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응급실에 내원한 자살 시도자의 특성과 반복 자살 시도에 영향을 미치는 요인

Characteristics of Suicide Attempters Admitted to the Emergency Room and Factors Related to Repetitive Suicide Attempts

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초록

Objectives:Suicide attempt history is one of the major suicide risk factors and the suicide mortality rate increases with the number of suicide attempts. This study aimed to compare demographic and clinical factors between first and multiple suicide attempters and investigate risk factors for multiple suicide attempts. Methods:Participants were 537 patients who were admitted to an emergency room after attempting suicide and divided into two groups (393 first attempters and 144 multiple attempters). Demographic factors, clinical characteristics, and suicide-related characteristics were compared between the two groups. Variables with a p-value lower than 0.1 were included in a multivariate logistic regression analysis. Logistic regression models were considered to identify independent risk factors for multiple suicide attempts. The significance level was set to 0.05. Results:Among demographic factors, the two groups differed in age, sex, education, occupation, and marital and cohabitation status. Multiple attempters were more likely to have a mental disorder, current use of psychiatric medication, interpersonal and psychiatric motivation for suicide, current suicidal thoughts, help seeking behavior, awareness of suicide, and agreement with psychiatric follow up. In the regression analysis, unmarried status, mental disorder, interpersonal or psychiatric stress, help seeking behavior, and antidepressant use emerged as significant risk factors of multiple suicide attempts. Conclusion:The study’s findings suggested that there are differences in the demographic and clinical characteristics of first and multiple suicide attempters. Specific strategies that consider unmarried status, mental disorder, interpersonal or psychiatric stress, help seeking behavior, and antidepressant use may be valuable for future suicide prevention.

Abstract

Objectives:Suicide attempt history is one of the major suicide risk factors and the suicide mortality rate increases with the number of suicide attempts. This study aimed to compare demographic and clinical factors between first and multiple suicide attempters and investigate risk factors for multiple suicide attempts. Methods:Participants were 537 patients who were admitted to an emergency room after attempting suicide and divided into two groups (393 first attempters and 144 multiple attempters). Demographic factors, clinical characteristics, and suicide-related characteristics were compared between the two groups. Variables with a p-value lower than 0.1 were included in a multivariate logistic regression analysis. Logistic regression models were considered to identify independent risk factors for multiple suicide attempts. The significance level was set to 0.05. Results:Among demographic factors, the two groups differed in age, sex, education, occupation, and marital and cohabitation status. Multiple attempters were more likely to have a mental disorder, current use of psychiatric medication, interpersonal and psychiatric motivation for suicide, current suicidal thoughts, help seeking behavior, awareness of suicide, and agreement with psychiatric follow up. In the regression analysis, unmarried status, mental disorder, interpersonal or psychiatric stress, help seeking behavior, and antidepressant use emerged as significant risk factors of multiple suicide attempts. Conclusion:The study’s findings suggested that there are differences in the demographic and clinical characteristics of first and multiple suicide attempters. Specific strategies that consider unmarried status, mental disorder, interpersonal or psychiatric stress, help seeking behavior, and antidepressant use may be valuable for future suicide prevention.

참고문헌 (57)

  1. World Health Organization, "National suicide prevention strategies" (2018), Department of Mental Health and Substance Abuse World Health Organization
  2. "Annual report on the causes of death statistics 2017" (2018)[URL]
  3. Jung JH, "National Injury Fact Book", pp.84~86 (2018), Korea Centers for Disease Control and Prevention
  4. Psychological Autopsy of Suicide completers and Suicide Attempt Case Management Service Implementation Plan, "Hong KU", Ministry of Health, Welfare and Family Affairs, 77~89 (2009)
  5. Beautrais AL, "Further suicidal behavior among medically serious suicide attempters", Suicide Life Threat Behav, 34, pp.1~11 (2004)
  6. Van Orden KA, "The interpersonal theory of suicide", Psychol Rev, 117, pp.575~ (2010)
  7. 이광헌, "자살 환자의 치료", 생물치료정신의학, 10(1), pp.15~24 (2004), 대한생물치료정신의학회
  8. Wang AG, "Core features of repeated suicidal behaviour: a long-term follow-up after suicide attempts in a low-suicide-incidence population", Soc Psychiatry Psychiatr Epidemiol, 41, pp.103~107 (2006)
  9. 2007 Report of crisis management team of Seoul Metropolitan Mental Health Center, "Seoul Metopolitan Mental Health Center", Book Communications, ~ (2008)
  10. Christiansen E, "Risk of repetition of suicide attempt, suicide or all deaths after an episode of attempted suicide: a register-based survival analysis", Aust N Z J Psychiatry, 41, pp.257~265 (2007)
  11. 정우영, "자살 및 자살시도자의 임상적 특성과 2~4년내 재시도율", 신경정신의학, 48(6), pp.487~494 (2009), 대한신경정신의학회
  12. 김성완, "자살에 대한 태도 및 자살행동 연구", 생물치료정신의학, 14(1), pp.43~48 (2008), 대한생물치료정신의학회
  13. Jeon HJ, "Lifetime prevalence and correlates of suicidal ideation, plan, and single and multiple attempts in a Korean nationwide study", J Nerv Ment Dis, 198, pp.643~646 (2010)
  14. Choi KH, "Risk and protective factors predicting multiple suicide attempts", Psychiatry Research, 210, pp.957~961 (2013)
  15. Tóth MD, "Risk factors for multiple suicide attempts among Roma in Hungary", Transcult Psychiatry, 55, pp.55~72 (2018)
  16. 김지우, "대학병원 응급실을 내원한 자살 시도자들의 특성 : 인구학적 및 정신사회적 자료", 생물치료정신의학, 21(2), pp.95~104 (2015), 대한생물치료정신의학회
  17. De Leo D, "Lifetime risk of suicide ideation and attempts in an Australian community:prevalence, suicidal process, and help-seeking behaviour", J Affect Disord, 86, pp.215~224 (2005)
  18. Henderson J, "Suicide–A statistical analysis by age, sex and method", J Clin Forensic Med, 12, pp.305~309 (2005)
  19. 허지원, "자살 시도에 영향을 미치는 정신사회적 요인", 신경정신의학, 46(2), pp.129~135 (2007), 대한신경정신의학회
  20. Durkheim E, "Suicide: A study in sociology" (1951), Free Press
  21. Kposowa AJ, "Marital status and suicide in the National Longitudinal Mortality Study", J Epidemiol Community Health, 54, pp.254~261 (2000)
  22. Stack S, "The effect of marital integration on African American suicide", Suicide Life Threat Behav, 26, pp.405~414 (1996)
  23. Agerbo E, "Familial, psychiatric, and socioeconomic risk factors for suicide in young people: nested case-control study", BMJ, 325, pp.74~ (2002)
  24. Beautrais AL, "Suicides and serious suicide attempts : two populations or one", Psychol Med, 31, pp.837~845 (2001)
  25. 박수빈, "Clinical Characteristics and Precipitating Factors of Adolescent Suicide Attempters Admitted for Psychiatric Inpatient Care in South Korea", PSYCHIATRY INVESTIGATION, 12(1), pp.29~36 (2015), 대한신경정신의학회[DOI]
  26. Wetherall K, "Explaining the income and suicidality relationship : Income rank is more strongly associated with suicidal thoughts and attempts than income", Soc Psychiatry Psychiatr Epidemiol, 50, pp.929~937 (2015)
  27. Cheng AT, "Mental illness and suicide : A case-control study in East Taiwan", Arch Gen Psychiatry, 52, pp.594~603 (1995)
  28. Henriksson MM, "Mental disorders and comorbidity in suicide", Am J Psychiatry, 150, pp.935~940 (1993)
  29. Perquier F, "Suicide attempters examined in a Parisian emergency department : contrasting characteristics associated with multiple suicide attempts or with the motive to die", Psychiatry Res, 253, pp.142~149 (2017)
  30. 제영묘, "자살과 정신 장애", 생물치료정신의학, 10(1), pp.3~10 (2004), 대한생물치료정신의학회
  31. Miranda R, "Suicide attempt characteristics, diagnoses, and future attempts: comparing multiple attempters to single attempters and ideators", J Am Acad Child Adolesc Psychiatry, 47, pp.32~40 (2008)
  32. Nock MK, "Mental disorders, comorbidity and suicidal behavior: results from the National Comorbidity Survey Replication", Mol Psychiatry, 15, pp.868~ (2010)
  33. 이병철, "항우울제와 자살", 생물정신의학, 13(4), pp.240~247 (2006), 대한생물정신의학회
  34. Culpepper L, "Suicidality as a possible side effect of antidepressant treatment", J Clin Psychiatry, 6, pp.79~ (2004)
  35. Jick SS, "Antidepressants and suicide", BMJ, 310, pp.215~218 (1995)
  36. Gibbons RD, "Early evidence on the effects of regulators’ suicidality warnings on SSRI prescriptions and suicide in children and adolescents", Am J Psychiatry, 164, pp.1356~1363 (2007)
  37. Rihmer Z, "Do antidepressants t(h)reat(en)depressives? Toward a clinically judicious formulation of the antidepressant-suicidality FDA advisory in light of declining national suicide statistics from many countries", J Affect Disord, 94, pp.3~13 (2006)
  38. Bridge JA, "Clinical response and risk for reported suicidal ideation and suicide attempts in pediatric antidepressant treatment : a meta-analysis of randomized controlled trials", JAMA, 297, pp.1683~1696 (2007)
  39. Sheets ES, "Comparing chronic interpersonal and noninterpersonal stress domains as predictors of depression recurrence in emerging adults", Behav Res Ther, 63, pp.36~42 (2014)
  40. Liu RT, "Stress generation in depression : A systematic review of the empirical literature and recommendations for future study", Clin Psychol Rev, 30, pp.582~593 (2010)
  41. Merchant C, "Predictors of multiple suicide attempts among suicidal Black adolescents", Suicide Life Threat Behav, 39, pp.115~124 (2009)
  42. Rudd MD, "Relationships among suicide ideators, attempters, and multiple attempters in a young-adult sample", J Abnorm Psychol, 105, pp.541~ (1996)
  43. Baca-Garcia E, "A prospective study of the paradoxical relationship between impulsivity and lethality of suicide attempts", J Clin Psychiatry, 62, pp.560~564 (2001)
  44. Jamison EC, "Previous suicide attempt and its association with method used in a suicide death", Am J Prev Med, 51, pp.S226~33 (2016)
  45. Sher L, "Depressed Multiple-Suicide-Attempters-A High-Risk Phenotype", Crisis (2017)
  46. Jeglic EL, "History of family suicide behaviors and negative problem solving in multiple suicide attempters", Arch Suicide Res, 9, pp.135~146 (2005)
  47. McAuliffe C, "Problem-solving ability and repetition of deliberate self-harm : a multicentre study", Psychol Med, 36, pp.45~55 (2006)
  48. Rudd MD, "Stigma and suicide warning signs", Arch Suicide Res, 17, pp.313~318 (2013)
  49. Hur JM, "Analyses of suicide victims admitted via the emergency departmentbased on psychiatric histories, past suicidal attempts and psychiatric diagnoses", J Korean Soc Clin Toxicol, 2, pp.106~115 (2004)
  50. 김호중, "응급실기반 자살시도자의 사후관리 사업 동의의 결과와 동의에 영향을 미치는 인자 연구", 대한응급의학회지, 29(2), pp.160~169 (2018), 대한응급의학회
  51. Lee J, "The factors affecting the registration rates for emergency department based post-suicidal care program", J Korean Soc Clin Toxicol, 13, pp.25~ (2015)
  52. 최규성, "최초 자살시도 방법으로 중독을 선택한 환자의 임상적 특성: 물리적 자해 방법을 사용한 환자와의 비교", 대한응급의학회지, 28(5), pp.493~501 (2017), 대한응급의학회
  53. Kim SY, "A study of patients with suicidal attempt", Journal of the Korean Society of Emergency Medicine, 10, pp.560~567 (1999)
  54. 조준호, "자살시도자에 대한 진료 체계 및 응급의학과-정신과 의료진의 인식 비교", 대한응급의학회지, 19(5), pp.535~540 (2008), 대한응급의학회
  55. 이주환, "응급실에 내원한 약물음독의 자살 시도자에서 정신건강의학과 진료 참여의 제한점", 대한임상독성학회지, 14(1), pp.37~46 (2016), 대한임상독성학회[DOI]
  56. Compton MT, "Social environment factors associated with suicide attempt among low-income African Americans: The protective role of family relationships and social support", Soc Psychiatry Psychiatr Epidemiol, 40, pp.175~185 (2005)
  57. 박소영, "Clinical Characteristics of the Suicide Attempters Who Refused to Participate in a Suicide Prevention Case Management Program", Journal of Korean Medical Science, 30(10), pp.1490~1495 (2015), 대한의학회

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