• 정신신체의학
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• 제24권2호
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• pp.236-243
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• 2016

연구목적 본 연구는 자살시도에서 알코올이 자살시도의 심각성 및 치명도에 미치는 영향이 성별에 따라 차이가 있는 지 여부를 확인하고자 하였다. 방 법 총 1,152명의 자살시도자(남성 487명, 여성 742명)를 분석 대상으로 하였으며, 음주 양상에 따라 알코올사용 장애군, 급성알코올사용군, 비알코올사용군으로 나누었다. 자살시도의 심각성과 치명도는 자살의도척도및 위험-구조평가척도로 평가하였다. 결 과 남성에서는 급성알코올사용군에 비해 알코올사용장애군에서 자살의도척도의 총점이 유의하게 낮았지만, 여성에서는 각 군 사이에 유의한 차이가 없었다. 위험-구조평가척도에서 남성은 각 군간에 차이가 없었으나, 여성은 알코올사용장애군에서 가장 높은 구조도와 가장 낮은 위험도 점수를 보였다. 결 론 알코올사용장애가 있는 여성 자살시도자는 구조가 쉬운 상황에서 충동적인 자살 시도를 하는 경향이 있다면, 남성은 알코올 사용장애 환자보다 급성 알코올 중독상태일 때 자살의도가 더 강했다. 자살시도자의 알코올의 사용이 성별에 따라 다른 영향을 미칠 수 있으며, 특히 여성에서 중요한 위험 요인임을 시사하고 있다.

• Clinical and Experimental Emergency Medicine
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• 제5권4호
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• pp.230-239
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• 2018

Objective The suicide rate in South Korea is very high and is expected to increase in coming years. Intoxication is the most common suicide attempt method as well as one of the common reason for presenting to an emergency medical center. We used decision tree modeling analysis to identify predictors of risk for suicide by intentional intoxication. Methods A single-center, retrospective study was conducted at our hospital using a 4-year registry of the institute from January 1, 2013 to December 31, 2016. Demographic factors, such as sex, age, intentionality, therapeutic adherence, alcohol consumption, smoking status, physical disease, cancer, psychiatric disease, and toxicological factors, such as type of intoxicant and poisoning severity score were collected. Candidate risk factors based on the decision tree were used to select variables for multiple logistic regression analysis. Results In total, 4,023 patients with intoxication were enrolled as study participants, with 2,247 (55.9%) identified as cases of intentional intoxication. Reported annual percentages of intentional intoxication among patients were 628/937 (67.0%), 608/1,082 (56.2%), 536/1,017 (52.7), 475/987 (48.1%) from 2013 to 2016. Significant predictors identified based on decision tree analysis were alcohol consumption, old age, psychiatric disease, smoking, and male sex; those identified based on multiple regression analysis were alcohol consumption, smoking, male sex, psychiatric disease, old age, poor therapeutic adherence, and physical disease. Conclusion We identified important predictors of suicide risk by intentional intoxication. A specific and realistic approach to analysis using the decision tree modeling technique is an effective method to determine those groups at risk of suicide by intentional intoxication.

• 한국재난정보학회 논문집
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• 제2권1호
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• pp.139-155
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• 2006

Over the past two decades suicide terrorism has become an ever-widening phenomenon. When suicide terrorism was first introduced in the Middle East it seemed that this new phenomenon was invincible and that it might change the innate imbalance between terror groups and their rivalry governments. This did not in fact occur. Looking at history of terrorism, it can be seen that suicide attacks are in actuality a very old modus operandi. However, contemporary suicide terrorism differs from such historical tactics, just as the whole phenomenon of terrorism differs from ancient modes of warfare. Modern suicide terrorism is aimed at causing devastating physical damage. through which it inflicts profound fear and anxiety. Its goal is to produce a negative psychological effect on an entire population rather than just the victims of the actual attack. The relatively high number of casualties guaranteed in such attacks, which are usually carried out in crowded areas, ensures full media coverage. Thus, suicide terrorism, ranks with other spectacular modus operandi such as blowing up airplanes in mid air or the use of Weapons of Mass Destruction as a sure means to win maximum effect. For the purposes of this paper a suicide terror attack is defined as a politically motivated violent attack perpetrated by a self-aware individual (or individuals) who actively and purposely causes his own death through blowing himself up along with his chosen target. The perpetrator's ensured death is a precondition for the success of his mission. The greatest potential risk suicide terrorism may pose in future is if terrorists carry out operations combined with other spectacular tactics such as blowing up airplanes or the use of Weapons of Mass Destruction. Such a combination will increase immensely the death toll of a single terror attack and will have a shocking psychological effect on public moral. At this level suicide terrorism would constitute a genuine strategic threat and would probably be confronted as such. This study portrays a general overview of the modern history of suicide terror activity worldwide, focusing on its main characteristics and the various aims and motivations of the terror groups involved. In addition, This study provides an overview what is to be done to prevent such terrorist attacks.

• 정신신체의학
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• 제26권2호
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• pp.164-171
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• 2018

연구목적 우울증은 흔한 정신 질환이며 자살의 주요 원인이다. 혈청 지질이 우울증, 자살과 연관이 있다는 연구가 지속되어 왔으나 아직 논란의 여지가 있다. 본 연구에서는 우울감을 주호소로 입원한 환자를 대상으로 우울과 자살, 혈청 지질과의 연관성을 조사하였다. 방 법 134명의 연구대상자를 자살 비시도자 86명, 자살 시도자 48명으로 분류하여 혈청 지질 수치, 간이정신상태 검사 II (KSCL95) 하위 항목 점수를 비교하였다. 또한 지질과 KSCL95 하위 항목의 상관 관계를 조사하였고, 혈청 지질이 자살 시도의 위험 요인으로 작용하는지 알아보았다. 결 과 두 집단은 서로 혈청 지질의 차이를 보이지 않았으나, KSCL95 하위 항목 중 강박증(obsession, OBS)이 자살 비시도군에서 더 높게 나타났다. 중성지방은 우울(depression, DEP), 공포 불안(phobic anxiety, PHOB), 광장 공포(agoraphobia, AGO), 정신증(schizophrenia, SCH), 낮은 자기 조절력(self-regulation problem, RGP) 항목과 양의 상관 관계를 보였다. 혈청 지질 중 높은 중성 지방이 자살 시도의 위험 요인으로 확인되었다. 결 론 중성 지방이 우울, 불안, 자기 조절감과 관련이 있으며, 높은 혈청 중성 지방 농도는 자살 시도의 위험 요인으로 작용하고 있음을 확인하였다.

• 정신신체의학
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• 제28권1호
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• pp.8-19
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• 2020

연구목적 본 연구에서는 정신과 외래 환자 중 자살 고위험 집단인 자살 사고, 자살 시도, 비자살적 자해 및 일반 정신과 환자 집단의 감별 시 MMPI-2-RF가 변별 도구로써 활용될 수 있는지 알아보고자 하였다. 방 법 모든 대상자는 한양대학교 구리병원에 정신과적 진료를 내원한 환자로, 정신건강의학과 전문의로부터 DSM-5에 근거한 진단을 받았고, 이들의 의무기록을 후향적으로 검토하여 네 집단(자살 사고, 자살 시도, 비자살적 자해, 통제집단으로 일반 정신과 환자)으로 분류하였다. 총 112예가 분석에 포함되었다. 수집된 자료를 분석하기 위해 기술 통계 분석, 성별을 공변인으로 한 다변량 공분산분석(MANCOVA)를 통해 집단 간 차이를 알아보고자 하였다. 결 과 연구 결과, 비임상군인 대학생을 대상으로 한 기존 선행 연구와 마찬가지로, 임상군인 정신과 외래 내원 환자들 중에서도 자살 고위험군이 저위험군에 비해 높은 정서적/내재화 문제(EID), 무력감/무망감(HLP), 자살/죽음 사고(SUI), 의기소침(RCd), 인지적 증상 호소(COG), 냉소적 태도(RC3), 역기능적 부정 정서(RC7)와 부정적 정서성/신경증(NEGE-r) 점수를 보였다. 하지만 자살에 대한 위험성이 높은 환자들을 자살 사고, 자살 시도, 비자살적 자해를 시도하는 개인들 총 세 집단으로 나누어 분석하였을 때, 세 집단 모두를 변별할 수 있는 변인은 관찰되지 않았다. 다만, 자살 시도 집단 및 비자살적 자해 집단이 일반 정신과 환자 집단에 비해 높은 행동화/외현화(BXD), 반사회적 행동(RC4), 공격성(AGG) 등을 보였으나, 자살 사고 집단과 일반 정신과 환자 집단 사이에는 유의한 차이가 없었다. 결 론 본 연구는 MMPI-2-RF가 임상군인 정신과 외래 내원 환자들 중 자살 위험이 높은 환자들을 자살사고, 자살 시도, 비자살적 자해 세 집단으로 구분했을 때, 이 세 집단을 변별할 수 있는 유용한 진단적 도구로써 기능할 수 있는지 확인해보고자 하였으나, 세 집단 모두를 변별해주는 요인은 관찰되지 않았다. 이에, 세 집단 간변별에는 MMPI-2-RF가 진단적으로 유용하지 않을 것으로 시사된다. 다만, 자살 사고 집단에서는 차이가 나타나지 않았으나 자살 시도 및 비자살적 자해 집단에서는 통제군인 일반 정신과 환자들에 비해 높은 공격성과 행동화가 나타나, 자살 사고가 실제 자살 시도로 이행되는 과정에서 이러한 지표들이 위험성을 판단할 수 있는 조기변별 지표로서 기능할 수 있을 것으로 보인다.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제27권3호
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• pp.51-60
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• 2021

Purpose: The purpose of this study is to derive the residential environment design elements that affect suicide, and then analyze the actual situation in terms of suicide prevention and suggest implications. Methods: The study was conducted through literature analysis, field surveys, and interviews with stakeholders. Results: As a result of extracting the variables related to the residential environment that affect suicide suggested in a total of 18 papers, 15 variables were extracted and organized into major categories such as housing type, health and welfare facilities, leisure and cultural facilities, and living environment. Next, we selected a public rental housing complex with a relatively high suicide rate among multi-family housing as the case, and conducted a empirical analysis. It was investigated that the facilities were insufficient, and apart from the quantitative satisfaction of the rest, various problems were exposed, such as the classification of users according to age and insufficient management in terms of the actual use of residents including suicide attempters. Implications: First, it is necessary to search for the design direction of the residential environment for suicide prevention. Second, it is necessary to find a way to solve the exclusion phenomenon that appears in space and programs. Third, when planning a space for suicide prevention, understanding of the behavior of high-risk groups should be reflected.

• 한국간호교육학회지
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• 제22권4호
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• pp.473-484
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• 2016

Purpose: The purpose of this study was to identify the relations among appropriateness of work, competency on student suicide and attitude toward suicide in health teachers. Methods: This study was a cross-sectional descriptive one. The subjects were 193 health teachers. Self-administered questionnaires were used to measure the variables of this study. Descriptive statistics, independent t-test, one way ANOVA, Pearson correlation, and stepwise multiple regression with SAS 9.3 software were used for the data analysis. Results: The attitude score toward suicide ranged from 1.47 to -1.03. The average score of appropriateness of work and competency related to student suicide were 2.34 and 2.81 respectively. Associated factors with competency related to student suicide among health teacher were appropriateness of work related to student suicide, two items of attitude toward suicide(suicide is an acceptable means to end an incurable illness and people who commit suicide are usually mentally ill), education level, education experience on suicide prevention and management, and the adjusted $R^2$ of the regression model was 34.3%. Conclusion: Health teachers were not tolerable to student suicide. However, they evaluated themselves as low in the appropriateness and competency to the work on student suicide, especially in screening and counselling of high risk groups. The results of this study suggest that it is necessary to develop education programs about counseling and intervention on student suicide for health teachers.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제31권4호
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• pp.185-192
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• 2020

Objectives: Our study aimed to analyze the demographic and clinical characteristics of children and adolescents during their first visit to psychiatric outpatient departments for the management of suicidal ideation and behavior, and to compare the changes before and in 2012 or later. Methods: This multicenter study was conducted at five university hospitals in a metropolitan area in South Korea. Medical records of patients aged 6-18 years were retrospectively reviewed from January 2009 to December 2016. Patients were analyzed by classifying them into suicidal and non-suicidal groups based on their visit to the hospital for management of suicidal ideation or suicide attempt and other mental problems, respectively. Results: There were differences in the year of visit, diagnosis, education level, and referral sources between patients in the suicidal and non-suicidal groups. Multiple regression analysis was conducted based on the sex, education level, referral by school, and diagnosis of depression in patients in the suicidal group, which revealed significant association. Conclusion: Suicide-related problems were significantly associated with the sex, education level, referral by school, and a diagnosis of depression in the patients. A well-connected referral system would be necessary for professional mental health management of high-risk children and adolescents.

• 대한불안의학회지
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• 제14권2호
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• pp.88-98
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• 2018

Objective : The purpose of this study was to establish a school-based mental health intervention. The success of which was indexed by its effects on the social anxiety symptoms of the enrolled adolescents. Methods : This program for promoting mental health among adolescents in the community was adopted by three middle schools that volunteered to participate in the project. The program included screening for emotional problems related to social anxiety, depression, suicide, and post-traumatic stress disorder. Case management was provided for groups considered high-risk for depression, suicide, or post-traumatic stress disorder; cognitive-behavior therapy was provided for those at high-risk of developing social anxiety. Additionally, educational programs for the prevention of suicide, a "loving life" module, and mental health promotional campaigns were also included. In total, 1,100 middle school students completed self-report questionnaires. Twenty-five students in the high-risk group for social anxiety participated in a cognitive-behavior therapy program, comprising eight sessions, and conducted by two clinical psychologists. Results : Following the suicide prevention education program, suicide awareness among students increased and coping strategies were improved. In addition, the loving life program was associated with positive self-perceptions by many students. Furthermore, social anxiety symptoms showed a statistically significant difference after the cognitive-behavior therapy program. After the therapy, not only did social anxiety symptoms improve, depressive symptoms and suicidal ideation decreased significantly, while self-esteem and psychological resilience significantly increased. Conclusion : A school-based mental health intervention was successfully implemented in three middle schools and improved the mental health of the participating students. Therefore, this intervention could be widely implemented to promote positive mental health among middle school students.

• 한국콘텐츠학회논문지
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• 제15권1호
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• pp.252-263
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• 2015

우리나라는 2004년부터 지금까지 OECD 국가 가운데 자살사망률 1위이며, 지속적으로 자살자 수와 자살사망률이 증가하고 있다. 효과적인 자살정책을 확인하기 위해 AHP(Analytic Hierarchy Process) 기법을 이용하여 자살예방의 주요 접근방법별 세부정책들의 우선순위를 조사하였다. 설문은 2013년 8월 23일, 26일 두 차례에 걸쳐 총 30명을 대상으로 워크숍 형식으로 실시하였다. 이중 학계는 20명(사회복지사 4명, 정신보건학자 7명, 정신의학자 5명, 임상심리학자 4명), 정책결정자는 5명, 공급자는 5명이였다. 2013년 9월 9일부터 12일까지 4일간 이메일로 사회복지분야와 임상심리분야에서 각각 5명씩 추가하여 총 40명을 대상으로 조사를 하였다. 세부 정책들의 중요도는 '자살시도자 관리,' '공공자살예방서비스 인프라 구축,' '유가족 지원사업,' '위험집단의 위기관리' 등의 정책에서 높은 것으로 나타났다.