Korean Journal of Psychosomatic Medicine (정신신체의학)

Korean Psychosomatic Society (한국정신신체의학회)
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The Characteristics of Child and Adolescent Suicide Attempters Admitted to a University Hospital

일 대학병원에 자살 시도 후 입원한 소아청소년들의 특성

  • Bang, Yeon-Sik (Department of Psychiatry, Yonsei University Wonju College of Medicine) ;
  • Lee, Jinhee (Department of Psychiatry, Yonsei University Wonju College of Medicine) ;
  • Min, Seongho (Department of Psychiatry, Yonsei University Wonju College of Medicine) ;
  • Ahn, Joung-Sook (Department of Psychiatry, Yonsei University Wonju College of Medicine) ;
  • Park, Ki-Chang (Department of Psychiatry, Yonsei University Wonju College of Medicine) ;
  • Kim, Min-Hyuk (Department of Psychiatry, Yonsei University Wonju College of Medicine)
  • 방연식 (연세대학교 원주의과대학 정신건강의학교실) ;
  • 이진희 (연세대학교 원주의과대학 정신건강의학교실) ;
  • 민성호 (연세대학교 원주의과대학 정신건강의학교실) ;
  • 안정숙 (연세대학교 원주의과대학 정신건강의학교실) ;
  • 박기창 (연세대학교 원주의과대학 정신건강의학교실) ;
  • 김민혁 (연세대학교 원주의과대학 정신건강의학교실)
  • Received : 2018.09.21
  • Accepted : 2018.10.29
  • Published : 2018.12.31
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Abstract

Objectives : The purpose of this study was to identify the differences of demographic and clinical characteristics between child-adolescents who received medical inpatient care and non-hospitalized adolescents after suicide attempts. Methods : The study included 35 child-adolescents who were hospitalized (Admission group) and 114 child-adolescents who were not hospitalized (Non-Admission group) as a result of a suicide attempt from 2009 to 2015. We compared sociodemographic, clinical, and suicide attempt-related characteristics through a chi-square test and logistic regression analysis to evaluate the differences between the two groups. Results : Child-adolescents of this study most commonly attempted suicide by poisoning, and for motivation of interpersonal problems. Admission group had significantly fewer attempts through injury by sharp objects (${\chi}^2=4.374$, p=0.037) and attempted suicide with a higher chance of actually dying when compared to Risk-Rescue Rating Scale (t=1.981, p=0.049). In addition, Admission group had relatively common motivation for academic problems (${\chi}^2=12.082$, p=0.001) and less motivation for interpersonal difficulties. (${\chi}^2=9.869$, p=0.002) Psychiatric diagnosis at the time of visiting the emergency department showed higher rates of depression in the admission group than Non-Admission group (${\chi}^2=8.649$, p=0.003). The results of logistic regression showed that depression affects hospitalization (OR=2.783, 95% CI 1.092-7.089, p=0.032). Conclusions : This study is meaningful in that it revealed the social and clinical characteristics of all child-adolescents who were hospitalized at a university hospital after attempting suicide. This study identified differences in motivation, methods, and psychiatric diagnosis of hospitalized adolescents and those who were not. Therefore, the results may help adolescent suicide attempters to get a discriminatory approach based on their admission.

연구목적 본 연구에서는 자살 시도 후 응급실에 내원한 소아청소년을 대상으로 입원 치료를 받은 군과 입원하지 않은 군의 사회인구학적, 임상적 특성을 비교하여 차이를 밝히고자 한다. 방 법 2009년부터 2015년까지 자살 시도로 응급실에 내원한 18세 이하 소아청소년을 대상으로 35명의 입원군과 114명의 비입원군으로 분류하였다. 두 군에 대해 교차분석과 회귀분석을 수행하여 사회인구학적 변수, 자살과 관련된 임상적 변수들을 비교 분석하였다. 결 과 자살 시도 후 입원군 소아청소년들과 비입원군 소아청소년들 모두 음독에 의한 자살시도를 가장 많이 시도했으며, 대인관계 곤란과 관련한 자살 동기가 가장 많았다. 입원군은 비입원군에 비해 예기손상을 통한 자살시도는 유의하게 적었고(${\chi}^2=4.374$, p=0.037), 치명도가 더 높은 자살시도를 했다(t=1.981, p=0.049). 또한, 입원군에서 학업과 관련된 문제가 자살 동기로 작용한 경우가 상대적으로 많았고(${\chi}^2=12.082$, p=0.001), 대인관계 곤란에 의한 자살 동기는 더 적었다(${\chi}^2=9.869$, p=0.002). 자살시도로 인한 응급실 내원 당시 입원군에서 우울장애진단 비율이 더 높았고(${\chi}^2=8.649$, p=0.003), 회귀 분석 결과에서도 우울장애가 입원 여부와 가장 높은 상관관계를 보였다(OR=2.783, 95% CI 1.092~7.089, p=0.032). 결 론 자살 시도 소아청소년들 중 입원군과 비입원군에서 자살 동기와 시도 방법, 정신과적 진단에서 차이를 확인하였다. 따라서, 본 연구의 결과는 자살 시도 소아청소년들의 위기개입 시 입원 여부에 따른 차별적인 접근을 하는데 도움이 될 것으로 생각된다.

Keywords

Table 1. Sociodemographic and clinical characteristics of subjects

JSSCBG_2018_v26n2_135_t0001.png 이미지

Table 2. Suicide-related characteristics of subjects

JSSCBG_2018_v26n2_135_t0002.png 이미지

Table 3. Binary logistic regression model of factors associated with admission after suicide attempt

JSSCBG_2018_v26n2_135_t0003.png 이미지

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