• Health Policy and Management
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• v.29 no.3
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• pp.312-322
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• 2019

Background: Since 2003, Korea has consistently shown the highest suicide rate among the Organization for Economic Cooperation and Development countries, and suicide remains the major cause of death. In particular, men are 2-3 times more likely to commit suicide than women, which called the 'gender paradox of suicide.' The areas with frequent suicide have spatially clustered patterns because suicide with a social contagion spreads around the neighborhood. The purpose of this study was twofold. The first was to estimate the hotspot areas of age-standardized male suicide mortality from 2008 to 2015. The second was to analyze the relationship between the hotspot areas and the regional characteristics for study years. Methods: The data was collected through the Korean Statistical Information Service. The study areas were 227 si gun gu administrative districts in Korea. The hotspot area was used as a dependent variable. Socio-demographic variables (number of marriages per 1,000 population, number of divorces per 1,000 population, and urbanization rate), financial variables (financial independence and social security budget), and health behaviors (EuroQol-5 dimension [EQ-5D], and depression experience rate) were used as independents variables. Results: The hotspot areas were commonly located in Gangwon-do, Chungcheongnam-do, Gyeongsangbuk-do, and Chungceongbuk-do. According to the results of panel logit regression, the number of divorces per 1,000 population, social security budget, and EQ-5D were statistically significant variables. Conclusion: The results of hotspot analysis showed the need for establishing a prevention zone of suicide using hotspot areas. Also, medical resources could be considered to be preferentially placed in the prevention zone of suicide. This study could be used as basic data for health policymakers to establish a suicide-related policy.

• Anxiety and mood
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• v.16 no.1
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• pp.1-8
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• 2020

Objective : This study aims to examine the association between exposure to suicide events and suicide ideation by analyzing the levels of suicide ideation among the groups with exposure to suicide death, non-suicide death, and no death in their social relationships. Methods : Data were derived from Wave I of the Longitudinal Study of Suicide Survivors' Mental Health. 1,998 adults nationwide selected using a stratified sampling method based on the Korean Census Data, were categorized into 3 groups with exposure to suicidal death, non-suicidal death, and no death. The levels of depression (Brief CES-D), subjective health status, and suicidal ideation (SSI) were measured. To examine the association between exposure to suicide and the level of suicide ideation, multiple regression analysis was used after controlling the socio-demographic and clinical factors including subjective health status and depression. Results : 32% reported their exposure to suicide. Compared to the other groups, the suicide-exposed group's level of depression and suicide ideation were significantly higher but the subjective health status was lower. Multiple regression model revealed that suicide exposure had a statistically significant association with suicidal ideation at p=0.000 even after controlling the clinical characteristics. Conclusion : HThe findings suggest that exposure to suicide is a risk factor for suicidal ideation. In the clinical field, it is necessary to consider patients' experience in exposure to suicide while treating and intervening in suicide-related cases. At the policy level, a mental health system for suicide prevention should consider this risk factor for those exposed to suicide in their family and social relationships.

• Korean Journal of Psychosomatic Medicine
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• v.29 no.2
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• pp.199-206
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• 2021

Objectives : This study aimed to compare the characteristics of suicide attempts among Korean patients with mixed and non-mixed depression. Methods : Patients who visited the emergency room due to a suicide attempt and participated in the Korean Cohort for the Model Predicting a Suicide and Suicide-related Behavior study were included. Using the Montgomery-Asberg Depression Rating Scale (MADRS) and Young Mania Rating Scale (YMRS), 111 patients were classified into the mixed depression (n=46) and non-mixed depression groups (n=65). The Koukopoulos Mixed Depression Rating Scale (KMDRS) score was calculated using the MADRS and YMRS scores. Suicide attempt characteristics were evaluated using the Columbia Suicidal Severity Rating Scale (C-SSRS) and Suicide Intent Scale (SIS). Results : In the mixed depression group, the reason item among the ideation intensity score of the C-SSRS was higher, and the deterrent item score was lower. Scores on the timing and suicide note items of the SIS were higher, and scores for overt communication items were lower in the mixed depression group. The KMDRS score was positively correlated with the C-SSRS ideation intensity and total SIS score. After adjusting for additional variables, the KMDRS scores had a significant effect on the C-SSRS ideation intensity and total SIS scores. Conclusions : The mixed depression group showed a difference in the intensity of suicidal ideation and suicidal intention compared to those in the non-mixed depression group. The overall suicidal ideation intensity and suicidal intention increased according to the degree of mixed depression.

• Health Policy and Management
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• v.24 no.2
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• pp.143-152
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• 2014

Background: Previous studies showed that the characteristics of population and regions were related to the suicide rates. This study purposed to analyze the relationships between regional factors and suicide rates with spatial analysis model. Methods: This is a cross sectional study based on the statistics of 2011 which was extracted from the 229 City Gun Gu administrative districts in Korea. Cause of death statistics on each district was used to produce the age-, sex-adjusted mortality rates resulting from suicide. Regional characteristics were measured by the number of doctors engaged in medical institutions per 1,000 population, divorced people's rate per 1,000 population, number of marriages per 1,000 population, and percent of welfare budget in general accounting. Statistical analysis was performed by using SAS ver. 9.3 and ArcGIS ver. 10.2 was used for geographically weighted regression (GWR). Results: In ordinary least square (OLS) regression, divorced people's rate per 1,000 population had a significant positive relationship with the standardized mortality rate per 100,000 population. Marriages per 1,000 population and the proportion of welfare budget in the general accounting had significant negative relationships with the mortality rates. Meanwhile, GWR provided that the directions of variable, divorced people's rate per 1,000 population, were varied depending on regions. The adjusted $R^2$ was improved from the 0.32 in OLS to the 0.46 in GWR. Conclusion: Results of GWR showed that regional factors had different effects on the suicide rates depending on locations. It suggested that policy interventions for reducing the suicide rate should consider the regional characteristics in obtaining policy objectives.

• Journal of The Korean Society of Integrative Medicine
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• v.11 no.4
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• pp.17-25
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• 2023

Purpose: This study aimed to examine the effectiveness of a suicide prevention education program called "Life Talk Talk" among middle and high school students in D City. Methods: The educational content of the "Life Talk Talk" program was compiled through nine rounds of consultations and meetings with suicide prevention experts. Prior to the implementation of the program, consent was obtained from all research participants and their guardians. First , a pilot study was conducted with 100 middle and high school students located in D city, following which the present study was conducted from May to July 2023 with 1,400 middle and high school students in D city. The effects of the program were evaluated by assessing the changes in suicidal ideation, help-providing abilities, and suicide prevention knowledge in the data collected both before and after the education. Statistical analysis included frequency analysis and a paired-sample t-test. Results: The final analysis included 1,380 participants. In the general characteristics,, 1,079 people (78 %) answered "yes" to the question about suicide prevention education experience . The study found a significant decrease in suicidal attitudes (t=-8.92, p<.001) and significant improvements in emotional and cognitive attitudes of participants after the "Life Talk Talk" program . Additionally, all five items related to help-providing abilities (t=-23.83, p<.001) and suicide prevention knowledge (p<.001) showed significant improvement from before the program. Conclusion: The significance of this study lies in demonstrating the effectiveness of the "Life Talk Talk" suicide prevention education program in reducing suicidal attitudes as well as improving help-providing abilities and suicide prevention knowledge. Therefore, to enhance the effectiveness of suicide prevention education, it is essential to regularly implement concise and engaging educational programs that capture the attention of adolescents.

• Journal of Korean Academy of Nursing
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• v.51 no.1
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• pp.40-53
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• 2021

Purpose: The purpose of this study was to develop and compare the prediction model for suicide attempts by Korean adolescents using logistic regression and decision tree analysis. Methods: This study utilized secondary data drawn from the 2019 Youth Health Risk Behavior web-based survey. A total of 20 items were selected as the explanatory variables (5 of sociodemographic characteristics, 10 of health-related behaviors, and 5 of psychosocial characteristics). For data analysis, descriptive statistics and logistic regression with complex samples and decision tree analysis were performed using IBM SPSS ver. 25.0 and Stata ver. 16.0. Results: A total of 1,731 participants (3.0%) out of 57,303 responded that they had attempted suicide. The most significant predictors of suicide attempts as determined using the logistic regression model were experience of sadness and hopelessness, substance abuse, and violent victimization. Girls who have experience of sadness and hopelessness, and experience of substance abuse have been identified as the most vulnerable group in suicide attempts in the decision tree model. Conclusion: Experiences of sadness and hopelessness, experiences of substance abuse, and experiences of violent victimization are the common major predictors of suicide attempts in both logistic regression and decision tree models, and the predict rates of both models were similar. We suggest to provide programs considering combination of high-risk predictors for adolescents to prevent suicide attempt.

• Korean Journal of Health Education and Promotion
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• v.26 no.4
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• pp.1-10
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• 2009

Objectives: The purpose of this study is to find the determinants of suicide impulse of residents living in mining region and other areas in one city. The past studies did not examine the suicide related attitudes or behaviors in mining region. This study also examines how coping resources and behaviors moderate the suicide impulse. Methods: For this purpose, hierarchical logistic regression method was used to predict the likelihood of suicide impulse. The personal characteristics, depression, coping resources and behaviors were considered as the independent variables. The data collected in this study was gathered through questionnaire survey with 502 residents in other areas as well as mining area in one city. Results and Conclusion: The results and conclusions are as follows: 1. The chi-square test revealed that residents living mining region showed higher percentage of suicide impulse compared to other areas. 2. The t-test revealed that those with suicide impulse had higher level of depression compared to those without it. This pattern was consistent in other areas as well as mining region. 3. The hierarchical logistic regression revealed that age, education, depression showed positive effect on suicide impulse in mining region. However, in other areas, education, illness, and depression showed positive effect on suicide impulse. Also, this result implies that suicide prevention efforts should be actively made in mining region.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.31 no.4
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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.

• Korean Journal of Psychosomatic Medicine
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• v.29 no.2
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• pp.144-152
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• 2021

Objectives : The purpose of this study is to identify differences between suicide attempters who used zolpidem and others who used different methods in emergency department. Methods : This study classified 2,734 suicide attempters, who went to emergency department from 2009 to 2018, into zolpidem user group, another drug user group and non-drug user group. For these three groups, chisquare test and logistic regression analysis were conducted regarding sociodemographic feature and clinical feature related with suicide. Results : In the result of logistic regression analysis of a variable, which showed meaningful difference between suicide attempter group who used zolpidem and the other group who did not use the drug, the occurrence of zolpidem-using suicide attempers was related with the case where anxiolytics/hypnotics was used or the case where lethality and intention was low. In the drug intoxication group which showed similar feature, there was also a relevance between anxiolytics/hypnotics and the occurrence of zolpidem-using suicide attempts. Conclusions : This study identified significant difference of sociodemographic and clinical feature in suicide attempter group who used zolpidem and the other group. This result can contribute to plan further medicinal treatment in using zolpidem.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.21 no.8
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• pp.315-324
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• 2020

The purpose of this study was to examine the relationship between emotional traumatic experience, stress, depression, and anxiety and to identify factors influencing suicide ideation. Data collection was carried out using a questionnaire survey administered to students from four health colleges in B city and a total of 289 questionnaires. Collected data were analyzed by frequency and percentage, mean, standard deviation, t-test, ANOVA, and multiple regression analysis using the SPSS/WIN program. The results show that there were significant differences in emotional trauma according to the general characteristics of the study subjects (p=.005) and stress related to grades (p=.029). Depression showed significant differences for gender (p=.020), religion (p=.022), and anxiety related to gender (p=.047). Suicidal thinking was not significantly different from the general characteristics. The suicidal ideation of the subjects was significantly correlated with emotional trauma (p<.001), stress (p<.001), depression (p<.001) and anxiety (p<.001). Factors affecting the suicidal ideation of the subjects were emotional trauma (t=4.117, p<.001), stress (t=2.909, p=.004), depression (t=3.421, p=.001), and anxiety (t=2.875, p=.004), and the explanatory power was 34.1%. This study can be used as basic data for the development of a suicide prevention program by identifying correlations between emotional traumatic experience, stress, depression, and anxiety related to suicide ideation and identifying factors affecting suicide ideation. Based on these results, the development of programs to reduce the college student suicide rate is necessary.