Medical Care Utilization During 1 Year Prior to Death in Suicides Motivated by Physical Illnesses
2
조회
0
다운로드
2
인용
0
참고문헌
키워드
초록
Objectives: Many epidemiological studies have suggested that a variety of medical illnesses are associated with suicide. Investigating the time-varying pattern of medical care utilization prior to death in suicides motivated by physical illnesses would be helpful for developing suicide prevention programs for patients with physical illnesses. Methods: Suicides motivated by physical illnesses were identified by the investigator’s note from the National Police Agency, which was linked to the data from the Health Insurance Review and Assessment. We investigated the time-varying patterns of medical care utilization during 1 year prior to suicide using repeated-measures data analysis after adjustment for age, gender, area of residence,and socioeconomic status. Results: Among 1994 suicides for physical illness, 1893 (94.9%) suicides contacted any medical care services and 445 (22.3%) suicides contacted mental health care during 1 year prior to suicide. The number of medical care visits and individual medical expenditures increased as the date of suicide approached (p<0.001). The number of medical care visits for psychiatric disorders prior to suicide significantly increased only in 40- to 64-year-old men (p=0.002), women <40 years old (p=0.011) and women 40 to 64 years old (p= 0.021)after adjustment for residence, socioeconomic status, and morbidity. Conclusions: Most of the suicides motivated by physical illnesses contacted medical care during 1 year prior to suicide, but many of them did not undergo psychiatric evaluation. This underscores the need for programs to provide psychosocial support to patients with physical illnesses.
Abstract
Objectives: Many epidemiological studies have suggested that a variety of medical illnesses are associated with suicide. Investigating the time-varying pattern of medical care utilization prior to death in suicides motivated by physical illnesses would be helpful for developing suicide prevention programs for patients with physical illnesses. Methods: Suicides motivated by physical illnesses were identified by the investigator’s note from the National Police Agency, which was linked to the data from the Health Insurance Review and Assessment. We investigated the time-varying patterns of medical care utilization during 1 year prior to suicide using repeated-measures data analysis after adjustment for age, gender, area of residence,and socioeconomic status. Results: Among 1994 suicides for physical illness, 1893 (94.9%) suicides contacted any medical care services and 445 (22.3%) suicides contacted mental health care during 1 year prior to suicide. The number of medical care visits and individual medical expenditures increased as the date of suicide approached (p<0.001). The number of medical care visits for psychiatric disorders prior to suicide significantly increased only in 40- to 64-year-old men (p=0.002), women <40 years old (p=0.011) and women 40 to 64 years old (p= 0.021)after adjustment for residence, socioeconomic status, and morbidity. Conclusions: Most of the suicides motivated by physical illnesses contacted medical care during 1 year prior to suicide, but many of them did not undergo psychiatric evaluation. This underscores the need for programs to provide psychosocial support to patients with physical illnesses.
참고문헌 (33)
- "Annual report on the cause of death statistics 2004" (2005)[URL]
- Levi F, "Suicide risk among incident cases of cancer in the Swiss Canton of Vaud", Oncology, 48(1), pp.44~47 (1991)
- Storm HH, "Suicides among Danish patients with cancer: 1971 to 1986", Cancer, 69(6), pp.1507~1512 (1992)
- Labisi O, "Suicide risk assessment in the depressed elderly patient with cancer", J Gerontol Soc Work, 47(1-2), pp.17~25 (2006)
- Miller M, "Cancer and the risk of suicide in older Americans", J Clin Oncol, 26(29), pp.4720~4724 (2008)
- Kyvik KO, "Suicides in men with IDDM", Diabetes Care, 17(3), pp.210~212 (1994)
- DeVivo MJ, "Suicide following spinal cord injury", Paraplegia, 29(9), pp.620~627 (1991)
- Mackenzie TB, "Medical illness and suicide, In Suicide over the life cycle: risk factors, assessment, and treatment of suicidal patients", pp.205~232 (1990), American Psychiatric Press
- Harwood DM, "Life problems and physical illness as risk factors for suicide in older people: a descriptive and case-control study", Psychol Med, 36(9), pp.1265~1274 (2006)
- Shah A, "Elderly suicide rates: cross-national comparisons of trends over a 10-year period", Psychogeriatr, 20(4), pp.673~686 (2008)
- Cho J, "Age and gender differences in medical care utilization prior to suicide", J Affect Disord, 146(2), pp.181~188 (2013)
- Luoma JB, "Contact with mental health and primary care providers before suicide: a review of the evidence", Am J Psychiatry, 159(6), pp.909~916 (2002)
- Park JY, "Suicidal incidence, methods and reasons of committed suicide according to age and sex in South Korea, 2004", J Korean Assoc Soc Psychiatry, 12(2), pp.68~77 (2007)
- 박재영, "인구사회적 요인, 암, 일부 정신질환 등이 자살에 미치는 영향: 성별, 연령별 분석", 예방의학회지, 41(1), pp.51~60 (2008), 대한예방의학회
- Andersen RM, "Revisiting the behavioral model and access to medical care: does it matter?", J Health Soc Behav, 36(1), pp.1~10 (1995)
- Agerbo E, "Combining individual and ecological data to determine compositional and contextual socio-economic risk factors for suicide", Soc Sci Med, 64(2), pp.451~461 (2007)
- Rubio A, "Suicide and Alzheimer’s pathology in the elderly: a case-control study", Biol Psychiatry, 49(2), pp.137~145 (2001)
- Arsenault-Lapierre G, "Psychiatric diagnoses in 3275 suicides: a meta-analysis", BMC Psychiatry, 4, pp.37~ (2004)
- Henriksson MM, "disorders and comorbidity in suicide", Am J Psychiatry, 150(6), pp.935~940 (1993)
- "uicide risk high for young people" (2009)[URL]
- Zhang J, "Mental disorders and suicide among young rural Chinese: a case-control psychological autopsy study", Am J Psychiatry, 167(7), pp.773~781 (2010)
- Rehse B, "Effects of psychosocial interventions on quality of life in adult cancer patients: meta analysis of 37 published controlled outcome studies", Patient Educ Couns, 50(2), pp.179~186 (2003)
- Phillips MR, "Risk factors for suicide in China: a national case-control psychological autopsy study", Lancet, 360(9347), pp.1728~1736 (2002)
- 전경숙, "의료이용의 남녀차이와 영향요인에 관한 연구", 한국보건간호학회지, 24(2), pp.182~196 (2010), 한국보건간호학회
- Joo K, "A comparative study on medical utilization between urban and rural Korea", Korean J Prev Med, 29(2), pp.311~329 (1996)
- Juurlink DN, "Medical illness and the risk of suicide in the elderly", Arch Intern Med, 164(11), pp.1179~1184 (2004)
- Quan H, "Association between physical illness and suicide among the elderly", Soc Psychiatry Psychiatr Epidemiol, 37(4), pp.190~197 (2002)
- Borson S, "Symptomatic depression in elderly medical outpatients. I. Prevalence, demography, and health service utilization", J Am Geriatr Soc, 34(5), pp.341~347 (1986)
- Koenig HG, "Depression in medically ill hospitalized older adults: prevalence, characteristics, and course of symptoms according to six diagnostic schemes", Am J Psychiatry, 154(10), pp.1376~1383 (1997)
- Crawford MJ, "The recognition and treatment of depression in older people in primary care", Geriatr Psychiatry, 13(3), pp.172~176 (1998)
- Chiu HF, "Elderly suicide prevention in East Asia", J Geriatr Psychiatry, 18(11), pp.973~976 (2003)
- De Leo D, "Suicide over the lifespan: the elderly, In Macmillan encyclopaedia of death and dying", pp.837~843 (2003), Thomson Gale
- Hawton K, "The psychological autopsy approach to studying suicide: a review of methodological issues", J Affect Disord, 50(2- 3), pp.269~276 (1998)