• Journal of Medicine and Life Science
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• 제18권2호
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• pp.31-34
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• 2021

The pharmacokinetic properties of transdermal nicotine patches (TNPs) are different from those of other routes of nicotine administration; further, acute nicotine poisoning by TNPs may present with different clinical features. In the present report, we describe the case of a 23-year-old woman who was admitted to emergency department (ED) at Jeju National University Hospital with loss of consciousness. Five hours before the ED visit, she used multiple TNPs to attempt suicide. Initially, nausea and vomiting occurred, and the symptoms worsened over time. We immediately removed the TNPs, and the application sites were gently washed with sterile water. The patient's level of consciousness gradually improved, and she fully recovered an altered mental status 5 hours later. Her initial urinary cotinine level was 324 ng/mL. Physicians should be aware that acute nicotine poisoning by TNPs can cause various toxic symptoms.

• 생물정신의학
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• 제3권2호
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• pp.258-261
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• 1996

Objective : Several studies hove suggested that reduction of cholesterol concentration and low cholesterol level increases suicide, homicide, and depression. The authors sought to determine whether low cholesterol is associated with a history of suicidal attempts among major depression patients. Method : The subjects were 105 patients with major depression, diagnosed according to the DSM-III-R criteria, and 105 age, sex matched healthy controls. Blood was token following overnight fast and serum cholesterol concentration were measured by a enzymatic method Results : The serum cholesterol level was significantly lower in the patients with major depression than in healthy controls($180.4{\pm}43.4mg/dl$ vs $199.7{\pm}35.8mg/dl$). And the serum cholesterol level was significantly lower in major depression patients with suicidal attempt than in major depression patients without suicidal attempt($156.7{\pm}38.2mg/dl$ vs $ 187.8{\pm}42.5mg/dl$) Conclusion : It is hypothesized that low cholesterol level is associated with depression by modifying the serotonin metabolism and the production of interleukin-2, low cholesterol concentration should be further investigated as a potential biological marker of suicidal risk in major depression. Prospective study with serial cholesterol determinations should be done.

• 대한불안의학회지
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• 제17권2호
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• pp.78-83
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• 2021

Objective : Current study investigated the association between internet addiction and suicidal attempts in psychiatric patients. Methods : Patients who visited emergency department or psychiatry outpatient unit of Chungnam National University Hospital from January 2020 to July 2021 were included in this study. Total of 192 participants, 96 suicidal attempt cases and 96 psychiatric control patients without history of suicidal attempt were matched by gender and baseline diagnosis. Depression and internet addiction were assessed by using Patient Health Questionnaire-9 (PHQ-9) and Young's Internet Addiction Test (IAT). Independent t-tests, and logistic regression analyses were conducted. Results : IAT scores were significantly higher in suicidal attempt case group (41.09±18.196 years) compared to psychiatric control patients without history of suicidal attempt (36.63±17.016 years) (p=0.040). Internet addiction (adjusted Odds Ratio [aOR]=2.049, 95% Confidence Interval [CI]=1.004-4.539, p=0.0493) was an independent risk factor for suicidal attempt in psychiatric patients after controlling age, gender, and sociodemographic factors, such as marital status, education level and employment status. Conclusion : This is the first study to investigate the relationship between internet addiction and suicidal attempt in psychiatric patients in Korea. Internet addiction is significantly associated with suicidal attempt in psychiatric patients, after adjusting sociodemographic variables. This study provides evidence to future studies to further investigate on causality of internet addiction and suicidality in psychiatric patients.

• 정신신체의학
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• 제26권2호
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• pp.135-144
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• 2018

연구목적 본 연구에서는 자살 시도 후 응급실에 내원한 소아청소년을 대상으로 입원 치료를 받은 군과 입원하지 않은 군의 사회인구학적, 임상적 특성을 비교하여 차이를 밝히고자 한다. 방 법 2009년부터 2015년까지 자살 시도로 응급실에 내원한 18세 이하 소아청소년을 대상으로 35명의 입원군과 114명의 비입원군으로 분류하였다. 두 군에 대해 교차분석과 회귀분석을 수행하여 사회인구학적 변수, 자살과 관련된 임상적 변수들을 비교 분석하였다. 결 과 자살 시도 후 입원군 소아청소년들과 비입원군 소아청소년들 모두 음독에 의한 자살시도를 가장 많이 시도했으며, 대인관계 곤란과 관련한 자살 동기가 가장 많았다. 입원군은 비입원군에 비해 예기손상을 통한 자살시도는 유의하게 적었고(${\chi}^2=4.374$, p=0.037), 치명도가 더 높은 자살시도를 했다(t=1.981, p=0.049). 또한, 입원군에서 학업과 관련된 문제가 자살 동기로 작용한 경우가 상대적으로 많았고(${\chi}^2=12.082$, p=0.001), 대인관계 곤란에 의한 자살 동기는 더 적었다(${\chi}^2=9.869$, p=0.002). 자살시도로 인한 응급실 내원 당시 입원군에서 우울장애진단 비율이 더 높았고(${\chi}^2=8.649$, p=0.003), 회귀 분석 결과에서도 우울장애가 입원 여부와 가장 높은 상관관계를 보였다(OR=2.783, 95% CI 1.092~7.089, p=0.032). 결 론 자살 시도 소아청소년들 중 입원군과 비입원군에서 자살 동기와 시도 방법, 정신과적 진단에서 차이를 확인하였다. 따라서, 본 연구의 결과는 자살 시도 소아청소년들의 위기개입 시 입원 여부에 따른 차별적인 접근을 하는데 도움이 될 것으로 생각된다.

• 생물정신의학
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• 제28권1호
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• pp.13-22
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• 2021

Objectives Despite growing attention to anxiety in bipolar disorder (BD), little research has assessed anxiety symptoms in the course of BD. The current prospective follow-up study examines the influence of subjectively and objectively measured anxiety symptoms on the course of BD. Methods A total of 49 patients with BD were followed-up prospectively for average of one year at an average of four months interval. The Korean version of the Beck Anxiety Inventory (K-BAI), the Hamilton Anxiety Rating Scale, heart rate variability (HRV) were used to measure anxiety subjectively, objectively and physiologically. Participants were divided into high and low anxiety groups based on their K-BAI scores. Kaplan-Meier survival analysis was performed to compare the recurrence of mood episode, suicide attempt, emergency room visit, and psychiatric hospitalization between two groups. Mediators were investigated with Cox proportional hazards models. Results Compared to the low anxiety group, the high anxiety group reported significantly higher impulsiveness (p = 0.016) and lower high frequency component on HRV (p = 0.007) after controlling for severity of BD. Regarding survival analysis, the high anxiety group showed hastened depressive episode recurrence (p = 0.048) and suicidal ideation was the mediator of the hazard ratio (HR) 1.089 (p = 0.029) in the Cox model. Moreover, the high anxiety group showed a tendency of accelerated suicide attempt (p = 0.12) and impulsivity was the risk factor of suicide attempt (HR = 1.089, p = 0.036). Conclusions This interim analysis of prospective study suggests that high anxiety level in BD may anticipate unfavorable course. Further studies are needed to understand the multifactorial mechanism of anxious bipolar patients.

• 한국콘텐츠학회논문지
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• 제13권5호
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• pp.366-376
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• 2013

본 연구는 749명의 대학생을 대상으로 인터넷 중독위험 정도에 따른 사회 심리적 건강상태를 파악하고 중독위험에 영향을 미치는 요인을 규명하기 위하여 시행되었다. 인터넷 중독위험 정도는 The 6th Korea Youth Risk Behavior Web-based Survey의 인터넷 중독 자가진단 척도로 측정하여 중독위험 사용자군, 정상 사용자군으로 분류하였고 각 군의 사회 심리적 건강상태는 절망감, 자살생각, 자살시도, 생활스트레스, 사회적 고립감, 정신건강 점수를 측정하여 비교하였다. 인터넷 정상 사용자군 및 중독위험 사용자군의 일반적 특성과 인터넷 중독위험 정도, 사회 심리적 건강은 t-test와 $x^2$-test로 비교 분석하였고, 인터넷 중독위험에 영향을 미치는 요인은 logistic regression analysis로 확인하였다. 연구결과 중독위험 사용자군은 82명(10.9%), 정상 사용자군은 667명(89.1%)이었고 절망감, 자살시도 경험, 생활스트레스, 사회적 고립감, 정신건강 점수에서 중독위험 사용자 군이 정상사용자군에 비해 빈도 및 점수가 유의하게 높아 사회 심리적 건강상태가 불량한 것으로 나타났다. 이상의 결과는 인터넷 중독사용 고위험 군을 조기선별하고 인터넷 중독 발생을 예방하며 나아가 이들을 위한 심리사회적 건강을 증진시키기 위한 프로그램 개발의 기초자료로 활용될 것을 기대한다.

• 농촌의학ㆍ지역보건
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• 제9권1호
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• pp.46-55
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• 1984

The socio-psychiatric study and personality analysis by Minnesota Multiphasic Personality Inventory on attempted suicides with drug intoxication in Seonsan-Gun and Cheongdo-Gun of Kyoungsang buk-Do was attempted to identify overall picture of attempted suicides and to detect some characteristics of personality. The total of 93 suicide attempted cases which were brought to the local clinics for the past 3 years from February, 1981 to February,1984 were sampled among them. The socio-psychiatric study and MMPI were performed with 45 attempters possible to be interviewed. The personalities of a group which answered "Still have the desire occasionally" or "Don't know about the present attitude toward suicide was compared with those of the other group who answered "Will not do it agagin". The results were as follows; 1) The sex ratio of the total attempters (93 cases) were 138.5. The highest rate by age group was found in the 3rd decade to be 27 cases. On the other hand, the sex ratio of interviewed cases were 136.8 and the highest rate was found in the age group of 50-59. 2) For the common characteristics of majority other than sex, 55.7% of cases were graduated primary school, and 62.2% were engaged in agriculture. 3) Except the fact that more of the attempted suicides happened during summer, there were no seasonal variation among other seasons. 4) The places selected for the attempted suicides were the houses in majority of cases (98%). Most of cases (53.3%) were found immediately after the attempt and 24.4% within one hour. For the poison taken, 86.7 took a sort of herbicides or insecticides, 55.6% were admitted to local clinics for only one day and 20% for two days. 5) The most common precipitating factors of the attempted suicides were family trouble and financial poverty. 6) The psychodynamic motives of the attempters were impulsive hostility(35.6%), abandonment(33.3%), guilt feeling (11.1%), manipulation and attention seeking (8.9%) and others. 7) In regard to their present attitude toward suicide, 29 cases (64.4%) expressed that they would never do such an act again, 37.8% of cases expressed that they really wanted to die at the time when they attempted. 8) The Psychopathic deviate, Paranoia, Depression, Schizophrenia scores were significantly higher in the attempters group who answered "Don't know" or "Possibly" for the question of "Will you attempt suicide again?" Than the group who answered" will not do it again".

• 대한임상독성학회지
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• 제14권1호
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• pp.37-46
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• 2016

Purpose: This study was designed to determine the factors hindering psychiatric intervention for suicide attempters in the emergency room (ER). Methods: Participants were 299 patients aged 18 years or older admitted to the ER for suicidal drug overdose between July 2012 and June 2014. Patients were divided into two groups according to whether they had received psychiatric treatment in the ER. Medical histories and follow-up treatments were determined by examining patients' medical records and through phone surveys, and were then compared using ${\chi}^2$-test and Fisher's exact test. In addition, the rate of satisfaction of the treatment group and the reasons for their dissatisfaction were also determined. Results: The treatment and non-treatment groups comprised 135 (45%) and 164 patients (55%), respectively. Factors influencing participation in psychiatric intervention were previous history of suicide attempts (p=0.004), history of psychiatric disorder (p<0.001), time of day (p=0.039), and day of the week (p=0.040) of arrival in the ER. Whether or not the patient received follow-up psychiatric treatment was not significantly relevant (p=0.300). Of the 82 patients who participated in the treatment satisfaction survey, 50.2% reported being unsatisfied, mainly because of unfriendly medical personnel (36.6%), discomfort regarding other people's perceptions (24.4%), and cursory care (14.6%). Conclusion: To raise the participation rate of psychiatric consult, cooperation with psychiatry at night and on weekends is required, and incorporation of patients without previous history of suicidal attempt or other psychiatric disorder is important. Resolution of complaints toward psychiatric consult in suicide attempt survivors is also required.

• 생물정신의학
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• 제11권2호
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• pp.110-116
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• 2004

Objectives:Recently, polymorphisms of several serotonin genes have been suggested to be associated with suicide, but the results are still unclear. We examined whether the T102C polymorphisms of the serotonin 2A receptor gene and the G861C polymorphisms of the serotonin 1B receptor gene were associated with suicidal behavior using drug intoxication. Methods:The subjects were 52 patients who visited emergency room with suicidal behaviors. Fifty controls were selected from healthy volunteers matched for sex and age to the suicide subjects. The polymorphisms were analyzed with TaqMan$^{(R)}$ assay using primers based on previous studies. Results:The T102C polymorphism of the serotonin 2A receptor gene showed no significant difference between the suicidal attempters and controls in both genotype and allele frequency analyses(p=0.179 and p=0.422, respectively). There was no statistically significant difference between the suicidal attempters and the controls in the G861C polymorphism of the serotonin 1B receptor gene and any significant effect of the genotype distributions or the allele frequencies was not observed(p=0.092 and p=0.987, respectively). Conclusion:These findings suggest that the T102C polymorphism in serotonin 2A receptor gene and the G861C polymorphism in serotonin 1B receptor gene are not related to the susceptibility to suicide attempts using drugs. To clarify the genetic influences of the serotonergic system on suicidal behavior, the polymorphisms of other candidate genes in the serotonergic system should be studied with larger numbers of subjects.

• 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.