DOI QR코드

DOI QR Code

Factors related to Suicide within One year of Diagnosis of Schizophrenia: A Retrospective Cohort Study using National Health Information Database

조현병 진단 후 1년 이내 자살 관련 요인: 국민건강보험공단 자료를 이용한 후향적 코호트 연구

  • Received : 2020.01.07
  • Accepted : 2022.02.20
  • Published : 2022.02.28

Abstract

This study aims to identify factors related to suicide within one year of schizophrenia diagnosis based on data from National Health Information Database. We obtained data of 102,540 patients diagnosed with schizophrenia between 2007 to 2010 from customized database, which was checked using the National Statistics Organization database and schizophrenia cohort was built. The number of suicide within one year of schizophrenia diagnosis was 615(0.60%), and the risk of suicide within one year was high among patients within age group of 25-34 and patients with medium-low to high economic status. The risk of suicide within one year among male patients was high within age group of 45-54 and patients with medium-low to high economic status. The risk of suicide within one year among female patients was high within patients with high economic status. Age and economic status need to be considered during suicide prevention intervention of schizophrenia patients diagnosed within one year and suicide related factors by sex need to be especially considered.

본 연구의 목적은 국민건강보험공단 자료를 이용하여 조현병 진단 후 1년 이내 자살과 관련된 요인을 규명하는 것이다. 연구대상 자료는 맞춤형 데이터베이스에서 2007년부터 2010년 사이에 조현병으로 진단받은 대상자 102,540명으로 통계청 사망자료를 확인한 후 조현병 코호트를 구축하였다. 연구결과 조현병 진단 후 1년 이내 자살 사망자는 615명(0.60%)이고, 1년 이내 자살 위험은 25-34세 집단(adjusted OR, 1.40; 95% CI, 1.06-1.86)과 중하(adjusted OR, 1.86; 95% CI, 1.38-2.50)부터 상위(adjusted OR, 1.89; 95% CI, 1.42-2.51)집단의 경제상태에서 높았다. 남성은 45-54세 집단(adjusted OR, 1.60; 95% CI, 1.05-2.43)과 중하(adjusted OR, 2.66; 95% CI, 1.79-3.95)부터 상위(adjusted OR, 2.18; 95% CI, 1.45-3.28)집단의 경제상태에서 자살 위험이 높았다. 여성은 상위집단(adjusted OR, 1.51; 95% CI 1.01-2.27)에서 자살 위험이 높았다. 따라서 조현병 진단 후 1년 이내 자살 예방을 위한 중재 시 연령과 경제상태를 고려해야 하며, 성별에 따른 자살 관련 요인에 초점을 두어야 할 것이다.

Keywords

Acknowledgement

This paper was supported by the Konyang University Research Fund in the second half of 2020.

References

  1. OECD(2021). Suicide Rates. OECE data. [Online]. data.oecd.org/healthstat/suicide-rates.htm
  2. National Statistics Office(2021). Results of Statistics on Causes of Death in 2020. Statistics Korea News. [Online]. kostat.go.kr/portal/korea_nw/1/6/2/index. board
  3. J. T. O. Cavanagh, A. J. Carson, M. Sharpe & S. M. Lawrie. (2003). Psychological autopsy studies of suicide: a systematic review. Psycho- logical Medicine, 33, 395-405. DOI : 10.1017/S0033291702006943
  4. Ministry of Health and Welfare. (2021). Mental Health Survey. [Online]. www.mohw.go.kr/react/al/sal0301vw.jsp?PAR_ME NU_ID=04&MENU_ID=0403&CONT_SEQ=369088
  5. J. McGrath, S. Saha, D. Chant & J. Welham. (2008). Schizophrenia: a concise overview of incidence, preval-ence, and mortality. Epidemiologic Reviews, 30(1), 67-76. DOI : 10.1093/epirev/mxn001
  6. B. A. Palmer, V. S. Pankratz & J. M. Bostwick. (2005). The lifetime risk of suicide in schizophrenia: a reexamination. Archives Of General Psychiatry, 62, 247-253. https://doi.org/10.1001/archpsyc.62.3.247
  7. R. M. Cassidy, F. Yang, F. Kapczinski & I. C. Passos. (2018). Risk factors for suicidality in patients with schizophrenia: a systematic review, meta-analysis, and meta-regression of 96 studies. Schizophrenia Bulletin, 44(4), 787-797. DOI : 10.1093/schbul/sbx131
  8. W. Kim, S-Y. Jang, S. Y. Chun, T-H. Lee, K-T. Han & E-C. Park. (2017). Mortality in schizophrenia and other psychoses: data from the South Korea national health insurance cohort, 2002-2013. Journal of Korean medical science, 32(5), 835-842. https://doi.org/10.3346/jkms.2017.32.5.835
  9. H. Lee, K. Lee, J-W. Koo & Seon-Cheol Park. (2015). Suicide in patients with schizophrenia : a review on the findings of recent studies. Korean Journal of Schizophrenia Research, 18(1), 5-9. DOI : G704-SER000002665.2015.18.1.002 https://doi.org/10.16946/kjsr.2015.18.1.5
  10. E. L. Gomez-Duran, C. Martin-Fumado & G. Hurtado - Ruiz. (2012). Clinical and epidemiological aspects of suicide in patients with schizophrenia, Actas Espanolas de Psiquiatria, 40(6), 333-345.
  11. C. H. Pan et al. (2021). Incidence and method of suicide mortality in patients with schizophrenia: a nationwide cohort study. Social Psychiatry and Psychiatric Epidemiology, 56, 1437-1446. DOI : 10.1007/s00127-020-01985-8
  12. A. Ventriglio, A. Gentile, I. Bonfitto, E. Stella, M. Mari, L. Steardo & A. Bellomo. (2016). Suicide in the early stage of schizophrenia. Frontiers in Psychiatry, 7, 116. DOI : 10.3389/fpsyt.2016.00116
  13. S. Park, S. Y. Kim & J. P. Hong. (2012). Cause-specific mortality of psychiatric inpatients and out patients in a general hospital in Korea. Asia-Pacific Journal of Public Health, 27(2), 164-175. DOI : 10.1177/1010539512452755
  14. J. Zaheer, M. Olfson & E. Mallia. (2020). Predictors of suicide at time of diagnosis in schizophrenia spectrum disorder: a 20-year total population study in Ontario, Canada. Schizophrenia Research, 222, 382-388. DOI : 10.1016/j.schres.2020.04.025
  15. S. K. W. Chan et al. (2018). Association of an early intervention service for psychosis with suicide rate among patients with first-episode schizophrenia spect- rum disorders. JAMA Psychiatry, 75(5), 458-464. DOI : 10.1001/jamapsychiatry.2018.0185
  16. Ministry of Legislation. (2021). Easy-to-find Living Regulations Information: Basic Livelihood Secu rity System. [ONline]. easylaw.go.kr/CSP/CnpClsMain.laf?csmSeq=1533& ccfNo=1&cciNo=1&cnpClsNo=1
  17. C. Coope et al. (2014). Suicide and the 2008 economic recession: who is most at risk? Trends in suicide rates in England and Wales 2001-2011. Social Science & Medicine. 117, 76-85. DOI : 10.1016/j.socscimed.2014.07.024. Epub 2014
  18. Ministry of Health and Welfare. (2021). Mental Health Welfare Act. [ONline]. www.mohw.go.kr /react /policy/index.j sp?PAR_MENU_ID=06&MENU_ID =06330405&PAGE=5