• Safety and Health at Work
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• v.7 no.1
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• pp.1-5
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• 2016

Background: Several studies have investigated the relationship between specific occupations and suicide mortality, as suicide rates differ by profession. The aim of this study was to investigate suicide mortality ratios across broad occupational groups in Greece for both sexes in the period 2000-2009. Methods: Data of suicide deaths were retrieved from the Hellenic Statistical Authority and comparative mortality ratios were calculated. Occupational classification was based on the International Classification of Occupations (ISCO-88) and the coding for Intentional self-harm (X60-X84) was based on the international classification of diseases (ICD-10). Results: Male dominant occupations, mainly armed forces, skilled farmers and elementary workers, and female high-skilled occupations were seen as high risk groups for suicide in a period of 10 years. The age-productive group of 30-39 years in Greek male elementary workers and the 50-59 age-productive group of Greek professional women proved to have the most elevated number of suicide deaths. Conclusion: Further research is needed into the work-related stressors of occupations with high suicide mortality risk and focused suicide prevention strategies should be applied within vulnerable working age populations.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.34 no.3
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• pp.152-158
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• 2023

Objectives: This study examined the associations between Internet addiction and suicide and non-suicidal self-injury (NSSI) among South Korean adolescents. Methods: We conducted a cross-sectional study of 1694 Korean adolescents. The suicidal Ideation Questionnaire and Deliberate Self-Harm Inventories were used to identify high-risk suicide and NSSI groups, respectively. Internet addiction was assessed using the Internet Addiction Scale. Other questionnaires included sociodemographic data, perceived academic stress, and daily life-related factors. We also performed a logistic regression analysis using the high suicide risk and NSSI groups as dependent variables. Results: The high suicide risk and NSSI prevalence rates among participants were 11.8% and 28.3%, respectively. A multivariable logistic regression analysis revealed that Internet addiction is associated with higher suicide risk and NSSI. Additionally, being female and academic stress were significant suicide risk factors, while male participants had a higher NSSI prevalence. Conclusion: Our results suggest that monitoring adolescents' Internet use and providing education to prevent Internet addiction would lower high suicide and NSSI risk. Moreover, suicide and NSSI risk screening in adolescents with Internet addiction and providing suitable interventions will be essential for the preventing suicide and NSSI.

• Therapeutic Science for Rehabilitation
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• v.13 no.3
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• pp.37-50
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• 2024

Korea has the highest suicide rate among Organization for Economic Cooperation and Development countries, with increasing rates observed among children and adolescents with low levels of life satisfaction. Patients in these age groups exhibit particularly turbulent and impulsive behaviors, which make suicide highly contagious and fatal. The loss of meaningful work or activities increases the risk of suicide, especially in young people. Following revisions to the Mental Health Welfare Act (2016), which has included occupational therapists among mental health professionals, a multidisciplinary approach including occupational therapy has been emphasized upon in mental health services. Screening tools for preventing suicide in children and adolescents include the Suicidal Ideation Scale, Beck's Suicidal Ideation Scale, Columbia-Suicide Severity Rating Scale, Reasons for Living Scale for Adolescents, and the Student Emotional and Behavioral Characteristics Test. The Canadian Occupational Performance Measure, which is an occupational therapy evaluation tool, is also used. Various suicide prevention programs have been proposed across academic disciplines; however, due to the urgent nature of high-risk groups, there is a need for timely services. Currently, most existing programs focus primarily on the cognitive-behavioral aspects. In this study, we aimed to introduce diverse suicide prevention programs for mental health professionals working with high-risk children and adolescents in order to equip them with the relevant information and help apply their learnings effectively in different situations.

• Journal of Preventive Medicine and Public Health
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• v.49 no.1
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• pp.69-78
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• 2016

Objectives: The suicide rate in Korea is increasing every year, and is the highest among the Organization for Economic Cooperation and Development countries. Psychiatric patients in particular have a higher risk of suicide than other patients. This study was performed to evaluate determinants of mental health care utilization among individuals at high risk for suicide. Methods: Korea Health Panel data from 2009 to 2011 were used. Subjects were individuals at high risk of suicide who had suicidal ideation, a past history of psychiatric illness, or had utilized outpatient services for a psychiatric disorder associated with suicidal ideation within the past year. The chi-square test and hierarchical logistic regression were used to identify significant determinants of mental health care utilization. Results: The total number of subjects with complete data on the variables in our model was 989. Individuals suffering from three or more chronic diseases used mental health care more frequently. Mental health care utilization was higher in subjects who had middle or high levels of educational attainment, were receiving Medical Aid, or had a large family size. Conclusions: It is important to control risk factors in high-risk groups as part of suicide prevention strategies. The clinical approach, which includes community-based intervention, entails the management of reduction of suicidal risk. Our study identified demographic characteristics that have a significant impact on mental health care utilization and should be considered in the development of suicide prevention strategies. Further studies should examine the effect of mental health care utilization on reducing suicidal ideation.

• Research in Community and Public Health Nursing
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• v.21 no.1
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• pp.71-81
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• 2010

Purpose: This study was to examine the effects of a depression intervention and suicide prevention program in adolescents with high risk of suicide. Methods: This research was designed as a nonequivalent control group pretest-posttest study. The participants were adolescents with high risk of suicide in mental health screening examination. A total of 40 adolescents (experimental group=21, control group=19) were sampled from C-gun, Chungbuk Province. The experimental group participated in the depression intervention and suicide prevention program for eight sessions while the control group did not participate in the program. Data were collected with a self-reporting structured questionnaire from November to December, 2008. SPSS/Win 12.0 was used for data analyses including chi-square test, t-test, and paired t-test. Results: After this program, there was no statistically significant difference in depression (t=1.498, p=.142) between the two groups, but depression decreased in the experimental group. There was a statistically significant difference in suicide ideation (t=2.058, p=.047). Conclusion: To decrease depression and suicide ideation in adolescents with high risk of suicide, it is necessary to offer this program in a more intensive course and for a longer period. Also, family consultation programs and individual case treatment and consultation programs should be offered.

• Journal of the Korean Society of School Health
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• v.36 no.3
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• pp.113-125
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• 2023

Purpose: The purpose of this study is to develop a model for predicting mental health risk among adolescents based on health behavior information by employing a hybrid machine learning method. Methods: The study analyzed data of 51,850 domestic middle and high school students from 2022 Youth Health Behavior Survey conducted by the Korea Disease Control and Prevention Agency. Firstly, mental health risk levels (stress perception, suicidal thoughts, suicide attempts, suicide plans, experiences of sadness and despair, loneliness, and generalized anxiety disorder) were classified using the k-mean unsupervised learning technique. Secondly, demographic factors (family economic status, gender, age), academic performance, physical health (body mass index, moderate-intensity exercise, subjective health perception, oral health perception), daily life habits (sleep time, wake-up time, smartphone use time, difficulty recovering from fatigue), eating habits (consumption of high-caffeine drinks, sweet drinks, late-night snacks), violence victimization, and deviance (drinking, smoking experience) data were input to develop a random forest model predicting mental health risk, using logistic and XGBoosting. The model and its prediction performance were compared. Results: First, the subjects were classified into two mental health groups using k-mean unsupervised learning, with the high mental health risk group constituting 26.45% of the total sample (13,712 adolescents). This mental health risk group included most of the adolescents who had made suicide plans (95.1%) or attempted suicide (96.7%). Second, the predictive performance of the random forest model for classifying mental health risk groups significantly outperformed that of the reference model (AUC=.94). Predictors of high importance were 'difficulty recovering from daytime fatigue' and 'subjective health perception'. Conclusion: Based on an understanding of adolescent health behavior information, it is possible to predict the mental health risk levels of adolescents and make interventions in advance.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.31 no.1
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• pp.33-40
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• 2020

Objectives: There is an increasing number of North Korean adolescents in South Korea. These adolescents need clinical attention as they experience a high risk of suicidal behavior because of the childhood adversity and acculturative challenges that they face before and after arriving in South Korea. This study assessed the risk of suicide attempts among North Korean adolescents compared to South Korean adolescents, and investigated the contributing factors for each group. Methods: We used data from the Korean Youth Risk Behavior Web-Based Survey (KYRBS) spanning 2011 to 2018, in which 404 adolescents had a father and/or mother who was a North Korean native. Data on 1,212 propensity-matched South Korean adolescents were extracted from the 2011 to 2018 KYRBS. Prevalence was calculated and compared by group. Separate odds ratios were calculated by group. Results: The North Korean group had a significantly higher suicide attempt rate [unadjusted odds ratio (OR)=8.27; adjusted OR=8.45]. Multivariate analysis indicated that having a low or high socioeconomic status and depressive symptoms were significantly associated with suicide attempts in North Korean adolescents, while being female, having a high socioeconomic status, alcohol use, and depressive symptoms were significantly related to suicide attempts in South Korean adolescents. Conclusion: The results found similarities and differences in the factors associated with the likelihood of suicide attempts in the two groups. From these results, different approaches are needed when planning interventions for each group.

• Korean Journal of Health Education and Promotion
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• v.28 no.2
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• pp.109-123
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• 2011

Objectives: The purpose of the present study was to explore the relationships between views on suicide, death, and life and lifetime suicidal attempts in the Korean context. Methods: Multiple logistic regression model was tested using data from Korean General Social Survey of 2009. We utilized the nationally representative survey data obtained via multistage stratified area probability sampling design from 1,599 respondents aged ${\geq}18$ years. Results: The proportion of lifetime suicidal attempts was 12.1% of entire sample in Korea. Some components of views on suicide and death influenced significantly on lifetime suicidal attempts after adjusting for demographic and health-related factors. The positive view on suicide(OR=0.76, 95% CI: 0.62-0.94), the naturalistic view on afterlife(OR=0.37, 95% CI: 0.67-0.99) and death concern(OR=0.67, 95% CI: 0.55-0.83) were risk factors of lifetime suicidal attempts. In contrast, the social responsibility view on suicide(OR=1.17, 95% CI: 1.00-1.37) and the transcendental view on afterlife(OR=1.25, 95% CI: 1.02-1.54) lowered the risk. Conclusions: Practical implications of the findings were discussed exploring policy evidences to screen high risk groups out and to reframe educational programs for suicide prevention. Strategic health messages need to be developed and transmitted for prevention of suicide.

• Anxiety and mood
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• v.13 no.2
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• pp.74-85
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• 2017

Objective : A variety of approaches are needed to solve high suicide rates in Korean society. Although suicide prevention education has been provided for the public and suicide risk groups in Korea, a systematic discussion of simple, effective suicide prevention guidelines for the general public has yet to be made. Self-help guidelines for suicide prevention, which can help prevent suicide in at risk individuals, will be developed through expert questionnaires. Methods : In order to develop the draft guidelines, suicide prevention self-help phrases were gathered and compiled from homepages and publicity materials of domestic and international suicide prevention and related organizations. A panel of 16 suicide prevention experts conducted primary and secondary surveys using the Delphi method, which derives results from consensus among expert groups. The validity and appropriateness of the guidelines was analyzed using content validity ratios (CVR). Results : Of 33 candidate phrases selected for the suicide prevention guidelines, 9 showed high CVR after the secondary Delphi round. The highest level of support with total agreement was given to 'Do not be alone, stay with someone'. However, more than half of the panelists evaluated 14/27 of the primary Delphi round and 12/26 of the secondary Delphi round phrases as invalid. The researchers completed 10 self-help guidelines for suicide prevention, after eliminating 1 redundant phrase and including 2 additional phrases that showed relatively high CVR. Conclusion : We have developed 10 self-help guidelines for suicide prevention through the consensus of experts. Further studies on the effects of the guidleines relative to suicide rates are needed after widespread dissemination.

• Journal of Preventive Medicine and Public Health
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• v.47 no.6
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• pp.327-335
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• 2014

Objectives: Several epidemiological studies on medical care utilization prior to suicide have considered the motivation of suicide, but focused on the influence of physical illnesses. Medical care expenditure in suicide completers with non-illness-related causes has not been investigated. Methods: Suicides motivated by non-illness-related factors were identified using the investigator's note from the National Police Agency, which was then linked to the Health Insurance Review and Assessment data. We investigated the medical care expenditures of cases one year prior to committing suicide and conducted a case-control study using conditional logistic regression analysis after adjusting for age, gender, area of residence, and socioeconomic status. Results: Among the 4515 suicides motivated by non-illness-related causes, medical care expenditures increased in only the last 3 months prior to suicide in the adolescent group. In the younger group, the proportion of total medical expenditure for external injuries was higher than that in the older groups. Conditional logistic regression analysis showed significant associations with being a suicide completer and having a rural residence, low socioeconomic status, and high medical care expenditure. After stratification into the four age groups, a significant positive association with medical care expenditures and being a suicide completer was found in the adolescent and young adult groups, but no significant results were found in the elderly groups for both men and women. Conclusions: Younger adults who committed suicide motivated by non-illness-related causes had a higher proportion of external injuries and more medical care expenditures than their controls did. This reinforces the notion that suicide prevention strategies for young people with suicidal risk factors are needed.