• 정신신체의학
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• 제24권2호
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• pp.236-243
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• 2016

연구목적 본 연구는 자살시도에서 알코올이 자살시도의 심각성 및 치명도에 미치는 영향이 성별에 따라 차이가 있는 지 여부를 확인하고자 하였다. 방 법 총 1,152명의 자살시도자(남성 487명, 여성 742명)를 분석 대상으로 하였으며, 음주 양상에 따라 알코올사용 장애군, 급성알코올사용군, 비알코올사용군으로 나누었다. 자살시도의 심각성과 치명도는 자살의도척도및 위험-구조평가척도로 평가하였다. 결 과 남성에서는 급성알코올사용군에 비해 알코올사용장애군에서 자살의도척도의 총점이 유의하게 낮았지만, 여성에서는 각 군 사이에 유의한 차이가 없었다. 위험-구조평가척도에서 남성은 각 군간에 차이가 없었으나, 여성은 알코올사용장애군에서 가장 높은 구조도와 가장 낮은 위험도 점수를 보였다. 결 론 알코올사용장애가 있는 여성 자살시도자는 구조가 쉬운 상황에서 충동적인 자살 시도를 하는 경향이 있다면, 남성은 알코올 사용장애 환자보다 급성 알코올 중독상태일 때 자살의도가 더 강했다. 자살시도자의 알코올의 사용이 성별에 따라 다른 영향을 미칠 수 있으며, 특히 여성에서 중요한 위험 요인임을 시사하고 있다.

• 생물정신의학
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• 제12권2호
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• pp.189-195
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• 2005

Objects:Some studies have suggested that brain-derived neurotrophic factor(BDNF), one of the most important neurotrophins, is involved in pathophysiology of depression and suicide. This study was performed to determine whether there is an abnormality in plasma BDNF concentration in suicidal attempters. Methods:The subjects were 71 suicidal attempters who visited emergency rooms in multi-medical centers. All subjects had been interviewed by using Structured Clinical Interview for DSM-IV(SCID), Hamilton Depression Rating Scale(HDRS), Young Mania Rating Scale(YMRS), and Positive And Negative Syndrome Scale(PANSS). The severity of the suicidal behavior was measured by Lethality of Suicide Attempt Rating Scale(LSARS) and Risk-Rescue Rating(RRR) system. Seventy-one age, sex, and diagnosis matched non-suicidal psychiatric patients who were consecutively admitted to a psychiatric ward during the same period recruited as psychiatric controls. They were drug-naive or drug-free at least more than 2 months. In addition, 80 healthy controls were randomly selected as normal controls. Plasma BDNF level was measured by the enzyme linked immunosorbent assay(ELISA) methods. Results:In overall F-test, differences of the plasma BDNF levels among the groups were statistically significant(F=20.226, p<0.001). In the multiple comparisons(Scheffe), while mean levels of plasma BDNF between normal controls and non-suicidal psychiatric patients were similar(p=0.984), the BDNF levels of suicidal attempters were lower than those of other two groups(p<0.001). LSARS and RRR did not reveal any significant correlations with BDNF levels in suicidal attempters. Conclusion:These results suggest that reduction of plasma BDNF level is related to suicidal behavior and BDNF level may be a biological marker of suicidal behavior.

• 대한임상독성학회지
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• 제18권2호
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• pp.102-109
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• 2020

Purpose: This study examined factors associated with the hospitalization of patients who visited the emergency department (ED) after deliberate self-poisoning. Methods: The medical records of the patients, who visited the ED at a tertiary teaching hospital after deliberate self-poisoning between March 2017 and December 2019, were reviewed retrospectively. Results: Fifty-seven in the hospitalization and 236 in the discharge group patients were included. The mean age in the hospitalization and discharge group was 48.8±20.4 and 41.8±19.1, respectively (p=0.020). Univariate analysis revealed statistically significant differences in age (p=0.020), mental status (p<0.001), request for help (p=0.046), chronic disease (p=0.036), substance ingested (p<0.001), and risk rescue-rating scale (p<0.001) between the two groups (hospitalization group and discharge group). In multiple logistic regression analysis for predicting the hospitalization of patients after deliberate self-poisoning, the Risk-Rescue Rating Scale (RRRS) was identified (OR=1.493, 95% confidential interval=1.330-1.675, p<0.001). Receiver operating characteristics analysis of RRRS for the decision to hospitalize showed a cut-off value of 38.9, with a sensitivity, specificity, and area under the curve of 96.4%, 77.0%, and 0.949, respectively. Conclusion: The RRRS can be used to determine the hospitalization for patients who visited the ED after deliberate self-poisoning. Nevertheless, multicenter prospective studies will be needed to determine the generalisability of these results.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제32권1호
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• pp.17-27
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• 2021

Objectives: Deliberate self-poisoning (DSP) is the most common suicide method and can be life-threatening. The purpose of this study was to investigate the factors related to the lethality of DSP and the characteristics of the adolescent group. Methods: A retrospective study was conducted on patients who had visited an academic hospital's regional emergency medical center between 2015 and 2018. The data reviewed through their medical records included sociodemographic factors, clinical variables, and psychiatric treatment. Four groups (Q1-Q4) were categorized by descriptive analysis using the risk-rescue rating scale. Results: A total of 491 patients were enrolled in this study. This study showed that high lethality had statistically significant associations with male sex, older age, admitting suicidal intentions, and the use of herbicides for suicide. Logistic regression analyses showed a significant association between high-lethality and female [odds ratio (OR)=0.50, 95% confidence interval (CI)=0.30-0.81, p=0.01], non-psychiatric drugs (over-the-counter drug: OR=2.49, 95% CI=1.08-5.74, p=0.03; herbicide: OR=8.65, 95% CI=3.91-19.13, p<0.01), and denial of suicide intent (OR=0.28, 95% CI=0.15-0.55, p<0.01). Conclusion: This study showed the clinical factors associated with the high lethality of DSP and suggested that efforts were needed to care for and thoroughly examine patients with DSP.

• 생물정신의학
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• 제13권2호
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• pp.95-102
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• 2006

Object : Nerve growth factor(NGF) is a protein involved in neuronal survival and plasticity in the central nervous system, which might play an important role in stress, depression and suicide. This study was performed to determine whether there is an alteration in plasma NGF concentrations in depressed patients with suicidal attempt. Methods : The subjects were 32 depressed patients who attempted suicide and admitted in emergency room. Forty-four hospitalized non-suicidal depressive patients and the 30 normal controls were closely matched with the suicidal group in terms of age and sex. Individuals in all 3 groups were evaluated independently by a semi-structured interview for the purpose of establishing a DSM-IV criteria diagnosis. The severity of depressive symptoms was evaluated using Hamilton depression rating scale(HDRS). The severity of the suicidal behavior was evaluated by Weisman and Worden's risk-rescue rating(RRR) system and the Lethality Suicide Attempt Rating Scale(LSARS). Plasma NGF level was measured by the enzyme linked immunosorbent assay(ELISA) method. Results : There were no statistically significant differences of the plasma NGF levels among groups. LSARS and RRR did not reveal any significant correlation with ${\beta}$-NGF level in suicidal depressive patients. Conclusion : This study do not support an association between ${\beta}$-NGF and suicidal depression. However it is necessary to investigate this association through other route such as postmortem brain.

• 정신신체의학
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• 제26권2호
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• pp.135-144
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• 2018

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.