생물치료정신의학 (Journal of the Korean society of biological therapies in psychiatry)

대한생물치료정신의학회 (The Korean Society of Biological Therapies in Psychiatry)
권호 표지

지역사회 거주 노인의 자살경향성 유병률과 위험요인

Prevalence and Risk Factors of Suicidality among Community-Dwelling Elderly

  • 김문범 (동국대학교 경주병원 정신건강의학과) ;
  • 이광헌 (동국대학교 경주병원 정신건강의학과) ;
  • 이관 (동국대학교 의과대학 예방의학교실) ;
  • 곽경필 (동국대학교 경주병원 정신건강의학과)
  • Kim, Moon Beom (Department of Psychiatry, Dongguk University Gyeongju Hospital) ;
  • Lee, Kwang-Hun (Department of Psychiatry, Dongguk University Gyeongju Hospital) ;
  • Lee, Kwan (Department of Preventive Medicine, Dongguk University College of Medicine) ;
  • Kwak, Kyung-Phil (Department of Psychiatry, Dongguk University Gyeongju Hospital)
  • 투고 : 2018.07.26
  • 심사 : 2018.09.12
  • 발행 : 2018.10.31

⟨ 이전 논문 다음 논문 ⟩

초록

Objectives : The purpose of this study was to investigate the prevalence and risk factors of suicidality among community-dwelling elderly. Methods : The participants were 2,201 elderly people whose ages were over 65. The participants were asked to complete questionnaires, including Mini International Neuropsychiatric Interview(MINI), module C, Short Geriatric Depression Scale of Korean version(SGDS-K), Korean Geriatric Anxiety Inventory(K-GAI), The Korean Health Status Measure for Elderly V 1.0, Korean version of Mini-Mental Status Examination for Dementia Screening(MMSE-DS). Their sociodemographic factors were investigated. The data were analyzed using the chi-square test and the logistic regression test to examine the relationship between suicidality and participants' risk factors. Results : The prevalence rate of suicidality was 23.3%. In multiple logistic regression, depressive symptoms (OR=3.301, 95% CI : 2.453-4.440), anxiety symptoms(OR=3.289, 95% CI : 2.515-4.303), low physical function (OR=1.606, 95% CI : 1.229-2.098), no spouse(OR=1.571, 95% CI : 1.037-1.690), elderly aged 80 years or older (OR=1.506, 95% CI : 1.094-1.740) were independently associated with suicidality. Conclusion : Suicidality in community-dwelling elderly was quite high, particularly related to depressive symptoms. The results of this study can be useful for development of community-based prevention and management programs for suicidality.

키워드

참고문헌

  1. Statistics Korea. 2016 Statistics on the aged; 2017.
  2. Statistics Korea. 2016 Statistics on cause of death; 2017.
  3. Hawley CJ, James DV, Birkett PL, Baldwin DS, de Ruiter MJ, Priest RG. Associated diagnoses and characteristics in a casualty population. Br J Psychiatry 1991;159:232-8. https://doi.org/10.1192/bjp.159.2.232
  4. Conwell Y. Suicide in later life: A review and recommendations for prevention. Suicide Life Threat Behav 2001;31:32-47.
  5. Kim HS. A Study epistemology of Korean elder's suicidal thought. J Kor Gerontol Soc 2006;22:159-72.
  6. Ferrini AF, Ferrini RL. Health in the later years. Boston: McGraw-Hill Higher Education; 2000.
  7. Han SS, Kang SW, Yoo WK, Phee YG. A study of the determinants of suicidal ideation among the elderly in Korea. Heal Soc Welf Rev 2009;29:192-212.
  8. Cho YR. A Survey on Generalized Anxiety Disorder and Its Risk Factors in Community-Dwelling Older Adults. Kor J Psychol : Gen 2008;27:711-36.
  9. Yang OK, Ju SH. An Exploratory Study on the Influencing Factors to Suicidal Ideation among Single-Household Elderly Population. Ment Health Soc Work 2011;37:321-47
  10. Choi YH, Kim SH. Suicide ideation and related factors according to depression in older adults. J Kor Gerontol Soc 2008;27:345-55.
  11. Jang MH, Kim YH. The relationship of stress, depression and suicidal ideation in the elderly. J Korean Acad Psychiatr Ment Health Nurs 2005;14:33-42.
  12. Alexopoulos GS, Reynolds CF, Bruce ML, Katz IR, Raue PJ, Mulsant BH, et al. Reducing suicidal ideation and depression in older primary care patients: 24-month outcomes of the PROSPECT study. Am J Psychiatry 2009;166:882-90. https://doi.org/10.1176/appi.ajp.2009.08121779
  13. Conwell Y, Duberstein PR, Caine ED. Risk factors for suicide in later life. Biol Psychiatry 2002;52;193-204. https://doi.org/10.1016/S0006-3223(02)01347-1
  14. Sheehan DV, Lecrubier Y, Sheehan KH, Amorim P, Janavs J, Weiller E, et al. The Mini-International Neuropsychiatric Interview(M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry 1998;59 Suppl 20:22-33;quiz 34-57.
  15. Jung JW, Kim HC, Sakong JK, Sung HM, Jung SW, Lee EJ, et al. Suicidality in Major Depressive Disorder: The Impact of Psychiatric Comorbidity. J Korean Neuropsychiatr Assoc 2012:51:85-92. https://doi.org/10.4306/jknpa.2012.51.2.85
  16. Yoon SY, Lim JH, Han CS. Rating Scale for Measurement-Based Clinical Practice of Depression. Korean J Psychopharmacol 2012;23:136-46.
  17. Bae JN, Cho MJ. Development of the Korean version of the Geriatric Depression Scale and its short form among elderly psychiatric patients. J Psychosom Res 2004;57:297-305. https://doi.org/10.1016/j.jpsychores.2004.01.004
  18. Pachana NA, Byrne GJ, Siddle H, Koloski N, Harley E, Arnold E. Development and validation of the Geriatric Anxiety Inventory. Int Psychogeriatr 2007;19:103-14. https://doi.org/10.1017/S1041610206003504
  19. Kim JY, Park MS, Oh DN. Reliability and Validity of Korean Geriatric Anxiety Inventory(K-GAI). J Muscle Jt Health 2014;21:75-84. https://doi.org/10.5953/JMJH.2014.21.1.75
  20. Kim TH, Jhoo JH, Park JH, Kim JL, Ryu SH, Moon SW, et al. Korean version of Mini Mental Status Examination for Dementia Screening and it's short form. Psychiatry Investig 2010;7:102-8. https://doi.org/10.4306/pi.2010.7.2.102
  21. Han JW, Kim TH, Jhoo JH, Park JH, Kim JL, Ryu SH, et al. A normative study of the Mini-Mental State Examination for Dementia Screening(MMSE-DS) and its short form(SMMSE-DS) in the Korean elderly. J Korean Geriatr Psychiatry 2010;14:27-37.
  22. Shin HC, Kim CH, Cho BL, Won JW, Song SW, Park YK, et al. The development of a Korean health status measure for the elderly. J Korean Acad Fam Med 2002;23:440-57.
  23. Conwell Y. Management of Suicidal Behavior in the Elderly. Psychiatri Clin North Am 1997;20:667-83. https://doi.org/10.1016/S0193-953X(05)70336-1
  24. Tsoh J, Chiu HF, Duberstein PR, Chan SS, Chi I, Yip PS, et al. Attempted suicide in elderly Chinese persons: a multi-group, controlled study. Am J Geriatr Psychiatry 2005;12:562-71.
  25. Kim HS, Kim BS. A Path Analysis on Suicidal Ideation on the Elderly. Kor J Counsel Psychoth 2007;19:801-18.
  26. Lynch SM. Measurement and prediction of aging anxiety. Research on Aging 2000;22:533-58. https://doi.org/10.1177/0164027500225004
  27. McIntosh JL. Suicide prevention in the elderly. Suicide Life Threat Behav 1995;25:180-92.
  28. Shah AK, De T. Suicide and the elderly. J Psychiatric Clin Pract 1988;2:3-17.
  29. McIntosh JL, Santos JF, Hubbard RW, Overholser JC, editors. Elder Suicide: Research, Theory, and Treatment. Washing DC: American Psychological Association; 1994.
  30. Vanderhorst RK, McLaren S. Social relationships as predictors of depression and suicidal ideation in older adults. Aging Ment Health 2005;9:517-25. https://doi.org/10.1080/13607860500193062
  31. Lee HK, Chang CG. The Relations of Health-related Quality of Life, Mental Health, and Suicidal Ideation among Korean Elderly. Korean Public Health Research 2012;38:69-79.
  32. Juurlink DN, Herrmann V, Szalai JP, Kopp A, Redelmeier DA. Medical illness and the risk of suicide in the elderly. Arch Intern Med 2004;164:1179-84. https://doi.org/10.1001/archinte.164.11.1179
  33. Park JH, Lee SB, Lee TJ, Lee DY, Jhoo JH, Youn JC, et al. Depression in vascular dementia is quantitatively and qualitatively different from depression in Alzheimer's disease. Dement Geriatr Cogn Disord 2007;23:67-73. https://doi.org/10.1159/000097039
  34. Szanto K, Gildengers A, Mulsant BH, Brown G, Alexopoulos GS, Reynolds CF 3rd. Identification of Suicidal Ideation and Prevention of Suicidal Behaviour in the Elderly. Drugs Aging and Therapy in Practice 2002;19:11-24. https://doi.org/10.2165/00002512-200219010-00002
  35. Kim KH, Kim JS, Lee BS, Lee EK, Ahn YM, Choi MH. A Study about the Factors Affecting the Suicidal Thought in Korean Elders. J Korean Acad Psychiatr Ment Health Nurs 2010;19:391-9. https://doi.org/10.12934/jkpmhn.2010.19.4.391
  36. Emad S, Laura C. Gender in early suicide: analysis of coroners inquest of 200 case of elderly suicide in Cheshire 1989-2001. Int J Geriatr Psychiatry 2008;18:1082-7.