• Korean Journal of Psychosomatic Medicine
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• v.4 no.1
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• pp.71-78
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• 1996

The objective of this study is to evaluate the relationship of hopelessness and suicidal lethality of suicide attempters. The subjects were 72 persons who attempted suicide and came to the emergency room of Chungbuk National University Hospital from April 1st, 1995 to March 31st, 1996. The hopelessness of suicide attempter was assessed by Beck Hopelessness Scale(BHS), and the suicidal lethality was assessed by Risk-Rescue score. The Risk-Rescue Scores exhibited no significant differences in demographic characteristics (sex, age, education, religion, marital status, socioeconomic class, occupation) and psychiatric diagnoses. But the Risk-Rescue scores were significantly higher in high BHS group(BHS score ${\geq}$ 9) than in low BHS group(BHS score <9) and positive correlation was observed between the BHS and the Risk-Rescue score(Rs=0.77 : p<0.05). These results suggest that level of hopelessness be a major risk factor for suicidal lethality.

• Journal of Korean Academy of Nursing
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• v.45 no.2
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• pp.183-191
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• 2015

Purpose: For the current article an examination was done as to whether engaging in sexual intercourse before or during adolescence has a negative impact on the suicidal behaviors of suicide ideation, suicide attempt, and suicide lethality and whether the impact varies according to the context of sexual intercourse and/or gender. Methods: Adolescents who experienced casual sex and romantic sex were compared to adolescents who retained their virginity. Data was from samples drawn from the three waves (2010~2012) of the Korea Youth Risk Behavior Web-Based Survey. Logistic models were used to adjust for a wide array of confounding variables. Results: Any type of sexual intercourse increases risk of all suicidal behaviors. Sexual intercourse in a romantic relationship exhibits enhanced risk of suicidal behaviors compared to casual sex. Adjusting for experience of sexual violence, however, decreases risk of romantic sex substantially, turning some estimates statistically insignificant. In addition, risks for suicide lethality are greater for girls than boys. Conclusion: Romantic sex put adolescents at higher risk for suicidal behaviors than casual sex owing to prevalent sexual violence in the relationships. Girls suffer more substantively adverse outcomes than boys. These results suggest that adolescents will benefit from comprehensive education on sexuality and sexual behaviors regarding how to form and maintain a romantic relationship that is characterized by personal integrity and mutual respect. It is also important to help victims of sexual violence recover from traumatic events by providing emotional support and effective counseling.

• Korean Journal of Biological Psychiatry
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• v.25 no.4
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• pp.118-124
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• 2018

Objectives Although impulsivity has long been thought as an important factor influencing suicidal behaviors, it is unknown whether impulsivity increases the risk of dying from suicidal behaviors and what specific component among constructs of impulsivity contributes to the risk of dying among suicide attempters. Methods To elucidate the association between impulsivity and medical lethality of suicide attempt among suicide attempters, we consecutively recruited 46 suicide attempters who visited an emergency room of a general hospital located in a metropolitan area, Seoul, Republic of Korea, due to suicide attempts and consented to participate in this study. Then we assessed medical lethality with the Beck Lethality Scale (LS) and impulsivity with the Korean version of the Barratt Impulsiveness Scale-11-Revised (BIS). Demographic variables were obtained from medical records and structured social work reports for suicide attempters. Results Although total scores of the BIS did not correlate with LS scores, only the scores of self-control, that is one of the Barrett's six theoretical constructs of impulsivity in which the higher score indicates less self-control and more impulsivity, had a significant positive correlation with scores of LS (p = 0.003). The association remained significant after adjusting for variables known to affect suicide lethality such as job status, recent alcohol consumption, diagnosis of depressive disorders, and having a plan for suicide (${\beta}=0.429$, p = 0.009). Conclusions Not impulsivity in general, but poor self-control, in particular, predicts lethal suicidal behaviors among suicide attempters. The degree of self-control should be evaluated when assessing patients with elevated suicide risk, and proper measures should be installed to prevent possible future lethal suicide attempts.

• Korean Journal of Biological Psychiatry
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• v.12 no.2
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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.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.32 no.1
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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.

• Korean Journal of Biological Psychiatry
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• v.13 no.2
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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.

• Korean Journal of Psychosomatic Medicine
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• v.24 no.2
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• pp.236-243
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• 2016

Objectives : The aim of this study was to clarify the role of alcohol use disorders and acute alcohol consumption in suicide attempts by gender. Methods : Data of 1,152 suicide attempters(487 males and 742 females) who had visited an emergency center was gathered. Suicide attempts were categorized into three groups according to alcohol use: an alcohol use disorder group(AUD), an acute alcohol use group(AAU), and a no-alcohol use group(NAU). The intent and lethality of suicide attempts were evaluated by Suicidal Intents Scale and Risk-Rescue Rating Scale. Results : For Suicidal Intents Scale score, the male AUD group revealed a significantly lower mean score than the male AAU one. However, there were no statistically significant differences for female subjects across subgroups. With regard to the Risk-Rescue Rating Scale score, there were no significant differences for males, while the AUD group showed both the lowest highest rescue scores and lowest risk-rescue scores within female groups. Conclusions : AUD in females was more likely regarding impulsive suicide attempts with high rescue chances. Consuming alcohol might have different effect on suicide attempts by gender and our study shows that alcohol use is an important risk factor according to gender, particularly with regard to female suicide attempts.

• Journal of Yeungnam Medical Science
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• v.41 no.1
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• pp.30-38
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• 2024

Background: Although Korea ranks first in the suicide rate of elderly individuals, there is limited research on those who attempt suicide, with preventive measures largely based on population-based studies. We compared the demographic and clinical characteristics of elderly individuals who attempted suicide with those of younger adults who visited the emergency department after suicide attempts and identified the factors associated with lethality in the former group. Methods: Individuals who visited the emergency department after a suicide attempt from April 1, 2017, to January 31, 2020, were included. Participants were classified into two groups according to age (elderly, ≥65 years; adult, 18-64 years). Among the 779 adult patients, 123 were elderly. We conducted a chi-square test to compare the demographic and clinical features between these groups and a logistic regression analysis to identify the risk factors for lethality in the elderly group. Results: Most elderly participants were men, with no prior psychiatric history or suicide attempts, and had a higher prevalence of underlying medical conditions and attributed their attempts to physical illnesses. Being sober and planning suicide occurred more frequently in this group. In the elderly group, factors that increased the mortality rate were biological male sex (p<0.05), being accompanied by family members (p<0.05), and poisoning as a suicide method (p<0.01). Conclusion: Suicide attempts in elderly individuals have different characteristics from those in younger adults and are associated with physical illness. Suicides in the former group are unpredictable, deliberate, and fatal. Therefore, tailored prevention and intervention strategies addressing the characteristics of those who are elderly and attempt suicide are required.

• Anxiety and mood
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• v.8 no.1
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• pp.41-49
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• 2012

Introduction : Suicide in Korea has increased to 31.2 persons per 100,000 population, the world's highest level. Suicide is the 10th leading cause of death in the world, but in Korea, it is 4th leading cause of death. Therefore suicide is a serious problem in Korea. Many suicide prevention strategies have been proposed. Despite efforts to prevent suicides in Korea, a steady increases in the number of suicides has been brought into question the effectiveness of suicide prevention activities in Korea. Methods : Strategy of restricting suicide methods in many countries was reviewed. Systematic approach to restrict suicidal methods in Korea is proposed. Results : Restricting suicide methods is one of the effective suicide prevention strategies employed in the UK and other countries. Since many suicides occur impulsively, suicide attempt lethality is an important factor in determining the rate of deaths in suicidal attempts. Physical restriction of suicide methods is important in preventing suicide, but restriction of cognitive access to information about suicide and suicide method is more important in preventing suicide. In particular hanging is one of the most common methods of suicides in Korea, it is crucial to develop strategies to prevent suicide by hanging cognitively. Also information about suicide should be properly controlled. To do this, suicide news reporting guidelines should be observed, and website makers whose websites provoke thoughts about suicide should be more strictly sanctioned. Conclusion : Restricting suicide methods along with other suicide prevention plans may be the most effective way to prevent suicide in Korea.

• Korean Journal of Psychosomatic Medicine
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• v.23 no.2
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• pp.100-106
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• 2015

Objectives : The purpose of this study was to find out the clinical and sociodemographic characteristics of elderly suicide attempters visiting emergency room, compared to non-elderly adult suicide attempters. Methods : We enrolled suicidal attempters who were treated in the emergency room of the Inje University Ilsan Paik Hospital between June 2013 and July 2015. We conducted a retrospective chart review of 336 suicidal attempters, and compared sociodemographic and clinical characteristics between elderly and non-elderly adult suicide attempters. Results : During the study period, 336 patients visited the emergency room of the medical center after suicide attempts. Among these, there were 71 elderly(21.2%) and 265 non-elderly adult(79.8%) suicide attempters. The suicidal methods among elderly were poisoning(73.3%), hanging(19.7%), cutting(5.6%), and jumping(1.4%). Those in non-elderly were poisoning(73.2%), cutting(17.0%), hanging(6.8%), and jumping(3.0%). The elderly suicide attempters had the tendency to choose more dangerous methods and showed higher lethality compared to adult suicide attempters(20.6% vs. 1.9%, ${\chi}^2=34.565$, p<0.05). On the other hand, premorbid psychiatric disorders had been more commonly diagnosed in non-elderly adults than elderly suicide attempters(49.8% vs. 26.8%, ${\chi}^2=12.024$, p<0.05). Conclusions : The results provide evidence of different sociodemographic and clinical characteristics of elderly suicide attempters compared to non-elderly ones visiting the emergency room. Through this study, it can be seen that the suicide attempt in the elderly tends to be severer than in the non-elderly, but only a small portion of them seek for help from psychiatric intervention. Further study is required to provide effective suicide prevention programs for elderly population.