• Anxiety and mood
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• v.9 no.1
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• pp.10-18
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• 2013

The increasing suicide rate is a serious problem in Korea. Because of increased awareness of suicidality as a problem and because completed suicide is the fourth leading cause of death, it is very important to assess the risk of suicide. The purpose of this review is to provide a systematic examination of predictive validity of measures of suicidal ideation and behavior. A number of instruments are described as useful for identifying individuals "at high risk" for suicidal behavior. However, the predictive validity for most suicide measures has not been established. The present review only includes suicide assessment instruments with published predictive validity. In addition to evaluating the suicide assessment with respect to predictive validity, the present review describes and summarizes the psychometric properties of each measure. In conclusion, because of the complexity of studying the risk of suicide and the paucity of well-designed studies, it is extremely difficult to compare and generalize these findings. In addition, only a few instruments, such as the Scale for Suicide Ideation, Suicide Intent Scale and the Beck Hopelessness Scale, have been found to be significant risk factors for completed suicide. Another problem in the field involves that there have been few suicide measures designed for elderly populations. Clearly, future research is needed to investigate the predictive validity of standardized measures for completed suicide, especially targeting elderly populations.

• Journal of The Korean Society of Clinical Toxicology
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• v.8 no.2
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• pp.51-60
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• 2010

Purpose: The aim of this study was to investigate toxic exposures in emergency centers with using a toxic exposure surveillance system-based report form as a preliminary study. Methods: We retrospectively reviewed the medical records of toxic exposure patients who visited emergency centers from January to December 2008. Results: 3,157 patients from 11 emergency centers were enrolled. Males were involved in 47.9% of the total cases of exposure and in 60.1% of the cases of fatal exposure. Suicidal intent was the most common (61.0%) reason and most (87.4%) fatal exposures were suicidal. Pesticides were involved in 30.7% of the cases and sedative/hypnotics/antipsychotics were involved in 20.5%. The substances most frequently involved in fatalities were pesticides, and a 48.4% fatality rate was recorded for paraquat exposure. Conclusion: The toxic exposure data showed the preliminary poisoning events in emergency centers. It is recommended that toxicology professionals should develop a toxic surveillance system and serial reporting should be performed.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.22 no.3
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• pp.208-214
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• 2021

It is necessary to consider the suicide problem of the senior citizens according to their occupation rather than simply dividing seniors according to whether they live in rural or urban areas to seek countermeasures against suicide. This study examines factors that influence the suicidal intentions of senior citizens engaged in the agriculture, forestry, and fishing industries using the ranking probit model. As a result, the suicidal intention of senior citizens working in the agriculture, forestry, and fishery industries who felt lonely increased by 3.0%, but the intention to commit suicide decreased by 1.1%, when they value their work, and the intent to commit suicide decreased by 2.7% when they feel a strong sense of belonging to their region. The more family members or relatives they meet every day, the suicide intentions of senior citizens in the agricultural, forestry, and fishing industries decreased by 2.5%. However, since the number of families living together is decreasing every year, there is an inevitable limit on face-to-face contact with family members or relatives. Therefore, it is necessary to establish policy that links the loneliness of senior citizens in the agricultural, forestry, and fishing industries with the effort of public institutions to promote social values.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.2 no.2
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• pp.156-160
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• 2006

Self-injurious behavior is defined as deliberated harm to one's own body without suicidal intent. It usually occurs as head banging or hitting, body hitting, skin cutting, or finger biting and includes ocular, genital, and self-inflicted oral mutilation. Self-injurious behavior can occur with mental retardation, comatose status, psychotic problem, poisoning, or character disorders. In pediatric patients, self-injurious behavior usually is reported to lip, cheek and tongue biting, and many kinds of dental management methods have been introduced to prevent self-injurious behavior patients from self biting. This report presents some self-inflicted oral mutilation patients who were all treated successfully with several appliances.

• Journal of The Korean Society of Clinical Toxicology
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• v.5 no.1
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• pp.74-78
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• 2007

The carbamates are a group of insecticides derived from carbamic acid, with a broad spectrum of uses as agricultural and household garden insecticides. Carbamate insecticides are reversible cholinesterase inhibitors. Their inhibitory action is mediated by reversible carbamylation of acetylcholine, as with the organophosphate insecticides. Carbamates are absorbed by the body through multiple routes, including inhalation, ingestion, and dermal absorption. Although poisoning can result from occupational exposure or accidental ingestion, in most cases there is suicidal intent. This is particularly true in developing countries, where the highest incidence of morbidity and mortality from this cause occurs. Cardiac complications often accompany poisoning by carbamate compounds, which may be serious and often fatal. The extent, frequency, and pathogenesis of cardiac toxicity from carbamate compounds has not been clearly defined. Possible mechanismsinclude sympathetic and parasymphatetic overactivity, hypoxemia, acidosis, electrolyte derangements, and a direct toxic effect of the compounds on the myocardium. Patients with carbamate poisoning should immediately be transferred to an intensive or coronary care unit where appropriate monitoring and resuscitative facilities are available. We here report a case of acute coronary syndrome resulting from acute carbamate ingestionthat resulted in a healthy discharge.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.12 no.1
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• pp.16-19
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• 2016

Oral self-injurious behavior (SIB) can be defined as the intentional, direct injuring of oral tissue, most often done without conscious suicidal intent and most commonly associated with tongue or lip biting. Chronic biting of oral mucosa is an innocuous self inflicted injury, commonly seen in children suffering from developmental and psychological problems. The cases presented in this report discuss oral SIB due to epilepsy, quadriplegia and their treatments. This report documents a successful self-injurious behavior treatment of epilepsy patients within a short time by applying a removable intraoral device. Clinicians should notice the possibility of oral SIB in various disorders. Moreover, different treatment should be performed according to the causative disorders and symptoms.

• Journal of The Korean Society of Clinical Toxicology
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• v.16 no.2
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• pp.161-164
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• 2018

The ingestion of corrosive substances often leads to severe morbidity and mortality. Acids produce coagulation necrosis with a lesser degree of penetration, whereas alkalis produce liquefactive necrosis with penetration. Acetic acid is a clear, colorless organic acid with a pungent, vinegar-like odor. The ingestion of highly concentrated acetic acid (glacial acetic acid) may cause a range of complications. On the other hand, perforation of the stomach is extremely rare but it has a high mortality rate. This paper reports a case of perforation of the stomach after the ingestion of glacial acetic acid with suicidal intent in an otherwise healthy 76-year-old woman.

• Sleep Medicine and Psychophysiology
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• v.16 no.2
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• pp.85-90
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• 2009

Introduction: There has been an increasing interest in the relationship between sleep and suicidality. In addition, suicidal patients habitually report their sleep problems. Although sleep-related complaints and electroencephalographic changes are generally encountered in psychiatric disorders, sleep complaints such as insomnia, hypersomnia and nightmares are more common in suicidal patients. In current study, we aimed at investigating the relationship between self-reported sleep duration and suicidality in general population. Methods: One thousand general population (male:female=500:500, mean age=$39.6{\pm}11.6$ years, ranged age=20-77 years) completed Center for Epidemiologic Study-Depression (CES-D), Beck Suicide Intent scale (BSI), Spielberger State-Trait Anger Expression Inventory (STAXI), Barratt Impulsiveness Scale (BIS), Morningness-Eveningness Scale (MES) and brief questionnaire of sleep habits. Results: After controlling for age and sex, score of BSI was correlated positively with the score of CES-D, STAXI and BIS on partial correlation analysis ($r_p$=0.251; p<0.001, $r_p$=0.352; p<0.001, and $r_p$=0.175; p<0.001, respectively). In addition, score of BSI was inversely correlated with the score of MES (rp=-0.066; p=0.037). However, score of BSI showed no significant correlation with sleep duration. However, regression analysis revealed that short (<6 hrs) or long (>10 hrs) sleep duration, the family history of psychiatric illness, the score of CES-D, and the score of STAXI predicted higher score of BSI significantly in total subjects (F=17.837, adjusted $R^2$=0.166; p=0.003, p=0.003, p<0.001, and p=0.003, respectively). This model was explained better in depressed subjects with 16 or higher score of CES-D (F=9.920, adjusted $R^2$=0.298). Conclusion: Current result suggested that not only short sleep duration (<6 hrs) but also long sleep duration (>10 hrs) might be related to suicidality.

• Korean Journal of Psychosomatic Medicine
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• v.21 no.2
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• pp.106-113
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• 2013

Objectives: The purpose of this study was to examine the characteristics and the psychosocial factors associated to the referral to psychiatric care in the suicide attempters visiting emergency center. Methods: We conducted a systematic chart review of 377 suicidal attempters visiting emergency center of the Korea University Ansan Hospital between January 2008 and December 2011. We gathered a data contain 20 items including psychosocial characteristics and factors related to suicide and factors related to psychiatric treatment. Multivariate logistic regression models were fitted to data to estimate the unique effects of sex, drunken status, companion, suicidal methods, place of suicide and current use of psychiatric medication on the referral to psychiatric care. Results: The female gender(OR=1.63, 95% CI=0.99-2.69), suicidal attempts at home(OR=3.40, 95% I= 1.21-9.56) and drunken state at visit(OR=2.34, 95% CI=1.10-5.01) are the factors that predict the risk of the non-referral of the patients to psychiatric intervention. Place of suicidal attempt was the most important factor do play a role in determining whether referral to psychiatric care will take place or not. Current use of psychiatric medication showed a trend toward significance(p=0.08, OR=1.67, 95% CI=0.95-2.95). Conclusions: These results suggest that when deciding whether to adapt or to refuse the referral to psychiatric care, the factors such as suicidal intent, lethality of suicide methods, familiar factors and alcohol may contribute onto the referral to psychiatric care. Additional research is required to investigate an association of these factors with referral to psychiatric care.

• Journal of The Korean Society of Clinical Toxicology
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• v.10 no.1
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• pp.22-32
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• 2012

Purpose: The purpose of this study was to examine the occurrence of toxic exposure cases in Korean emergency centers using a toxic exposure surveillance system-based report form and to provide guidelines for the prevention and treatment of toxic exposures. Methods: We retrospectively reviewed the medical records of toxic exposure patients who had visited emergency centers from January 2009 to December 2009. Epidemiology data points for the toxic exposure cases included age, gender, type of exposure, number and kind of substances involved, reason and route of poison exposure, management of the patients in the emergency departments, and the clinical outcome. Results: A total of 3,501 patients from 12 emergency departments were enrolled in the study. 50.0% of the total exposure patients were male and 63.0% of the total cases were fatal. Acute intoxication occurred in 91.3% of the total patients and suicidal intent was the most common (43.3%) reason for exposure. The most common route of exposure was ingestion (75.9%). Of the total cases, pesticides were involved in 26.3%, sedatives/hypnotics/antipsychotics were involved in 22.0%, and bites and envenomations were involved in 15.7%. Conclusion: We provided a database of patients who were admitted to emergency departments after poisoning incidents. We recommend that toxicology professionals develop a classification scheme for toxicants which is adequate for Korean domestic circumstances and initiate a toxic surveillance system for all types of exposures. With support of a psychiatric surveillance system for suicidal patients and establishment of social mediation for pesticide poisoning, major reductions in poison exposures can be achieved.