problems, suicidal ideation, and self-harm behaviors in adolescence. J Psychiatr Res 2011;45: 505-11. https://doi.org/10.1016/j.jpsychires.2010.09.005
  41. Yoo JS, Son JW, Nam MS. Factors Influencing Suicide Ideation among Adolescents. J Korean Acad Community Health Nurs 2008;19: 419-430.

피인용 문헌

  1. The Factor Associated with Suicide Risk of High School Students Using the Adolescent Mental Health and Problem Behavior Screening Questionnaire-II vol.16, pp.3, 2016, https://doi.org/10.15384/kjhp.2016.16.3.162
  2. A Survey for Mental Health of Children Whose Parents Have Psychiatric Disorders: A Preliminary Study for Mental Health Screening of High Risk Children vol.28, pp.4, 2017, https://doi.org/10.5765/jkacap.2017.28.4.235