Prevalence and Risk Factors Associated with Suicide Ideation and Attempts in Korean College Students
2
조회
0
다운로드
9
인용
0
참고문헌
키워드
초록
Objective: Suicide is a leading cause of death in college age students. Identification of the associated risk factors has important implications for how to prevent and respond to this population; however, few studies have been performed on this topic in this age group. The purpose of this study was to evaluate the prevalence and risk factors associated with suicide ideation and attempts in college students. Methods: Three hundred sixty-eight college students participated in this cross-sectional observational study. The recent (over two weeks) suicide ideation and lifetime suicide attempts were defined according to Moscicki’s suicide behavior index. Sociodemographic variables were assessed and psychopathology measured using the Beck Depression Inventory, the Bipolar Spectrum Diagnostic Scale and the Alcohol Use Disorders Identification Test. A hierarchical multiple logistic regression analysis was used to identify the significant risk factors related to suicide ideation and attempts. Results: The two-week prevalence of suicidal ideation was 9.8%, and the lifetime prevalence of suicide attempts was 3.3%. The univariate analysis showed that students who had more severe depression (p<0.001), a higher probability for bipolar disorder (p<0.001) and decrement of academic achievement (p<0.005) were more likely to have suicide ideation. Those with factors such as severe depression (p<0.05), a higher probability of bipolar disorder (p<0.001), a low socioeconomic status (p<0.001), who lived alone (p<0.01), and were female (p<0.05) had a higher risk for suicide attempts. The most important predictors of suicide ideation, by the logistic regression analysis, were depression, probability for bipolar disorder and academic achievement, and the risks identified for suicide attempts were socioeconomic status and probability of bipolar disorder. Conclusion: Suicide ideation and attempts were common in college students. The results of this study suggest that early identification and management of mood disorders and other sociodemographic risk factors may have implications for intervention and prevention.
Abstract
Objective: Suicide is a leading cause of death in college age students. Identification of the associated risk factors has important implications for how to prevent and respond to this population; however, few studies have been performed on this topic in this age group. The purpose of this study was to evaluate the prevalence and risk factors associated with suicide ideation and attempts in college students. Methods: Three hundred sixty-eight college students participated in this cross-sectional observational study. The recent (over two weeks) suicide ideation and lifetime suicide attempts were defined according to Moscicki’s suicide behavior index. Sociodemographic variables were assessed and psychopathology measured using the Beck Depression Inventory, the Bipolar Spectrum Diagnostic Scale and the Alcohol Use Disorders Identification Test. A hierarchical multiple logistic regression analysis was used to identify the significant risk factors related to suicide ideation and attempts. Results: The two-week prevalence of suicidal ideation was 9.8%, and the lifetime prevalence of suicide attempts was 3.3%. The univariate analysis showed that students who had more severe depression (p<0.001), a higher probability for bipolar disorder (p<0.001) and decrement of academic achievement (p<0.005) were more likely to have suicide ideation. Those with factors such as severe depression (p<0.05), a higher probability of bipolar disorder (p<0.001), a low socioeconomic status (p<0.001), who lived alone (p<0.01), and were female (p<0.05) had a higher risk for suicide attempts. The most important predictors of suicide ideation, by the logistic regression analysis, were depression, probability for bipolar disorder and academic achievement, and the risks identified for suicide attempts were socioeconomic status and probability of bipolar disorder. Conclusion: Suicide ideation and attempts were common in college students. The results of this study suggest that early identification and management of mood disorders and other sociodemographic risk factors may have implications for intervention and prevention.
참고문헌 (62)
- "2005 Annual report on the morbidity rate of suicide" (2005)[URL]
- Kisch J, "Aspects of suicidal behavior, depression, and treatment in college students: results from the spring 2000 national college health assessment survey", Suicide Life Threat Behav, 35, pp.3~13 (2005)
- Westefeld JS, "Perce-ptions concerning college student suicide: data from four universities", Suicide Life Threat Behav, 35, pp.640~645 (2005)
- Schweitzer R, "Suicidal ideation and behaviours among university students in Australia", Aust N Z J Psychiatry, 29, pp.473~479 (1995)
- Xu HL, "Risk factors for suicide attempt among college students at Central South University", Zhonghua Liu Xing Bing Xue Za Zhi, 25, pp.288~291 (2004)
- 노명선, "대학생들의 자살관련행동에 관한 연구", 신경정신의학, 46(1), pp.35~40 (2007), 대한신경정신의학회
- Yen YC, "Suicidal ideation and associated factors among community-dwelling elders in Taiwan", Psychiatry Clin Neurosci, 59, pp.365~371 (2005)
- Fevziye Toros, "Suicide Attempts and Risk Factors among Children and Adolescents", Yonsei Medical Journal, 45(supp), pp.367~374 (2004), 연세대학교의과대학
- Beautrais AL, "Risk factors for suicide and attempted s", Aust N Z J Psychiatry, 34, pp.420~436 (2000)
- Johansson SE, "Unemployment is an important risk factor for suicide in contemporary Sweden: an 11-year follow-up study of a cross-sectional sample of 37,789 people", Public Health, 111, pp.41~45 (1997)
- Oksuz E, "Socioeconomic factors and health risk behaviors among university students in Turkey: questionnaire study.", Croat Med J, 46, pp.66~73 (2005)
- Park HS, "Predictors of suicidal ideation among high school students by gender in South Korea", J Sch Health, 76, pp.181~188 (2006)
- Spann M, "Suicide and African American teenagers: risk factors and coping mechanisms", Suicide Life Threat Behav, 36, pp.553~568 (2006)
- 이현지, "대학생 자아정체감과 무망감, 우울이 자살사고의 관계에 관한 연구", 청소년학연구, 14(3), pp.243~264 (2007), 한국청소년학회
- 손정남, "대학생의 자살생각 관련 요인에 대한 판별분석", 정신간호학회지, 16(3), pp.267~275 (2007), 정신간호학회
- Rihmer Z, "Bipolar disorders and suicidal behaviour", Bipolar Disord, 4(11), pp.21~25 (2002)
- Jamison KR, "Suicide and bipolar disorder", J Clin Psychiatry, 61(9), pp.47~51 (2000)
- Rihmer ZZ, "Suicide risk in mood disorders", Curr Opin in Psychiatry, 20, pp.17~22 (2007)
- Murphy GE, "The lifetime risk of suicide in alcoholism", Arch Gen Psychiatry, 47, pp.383~392 (1990)
- Sher L, "Alcoholism and suicidal behavior: a clinical overview", Acta Psychiatr Scand, 113, pp.13~22 (2006)
- Lejoyeux M, "Characteristics of suicide attempts preceded by alcohol consumption", Arch Suicide Res, 12, pp.30~38 (2008)
- Sher L, "Triggers for suicidal behavior in depressed older adolescents and young adults: do alcohol use disorders make a difference?", Int J Adolesc Med Health, 19, pp.91~98 (2007)
- Brener ND, "Suicidal ideation among college students in the United States", J Consult Clin Psychol, 67, pp.1004~1008 (1999)
- Hashim IH, "Cultural and Gender Differences in Perceptions of Stressors and Coping Skills: A Study of Western and African College Students in China", Sch Psychol Int, 24, pp.182~203 (2003)
- Bush HS, "Personal assessment of stress factors for college students", J Sch Health, 55, pp.370~375 (1985)
- Juon HS, "Epidemiology of suicidal behavior among Korean adolescents", J Child Psychol Psychiatry, 35, pp.663~676 (1994)
- Ang RP, "Relationship between academic stress and suicidal ideation: testing for depression as a mediator using multiple regression", Child Psychiatry Hum Dev, 37, pp.133~143 (2006)
- 정혜경, "청소년의 자살충동에 영향을 미치는 예측요인", 청소년학연구, 10(2), pp.107~126 (2003), 한국청소년학회
- Hawton K, "Attempted suicide in Oxford University students, 1976-1990", Psychol Med, 25, pp.179~188 (1995)
- Hawton K, "Suicide in Oxford University students, 1976-1990", Br J Psychiatry, 166, pp.44~50 (1995)
- Kirmayer LJ, "Suicide attempts among Inuit youth: a community survey of prevalence and risk factors", Acta Psychiatr Scand, 94, pp.8~17 (1996)
- Kochanek KD, "Deaths: final data for 2002. National Vital Statistics Reports" (2004), National Center for Health Statistics
- Langhinrichsen-Rohling J, "Suicidal behavior, negative affect, gender, and self-reported delinquency in college students", Suicide Life Threat Behav, 34, pp.255~266 (2004)
- Ellis JB, "Adaptive characteristics and suicidal behavior: a gender comparison of young adults", Death Stud, 31, pp.845~854 (2007)
- Rehkopf DH, "The association between suicide and the socioeconomic characteristics of geographical areas: a systematic review", Psychol Med, 36, pp.145~157 (2006)
- 홍성철, "사회계층이 자살 사망 위험도에 미치는 영향", 보건과 사회과학, 14, pp.249~271 (2003), 한국보건사회학회
- Andrews B, "The relation of depression and anxiety to life-stress and achievement in students", Br J Psychol, 95, pp.509~521 (2004)
- Perkins DF, "An Ecological Risk-Factor Examination of Suicide Ideation and Behavior of Adolescents", J Adolescent Res, 17, pp.3~26 (2002)
- Gould MS, "Separation", divorce and child and adolescent completed suicide, 1998, pp.37, 155~162
- Brent DA, "Familial risk factors for adolescent suicide: a case-control study", Acta Psychiatr Scand, 89, pp.52~58 (1994)
- Mościcki EK, "Suicide attempts in the Epidemiologic Catchment Area Study", Yale J Biol Med, 61, pp.259~268 (1988)
- Beck AT, "An inventory for measuring depression", Arch Gen Psychiatry, 4, pp.561~571 (1961)
- Steer RA, "Mean Beck Depression Inventory-II scores by severity of major depressive episode", Psychol Rep, 88, pp.1075~176 (2001)
- Rhee MK, "A standardization study of Beck Depression Inventory I-Korean Version (K-BDI)", Kor J Psychopathol, 4, pp.77~95 (1995)
- Nassir Ghaemi S, "Sensitivity and specificity of a new bipolar spectrum diagnostic scale", J Affect Disord, 84, pp.273~277 (2005)
- Donovan DM, "Concurrent validity of the Alcohol Use Disorders Identification Test (AUDIT) and AUDIT zones in defining levels of severity among out-patients with alcohol dependence in the COMBINE study", Addiction, 101, pp.1696~1704 (2006)
- Saunders JB, "Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO Collaborative Project on Early Detection of Persons with Harmful Alcohol Consumption--II", Addiction, 88, pp.791~804 (1993)
- Lee BO, "Development of Korean Version of Alcohol Use Disorders Identification Test (AUDIT-K): Its Reliability and Validity", Korean Acad Addiction Psychiatry, 4, pp.83~92 (2000)
- D’Zurilla TJ, "Relation between social problem-solving ability and subsequent level of psychological stress in college students", J Pers Soc Psychol, 61, pp.841~846 (1991)
- Towbes LC, "Chronic stress in the lives of college students: Scale development and prospective prediction of distress", J Youth Adol, 25, pp.199~217 (1996)
- Sajatovic M, "Bipolar disorder: disease burden", Am J Manag Care, 11, pp.S80~S84 (2005)
- Krishnan KR, "Psychiatric and medical comorbidities of bipolar disorder", Psychosom Med, 67, pp.1~8 (2005)
- Dilsaver SC, "High rate of unrecognized bipolar mixed states among destitute Hispanic adolescents referred for “major depressive disorder”", J Affect Disord, 84, pp.179~186 (2005)
- Murphy GE, "Suicide in alcoholism" (1992), Oxford University
- Lipschitz A, "Suicide prevention in young adults (age 18-30)", Suicide Life Threat Behav, 25, pp.155~170 (1995)
- Taylor R, "Mental health and socio-economic variations in Australian suicide", Soc Sci Med, 61, pp.1551~1559 (2005)
- Weissman MM, "Prevalence of suicide ideation and suicide attempts in nine countries", Psychol Med, 29, pp.9~17 (1999)
- Rudd MD, "An integrative model of suicidal ideation", Suicide Life Threat Behav, 20(1), pp.16~30 (1990)
- Dubow EF, "A two-year longitudinal study of stressful life events, social support, and social problem-solving skills: contributions to children’s behavioral and academic adjustment", Child Dev, 62, pp.583~599 (1991)
- Galfalvy HC, "Evaluation of clinical prognostic models for suicide attempts after a major depressive episode", Acta Psychiatr Scand, 117, pp.244~252 (2008)
- Beck AT, "Suicide ideation at its worst point: a predictor of eventual suicide in psychiatric outpatients", Suicide Life Threat Behav, 29, pp.1~9 (1999)
- Witte TK, "Variability in suicidal ideation: a better predictor of suicide attempts than intensity or duration of ideation?", J Affect Disord, 88, pp.131~136 (2005)