• 사물인터넷융복합논문지
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• 제7권1호
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• pp.43-54
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• 2021

본 연구는 베이비붐세대 남성의 자살예방을 위한 프로토콜을 구성하기 위하여 실시되었다. 연구에 참여한 전문가 패널들은 베이비붐세대 남성들의 심리적 특성과 자살에 대한 지식 및 실무적인 경험을 갖춘 전문인력으로 총 17명이 구성되었다. 조사의 첫 번째 단계는 질문지 문항을 구성하는 단계로 다양한 연구 자료를 활용하여 본 연구에 참여한 정신간호학 교수 2인, 정신전문간호사 2인에 의해 문항이 도출되었다. 2단계는 전문가 집단의 1차 델파이 조사로 2015년 10월 13일부터 11월 1일까지 실시되었으며 3단계인 2차 델파이 조사는 2015년 11월 10일부터 12월 4일까지 실시되었다. 조사 결과 영역I '베이비붐세대 남성의 특성', 영역II '베이비붐세대 남성의 자살징후', 영역III '베이비붐세대 남성의 자살위험요인', 영역IV '베이비붐세대 남성의 자살 보호요인', 영역V '자살예측 측정도구', 영역VI '지역사회연계 기관', 영역 VII '베이비붐세대 남성의 정신건강프로그램' 등 총 7개 영역으로 구성되었다. 본연구는 베이비붐세대 남성들의 자살예방을 위한 가이드라인으로써 지역사회 정신보건 실무자들에게 유용한 자료가 될 수 있을 것이다.

• 지역사회간호학회지
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• 제30권2호
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• pp.130-140
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• 2019

Purpose: The aim of this study is to explore levels of suicidal ideation and identify subgroups of high suicidal risk among the depressed elderly in Korea. Methods: A descriptive cross-sectional design was adopted on secondary data from the 6th (1st year) Korean national health and nutrition examination survey (KNHANES). A total of 239 depressed elders aged 60 or over who participated in the KNHANES. The prevalence of suicidal ideation and its related factors, including sociodemographic, physical, psychological characteristics and quality of life (EQ-5D index) were examined. Descriptive statistics and a decision tree analysis were performed using the SPSS/WIN 23.0 and SPSS Modeler 14.2 programs. Results: Of the depressed elderly, 28.9% had suicidal ideation. Three groups with high suicidal ideation were identified. Predictive factors included perceived stress level, household income level, quality of life and restriction of activity. In the highest risk group were those depressed elderly with moderate and low levels of stress, less than .71 of EQ-5D index and restriction of activity, and 80.0% of these participants had suicidal ideation. The accuracy of the model was 80.8%, its sensitivity 85.9%, and its specificity 68.1%. Conclusion: Multi-dimensional intervention should be designed to decrease suicide among the depressed elderly, particularly focusing on subgroups with high risk factors. This research is expected to contribute itself to the policy design and solution building in the future as it suggests policy implications in preventing the suicide of the depressed elderly.

• 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.

• 보건교육건강증진학회지
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• 제33권2호
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• pp.27-37
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• 2016

Objectives: This study investigated the relationship between adolescents' suicidal ideation and their physical health conditions to contribute to lower suicide rates among adolescents. Methods: Secondary analysis of 2108 high school students of $10^{th}$ grade was conducted using the Korean Child and Youth Panel survey in 2013. The association between suicidal ideation and socio-demographic and health characteristics were analyzed using Chi-square tests and regression models. Results: Adolescents' physical health conditions were significantly related to suicidal ideation. In particular, rhinitis and various symptoms such as feeling feverish, low appetite, feeling of nausea, stomachache while studying, and sleeping problem showed statistically significant relationships with suicidal ideation (P < .05). Furthermore, the higher frequency of diseases and body symptoms increases the rate of suicidal ideation. Considering socio-economic characteristics, family structure was also important. Conclusions: Physical health condition is a major contributor to adolescent's suicidal ideation. results suggest that improving social support system for adolescents' physical health conditions across family and school may be important in suicide prevention efforts.

• 보건교육건강증진학회지
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• 제31권5호
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• pp.97-107
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• 2014

Objectives: The purpose of this study was to examined the association between unemployment and suicidal ideation in Korea. Methods: We analyzed data from the Korean National Health and Nutrition Examination Surveys (KNHANES) IV, conducted in 2009. Statistical analysis methods used in this study were $x^2$-test, Hierarchial logistic regression analysis and other basic statistics using SPSS version 19.0. Results: The suicidal ideation of unemployment workers was 24.7% in male and 35.9% in female. After adjusting for sociodemographic characteristics and health-related characteristics, the risk for suicidal ideation of unemployment workers was significantly higher than employment workers. In men, the OR for suicidal ideation of the employed workers compared with the employed was 2.13, and in women, the OR was 1.31. Conclusions: The findings suggest the impact of unemployment status on suicidal ideation and the need for further prospective investigation that lead to interventions should be required to introduce of suicide prevention program for unemployment worker.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제27권4호
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• pp.306-312
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• 2016

Objectives: We aimed to compare the smoking behaviors in adolescents from monocultural and multicultural families and to evaluate the associations between their smoking behavior and number of suicide attempts. Methods: The data used in this study was collected from The Tenth Korea Youth Risk Behavior Web-based Survey. The differences in the sociodemographic characteristics between the adolescents in the multicultural and monocultural families were analyzed through the ${\chi}^2$-test, and a logistic regression was conducted to evaluate the relationships between the smoking behavior and number of suicide attempts of the adolescents in multicultural families. The process involved an analysis using a complex sample design. Results: There was significant difference in the weighted rates of the current smoking behavior (13.3% vs. 8.4%, p<0.001), experience of violence (6.8% vs. 2.3%, p<0.001), and number of suicide attempts (5.4% vs. 2.7%, p<0.001) between the adolescents from the multicultural and monocultural families. In both groups, the current smoking behavior was associated with the number of suicide attempts (multicultural families OR=6.5, p=0.005; monocultural families OR=1.5, p<0.001). Conclusion: Our results showed that the percentage of current smokers in the adolescents from multicultural families was higher than that in the monocultural families and that current smoking behavior is related to the number of suicide attempts in both groups, after adjustment for age, sex, socioeconomic status, academic achievement, current smoking behavior, depressive mood and experience of violence.

• 정신신체의학
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• 제21권2호
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• pp.106-113
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• 2013

연구 목적 이 연구는 응급실을 내원한 자살 시도자들의 특성과 정신건강의학과 진료 의뢰와 관련된 정신사회학적 요인을 알아내기 위해 진행되었다. 연구 방법 2008년 1월부터 2011년 12월까지 자살시도로 고려대학교 안산병원 응급실에 내원한 377명의 환자들을 대상으로 연구를 진행하였다. 우리는 정신사회학적 특성 및 자살 관련 변인, 정신건강의학과 치료 관련 변인 총 20개 항목에 관한 정보를 수집하였다. 다변량로지스틱 회귀분석을 통해 우리는 성별, 내원 당시 음주 상태, 동행보호자, 자살 방법, 자살 시도 장소, 최근 정신건강의학과 약물 복용력이 정신건강의학과 진료 의뢰에 미치는 독립적인 효과를 측정하였다. 연구 결과 자살 시도자의 응급실 내원 후 정신건강의학과 진료 의뢰 거부에 영향을 미치는 요인으로서 여성(OR=1.63, 95% CI=0.99-2.69), 집에서의 자살시도(OR=3.40, 95% CI=1.21-9.56), 내원시 음주상태(OR=2.34, 95% CI=1.10-5.01)가 확인되었으며 이중 집에서의 자살시도가 가장 큰 영향을 미치는 요인으로 확인되었다. 최근 정신건강의의학과 약물 투약(p=0.08, OR=1.67, 95% CI=0.95-2.95) 또한 정신건강의학과 진료 의뢰 거부에 영향을 미치는 경향을 보였다. 결 론 본 연구를 통해 자살 시도자의 자살 의도 및 자살 방법의 치명도, 환자 및 보호자의 자살시도에 대한 위험성 평가, 음주 여부 등이 정신건강의학과 진료 여부 결정에 영향을 주는 요인으로 확인되었다. 추후 이들을 대상으로 하는 전향적 후속 연구가 필요할 것으로 생각된다.

• 대한지역사회영양학회지
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• 제20권1호
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• pp.30-40
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• 2015

Objectives: This study was performed to investigate the associations of food security with socio-demographic characteristics, nutrient intakes and mental health status among older Korean adults. Methods: This study was conducted using data from the 2008-2010 Korea National Health and Nutrition Examination Survey (KNHANES). Subjects were 4,451 adults aged 65~98 years. Food security was measured using a self-reported question on food sufficiency of subjects' household. Based on the answers, study subjects were classified into secure, mildly insecure, moderately insecure, and severely insecure groups. Dietary intake was estimated by 24-hour dietary recall. Nutrient intake was assessed by dietary reference intakes (DRI). As for mental health status, the data on mental stress, depression, and suicide ideation were used. Results: Rate of food insecurity in older adults was 14.3%. Old age, being female, low education, low income level, living alone, and discomfort in daily living were more related to food insecurity. Means of nutrient intakes were significantly different according to food security status. Intakes of calcium, potassium, and vitamin $B_2$ were lower than recommended intakes in all groups. Consumption amounts of soy and soybean products, vegetables, mushrooms, fruits, vegetable oils, meats, eggs, seafood, and dairy products were lower in food insecure groups. Mental stress, depression, and suicide ideation were higher in food insecure groups independent of the gender and income level. Conclusions: These present findings suggested that food security is related to mental health as well as nutrition status in older Korean adults. A national system that include food and psychosocial support programs for the elderly should be considered in order to improve the overall health of older Korean adults.

• 한국학교보건학회지
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• 제32권2호
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• pp.105-115
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• 2019

Purpose: The purpose of this study was to compare the mental health factors related to health risk behaviors between multicultural and monocultural adolescents. Methods: The study subjects were selected from the 2018 Korea Youth Risk Behavior Web-Based Survey Dataset. A total of 60,040 multicultural and monocultural adolescents were included in the analysis. A $x^2$ test and logistic regression were conducted, using SPSS 18.0, to compare the general characteristics, mental health, and health risk behaviors of the multicultural and monocultural adolescents. This process involved a complex sample design. Results: There was a significant difference in the rates of suicidal behaviors. Multicultural adolescents showed a significantly higher rate of suicidal ideation (8.6% vs. 8.5%, p=.004), suicidal plan (3.2% vs. 2.4%, p=.004), and suicidal attempt (5.0% vs 3.1%, p=.04) than monocultural adolescents. Perceived stress had a significant impact only on monocultural adolescents. Monocultural adolescents with high levels of perceived stress were at a greater risk of drinking (high stress=reference; low stress OR=0.91, p=.025) and smoking (high stress=reference; low stress OR=0.90, p=.029) than those with low stress. Multicultural adolescents who had made suicide attempts were at a higher risk of drinking (multicultural OR=7.879, p<.001; monocultural OR=2.481, p<.001) and smoking (multicultural OR=4.011, p=.015; monocultural OR=2.800, p<.001) than monocultural adolescents. Conclusion: To implement an effective smoking and drinking prevention program, it is necessary to consider how we can reduce the risk factors. Stress management is important for monocultural adolescents and a proactive suicide-screening program and a suicide prevention program should be included in the program for both multicultural and monocultural adolescents.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제32권1호
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• pp.17-27
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• 2021

Objectives: Deliberate self-poisoning (DSP) is the most common suicide method and can be life-threatening. The purpose of this study was to investigate the factors related to the lethality of DSP and the characteristics of the adolescent group. Methods: A retrospective study was conducted on patients who had visited an academic hospital's regional emergency medical center between 2015 and 2018. The data reviewed through their medical records included sociodemographic factors, clinical variables, and psychiatric treatment. Four groups (Q1-Q4) were categorized by descriptive analysis using the risk-rescue rating scale. Results: A total of 491 patients were enrolled in this study. This study showed that high lethality had statistically significant associations with male sex, older age, admitting suicidal intentions, and the use of herbicides for suicide. Logistic regression analyses showed a significant association between high-lethality and female [odds ratio (OR)=0.50, 95% confidence interval (CI)=0.30-0.81, p=0.01], non-psychiatric drugs (over-the-counter drug: OR=2.49, 95% CI=1.08-5.74, p=0.03; herbicide: OR=8.65, 95% CI=3.91-19.13, p<0.01), and denial of suicide intent (OR=0.28, 95% CI=0.15-0.55, p<0.01). Conclusion: This study showed the clinical factors associated with the high lethality of DSP and suggested that efforts were needed to care for and thoroughly examine patients with DSP.