충청지역 ‘정신건강 전문가 학교방문지원사업’에서 자해나 자살시도군의 특성
The Characteristics of Students Who Had Attempted Self-Injury or Suicide in Chungcheongdo ‘Professional School Visits Outreach Project’
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Objectives This study examined the characteristics of students who participated in the ‘Professional School Visits Outreach Project’ and evaluated the factors affecting self-injury or suicidal attempts. Methods In a cross-sectional study, psychiatrists or mental health professionals conducted a semi-structured interview with 296 students, families, and teachers in Chungcheong province and recorded the socioeconomic status (SES), past psychiatric history, current clinical symptoms, and mental status exams. Logistic regression analysis was performed on the variables with differences between the students who had attempted self-harm or suicide and those who had not. Results The subjects of this study belonged to a relatively low SES. In addition, their provisional diagnosis was mainly attention-deficit/hyperactivity disorder (38.5%) or depression (29.1%). Approximately 18.2% of students had attempted self-injury or suicide. The variables with differences between students who had attempted self-harm or suicide and those who had not, were female [odds ratio (OR) 2.878, p=0.002], provisional diagnosis of depression (OR 3.045, p=0.001), and a history of bullying victim (OR 1.927, p=0.048). Although the risks of self-injury or suicidal attempts were not increased by child abuse alone, it was increased in girls who experienced both childhood abuse and bullying victim (OR 4.222, p=0.002). Conclusion The ‘Professional School Visits Outreach Project’ provides therapeutic opportunities for low SES and high-risk adolescents with multiple difficulties, such as child abuse, bullying victim, and suicidal behaviors. In addition, the recurrent experience of trauma in girls appears to increase the risk of adolescent self-injury or suicidal attempts.
Abstract
Objectives This study examined the characteristics of students who participated in the ‘Professional School Visits Outreach Project’ and evaluated the factors affecting self-injury or suicidal attempts. Methods In a cross-sectional study, psychiatrists or mental health professionals conducted a semi-structured interview with 296 students, families, and teachers in Chungcheong province and recorded the socioeconomic status (SES), past psychiatric history, current clinical symptoms, and mental status exams. Logistic regression analysis was performed on the variables with differences between the students who had attempted self-harm or suicide and those who had not. Results The subjects of this study belonged to a relatively low SES. In addition, their provisional diagnosis was mainly attention-deficit/hyperactivity disorder (38.5%) or depression (29.1%). Approximately 18.2% of students had attempted self-injury or suicide. The variables with differences between students who had attempted self-harm or suicide and those who had not, were female [odds ratio (OR) 2.878, p=0.002], provisional diagnosis of depression (OR 3.045, p=0.001), and a history of bullying victim (OR 1.927, p=0.048). Although the risks of self-injury or suicidal attempts were not increased by child abuse alone, it was increased in girls who experienced both childhood abuse and bullying victim (OR 4.222, p=0.002). Conclusion The ‘Professional School Visits Outreach Project’ provides therapeutic opportunities for low SES and high-risk adolescents with multiple difficulties, such as child abuse, bullying victim, and suicidal behaviors. In addition, the recurrent experience of trauma in girls appears to increase the risk of adolescent self-injury or suicidal attempts.
참고문헌 (45)
- Shonkoff JP, "The lifelong effects of early childhood adversity and toxic stress", Pediatrics, 129, pp.e232~e246 (2012)
- Merikangas KR, "Lifetime prevalence of mental disorders in US adolescents: results from the national comorbidity study-adolescent supplement (NCS-A)", J Am Acad Child Adolesc Psychiatry, 49, pp.980~989 (2010)
- Jones PB, "Adult mental health disorders and their age at onset", Br J Psychiatry, 202, pp.s5~s10 (2013)
- Costello EJ, "Prevalence and development of psychiatric disorders in childhood and adolescence", Arch Gen Psychiatry, 60, pp.837~844 (2003)
- Copeland WE, "Longitudinal patterns of anxiety from childhood to adulthood : the Great Smoky Mountains Study", J Am Acad Child Adolesc Psychiatry, 53, pp.21~33 (2014)
- Erskine HE, "Long-term outcomes of attention-deficit", hyperactivity disorder and conduct disorder : a systematic review and meta-analysis, 2016, pp.55, 841~850
- Hopfer C, "Conduct disorder and initiation of substance use : a prospective longitudinal study", J Am Acad Child Adolesc Psychiatry, 52, pp.511~518 (2013)
- Kessler RC, "Prevalence, persistence, and sociodemographic correlates of DSM-IV disorders in the National Comorbidity Survey Replication Adolescent Supplement", Arch Gen Psychiatry, 69, pp.372~380 (2012)
- Hong KE, "Korean textbook of child psychiatry" (2014), Hakjisa
- Prevalence and risk factors of psychiatric disorders in child and adolescent population -shool based research-, "Seoul National University Hospital", Korea Mental Health Technology R&D Project, Ministry of Health and Welfare, ~, pp.Report No.: HM16C1994 (2018)
- Merikangas KR, "Service utilization for lifetime mental disorders in US adolescents : results from the National Comorbidity Survey Replication–Adolescent Supplement(NCS-A)", J Am Acad Child Adolesc Psychiatry, 50, pp.32~45 (2011)
- Olfson M, "Trends in mental health care among children and adolescents", N Engl J Med, 372, pp.2029~2038 (2015)
- Stagman S, "Children’s mental health: what every policymaker should know" (2010), National Center for Children in Poverty, Columbia University
- Korean Academy of Child and Adolescent Psychiatry, "A trial application of evidence-based and school-based community program for enhancement of mental health in school children" (2010), National Center for Mental Health
- Atkins MS, "Schooling and children’s mental health : realigning resources to reduce disparities and advance public health", Annu Rev Clin Psychol, 13, pp.123~147 (2017)
- Armbruster P, "Bridging the gap between service need and service utilization : a school-based mental health program", Community Ment Health J, 33, pp.199~211 (1997)
- Armbruster P, "Are school based mental health services effective? Evidence from 36 inner city schools", Community Ment Health J, 35, pp.493~504 (1999)
- 전홍진, "청소년 자살 관련 현황 및 위험요인", 대한의사협회지, 56(2), pp.93~99 (2013), 대한의사협회
- Cash SJ, "Epidemiology of youth suicide and suicidal behavior", Curr Opin Pediatr, 21, pp.613~619 (2009)
- Kataoka S, "Who gets care? Mental health service use following a school-based suicide prevention program", J Am Acad Child Adolesc Psychiatry, 46, pp.1341~1348 (2007)
- Nemeroff R, "Establishing ongoing, early identification programs for mental health problems in our schools: a feasibility study", J Am Acad Child Adolesc Psychiatry, 47, pp.328~338 (2008)
- Green JG, "School mental health resources and adolescent mental health service use", J Am Acad Child Adolesc Psychiatry, 52, pp.501~510 (2013)
- Dowdy E, "School-based screening : a population-based approach to inform and monitor children’s mental health needs", School Ment Health, 2, pp.166~176 (2010)
- Curtis MJ, "Relationships among the professional practices and demographic characteristics of school psychologists", School Psychol Rev, 31, pp.30~42 (2002)
- 오인수, "정신건강 전문가의 학교방문 지원 서비스의 효과성 분석", 교육문제연구, 30(3), pp.227~258 (2017), 교육문제연구소
- Busner J, "The clinical global impressions scale: applying a research tool in clinical practice", Psychiatry (Edgmont), 4, pp.28~37 (2007)
- Burns BJ, "Children’s mental health service use across service sectors", Health Aff (Millwood), 14, pp.147~159 (1995)
- Owens PL, "Barriers to children’s mental health services", J Am Acad Child Adolesc Psychiatry, 41, pp.731~738 (2002)
- Weist MD, "Evaluation of expanded school mental health programs", Community Ment Health J, 36, pp.395~411 (2000)
- 하경희, "학생 정신건강 지역협력모델이 학교 정신건강 인식에 미치는 영향", Journal of the Korean Academy of Child and Adolescent Psychiatry, 27(2), pp.100~108 (2016), 대한소아청소년 정신의학회[DOI]
- "‘Emotional crisis’ elementary and middle school students close to 100,000… suicide risk group 3times twice" (2018)[URL]
- A Study on supporting plan for promoting mental health in children and adolescents II, "Choi IJ", National Youth Policy Institute, ~, pp.Report No.: 12-R15 (2012)
- 이충호, "학교폭력 참여자 역할에 따른 정신병리 비교", 신경정신의학, 56(3), pp.111~117 (2017), 대한신경정신의학회[DOI]
- Collection of Korean child and adolescent well-being index and its international comparison with other OECD countries, "Yonsei University School of Sociology", Korean Bang Jeong-hwan Foundation, ~ (2017)
- Anyon Y, "Health risks, race, and adolescents’ use of school-based health centers:policy and service recommendations", J Behav Health Serv Res, 40, pp.457~468 (2013)
- Alegría M, "Disparities in child and adolescent mental health and mental health services in the US" (2015), William T. Grant Foundation
- 김효진, "지난 10년간 일 대학병원 정신건강의학과 소아청소년 초진환자 분포의 변화", Journal of the Korean Academy of Child and Adolescent Psychiatry, 26(3), pp.165~175 (2015), 대한소아청소년 정신의학회
- 은광수, "대구지역 한 대학병원 정신과를 방문한 소아 청소년 외래환자 분포의 변화", 생물치료정신의학, 11(1), pp.78~88 (2005), 대한생물치료정신의학회
- Bridge JA, "Adolescent suicide and suicidal behavior", J Child Psychol Psychiatry, 47, pp.372~394 (2006)
- Swannell SV, "Prevalence of nonsuicidal self-injury in nonclinical samples: systematic review, meta-analysis and meta-regression", Suicide Life Threat Behav, 44, pp.273~303 (2014)
- Curtin SC, "Increase in suicide in the United States, 1999-2014", NCHS Data Brief, (241), pp.1~8 (2016)
- Séguin M, "Developmental model of suicide trajectories", Br J Psychiatry, 205, pp.120~126 (2014)
- Afifi TO, "Population attributable fractions of psychiatric disorders and suicide ideation and attempts associated with adverse childhood experiences", Am J Public Health, 98, pp.946~952 (2008)
- Dube SR, "Childhood abuse, household dysfunction, and the risk of attempted suicide throughout the life span: findings from the Adverse Childhood Experiences Study", JAMA, 286, pp.3089~3096 (2001)
- Barker ED, "Joint development of bullying and victimization in adolescence : relations to delinquency and self-harm", J Am Acad Child Adolesc Psychiatry, 47, pp.1030~1038 (2008)