• 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.

• Journal of Yeungnam Medical Science
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• 제41권1호
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• pp.30-38
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• 2024

Background: Although Korea ranks first in the suicide rate of elderly individuals, there is limited research on those who attempt suicide, with preventive measures largely based on population-based studies. We compared the demographic and clinical characteristics of elderly individuals who attempted suicide with those of younger adults who visited the emergency department after suicide attempts and identified the factors associated with lethality in the former group. Methods: Individuals who visited the emergency department after a suicide attempt from April 1, 2017, to January 31, 2020, were included. Participants were classified into two groups according to age (elderly, ≥65 years; adult, 18-64 years). Among the 779 adult patients, 123 were elderly. We conducted a chi-square test to compare the demographic and clinical features between these groups and a logistic regression analysis to identify the risk factors for lethality in the elderly group. Results: Most elderly participants were men, with no prior psychiatric history or suicide attempts, and had a higher prevalence of underlying medical conditions and attributed their attempts to physical illnesses. Being sober and planning suicide occurred more frequently in this group. In the elderly group, factors that increased the mortality rate were biological male sex (p<0.05), being accompanied by family members (p<0.05), and poisoning as a suicide method (p<0.01). Conclusion: Suicide attempts in elderly individuals have different characteristics from those in younger adults and are associated with physical illness. Suicides in the former group are unpredictable, deliberate, and fatal. Therefore, tailored prevention and intervention strategies addressing the characteristics of those who are elderly and attempt suicide are required.

• 한국임상약학회지
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• 제22권4호
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• pp.304-315
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• 2012

Today, suicide by self-poisoning of prescribed or non-prescribed drugs on purpose has been increasing and is a major cause of mortality. It is very important to treat promptly and properly for saving the lives from those suicides. There is neither an organization such as poison control center nor measurement in S. Korea, though. The object of this study was to evaluate information of frequently used substances for suicide attempt in S. Korea. Our results also can provide healthcare provider including pharmacists and doctors, etc and contribute to increasing health and welfare for Korean. From June $1^{st}$ 2006 to April $30^{th}$ 2012, we retrospectively studied patients visiting emergency room due to suicide attempt. We collected information of underlying disease, history of past medical condition and suicide attempt, ingredient and getting route of ingesting substances, emergency treatment, and outcome by reviewing electronic medical record. We also evaluated actual treatment of self-poisoning and made guide information about antidote medication for S. Korean healthcare provider. Among total 242 cases of suicidal attempts, cases ingesting substances including prescription, non-prescription drugs and agricultural chemicals were 86.4%. The most frequently used drugs for suicide attempt were sedatives-hypnotics (53.6%), followed by analgesics (16.7%) and antidepressants (12.4%). Analgesics including acetaminophen and aspirin were most in teenagers but sedatives-hypnotics including benzodiazepines, non-benzodiazepine (zolpidem) and antihistamine were most in other ages including elderly people. Most frequently used antidote was activated charcoal (62.7%) and specific antidotes for some substances (acetaminophen, aspirin, agricultural chemicals) were also treated properly, accompanying with medication for supportive care. In conclusion, the most used substances for suicide attempt were sedatives-hypnotics and treatments for self-poisoning in emergency room were appropriate based on existing references. Therefore, information of frequently used substances and antidote reflecting these results will be useful for South Korean healthcare provider.

• Journal of Chest Surgery
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• 제28권1호
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• pp.85-89
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• 1995

The early esophgeal carcinoma is limited to the mucosa or submucosa without lymph node metastsis which shows good 5-years survival rate. It is nearly 85-90% nowadays,if we just find and manage it.It is really helpful to use the endoscope in management and diagnosis, in addition the biopsy under the endoscopic finding.We experienced one case of early esophageal carcinoma. The patient was 57years old female,who ingested lye 27years ago for suicidal attempt, after 10years, the dysphagia was aggravated slowly. Before admission dysphagia was severely aggravated during 2months. Confirmation of diagnosis was made by endoscopic biopsy.Operation method was substernal colon bypass and total esophagectomy through right thoracotomy. Postoperative course was smooth.We report early esophgeal carcinoma related to lye stricture that was detected by the method of endoscopic examination and biopsy. It is important to screen the patients with longstanding history of benign esophageal stricture by the endoscopic biopsy.

• Journal of Medicine and Life Science
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• 제16권3호
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• pp.60-63
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• 2019

The rate of suicide is the 5th leading cause of death in Korea. Moreover, suicide is the 1st cause of death in from 2nd to 4th decade. In order to treat suicide attempters who have visited the emergency room and to prevent retries, it is necessary to understand the nature of the suicide and to take the right approach. Suicide is more than doubled in women, and retry rates are high among patients with a history of suicide. Suicidal means are throat, fall, gas poisoning, poisoning and drowning. All suicide attempters should suspect and treat cervical spine injury and airway management, and rapid hyperbaric oxygen therapy is recommended for carbon monoxide addicts. Interviewing a suicide attempter requires a sympathetic attitude and examines the underlying depression or adaptation disorders. Interdisciplinary care with mental health departments is necessary, and interventions in emergency roombased suicide attempt management work can be helpful to connect with the community.

• 대한임상독성학회지
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• 제7권1호
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• pp.44-46
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• 2009

Herein, we report a case of emergency cesarean section after severe maternal drug intoxication in late pregnancy. At a 38-week-gestation, a 32-year-old woman with a 10-year history of bipolar disorder took olanzapine (200 mg), diazepam (20 mg), and zolpidem (200 mg) as part of a suicidal attempt. Given her unconscious state and the evident concern regarding the toxic effects of the drugs on the fetus, a cesarean section was performed immediately. The patient gave birth to a male baby with Apgar scores of 5 at 1 and 8 at 5 minutes. The baby showed dyspnea and decreased activity directly after birth. After supportive care, the condition of both mother and baby improved and both were discharged.

• 한국산학기술학회논문지
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• 제15권7호
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• pp.4157-4164
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• 2014

목적 이 연구는 한국군 병사의 자살사고 예방을 위해 영적안녕, 자기통제, 조직몰입의 상관관계를 밝히는 것이다. 방법 599여명의 한국군 병사를 대상으로 2013년 12월 1일부터 31일까지 조사한 설문지를 통해 영적안녕, 자기통제, 조직몰입의 상관성을 조사한 양적인 설문조사연구이다. 자료는 SPSS 18.0 프로그램을 이용한 t-test, ANOVA, Pearson's correlation coefficient로 처리하였다. 결과 영적안녕, 자기통제, 조직몰입 간에는 정적 상관관계가 있다. 결론 영적안녕과 자기통제는 대상자들의 조직몰입과 정적 상관관계를 갖는다. 조직몰입을 높이기 위해서는, 건강문제로서 영적안녕에 대한 필요성이 중요함을 인식할 필요가 있다. 또한 영적안녕, 자기통제에 대한 교육 프로그램의 도입 및 자체 개발 및 적용이 필요하다. 이는 병사의 삶을 더욱 건강히 하고, 사회적으로 큰 이득이 될 것이다.

• 대한불안의학회지
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• 제9권1호
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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.

• Archives of Plastic Surgery
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• 제47권3호
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• pp.250-255
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• 2020

Background Rosenthal et al. classified female, habitual, non-suicidal wrist cutters as a group and introduced the concept of wrist-cutting syndrome. We investigated the characteristics of wrist-cutting patients at our institution in comparison with results reported previously. Methods We conducted a retrospective study involving 115 patients who had cut their wrists and been examined at the emergency department of a single hospital in Seoul, Korea, between March 2014 and August 2018. Results There were more women (73 patients; 63.5%) than men (42 patients; 36.5%), and the women (mean age, 34.42 years) were significantly younger than the men (mean age, 50.07 years). The patients who had cut their wrists repeatedly were mainly women (22 of 26 patients; 84.6%); however, men caused more severe damage than women. Substance use before a suicide attempt did not significantly increase the severity of wrist cutting. Our institution planned and implemented a suicide prevention intervention program to improve the continuity of outpatient care. The number of patients who continued psychiatric treatment increased significantly after program completion. Conclusions We confirmed that most patients were young women who were not suicidal in the true sense because their wounds were not severe. Our study showed a protective role of the barrier tendons (flexor carpi radialis, palmaris longus, flexor carpi ulnaris), and we suggest careful repair of the barrier tendons to protect neurovascular structures against subsequent cutting events. We found that it was possible to improve the continuity of patient counseling by managing patients through a psychiatric treatment program.

• 대한불안의학회지
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• 제8권1호
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• pp.41-49
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• 2012

Introduction : Suicide in Korea has increased to 31.2 persons per 100,000 population, the world's highest level. Suicide is the 10th leading cause of death in the world, but in Korea, it is 4th leading cause of death. Therefore suicide is a serious problem in Korea. Many suicide prevention strategies have been proposed. Despite efforts to prevent suicides in Korea, a steady increases in the number of suicides has been brought into question the effectiveness of suicide prevention activities in Korea. Methods : Strategy of restricting suicide methods in many countries was reviewed. Systematic approach to restrict suicidal methods in Korea is proposed. Results : Restricting suicide methods is one of the effective suicide prevention strategies employed in the UK and other countries. Since many suicides occur impulsively, suicide attempt lethality is an important factor in determining the rate of deaths in suicidal attempts. Physical restriction of suicide methods is important in preventing suicide, but restriction of cognitive access to information about suicide and suicide method is more important in preventing suicide. In particular hanging is one of the most common methods of suicides in Korea, it is crucial to develop strategies to prevent suicide by hanging cognitively. Also information about suicide should be properly controlled. To do this, suicide news reporting guidelines should be observed, and website makers whose websites provoke thoughts about suicide should be more strictly sanctioned. Conclusion : Restricting suicide methods along with other suicide prevention plans may be the most effective way to prevent suicide in Korea.