• 재활치료과학
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• 제7권1호
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• pp.11-26
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• 2018

목적 : 본 사례연구는 자살시도로 인한 저산소성 허혈성 뇌손상 환자의 특징적 증상과 신경학적 회복 양상을 고려한 인지 및 연하 재활 중심의 작업치료 중재를 소개하고 중재 효과로 인한 회복 양상에 대해 알아보고자 하였다. 연구방법 : 연구 대상은 자살시도로 인한 저산소성 허혈성 뇌손상을 진단받은 32세 남성으로 치료기간은 2016년 9월 8일부터 12월 6일까지이며, 주 5회 하루 한 번 재활치료를 받았다. 작업치료는 신경학적 기전으로 인한 저산소 허혈성 뇌손상의 특징과 자살이라는 정신 건강학적 특징을 바탕으로 이루어 졌으며, 인지와 연화 재활 중심의 프로그램이었다. 인지기능은 Mini Mental State Examination-Korean(MMSE-K), Computerized Neurocognitive Function Test(CNT), 일상생활활동 수준은 Korean-Modified Barthel Index(K-MBI), 연하기능은 Videofluoroscopic Dysphagia Scale(VDS), American Speech-Language-Hearing Association National Outcomes Measurements System (ASHA-NOMS)로 평가하였다. 결과 : 저산소성 허혈성 뇌손상 환자의 지연성 뇌손상 기전에 따라 인지기능 평가인 MMSE-K, CNT와 일상생활활동 수준을 평가하는 K-MBI, 연하기능을 평가하는 VDS, ASHA NOMS 결과에서 초기 평가 결과에 비해 모든 기능에서 저하가 나타났으나 회복 기전과 함께 재활 치료가 병행되며 모든 기능이 회복되어 초기 평가 수준으로 호전되었다. 결론 : 본 연구 결과 자살시도로 인한 심리적 요인과 저산소성 허혈성 뇌손상으로 인한 인지 및 연하적 요인을 고려한 일반적인 작업치료 프로그램은 환자에게 긍정적 회복 양상을 나타냈다. 이를 바탕으로 저산소성 허혈성 뇌손상으로 인한 지연성 뇌손상이 발생한 환자에게 작업치료의 개입은 필요한 부분이며, 정신건강과 인지 및 연하기능의 중심 프로그램이 개발되어야할 것이다.

• 한국산학기술학회논문지
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• 제16권12호
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• pp.8728-8737
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• 2015

본 연구는 과거와 현재의 응급의료센터에 내원한 자살기도자들의 임상적 특징을 비교하여, 향후 환자 발생시 임상적인 중증도 예측과 자살예방 연구의 토대로 활용하기 위함이다. 저자는 1998년 1월부터 12월과 2013년 8월부터 2015년 7월에 원광대학교병원 응급의료센터에 내원한 자살기도자들의 임상적 특징의 변화를 후향적으로 비교 분석하였다. 발생률에서는 1998년도에는 남성(1.1:1)이 더 많았으나 2013-2015년도에는 여성(1.3:1)이 더 많았고, 1998년도에는 20대, 30대, 60대 이상에서 많았던 반면에 2013-2015년도에는 30-50대에 많았다. 자살 시도 방법에서 가장 많았던 것은 중독이었다(90.8%;1998, 72.7%;2013-2015). 자살기도로 인한 사망률은 1998년에 16.9%(남성 23.1%, 여성 10.0%)에서 2013-2015년에는 13.8%(남성 18.1%, 여성 10.5%)로 감소하였다. 전체 자살기도자(총 516명) 중 재발한 환자는 37명이었으며, 자살기도자 중 48.3%는 정신건강의학과에 협진을 의뢰하였으나, 재발한 환자 전수에서 정신질환을 가지고 있었고, 정신질환자가 일반인에 비해 자살률이 높기 때문에 앞으로 발생하는 모든 자살기도자는 정신건강의학과와의 협진과 지속적인 추적관찰이 필요하겠다.

• 생물정신의학
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• 제12권2호
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• pp.189-195
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• 2005

Objects:Some studies have suggested that brain-derived neurotrophic factor(BDNF), one of the most important neurotrophins, is involved in pathophysiology of depression and suicide. This study was performed to determine whether there is an abnormality in plasma BDNF concentration in suicidal attempters. Methods:The subjects were 71 suicidal attempters who visited emergency rooms in multi-medical centers. All subjects had been interviewed by using Structured Clinical Interview for DSM-IV(SCID), Hamilton Depression Rating Scale(HDRS), Young Mania Rating Scale(YMRS), and Positive And Negative Syndrome Scale(PANSS). The severity of the suicidal behavior was measured by Lethality of Suicide Attempt Rating Scale(LSARS) and Risk-Rescue Rating(RRR) system. Seventy-one age, sex, and diagnosis matched non-suicidal psychiatric patients who were consecutively admitted to a psychiatric ward during the same period recruited as psychiatric controls. They were drug-naive or drug-free at least more than 2 months. In addition, 80 healthy controls were randomly selected as normal controls. Plasma BDNF level was measured by the enzyme linked immunosorbent assay(ELISA) methods. Results:In overall F-test, differences of the plasma BDNF levels among the groups were statistically significant(F=20.226, p<0.001). In the multiple comparisons(Scheffe), while mean levels of plasma BDNF between normal controls and non-suicidal psychiatric patients were similar(p=0.984), the BDNF levels of suicidal attempters were lower than those of other two groups(p<0.001). LSARS and RRR did not reveal any significant correlations with BDNF levels in suicidal attempters. Conclusion:These results suggest that reduction of plasma BDNF level is related to suicidal behavior and BDNF level may be a biological marker of suicidal behavior.

• 동의신경정신과학회지
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• 제29권2호
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• pp.99-109
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• 2018

Objectives: To analyze the reports of qualitative research about depressed mood and suicidal ideation of Korean Seniors. Methods: Eleven published qualitative research studies were selected for analysis. We extracted common topics and factors of each stage, Selected factors were paralleled and synthesized to make a flow chart of the phenomena. Results: Depressed mood arousals of Korean seniors are categorized by causation factors, which include economic, psychosomatic, and social factors, and positive-negative coping strategies, which include cognitive-behavioral factors. Suicidal experiences are categorized as ideation, suicidal attempt, and after-suicide stage. In the latter, participants reported three types of lifestyles by their enthusiasm for 'being alive'. Conclusions: Through the qualitative synthesis of research, we could analyze and categorize major factors and coping strategies of participants who exhibited a depressed mood or suicidal ideation.

• 한국의료질향상학회지
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• 제19권2호
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• pp.50-64
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• 2013

Objectives : Suicide is a serious sentinel event in healthcare organization. Suicide and suicidal attempt are fatal and long lasting mental and physical damage to themselves, family, and medical staffs. To develope the system to prevent suicidal accident in hospital, we reviewed and analysed one case of suicidal sentinel event. Methods: The risks of suicidal sentinel event were evaluated and analysed through the root cause analysis and failure mode effects analysis. Result: We found several root causes such as initial assessment of oldest patient and security issues. Couple of action plans to fix the problems were done immediately. According to failure mode, we evaluate the risk priority number to modify the action plans. Conclusion: To reduce the risk of sentinel events, we reviewed the suicidal event and established the new system and action plan to prevent sentinel events.

• 한국학교ㆍ지역보건교육학회지
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• 제12권1호
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• pp.1-20
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• 2011

Purpose: The purpose of this study is to analyze factors affecting suicidal ideation of athletes in middle and high school. Methods: The data in this study came from the survey which conducted to 500 students of physical education high school athletes and elite athletes in general school from the beginning of December 2009 to the end of January 2010 in Seoul and Kyunggi. Finally 436 cases was used. The dependant variable is suicidal ideation in this study. And the independent variables are socio-demographic factors, exercise-related factors, school and family environments, stress and depression factor. The analysis method is logistic regression analysis. Finally 436 cases was used. Results: First, the rate of suicidal ideation of athletes in middle and high school was 28.9%. Second, there were significant differences between stress and sex, grades, athletic career, kind of sport, sport skill level, the average exercise time per day, family circumstances, life satisfaction, future expectations. Third, there were significant differences between depression and sex, academic achievements, the average exercise time per day, family circumstances, life satisfaction, future expectations. Fourth, there were significant differences between suicidal ideation and sport skill level, academic achievements, the average exercise time per day, family circumstances, life satisfaction, future expectations. Fifth, the higher level of stress and degree of depression, the more increased the risk of suicidal ideation. Conclusions: Considering the close relationship between suicidal ideation and suicidal attempt, to reduce the suicidal ideation of athletes in middle and high school it is necessary to adjust exercising time properly and to promote life satisfaction. Also to overcome depression and stress support system should be established and to promote self-efficacy cognition strength program should be introduced in the school. So athletes in middle and high school should have confidence and self-confidence on the future.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제29권3호
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• pp.114-121
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• 2018

Objective: Although suicide is a serious public health concern for adolescents, there is a lack of studies that explore its risk factors in the Republic of Korea. The present study aims to investigate risk factors associated with suicidal behaviors in Korean adolescents. Methods: Participants consisted of 2258 middle and high school students who completed a series of questionnaires regarding suicide ideation or attempts, non-suicidal self-injuries, depression, impulsivity, drinking behaviors, and negative life events, including peer bullying. Results: Among the participants, 8.3% of students reported suicide ideation, while 3.2% reported a history of a suicide attempt in the past 12 months. Depression, peer-victimization, internet-related delinquency, and positive attitudes toward suicide were associated with suicidal ideations and attempts. Adverse life events were also associated with suicide ideation, but not attempts, while not living with both parents and poor family relationships were associated with suicide attempts, but not ideations. Non-suicidal self-injuries were associated with both suicide ideations and attempts. Students with suicidal ideations and attempts can be differentiated depending on the presence of self-injury. Conclusion: In addition to depression or behavioral problems, non-suicidal self-injuries and lack of support from family may also play significant roles in suicide attempts in adolescents. To facilitate the prevention of suicide in adolescents, longitudinal studies should be followed to confirm the risk factors identified in this study.

• 지역사회간호학회지
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• 제32권3호
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• pp.292-302
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• 2021

Purpose: Suicide among adolescents is a serious problem worldwide, and especially, the suicide rate of teenagers is increasing rapidly in South Korea. This study was conducted to investigate the factors affecting the respective suicidal behavior in terms of home-environment characteristics, health behavior characteristics, and psychological health characteristics in Korean adolescents. Methods: The data of the Web-based Survey of the Youth Risk Behavior from 2015 to 2017 collected by the Korea Centers for Disease Control and Prevention (KCDC) was analyzed using multivariable logistic regression analysis. Results: The influential factors by depression and suicidal behavior (suicidal ideation (SI), suicidal plan (SP), and suicidal attempt (SA)) were female(adjusted odds ratios [aOR], 1.45, 1.69, 1.30, 2.19), age (aOR 1.03, 0.98, 0.97, 0.90), no family members (aOR 1.21, 1.36, 2.11, 2.32), living with only the father (aOR 1.05, 1.06, 1.07, 1.11), high economic status (aOR 1.15, 1.22, 1.34, 1.46), residence in relatives' home (aOR 1.6, 1.36, 2.34, 1.97), drinking experience (aOR 1.35, 1.47, 1.57, 1.76), smoking experience (aOR 1.28, 1.30, 1.31, 1.94), hospital treatment experience due to violence (aOR 2.18, 3.33, 6.24, 8.40), bad health status (aOR 1.23, 1.48, 2.00, 2.15), unhappiness (aOR 2.49, 6.14, 6.72, 8.89), and a lot of stress (aOR 6.05, 10.40, 4.86, 5.52). Conclusion: The suicidal behavior risk screening and prevention program for adolescents should be developed considering the subjective happiness and hospital treatment experience status due to violence that affects suicidal behavior.

• Archives of Plastic Surgery
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• 제37권5호
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• pp.676-680
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• 2010

Purpose: Median nerve entrapment syndrome within carpal tunnel is usually called carpal tunnel syndrome and it is the most common form of peripheral nerve entrapment syndrome. Many factors such as diabetes mellitus, hypothyroidism, hormonal replacement theraphy, corticosteroid use, rhematoid arthritis and wrist fractures may cause carpal tunnel syndrome. To the best of our knowledge, this is the first case report of median nerve entrapment syndrome due to adhesion of laceration wound after suicidal attempt. Methods: A 28-year-old woman presented with a sensory change and thenar hypotrophy on her left hand. On her history, she attempted suicide by slashing her wrist. Initial electromyography (EMG) showed that the nerve conduction velocities of median nerve was delayed. Therefore, we performed surgical procedures. When exploration, Fibrous scar tissue observed around the median nerve but nerve had not been injured. Transcarpal ligament was completely released and adjacent fibrous tissue was removed to decompress the median nerve. Results: The postoperative course was uneventful until the first year. Opposition difficulty and thenar hypotrophy were improved progressively after the surgery. Sensory abnormality was slowly improved over one year. Conclusion: We report a case of median nerve entrapment syndrome that was caused by adhesion of laceration wound after suicidal attempt. This is an unusual cause of median nerve entrapment syndrome, the symptoms were relieved after transcarpal ligament release and fibrous scar tissue removal.

• 대한간호학회지
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• 제45권2호
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• pp.183-191
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• 2015

Purpose: For the current article an examination was done as to whether engaging in sexual intercourse before or during adolescence has a negative impact on the suicidal behaviors of suicide ideation, suicide attempt, and suicide lethality and whether the impact varies according to the context of sexual intercourse and/or gender. Methods: Adolescents who experienced casual sex and romantic sex were compared to adolescents who retained their virginity. Data was from samples drawn from the three waves (2010~2012) of the Korea Youth Risk Behavior Web-Based Survey. Logistic models were used to adjust for a wide array of confounding variables. Results: Any type of sexual intercourse increases risk of all suicidal behaviors. Sexual intercourse in a romantic relationship exhibits enhanced risk of suicidal behaviors compared to casual sex. Adjusting for experience of sexual violence, however, decreases risk of romantic sex substantially, turning some estimates statistically insignificant. In addition, risks for suicide lethality are greater for girls than boys. Conclusion: Romantic sex put adolescents at higher risk for suicidal behaviors than casual sex owing to prevalent sexual violence in the relationships. Girls suffer more substantively adverse outcomes than boys. These results suggest that adolescents will benefit from comprehensive education on sexuality and sexual behaviors regarding how to form and maintain a romantic relationship that is characterized by personal integrity and mutual respect. It is also important to help victims of sexual violence recover from traumatic events by providing emotional support and effective counseling.