• 수면정신생리
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• 제29권1호
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• pp.15-20
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• 2022

배 경: 본 연구는 자살시도자와 자살사망자 간 자살방법, 스트레스 요인, 정신과적 진단에 차이가 있는지 확인하고자 하였다. 방 법: 두 가지 후향적인 자료를 분석에 사용하였다. 자살시도자의 경우 삼성서울병원의 의무기록을 확인하여 680명의 의무기록을 수집하였고 한국생명존중재단의 심리부검과정을 통해 11,722명의 자살사망자 데이터를 제공받았다. 두 가지 자료의 자살방법, 스트레스 요인, 정신과적 진단에서의 차이를 확인하였다. 결 과: 자살사망자는 자살시도자에 비해 남성이 많았고 연령대가 높은 것으로 나타났다. 자살 방법 중 목 매달기나 농약 음독과 같은 방법이 자살사망자와 관련이 있었다. 자살시도자의 경우 둔기를 이용해 손목을 긋거나 약물을 음독하는 경우와 연관이 있는 것으로 나타났다. 모든 종류의 스트레스 요인이 자살사망자에게서 높았으며, 특히 경제적인 문제와 신체적인 문제가 자살사망자에게서 높은 비율로 나타났다. 진단의 경우 연령과 성별에 따른 영향을 배제하자 자살시도자와 자살사망자 간 차이를 규명할 수 없었다. 결 론: 자살시도자와 자살사망자 사이에 자살 방법, 스트레스 요인에 차이가 있다는 것을 확인하였다. 이는 경제적인 문제와 신체적인 문제가 동반된 경우 자살 사망의 위험이 더 높을 수 있음을 시사한다.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제32권1호
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• pp.3-9
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• 2021

Objectives: It is hard to accumulate research data on adolescents' suicide, because friends and family of the suicide completers might be reluctant to share the experience. To overcome the lack of information on adolescent suicide victims, the authors examined the risk and protective factors for adolescents' suicide from a character in a novel. Methods: Krystal, an adolescent female in the novel The Casual Vacancy by Joanne Rowling, failed to overcome her unfortunate circumstances and committed suicide. The authors analysed Krystal's case based on the guideline for patients with suicidal behaviours to address the complicated situation of her death. Results: Krystal grew up in a poor and dangerous environment. Despite the environmental hardships, she developed ego maturation with affectionate help from Mr Fairbrother, an assistant coach of the Girls' Rowing Team and a parish councillor. The sudden passing away of Mr Fairbrother brought on a crisis of identity for Krystal. In addition, a villainous character raped her and her brother drowned to death, which brought her great sorrow. She felt helpless and committed suicide. Conclusion: In spite of many risk factors for suicide, Krystal was able to keep her life with a few protective factors, a younger brother in the home, and a sense of responsibility for the family. After the loss of her brother, however, she collapsed in a moment. Krystal's suicide might not only be a personal choice but a breakdown of the social protection system for the youth.

• Journal of Preventive Medicine and Public Health
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• 제47권6호
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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.