정신과적 취약성을 통해 살펴본 한국형 자살 특성: 성차에 따른 정신과적 문제를 중심으로
Characteristics of suicide in South Korea analyzed through psychiatric vulnerability: Focusing on gender differences in psychiatric problems
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자살에서 정신과적 요인은 매우 중요하다고 알려져 있으며, 역학적 특성 중 성차에 대해서 이해하는 것은 정신과적 장면에서의 개입 및 자살 예방에 있어서 중요하다. 따라서 본 연구는 정신과적 문제의 성차를 중심으로 대한민국의 자살 현상을 후향적으로 분석하고자 하였다. 따라서 2013-2017년 동안의 자살사망자 전수조사 통계를 토대로 하여, 50,304명의 자살 사망자를 대상으로 사망 당시의 정신과적 증상 및 과거 진단과 치료 여부가 성차에 따라 차이가 있는지를 살펴보았으며, 각 성별로 자살에 영향을 주는 대표적 정신과적 문제를 선정한 후 연령에 따라 추정되는 원인의 빈도에 대해서도 파악하였다. 연구 결과, 전체 자살자 수는 남성이 많았고, 성비에서 기대되는 것에 비해 정신과적 문제가 있었다고 추정되는 자들은 여성에게서 더 높은 것으로 시사된다. 정신과적 문제가 있었다고 추정되는 자들 중 과거의 정신과적 진단이력 및 정신과적 치료를 받은 경험 모두 남성에 비해 여성에게서 더 높은 것으로 보고되었다. 또한 대표적인 여성 취약형 정신과적 문제는 우울 증상 및 우울장애가 전체 중 가장 많은 비중을 차지하였고, 그 다음으로는 불안 증상 및 불안장애로 나타났다. 또한 남성 취약형 정신과적 문제는 알코올 남용, 오용 및 알코올 장애로 나타났고, 그 다음으로는 도박, 성 등 부적절한 행위 반복 및 행위중독으로 나타났다. 본 연구를 통해 한국에서의 자살자 중 정신과적 문제가 있었던 개인의 성차적 특성에 대해 면밀히 파악하였던 바, 자살의 예방 및 개입에 있어 차별적인 접근이 필요하다는 함의점이 시사된다.
Abstract
Understanding psychiatric factors is crucial in addressing suicide, and recognizing gender differences in these factors is essential for effective intervention and prevention in psychiatric settings. This study aims to retrospectively analyze the phenomenon of suicide in South Korea, with a focus on gender differences in psychiatric problems. Using comprehensive survey statistics on suicide deaths from 2013 to 2017, we examined 50,304 cases to identify differences in psychiatric symptoms at the time of death, past diagnoses, and treatment history according to gender. We also identified the representative psychiatric problems influencing suicide for each gender and analyzed the frequency of presumed causes according to age. Our results showed that the total number of suicides was higher among males than males. However, the presumed prevalence of psychiatric problems at the time of death was higher among females than males. Among those presumed to have had psychiatric problems, females had higher rates of past psychiatric diagnoses and experiences of psychiatric treatment than males. For females, the most prevalent psychiatric problems were depressive symptoms and disorders, followed by anxiety symptoms and disorders. In contrast, for males, the most prevalent problems were alcohol abuse, misuse, and alcohol use disorders, followed by repetitive inappropriate behaviors and behavioral addictions such as gambling and sexual behaviors. This study highlights the gender-specific characteristics of individuals with psychiatric problems who committed suicide in South Korea, underscoring the need for differentiated approaches in suicide prevention and intervention.
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