• Korean Journal of Culture and Social Issue
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• v.29 no.1
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• pp.75-99
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• 2023

The current study aimed to explore the suicidal behaviors and risk factors of completed suicides using psychological autopsy and use them as index variables to classify suicidal types. In addition, this study looked into the influential factors that affect each suicidal type. related to suicidal behaviors and suicidal risk factors by psychological autopsy. In addiction, the distinctions among the classes were analyzed. For this, psychological autopsies were conducted on the families and the close ones of 128 completed suicides. Then, the index variables were finally chosen for classifying suicidal types. The selected index variables for suicidal risk factors were mental disorders, suicide/self-harm, significant changes in physical appearance, marital conflict, adjustment and relationship issues at work/school, unemployment/layoff, jobless status and serious financial problems. The selected index variables for suicidal behaviors were expressing their suicidal attempts, writing suicidal notes, asking for help, the time/place/method of suicidal behavior, past suicidal/self-harm experience and the first person who witnessed the suicide. The Latent Class Analysis(LCA) and the 3-step method were used for classifying suicidal types. Then external variables(financial changes, cohabitation, existence of stressors, changes in stress level or relationships and family members with mental disorder/alchohol problems/ physical disorders, and work/school stisfaction) were applied for distinguishing classes. As a result, 5 classes(financial problems, adjustment problems, complex problems, psychiatric problems, and response to event[s]) were revealed on suicidal behaviors and 3 classes(residence- suicidal attempt- found by family, nonresidence- nonsuicidal attempt- found by acquaintances, residence- nonsuicidal attempt- found by family) were presented on suicidal risk factors. External variables such as gender, marital status, cohabitation, changes in relationships significantly differentiated among the 3 classes. Especially, class 3(residence- nonsuicidal attempt- found by family) tended to cohabit with others, were married, and had a significantly high level of interpersonal conflicts. When comparing the 5 classes of suicidal risk factors, auxiliary variables such as economic changes, cohabitation, stress, relationship changes, and family-related problems, and school/work satisfaction significantly differentiated the 5 classes. Especially class 3 (complex problems) experienced comparatively less family-related problems, but showed an aggravating level of personal stress. Suicial prevention strategies should be provided considering the characteristics of each class and the influential factors.

• Journal of Preventive Medicine and Public Health
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• v.48 no.1
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• pp.28-37
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• 2015

Objectives: Among the Korean elderly (those 65 years of age and older), the suicide rate is 80.3/100 000 people, which is ten times higher than the Organization for Economic Cooperation and Development average. Because South Korea is rapidly becoming an aging population, this high elderly suicidal rate will only get worse. Although the size of the elderly suicide problem is quite large, previous research in South Korea has surveyed restricted areas and not the entire country. Even though the factors that affect elderly suicide are complicated, there has been little research into these influencing factors. Thus, this research uses the national survey data (Community Health Survey) that was obtained in 2009. Additionally, we analyze factors affecting elderly suicidal ideation and attempts as well as the paths of these effects. Methods: Community Health Survey data obtained by the Korea Centers for Disease Control and Prevention in 2009 was used for this study. We additionally examined the factors that affect suicide with chi-squared tests, t-tests, Pearson's correlation test, and path analysis. Results: Depressive symptoms and suicidal ideation are the only factors that directly affect suicidal attempts. Demographic, behavioral, and physical activity factors have indirect effects on suicidal attempts. Conclusions: Depression has the strongest influence on suicidal ideation and attempts. Demographic, behavioral, and physical activity factors affect suicidal attempts mostly through depressive symptoms. In addition, there is a path that suggests that demographic, behavioral, and physical activity factors affect suicidal attempts not through depression symptoms but only through suicidal ideation. This means that the elderly who do not have depression symptoms attempt suicide according to their own situations and characteristics.

• Journal of Korean Academy of Nursing
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• v.41 no.5
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• pp.652-662
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• 2011

Purpose: The suicide rate of adolescents in Korea is increasing annually. Therefore, this research was done to identify the suicide attempt rate of middle and high school students and to identify factors that influence suicidal attempts. Methods: The Korea Youth Health Risk Behavior Web-based Survey (2007) was used as data. Discriminant analysis and logistic regression were performed to analyze the data depending on gender to consider the gender difference in assessing the influence of each independent variable on suicidal attempts. Results: Discriminant analysis according on gender showed that 13 factors correlated with suicidal attempts for boys, and 20 factors for girls. The most highly correlated factors were smoking, depression and inhalation experience. For inhalation experience, boys had 2.7 times higher possibility of suicide attempts (95% CI 1.8-3.0) and girls, a 2.4 times higher possibility (95% CI 1.7-3.5). Conclusion: The results of the study indicate a need to classify adolescents for expectation of suicide risk and high danger for suicidal attempts through, and introduce suicide prevention programs for these adolescents. In particular, it is necessary to start intervention with students who smoke, have sexual and inhalation experiences and high levels of depression.

• Korean Journal of Biological Psychiatry
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• v.6 no.2
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• pp.227-234
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• 1999

An association of low total cholesterol in blood with psychiatric diseases and suicidal behavior has been suggested. As part of an attempt to further explore this relationship, we examine first, whether serum cholesterol levels in psychiatric patients with suicidal attempt would be lower than in non-suicidal psychiatric inpatients or normal controls, second, whether such significant difference of cholesterol levels would be present when the diagnostic groups are analyzed separately, third, whether low cholesterol level would be associated with a history of serious suicidal attempts, and finally, whether low cholesterol level in suicide attempters is a state or a trait marker. We determined the serum cholesterol levels in 231 patients admitted to an emergency room following an suicidal attempt, in the same numbers of age-, sex- and diagnosis- matched non-suicidal psychiatric controls, and in the same numbers of age-, sex matched normal controls. The seriousness of an attempt was divided into 5 grades according to the degree of the resulting medical injury. Total cholesterol levels in suicide attempters were significantly lower compared with both psychiatric and normal controls, when sex, age, and nutritional status (i.e., body mass index) were controlled for. This significant relationship was observed in major depressive disorders and personality disorders, but not in schizophrenia and bipolar type I disorders. The severity of suicide by a lowering of blood cholesterol was related to the magnitude of the cholesterol reduction. After treatment of their psychiatric ailments, the cholesterol levels in suicide attempters were significantly increased. This result suggests that low cholesterol level in psychiatric patients might be a potential biological marker of suicide risk. It is hypothesized that low cholesterol levels is associated with the suicide by modifying the serotonin metabolism, the production of interleukin-2 and melatonin metabolism in psychiatric patients.

• 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.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.26 no.3
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• pp.149-158
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• 2015

Objectives : The objective of this study was to identify the risky behavior subtypes in adolescents with depression, and the relationship between those subtypes and suicide attempt. Methods : Ninety adolescents who met the Diagnostic and Statistical Manual of Mental Disorders-4th edition criteria for major depressive disorder, dysthymia, or depressive disorder not otherwise specified participated in the study. Participants were interviewed about suicidal attempts, non-suicidal self-injuries. Smoking, drinking behaviors, and searching for the word "suicide" on the internet, negative life events including bulling-bullied experiences, and history of abuse were also included with questionnaires. Results : The results of cluster analysis showed that four risky behaviors were divided into three clusters : non-risky type, characterized by few risky behaviors ; delinquency type, which was characterized by smoking and drinking ; non-suicidal self-injury type. In non-suicidal self-injury type, percentage of girls was higher and clinical symptoms were more severe than delinquency type. In addition, delinquency type members could be a bully, while non-suicidal self-injury type members could be abused by a family member. Logistic regression analysis showed that both risky behavior subtypes were significant predictors of suicide attempt. Conclusion : These results suggest that two types of risky behaviors of depressed adolescents have an effect on the suicide attempts independently. Then, the implications and limitations of the study were discussed and directions for future studies were suggested.

• 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.

• Research in Community and Public Health Nursing
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• v.24 no.2
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• pp.135-142
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• 2013

Purpose: The purpose of this study is to explore influencing factors which contribute to the suicidal ideation in community residents who have ever experienced suicidal attempts. Methods: The subjects of this study were a total of 165 local residents with some experiences of suicidal attempts in B City and K Province. The data were collected from May 1st to October 30th, 2012 and self-report questionnaires including Suicidal Ideation Inventory, Self-Esteem Inventory, Depression, Family and Social Support Inventory were used as a measurement tool. The data were analyzed using t-test, ANOVA, Pearson correlation coefficients, multiple regression with the SPSS/WIN 18.0 program. Results: The average score of suicidal ideation in the local residents with experiences of suicidal attempts was $12.7{\pm}6.25$. Predicted factors on suicidal ideation in the local residents with experiences of suicide attempts included self-esteem, depression and physical illness, and the suicidal ideation has a variance explanation power of 54%. Conclusion: The development and application of intervention programs, which can help to increase self-esteem levels and decrease depression levels among community residents with experiences of suicidal attempts, are first needed. Furthermore, nursing services of customized self-management for people with physical disabilities are needed on the basis of their own physical problems.

• The Journal of the Korea Contents Association
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• v.19 no.6
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• pp.644-654
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• 2019

The purpose of this study was to investigate the effects of depression, self-esteem and daily life ability on suicidal ideation in elderly people with chronic illness. The subjects were 170 outpatients and inpatients in a general hospital in D city. After conducting questionnaires for data collection, t-test, ANOVA and multiple regression analysis were performed and analyzed using SPSS 12.0 / win program. The results showed that suicidal ideation was influenced by gender, health status, chronic disease diagnosis, and experience of suicide attempt, with a positive correlation with depression and a negative correlation with daily life ability. The suicide attempt experience, depression, self-esteem and daily living ability showed 50.8% explanatory power against suicidal ideation. In order to reduce suicidal ideation, it is necessary to reduce suicidal ideation of elderly people with chronic diseases by managing an intervention program that reduces depression and improves daily life ability.

• Korean Journal of Psychosomatic Medicine
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• v.29 no.1
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• pp.1-10
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• 2021

Objectives : This study was conducted to investigate differences in psychological characteristics between major depressive disorder (MDD) patients with and without suicide attempt using MMPI-2-RF. Methods : Subjects were 107 MDD patients who had visited the department of psychiatry of hallym university hospital and met the DSM-IV diagnostic criteria of MDD by the korean version of MINI-Plus 5.0.0. The patients were divided into suicidal attempters (n=43) and non-suicidal attempters (n=64) using C-SSRS. The one-way ANOVA was used to compare MMPI-2-RF scale scores between two groups. Additionally, ANCOVA was conducted considering the severity of depressive symptom and comorbidity as covariate. Results : Our results showed that Suicide/Death Ideation (SUI), Inefficacy (NFC) and Interpersonal Passivity (IPP) scales were significantly higher in the MDD patients with suicidal attempt compared to MDD patients without suicidal attempt (p<0.05). However, after controlling for the severity of depressive symptom and comorbidity, SUI scale showed a significant tendency (p<0.10). Conclusions : The result suggests that MMPI-2-RF scales could be a useful tool for identifying patients transitioning to actual suicidal attempts in the moderate or severe major depressive disorder group. Limitations of this study and directions for further research are also discussed.