• Korean Journal of Clinical Pharmacy
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• v.28 no.4
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• pp.308-319
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• 2018

Background: Some mental illnesses such as depression are known to be one of the risk factors of suicide and proper antidepressant therapy can reduce suicidal behavior. Objectives: This study aimed to analyze regional variations in antidepressant consumption and adherence, suicide rate, prevalence of suicide related mental disorders, and access to relevant healthcare services. Methods: Cross-sectional analyses were conducted using National Patients Sample data compiled by the Health Insurance Review and Assessment Service between 2014 and 2016. We included patients who had a diagnosis record of suicide related mental disorders during the study period. Cause of death statistics and National health and medical statistics were used to identify suicide rate and distribution of healthcare service. We conducted visual analyses, chi-squared tests, independent t-tests and correlation analyses to demonstrate regional variations. Results: Between 2014 and 2016, the average prevalence of suicide related mental disorders was 5.4 per cent. Suicide rate and prevalence of suicide related mental disorders were higher in Gangwon, Chungcheong, and Jeolla (p < 0.001), and lower in Seoul (p < 0.001) than the national average. Unexpectedly, regional variations in antidepressant consumption were seen in the limited area including Daejeon, Chungnam and Gyeongnam (p < 0.05). The number of mild patient-centered clinics was associated positively with antidepressant consumption (p < 0.01) and associated negatively with suicide rate (p < 0.01). Conclusion: There were some regional variations in prevalence of suicide related mental disorders, antidepressant adherence and suicide rate. The higher level of antidepressant therapy and the lower level of suicide rates were seen in regions with easy access to mild patient-centered clinics.

• Research in Community and Public Health Nursing
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• v.33 no.2
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• pp.164-174
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• 2022

Purpose: The purpose of this study is to examine the effects of the rural elderly suicide literacy level upon suicide stigma and coping advice with suicidal crises (recommending professional help for a suicidal person). In particular, this study investigates the role of cultural norms (perceived social expectations for the experience of negative emotions) on suicide stigma and coping ability. Methods: A survey was conducted addressing elderly people (N=119) living in rural areas. Regression analysis using SPSS PROCESS macro was used to examine the relationships among the key variables. Results: Participants with higher suicide literacy showed lower suicide stigma, and this perception had a significant effect on enhancing their coping advice with suicidal crises. Also, perceived social expectations significantly influenced the relationship between suicide stigma and coping advice. With lower levels of social expectations, the mediating effect of suicide stigma on the relationship between suicide literacy and recommending professional help did not exist whereas the indirect effect was significant when it pertained to high levels of social expectations. Conclusion: This result signifies that suicide stigma serves as a barrier deterring Koreans from reaching out for professional help regarding their mental health. Moreover, these findings underscore the importance of cultural psychological factors such as perceived social expectations in terms of developing suicide prevention strategies.

• Health Policy and Management
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• v.33 no.2
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• pp.194-292
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• 2023

Background: This study aimed to update suicide-related indicators, including the number of suicidal deaths, suicide rate, and the prevalence of suicidal ideation and suicide attempts. We observed trends in suicide-related indicators based on up-to-date information. Methods: This study used five data sources to evaluate the trends of suicide-related indicators: Statistics Korea (1983-2021), Korean Wealth Panel Study (KOWEPS, 2012-2021), and Korea Health Panel Survey (KHP, 2010-2013, 2016-2019), Korean National Health and Nutrition Examination (KNHANES, 2007-2013, 2015-2021), Korean Community Health Survey (KCHS, 2008-2009, 2013, 2017, 2021). Results: The suicide rate per 100,000 population increased from 25.7 in 2020 to 26.0 in 2021. The rates of suicidal ideation from recently available data were 4.28% (KNHANES, 2021), 6.52% (KCHS, 2021), 1.61% (KOWEPS) and 7.10% (KHP, 2019). The suicidal attempts rates were 0.46% (KNHANES, 2021) and 0.34% (KCHS, 2021). The annual percentage change (APC) of suicide rate showed that suicide rates increased in the younger population (APC=9.02% in <19 years, APC=5.13 in 20-39 years) although the rates decreased in the older population (APC=-3.37 in 60-79 years, APC=-2.25 in >80 years). Conclusion: The suicide rate and related indicators increased in 2021 compared to 2020. Thus, continuous observation and appropriate suicide prevention policies as well as studies about the factors that affected the increase in 2021 are needed.

• Korean Journal of Health Education and Promotion
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• v.30 no.3
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• pp.59-73
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• 2013

Objectives: The study is aimed at examining the individual reasons and regional/environmental factors of online search on suicide using social big data to predict practical behaviors related to suicide and to develop an online suicide prevention system on the governmental level. Methods: The study was conducted using suicide-related social big data collected from online news sites, blogs, caf$\acute{e}$s, social network services and message boards between January 1 and December 31, 2011 (321,506 buzzes from users assumed as adults and 67,742 buzzes from those assumed as teenagers). Technical analysis and development of the suicide search prediction model were done using SPSS 20.0, and the structural model, nd multi-group analysis was made using AMOS 20.0. Also, HLM 7.0 was applied for the multilevel model analysis of the determinants of search on suicide by teenagers. Results: A summary of the results of multivariate analysis is as follows. First, search on suicide by adults appeared to increase on days when there were higher number of suicide incidents, higher number of search on drinking, higher divorce rate, lower birth rate and higher average humidity. Second, search on suicide by teenagers rose on days when there were higher number of teenage suicide incidents, higher number of search on stress or drinking and less fine dust particles. Third, the comparison of the results of the structural equation model analysis of search on suicide by adults and teenagers showed that teenagers were more likely to proceed from search on stress to search on sports, drinking and suicide, while adults significantly tended to move from search on drinking to search on suicide. Fourth, the result of the multilevel model analysis of determinants of search on suicide by teenagers showed that monthly teenagers suicide rate and average humidity had positive effect on the amount of search on suicide. Conclusions: The study shows that both adults and teenagers are influenced by various reasons to experience stress and search on suicide on the Internet. Therefore, we need to develop diverse school-level programs that can help relieve teenagers of stress and workplace-level programs to get rid of the work-related stress of adults.

• Journal of Korean Home Economics Education Association
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• v.32 no.4
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• pp.67-79
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• 2020

The purpose of the study were to analyze the patterns of adolescent suicide attempts, and to explore the effects of personal psychology (subjective depression, subjective stress), health status (BMI, subjective health perception), and subjective academic performance on the types of youth suicide attempts. For this research, data of 'The 15th Korea Youth Risk Behavior Survey' were analyzed employing a hierarchical logistic regression analysis. The findings are as follows. First, out of 1,731 youth suicide attempts 156 (9%) were impulsive and 1,575 (91%) were planned. Girls(67.3%) attempted suicide more than boys (32.5%), and middle school students (62%) attempted suicide more than high school students (38%). Second, the variables that significantly affect suicide attempt types were subjective depression, subjective stress, and subjective health perception, after controlling for gender, grade level, school type, and SES. The rate of planned suicide attempts was higher among those who experienced depression than among those who did not. In the case of subjective stress, adolescents who felt stressed were likely to commit planned suicide attempts. Those who attempted impulsive suicide showed 1.32 times higher subjective health perception scores than those who attempted planned suicide, indicating adolescents who perceived they were not healthy were more likely to attempt planned suicide. BMI and subjective academic performance did not have a significant effect on the types of youth suicide attempts. These findings suggested the necessity of systematic intervention in Home Economics classes or extra-curricular programs, to prevent potential youth suicide attempts.

• Health Policy and Management
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• v.30 no.1
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• pp.112-119
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• 2020

Suicide has been a long-standing problem for global public health, along with almost 800,000 deaths from suicide worldwide in 2016, accounting for 1.4% of all deaths. South Korea was ranked first in suicide mortality in 2018 among countries in the Organization for Economic Cooperation and Development. This study aimed to suggest up-to-date information about suicide-related indicators such as the rate of suicidal ideation, suicide attempt, and suicide death, and its trends by applying sampling weight to make it nationally representative. In this study, we used the data sources: Korea National Health and Nutrition Examination (KNHANES, '07-13, '15-18), Korean Community Health Survey (KCHS, '08-09, '13, '17), Korean Wealth Panel Study (KOWEPS, '12-18), Korea Health Panel Survey (KHP, '10-13), and Statistics Korea (1983-2017). The rate of suicidal ideation as recent year was 4.73% (KNHANES, '17), 6.96% (KCHS, '17), 2.29% (KOWEPS, '18), and 5.39% (KHP, '13). That of suicide attempt as recent year was 0.51% (KNHANES, '18), 0.32% (KCHS, '17), and 0.15% (KOWEPS, '18). Annual percentage change (APC) of suicidal ideation was -15.4% (KNHANES, '07-13, '15, '17), -2.5% (KCHS, '08-09, '13, '17), -10.8% (KOWEPS, '12-18), and -10.9% (KHP, '10-13). APC of suicide attempt was -4.4% (KNHANES, '07-13, '15-18), -4.4% (KCHS, '08-09, '13, '17), and -13.6% (KOWEPS, '12-18). APC of death by intentional self-harm was -1.25% (Statistics Korea, '07-18). All suicide-related indicators were found to be decreasing in the overall from 2009. Individuals with lower income level were more likely to experience suicidal ideation and suicide attempts. Even though suicide rate had been continuously decreasing from its highest point in 2011 (suicide rate: 31.7 per 100,000 population) to 2017 (suicide rate: 24.3 per 100,000 population), it increased again in 2018 (suicide rate: 26.6 per 100,000 population). This information would be grounded on policy implementation for suicide prevention, thus continuous data observation is necessary.

• Journal of Environmental Health Sciences
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• v.46 no.4
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• pp.388-397
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• 2020

Objectives: The aim of this study was to assess the association between the use of heated tobacco products (HTP) and suicidal behaviors such as suicidal ideation, suicide planning, and suicide attempts among adolescents in South Korea. Methods: The study used a cross-sectional design. Data was from the 15th Korea Youth Risk Behavior Web-based Survey (KYRBS) performed in 2019 by the Ministry of Education, Ministry of Health and Welfare, and Korean Center for Disease Control and Prevention. Heated tobacco product use was used as a main independent variable and suicide-related behaviors such as suicidal ideation, planning, and attempts were applied as dependent variables. Out of 60,100 students, 57,303 responded. Results: HTP use significantly increased the odds of a suicide attempt and suicide planning among adolescents. After controlling for confounders, when comparing 'current HTP users' with 'never HTP users', the adjusted odds ratio (OR) was 1.78 (95% confidence interval (CI): 1.38-2.30) for suicide attempts among adolescents. After controlling the confounders, comparing 'current HTP users' with 'never HTP users', the adjusted OR was 1.36 (95% CI: 1.06-1.73) for suicide planning among adolescents. For sadness/despair among adolescents, when comparing 'current HTP users' with 'never HTP users', the adjusted OR was 1.29 (95% CI: 1.11-1.50). However, HTP use had no significant association with suicidal ideation among adolescents. Conclusions: Current HTP users were more likely to attempt to commit suicide, and more likely to plan to commit suicide than never HTP users among adolescents. These results may be useful in developing a scientific basis for designing suicide prevention programs targeting adolescents.

• Archives of Plastic Surgery
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• v.42 no.2
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• pp.131-142
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• 2015

Literature indicates an increased risk of suicide among women who have had cosmetic breast implants. An explanatory model for this association has not been established. Some studies conclude that women with cosmetic breast implants demonstrate some characteristics that are associated with increased suicide risk while others support that the breast augmentation protects from suicide. A systematic review including data collection from January 1961 up to February 2014 was conducted. The results were incorporated to pre-existing suicide risk models of the general population. A modified suicide risk model was created for the female cosmetic augmentation mammaplasty candidate. A 2-3 times increased suicide risk among women that undergo cosmetic breast augmentation has been identified. Breast augmentation patients show some characteristics that are associated with increased suicide risk. The majority of women reported high postoperative satisfaction. Recent research indicates that the Autoimmune syndrome induced by adjuvants and fibromyalgia syndrome are associated with silicone implantation. A thorough surgical, medical and psycho-social (psychiatric, family, reproductive, and occupational) history should be included in the preoperative assessment of women seeking to undergo cosmetic breast augmentation. Breast augmentation surgery can stimulate a systematic stress response and increase the risk of suicide. Each risk factor of suicide has poor predictive value when considered independently and can result in prediction errors. A clinical management model has been proposed considering the overlapping risk factors of women that undergo cosmetic breast augmentation with suicide.

• Anxiety and mood
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• v.13 no.2
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• pp.60-65
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• 2017

Non-suicidal self-injury (NSSI) has been noted as a significant risk factor for possible suicide attempts. According to the Interpersonal Psychological Theory of Suicide, individuals can attempt suicide after they have acquired the capability to commit it. The acquired capability for suicide can be defined as one's habituated level to the pain and fear associated with suicidal behaviors. This is obtained through constant exposure to painful and provocative events, NSSIs being a prime example. This article reviews prior related studies to determine the extent to which the acquired capability for suicide can be utilized as a predictive factor for fatal suicide attempts following NSSIs. Our review finds a total of 11 studies that directly or indirectly support the claim that the acquired capability for suicide should be considered as a relevant factor linking NSSIs and suicide attempts. Given that NSSIs are most frequently observed in clinical settings, our findings suggest that the acquired capability for suicide will be a useful indicator for clinicians to predict the risk of future suicide attempts by patients.

• The Journal of the Korea Contents Association
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• v.20 no.1
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• pp.530-538
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• 2020

Recently, the suicide rate problem in Korea is very serious. Local governments are pushing various policies to lower suicide rates. The purpose of this study is to assess the difference in the suicide rate among regions and to identify the trend of change by concentration index(CI). The major findings are as follows. First, county suicide rate was the highest in the last 20 years and the lowest in the city. The low suicide rate in urban areas continues. Second, suicide rates are increasing in all regions. But the gap between the district and the county was decreasing. The difference in suicide rates between urban and rural areas is decreasing. Third, the suicide rate concentration index was negative for all 20 years. Suicide rates in low-density farming and fishing villages. Fourth, the absolute value of the concentration index has been continuously decreasing for 20 years. The gap between suicide and rural areas is decreasing. Therefore, inter-regional suicide rate is estimated to be leveling up.