• Journal of Medicine and Life Science
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• 제16권3호
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• pp.60-63
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• 2019

The rate of suicide is the 5th leading cause of death in Korea. Moreover, suicide is the 1st cause of death in from 2nd to 4th decade. In order to treat suicide attempters who have visited the emergency room and to prevent retries, it is necessary to understand the nature of the suicide and to take the right approach. Suicide is more than doubled in women, and retry rates are high among patients with a history of suicide. Suicidal means are throat, fall, gas poisoning, poisoning and drowning. All suicide attempters should suspect and treat cervical spine injury and airway management, and rapid hyperbaric oxygen therapy is recommended for carbon monoxide addicts. Interviewing a suicide attempter requires a sympathetic attitude and examines the underlying depression or adaptation disorders. Interdisciplinary care with mental health departments is necessary, and interventions in emergency roombased suicide attempt management work can be helpful to connect with the community.

• 한국임상약학회지
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• 제29권3호
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• pp.202-208
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• 2019

Objective: Suicide has recently become an important social problem. Thus, we analyzed prescription drugs that cause suicidal ideation. Methods: Of 156 drugs on the the Minister of Food and Drug Safty (MFDS) EZ-Drug site that had "suicide" listed as a side effect, 78 had "suicide" listed as a warning or contraindication; those 78 drugs were analyzed using data from the 2016 Health Insurance and Review and Assessment Services National Patient Sample (HIRA-NPS). Results: 51 "suicide risk" drugs was identified. Of all patients, 5.2% had received such drugs. The prescription rate was 0.8% of all prescriptions, accounting for 1.6% of all prescription days. From logistic regression analysis, the prescription rate for the drugs was approximately 1.1 times higher for women than for men. With regard to age, the prescription rate for patients 66 years and older was 15.5 times higher than those for patients 25-years and lower. With regard to medical departments, the prescription rates in psychiatry and dermatology departments were 8.1 times higher and 0.6 times lower than those in internal medicine departments, respectively. With regard to region, the prescription rates in Daegu and Jeju were 1.3 times higher and 0.79 times lower than those in Seoul, respectively. Conclusion: Drug-induced suicidal behavior is possible, and therefore efforts are needed to prevent it.

• 한국사회정책
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• 제25권4호
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• pp.233-263
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• 2018

이 글은 정부의 자살예방을 위한 노력이 효과적으로 작동하지 않은 것은 변화하는 자살의 위험양식과 그 메커니즘을 포착하지 못했기 때문이라는 판단 하에 한국 사회의 자살위험 발생 양식의 역동적 변화를 밝히고자 한다. 이를 위해 자살율이 급증한 1997-1998년과 2008-2009년 두 경제위기 시기 자살 위험양식의 차이를 젠더 관점에서 살펴봄으로써 다음과 같은 세 가지 주요 논의를 제공한다. 첫째, 두 경제위기 시기 자살률이 증가한 기전이 서로 달랐다. 1997년 외환위기는 대기업 상용직 중심의 실업이, 2008년 금융위기는 비정규직 중심의 노동빈곤이 자살을 증가시키는 핵심 메커니즘으로 작동했다. 둘째, 따라서 각 시기별 남성과 여성의 자살위험 양식이 다르다. 다시 말해 1997년 외환위기의 효과는 대기업 상용직으로 주로 일하던 남성에게, 2008년 금융위기의 효과는 노동빈곤의 처지에 주로 있는 여성에게 상대적으로 더 크게 영향을 미쳤다. 마지막으로, 두 시기 발견되는 자살 위험양식과 메커니즘의 젠더 차이는 여성차별적 노동시장구조와 남성주도적 사회정책의 결과로 이해 가능하다. 즉, 여성을 사회적 보호가 미치지 못하는 노동시장의 주변부에 위치시킴과 동시에, 오히려 이들을 위기 시기 완충요소로 활용한 결과이다. 결론적으로 자살의 원인은 노동시장과 사회정책이라는 근본적이고 사회적인 지점에 있으며, 이러한 위험이 젠더와 결합하면서 또 다른 차별로 결과한다는 점을 알 수 있다. 따라서 한국의 자살예방을 위한 정책적 전략은 젠더 관점으로 접근하는 것이 바람직하며, 인구집단 건강 관점에서 자살의 사회적 원인에 그 중심을 둘 것을 제안한다.

• 한국콘텐츠학회논문지
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• 제14권11호
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• pp.215-224
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• 2014

지금의 노인세대는 개인도 국가도 노후를 준비하지 못한 세대들이며 그에 따른 경제적 어려움과 유병장수로 인한 건강문제와 다양한 사회적 문제의 등장으로 스스로 생을 마감하는 자살이라는 극단적인 방법을 선택하는 경우가 많다. 노인자살은 사회적으로 큰 이슈가 될 정도로 급속도로 증가 하고 있다. 노인 자살과 관련하여 최근에 들어 와서 많은 관심으로 여러 방면에 연구가 진행되고 있으나 미시적인 자살의 요인에 관한 연구가 대다수이고, 소수의 거시적 차원의 연구도 국가적 수준에 국한되는 경향으로 인해 지역별 노인자살에 대한 연구는 극히 부족한 실정이다. 그리하여 지역적 특성에 따른 지역적 수준에서의 노인자살 연구가 절실히 요망된다. 따라서 본 연구는 2003년에서 2011년까지 9년간 지역별(16개시도) 노인 자살률 현황을 성별(남자노인 vs 여자노인)과 연령별(전기노인 vs 후기노인)로 나누어 보다 구체적으로 분석한 후 노인자살률과 사회경제적 요인의 관련성과 미치는 영향을 검토함으로써 자살예방을 위한 정책적 시사점을 제언하였다.

• 수면정신생리
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• 제23권1호
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• pp.5-9
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• 2016

Previous research has identified the biological, psychological, and social factors that confer an elevated risk for suicide. Evidence suggests that sleep disturbances are one of the risk factors that predict an increased risk for suicidal behaviors. Both sleep disorders and general sleep complaints are linked to higher levels of suicidal ideation and depression, as well as increased rates of suicide and suicide attempts. The causal mechanism of this association is not clear. For example, it is not known if insomnia is an independent phenomenon that if interrupted could prevent the emergence of a mental disorder, or if insomnia is a symptom of another developing illness. Hypofrontality, HPA dysfunction, and an impaired serotonergic system are potential mechanisms underlying the association of sleep disturbances and suicidal behavior. Future research is necessary to examine the specific mechanism of this association between sleep and suicide, which may lead to an effective intervention and diminished suicide risk.

• 대한불안의학회지
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• 제13권2호
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• pp.74-85
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• 2017

Objective : A variety of approaches are needed to solve high suicide rates in Korean society. Although suicide prevention education has been provided for the public and suicide risk groups in Korea, a systematic discussion of simple, effective suicide prevention guidelines for the general public has yet to be made. Self-help guidelines for suicide prevention, which can help prevent suicide in at risk individuals, will be developed through expert questionnaires. Methods : In order to develop the draft guidelines, suicide prevention self-help phrases were gathered and compiled from homepages and publicity materials of domestic and international suicide prevention and related organizations. A panel of 16 suicide prevention experts conducted primary and secondary surveys using the Delphi method, which derives results from consensus among expert groups. The validity and appropriateness of the guidelines was analyzed using content validity ratios (CVR). Results : Of 33 candidate phrases selected for the suicide prevention guidelines, 9 showed high CVR after the secondary Delphi round. The highest level of support with total agreement was given to 'Do not be alone, stay with someone'. However, more than half of the panelists evaluated 14/27 of the primary Delphi round and 12/26 of the secondary Delphi round phrases as invalid. The researchers completed 10 self-help guidelines for suicide prevention, after eliminating 1 redundant phrase and including 2 additional phrases that showed relatively high CVR. Conclusion : We have developed 10 self-help guidelines for suicide prevention through the consensus of experts. Further studies on the effects of the guidleines relative to suicide rates are needed after widespread dissemination.

• 수면정신생리
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• 제20권1호
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• pp.5-9
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• 2013

One of hypothesis is that sleep loss related to a decrease in serotonergic activity plays a significant role in attempted suicide. A growing evidence suggests that central serotonergic activity plays a key role in the etiology of suicide. It has been reported that the cerebrospinal fluid (CSF) levels of 5-hydroxyindoleacetic acid (5-HIAA), the main metabolite of serotonin, were reduced in suicide attempters. In addition, there is evidence that tryptophan hydroxylase is associated with suicide. The association between sleep and suicide was also suggested by some researchers. Several recent studies have showed the association between sleep disturbance and suicide rates in patients with mental disorders and in a general population. In addition, it has been suggested that serotonin plays a role in maintaining arousal and regulating muscle tone and in regulating some of the phasic events of REM sleep. Especially, it is well-known that 5-HT2 receptors are related to slow wave sleep. In conclusion, it is clear that sleep, serotonin activity, and suicide are linked, although the direction of causation needs clarification. In future, large population-based cohort studies are needed to demonstrate the direction of causation in the relationships between sleep, serotonin activity, and suicide.

• Safety and Health at Work
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• 제7권1호
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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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• 제56권3호
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• pp.264-271
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• 2023

Objectives: Hanging is a common method of attempted suicide. This study investigated the epidemiological profile of attempted and completed suicides by hanging in southern Iran. Methods: This cross-sectional study was performed on 1167 suicide attempts by hanging between 2011 and 2019. All data related to suicide attempts by hanging were collected from the Fars Suicide Surveillance System. The trends in suicide cases and the mean age of attempted and completed suicides were plotted. The chi-square test was used to identify suicide-related factors. Crude rates of incidence, mortality, and standardized fatality during the study period were calculated. Finally, logistic regression was used to identify the predictors of death in individuals who attempted suicide. Results: The mean age of those who attempted suicide was 33.21±16.82 years; the majority were male (80.5%). The rate of attempted and completed suicide by hanging were 3.50 and 2.79 per 100 000 people, respectively. The case-fatality rate was calculated as 79.34%. The results of our study indicated an increasing trend in suicide attempts by hanging. The likelihood of death was 2.28 times higher in individuals with a previous history of suicide attempts and 1.85 times higher in those with a psychological disorder. Conclusions: The findings of this study suggest an increasing trend in attempted and completed suicide by hanging, especially among individuals with a history of suicide attempts and psychological disorders. It is necessary to take action to reduce the rate of suicide attempts and identify the underlying causes of suicide attempts by hanging.

• 수면정신생리
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• 제29권1호
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• pp.15-20
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• 2022

배 경: 본 연구는 자살시도자와 자살사망자 간 자살방법, 스트레스 요인, 정신과적 진단에 차이가 있는지 확인하고자 하였다. 방 법: 두 가지 후향적인 자료를 분석에 사용하였다. 자살시도자의 경우 삼성서울병원의 의무기록을 확인하여 680명의 의무기록을 수집하였고 한국생명존중재단의 심리부검과정을 통해 11,722명의 자살사망자 데이터를 제공받았다. 두 가지 자료의 자살방법, 스트레스 요인, 정신과적 진단에서의 차이를 확인하였다. 결 과: 자살사망자는 자살시도자에 비해 남성이 많았고 연령대가 높은 것으로 나타났다. 자살 방법 중 목 매달기나 농약 음독과 같은 방법이 자살사망자와 관련이 있었다. 자살시도자의 경우 둔기를 이용해 손목을 긋거나 약물을 음독하는 경우와 연관이 있는 것으로 나타났다. 모든 종류의 스트레스 요인이 자살사망자에게서 높았으며, 특히 경제적인 문제와 신체적인 문제가 자살사망자에게서 높은 비율로 나타났다. 진단의 경우 연령과 성별에 따른 영향을 배제하자 자살시도자와 자살사망자 간 차이를 규명할 수 없었다. 결 론: 자살시도자와 자살사망자 사이에 자살 방법, 스트레스 요인에 차이가 있다는 것을 확인하였다. 이는 경제적인 문제와 신체적인 문제가 동반된 경우 자살 사망의 위험이 더 높을 수 있음을 시사한다.