• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.31 no.4
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• pp.169-176
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• 2020

Exploring the risk factors of adolescent suicide is important for effective suicide prevention. This study explored the clustering of adolescent suicides based on six risk factors: mental disorder, broken family, depression, anxiety, previous suicide attempts, and deviant behaviors. Using 173 student suicide reports obtained from the Ministry of Education, we evaluated the associations between suicide and variables related to mental disorders; dysfunctional family life; depression and anxiety; previous suicide attempts; deviant behaviors such as drinking and smoking; and school life characteristics, including attendance and discipline, problems within the past year, and incidents prior to suicide. In addition, reports of warning signs just before suicide were included in the analysis. The two-stage cluster analysis classified the students into three clusters: the silent type (cluster 1; 48.55%), in which no risk factors were observed; environmental-risk type (cluster 2: 24.28%), which featured a high frequency of broken households, deviant behaviors such as smoking/drinking and running away from home; and depressive type (cluster 3: 27.17%), which featured a high frequency of mental health problems such as depression, anxiety, and suicide attempts. Identifying the sub-types of adolescent suicide may help to inform tailored suicide prevention and intervention strategies in school.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.34 no.3
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• pp.152-158
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• 2023

Objectives: This study examined the associations between Internet addiction and suicide and non-suicidal self-injury (NSSI) among South Korean adolescents. Methods: We conducted a cross-sectional study of 1694 Korean adolescents. The suicidal Ideation Questionnaire and Deliberate Self-Harm Inventories were used to identify high-risk suicide and NSSI groups, respectively. Internet addiction was assessed using the Internet Addiction Scale. Other questionnaires included sociodemographic data, perceived academic stress, and daily life-related factors. We also performed a logistic regression analysis using the high suicide risk and NSSI groups as dependent variables. Results: The high suicide risk and NSSI prevalence rates among participants were 11.8% and 28.3%, respectively. A multivariable logistic regression analysis revealed that Internet addiction is associated with higher suicide risk and NSSI. Additionally, being female and academic stress were significant suicide risk factors, while male participants had a higher NSSI prevalence. Conclusion: Our results suggest that monitoring adolescents' Internet use and providing education to prevent Internet addiction would lower high suicide and NSSI risk. Moreover, suicide and NSSI risk screening in adolescents with Internet addiction and providing suitable interventions will be essential for the preventing suicide and NSSI.

• Journal of Korean Academy of Nursing
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• v.46 no.1
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• pp.59-68
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• 2016

Purpose: Increase in suicide rate for senior citizens which has become widespread in our society today. It is not a normal social phenomenon and is beyond the danger level. The contents of this study include Korean senior citizens' suicide related risk factors and warning signs, and the development of a simple Geriatric Suicide Risk Scale. Methods: This study is Methodological Research to verify reliability and validity of the Geriatric Suicide Risk Scale according to the tool development process suggested by Devellis (2012). Results: For predictive validity assessment, high suicide screening accuracy was showed with an Area under the ROC curve (AUC) of .93. For the optimal cutoff point of 11, sensitivity was 93.9%, and specificity, 75.7% which are excellence levels. Cross validity for assessment of generalization possibility showed the Area under the ROC curve (AUC) as .82 and in case of a cutoff point of 11, sensitivity was 73.7%, and specificity, 65.9%. Conclusion: When it comes to practical nursing, it is significant that the Korean Geriatric Suicide Risk Scale has high reliability and validity through adequate tool development and the tool assessment step to select degree of suicide risk of senior citizens. Also, it can be easily applied and does not take a long time to administer. Further, it can be used by health care personnel or the general public.

• Safety and Health at Work
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• v.7 no.1
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• pp.1-5
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• 2016

Background: Several studies have investigated the relationship between specific occupations and suicide mortality, as suicide rates differ by profession. The aim of this study was to investigate suicide mortality ratios across broad occupational groups in Greece for both sexes in the period 2000-2009. Methods: Data of suicide deaths were retrieved from the Hellenic Statistical Authority and comparative mortality ratios were calculated. Occupational classification was based on the International Classification of Occupations (ISCO-88) and the coding for Intentional self-harm (X60-X84) was based on the international classification of diseases (ICD-10). Results: Male dominant occupations, mainly armed forces, skilled farmers and elementary workers, and female high-skilled occupations were seen as high risk groups for suicide in a period of 10 years. The age-productive group of 30-39 years in Greek male elementary workers and the 50-59 age-productive group of Greek professional women proved to have the most elevated number of suicide deaths. Conclusion: Further research is needed into the work-related stressors of occupations with high suicide mortality risk and focused suicide prevention strategies should be applied within vulnerable working age populations.

• Journal of Preventive Medicine and Public Health
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• v.49 no.1
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• pp.69-78
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• 2016

Objectives: The suicide rate in Korea is increasing every year, and is the highest among the Organization for Economic Cooperation and Development countries. Psychiatric patients in particular have a higher risk of suicide than other patients. This study was performed to evaluate determinants of mental health care utilization among individuals at high risk for suicide. Methods: Korea Health Panel data from 2009 to 2011 were used. Subjects were individuals at high risk of suicide who had suicidal ideation, a past history of psychiatric illness, or had utilized outpatient services for a psychiatric disorder associated with suicidal ideation within the past year. The chi-square test and hierarchical logistic regression were used to identify significant determinants of mental health care utilization. Results: The total number of subjects with complete data on the variables in our model was 989. Individuals suffering from three or more chronic diseases used mental health care more frequently. Mental health care utilization was higher in subjects who had middle or high levels of educational attainment, were receiving Medical Aid, or had a large family size. Conclusions: It is important to control risk factors in high-risk groups as part of suicide prevention strategies. The clinical approach, which includes community-based intervention, entails the management of reduction of suicidal risk. Our study identified demographic characteristics that have a significant impact on mental health care utilization and should be considered in the development of suicide prevention strategies. Further studies should examine the effect of mental health care utilization on reducing suicidal ideation.

• Journal of Preventive Medicine and Public Health
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• v.55 no.2
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• pp.164-172
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• 2022

Objectives: We aimed to estimate the space-time distribution of the risk of suicide mortality in Iran from 2006 to 2016. Methods: In this repeated cross-sectional study, the age-standardized risk of suicide mortality from 2006 to 2016 was determined. To estimate the cumulative and temporal risk, the Besag, York, and Mollié and Bernardinelli models were used. Results: The relative risk of suicide mortality was greater than 1 in 43.0% of Iran's provinces (posterior probability >0.8; range, 0.46 to 3.93). The spatio-temporal model indicated a high risk of suicide in 36.7% of Iran's provinces. In addition, significant upward temporal trends in suicide risk were observed in the provinces of Tehran, Fars, Kermanshah, and Gilan. A significantly decreasing pattern of risk was observed for men (β, -0.013; 95% credible interval [CrI], -0.010 to -0.007), and a stable pattern of risk was observed for women (β, -0.001; 95% CrI, -0.010 to 0.007). A decreasing pattern of suicide risk was observed for those aged 15-29 years (β, -0.006; 95% CrI, -0.010 to -0.0001) and 30-49 years (β, -0.001; 95% CrI, -0.018 to -0.002). The risk was stable for those aged >50 years. Conclusions: The highest risk of suicide mortality was observed in Iran's northwestern provinces and among Kurdish women. Although a low risk of suicide mortality was observed in the provinces of Tehran, Fars, and Gilan, the risk in these provinces is increasing rapidly compared to other regions.

• Archives of Plastic Surgery
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• v.42 no.2
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• pp.131-142
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• 2015

Literature indicates an increased risk of suicide among women who have had cosmetic breast implants. An explanatory model for this association has not been established. Some studies conclude that women with cosmetic breast implants demonstrate some characteristics that are associated with increased suicide risk while others support that the breast augmentation protects from suicide. A systematic review including data collection from January 1961 up to February 2014 was conducted. The results were incorporated to pre-existing suicide risk models of the general population. A modified suicide risk model was created for the female cosmetic augmentation mammaplasty candidate. A 2-3 times increased suicide risk among women that undergo cosmetic breast augmentation has been identified. Breast augmentation patients show some characteristics that are associated with increased suicide risk. The majority of women reported high postoperative satisfaction. Recent research indicates that the Autoimmune syndrome induced by adjuvants and fibromyalgia syndrome are associated with silicone implantation. A thorough surgical, medical and psycho-social (psychiatric, family, reproductive, and occupational) history should be included in the preoperative assessment of women seeking to undergo cosmetic breast augmentation. Breast augmentation surgery can stimulate a systematic stress response and increase the risk of suicide. Each risk factor of suicide has poor predictive value when considered independently and can result in prediction errors. A clinical management model has been proposed considering the overlapping risk factors of women that undergo cosmetic breast augmentation with suicide.

• Research in Community and Public Health Nursing
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• v.28 no.3
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• pp.240-250
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• 2017

Purpose: In South Korea, suicide mortality has rapidly increased, so it has become a major public health concern. Multicultural adolescents are regarded as a high-risk group due to their situation. In this study, we compared the prevalence and risk factors of suicide ideation between Korean and multicultural adolescents. Methods: Data from the eleventh Korean Youth Risk Behavior Web-based Survey (2015), collected by the Korean Centers for Disease Control and Prevention, were statistically analyzed using the descriptive statistics and multivariate logistic regression. The total participants were 63,376 in numbers. They were composed of 62,649 (98.9%) Korean and 727 (1.1%) multicultural adolescents. Results: I found that the prevalence of suicide ideation was significantly higher among the multicultural adolescents (15.8%) compared with those of Korean (11.3%). The risk factors of suicide ideation in the Korean group were co-residence without family, poor perceived health status, depressive mood, high stress level, poor perceived happiness level, and experience of violence. Conversely, the risk factors of the multicultural group were smoking, depressive mood, and experience of violence. Conclusion: These findings suggest that appropriate and practical prevention strategies should focus on psychological and environmental factors in order to prevent suicide ideation and reduce suicide behavior in Korean and multicultural adolescents.

• Research in Community and Public Health Nursing
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• v.21 no.1
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• pp.71-81
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• 2010

Purpose: This study was to examine the effects of a depression intervention and suicide prevention program in adolescents with high risk of suicide. Methods: This research was designed as a nonequivalent control group pretest-posttest study. The participants were adolescents with high risk of suicide in mental health screening examination. A total of 40 adolescents (experimental group=21, control group=19) were sampled from C-gun, Chungbuk Province. The experimental group participated in the depression intervention and suicide prevention program for eight sessions while the control group did not participate in the program. Data were collected with a self-reporting structured questionnaire from November to December, 2008. SPSS/Win 12.0 was used for data analyses including chi-square test, t-test, and paired t-test. Results: After this program, there was no statistically significant difference in depression (t=1.498, p=.142) between the two groups, but depression decreased in the experimental group. There was a statistically significant difference in suicide ideation (t=2.058, p=.047). Conclusion: To decrease depression and suicide ideation in adolescents with high risk of suicide, it is necessary to offer this program in a more intensive course and for a longer period. Also, family consultation programs and individual case treatment and consultation programs should be offered.

• Journal of Oriental Neuropsychiatry
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• v.35 no.2
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• pp.153-162
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• 2024

Objectives: Among OECD countries, South Korea has been having the highest suicide rate since 2018, with 24.1 deaths per 100,000 people reported in 2020. The objectie of this study was to examine the use of generative artificial intellicence (AI) chatbots to train third-year Korean medicine (KM) students in conducting suicide risk assessments for patients with depressive disorders to train students for their clinical practice skills. Methods: The Claude 3 Sonnet model was utilized for chatbot simulations. Students performed mock consultations using standardized suicide risk assessment tools including Ask Suicide-Screening Questions (ASQ) tool and ASQ Brief Suicide Safety Assessment. Experiences and attitudes were collected through an anonymous online survey. Responses were rated on a 1~5 Likert scale. Results: Thirty-six students aged 22~30 years participated in this study. Their scores for interest and appropriateness (4.66±0.57), usefulness (4.60±0.61), and overall experience (4.63±0.60) were high. Their evaluation of the usability of artificial intelligence chatbot was also high at 4.58±0.70 points. However, their trust in chatbot responses (Q12) was lower (3.86±0.99). Common issues related to dissatisfaction included conversation disruptions due to token limits and inadequate chatbot responses. Conclusions: This is the first study investigating generative AI chatbots for suicide risk assessment training in KM education. Students reported high satisfaction, although their trust in chatbot accuracy was moderate. Technical limitations affected their experience. These preliminary findings suggest that generative AI chatbots hold promise for clinical training, particularly for education in psychiatry. However, improvements in response accuracy and conversation continuity are needed.