• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제30권1호
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• pp.26-33
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• 2019

Objectives: Suicide is the most frequent cause of death among Korean adolescents, and adolescents who have experienced trauma have an increased risk of post-traumatic stress disorder (PTSD) symptoms, depression, and suicide attempts. However, resilience and self-esteem are protective factors. We examined the effects of resilience and self-esteem on the relationship among traumatic experiences, PTSD symptoms, depression, and suicidal ideation. Methods: Middle-school students (n=403) completed questionnaires assessing traumatic experiences, PTSD symptoms, depression, suicidal ideation, resilience, and self-esteem. Path analysis was performed to investigate the mediating effects of PTSD symptoms, resilience, self-esteem, and depression on the relationship between trauma exposure and suicidal ideation. Results: Traumatic experience was positively correlated with PTSD symptoms, depression, and suicidal ideation. PTSD symptoms and depression were positively correlated with suicidal ideation. The relationship between traumatic experiences and suicidal ideation was mediated by PTSD symptoms, which had both direct and indirect effects on suicidal ideation; the indirect effect was mediated by resilience, self-esteem, and depression. Conclusion: Korean adolescents who had experienced trauma were more likely to develop PTSD symptoms, increasing their risk of depression and suicidal ideation. However, self-esteem and resilience may help protect against depression and suicidal ideation. Our findings could inform suicide prevention initiatives.

• 대한통합의학회지
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• 제11권1호
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• pp.141-148
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• 2023

Purpose : This study examined the relationship between suicidal thoughts, hand grip strength, socioeconomic status, educational level, and disease occurrence. Methods : Korean national health and nutrition examination survey 2017 were used in this study. 5,449 were analysed. For comparison between groups, cross-tabulation analysis and mean comparison were performed. Logistic regression analysis were performed to analyze the influencing factors between grip strength and suicidal ideation. Results : Our results are consistent with the literature on the importance of socioeconomic status in health. The lower the level of education, the higher the suicidal thoughts. Being single or divorced was also significantly associated with suicidal ideation. Moreover, a lower income level was significantly associated with a higher suicide intention. Furthermore, older ages, lower educational levels, and lower income were significantly associated with a higher odds ratio of suicidal thoughts. Interestingly, suicidal thoughts were significantly lower among non-smokers. In contrast, suicide intention did not differ significantly according to gender, age, monthly drinking habit, aerobic physical activity, and disease occurrence. Suicidal thoughts decreased as grip strength increased and this was statistically significant. Socioeconomic status, disease occurrence, and handgrip strength level affected the security of an individual's livelihood and were significant risk factors for suicidal thoughts. These associations remained significant in multiple logistic regression even after controlling for all covariates. Conclusion : Future prevention intervention efforts to reduce suicide risks should consider handgrip strength. Studies to explore the possible proximal risk factors and mediators between handgrip strength and suicidal thoughts are also warranted.

• 의료법학
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• 제20권2호
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• pp.261-285
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• 2019

자살예방의 필수적인 정책은 바로 자살재시도율 관련 지표 수집 및 이에 기초한 추적조사를 통해 자살 시도자들을 지속적으로 관리 및 치료하는 것이다. 우리나라의 경우 「개인정보보호법」에 의해서 사례관리에 동의한 대상자들만이 추적 관찰이 가능하게 되어 있어, 연구 참여율 및 서비스 참여율이 저조하여 연구 참여자가 자살기도자의 일부에 국한된다는 한계점이 지속적으로 제기되고 있다. 이에 「자살예방법」 제14조 및 제20조에 따라 자살예방정책의 실질적 활용을 높이기 위한 방안으로 보건복지부법령에서 개선되어야 할 정책적 제안들을 비교 정책적으로 고찰하였다. 정책적 개선을 위한 기준으로서 기술적, 윤리적인 차원에서 고려해야 할 정보의 비식별화 조치 및 비영리 연구, 치료 목적으로만 의료정보에 접근할 수 있는 방안들을 제시하였으며, 한국형 중증도 분류 체계의 기준에 의해 외과적인 중증도와 더불어 자살위험도 평가를 통해 자살에 관한 심각성을 고려하여 지속적인 추적관찰 여부의 객관적 판단을 할 수 있는 기준을 제시하였다. 더불어 비교법적 고찰을 통해 즉각적인 정신과적 치료의 연계와 더불어 자살 시도자 및 보호자가 정신과적 진료에 실제로 접근함에 있어 진입장벽으로 여기는 건강보험 적용의 문제해결을 위해 효과적인 사례관리를 위한 사례관리 전문 교육에 대한 정책적 지원이 추가될 필요가 있음을 제언하였다.

• Psychiatry investigation
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• 제15권11호
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• pp.1037-1045
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• 2018

Objective The present study aimed to identify risk factors for future SI and to predict individual-level risk for future or persistent SI among college students. Methods Mental health check-up data collected over 3 years were retrospectively analyzed. Students were categorized as suicidal ideators and non-ideators at baseline. Logistic regression analyses were performed separately for each group, and the predicted probability for each student was calculated. Results Students likely to exhibit future SI had higher levels of mental health problems, including depression and anxiety, and significant risk factors for future SI included depression, current SI, social phobia, alcohol problems, being female, low self-esteem, and number of close relationships and concerns. Logistic regression models that included current suicide ideators revealed acceptable area under the curve (AUC) values (0.7-0.8) in both the receiver operating characteristic (ROC) and precision recall (PR) curves for predicting future SI. Predictive models with current suicide non-ideators revealed an acceptable level of AUCs only for ROC curves. Conclusion Several factors such as low self-esteem and a focus on short-term rather than long-term outcomes may enhance the prediction of future SI. Because a certain range of SI clearly necessitates clinical attention, further studies differentiating significant from other types of SI are necessary.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제31권4호
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• pp.185-192
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• 2020

Objectives: Our study aimed to analyze the demographic and clinical characteristics of children and adolescents during their first visit to psychiatric outpatient departments for the management of suicidal ideation and behavior, and to compare the changes before and in 2012 or later. Methods: This multicenter study was conducted at five university hospitals in a metropolitan area in South Korea. Medical records of patients aged 6-18 years were retrospectively reviewed from January 2009 to December 2016. Patients were analyzed by classifying them into suicidal and non-suicidal groups based on their visit to the hospital for management of suicidal ideation or suicide attempt and other mental problems, respectively. Results: There were differences in the year of visit, diagnosis, education level, and referral sources between patients in the suicidal and non-suicidal groups. Multiple regression analysis was conducted based on the sex, education level, referral by school, and diagnosis of depression in patients in the suicidal group, which revealed significant association. Conclusion: Suicide-related problems were significantly associated with the sex, education level, referral by school, and a diagnosis of depression in the patients. A well-connected referral system would be necessary for professional mental health management of high-risk children and adolescents.

• 한국학교보건학회지
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• 제27권2호
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• pp.100-108
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• 2014

Purpose: The purpose of this study is to examine the effects of clinical art therapy programs utilized at schools on adolescents' suicidal thoughts and stress relief and to validate their effectiveness as a type of adolescent suicide prevention program. Methods: 12 sessions of clinical art therapy for youth suicide prevention were provided, once a week for 90 minutes, for 20 students at five middle schools in Seoul who were at high risk of committing suicide. By using the paired sample t-test, the study presented qualitative data on the analysis of pre- and post- questionnaires and on the subjects' EEG test and saliva test. Results: First, through the clinical art therapy program, the subjects' happiness index improved significantly while their scores of depression and suicidal ideation (suicidal thoughts) decreased. Second, in the EEG and saliva test conducted after the art therapy sessions, emotional stability increased and stress was reduced significantly. Third, according to the results of pre- and post- K-HTP tests and individual activities, the subjects started to recognize the seriousness of suicide and show emotional stability and positive changes in overall attitudes, valuing the rights and life of their own 'precious selves' (self respect). Conclusion: The results of this study indicate that the clinical art therapy program is significantly effective at preventing suicidal ideation by reducing suicidal impulses and depression, by increasing the happiness index, which can serve as a protective factor against suicide, and by increasing emotional stability while reducing stress. Based on the results, there is a need to develop policy measures regarding art therapy programs which can be utilized at schools.

• 산업진흥연구
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• 제3권2호
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• pp.63-78
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• 2018

본 연구는 청소년의 자살생각에 영향을 미치는 요인을 규명하기 위해 서베이 연구방법을 사용하였다. 본 연구결과는 다음과 같다. 첫째, 부모와 청소년 자녀의 심리적인 거리감을 좁히고 가족 내에서 더욱 화합하기 위한 각 가정에서의 노력이 필요하며, 부모 자녀 간에 때때로 무심코 가해지는 신체적, 언어적인 폭력을 의식적으로 줄여야 한다. 둘째, 자살시도를 하는 청소년이 발생할 때, 학교나 교육기관, 지역사회의 상담관련 기관에서는 청소년의 위기상황에 효과적으로 대응할 수 있도록 해야 하며, 자살예방교육 및 자살태도 교육 등 그 후속조치를 반드시 실시하여 청소년들의 모방 자살이나 충동적인 자살생각을 줄일 수 있도록 노력하여야 한다. 셋째, 청소년의 자살예방 및 관련 프로그램을 개발할 때 이를 고려한 차별화된 프로그램과 자살예방 교육을 시도해야 할 것이다. 넷째, 학교밖 청소년에게도 실시할 수 있는 체계를 마련하여 우울이 높은 청소년을 조기에 발견하여 개입하는 것이 청소년의 자살생각을 예방하는 데에 필요하리라 본다.

• 디지털융복합연구
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• 제13권3호
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• pp.271-281
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• 2015

본 연구는 "2011년도 전국 노인생활실태 및 복지욕구조사"의 데이터베이스를 이용하여 우리나라 노인들의 자살생각에 영향을 미치는 요인들을 규명하는 것을 주목적으로 한다. 분석표본은 10,003건이다. 본 연구는 기존의 노인자살 선행연구에서 투입되지 않았던 사회적 질 관련 요인을 분석에 포함시켜 노인이 살고 있는 사회적 환경의 질적 수준이 자살생각에 미치는 영향을 분석하였다. 위계적 로지스틱 회귀분석 결과, 남성일 경우, 연령이 낮을수록, 도시에 거주할 경우, 독신가구일 경우, 주관적 생활수준이 낮을수록, 일상생활수행기능이 열악할수록, 노인우울이 심할수록, 자살생각을 더 많이 하는 것으로 나타났다. 사회적 질 관련 변인은 타인으로부터 대화기피, 의견무시, 못들은 척, 짜증, 불평 등의 부정적인 말과 행동을 경험하고 감정을 상한 적이 있다고 응답한 경우가 자살생각에 가장 커다란 영향력을 가지는 변인인 것으로 나타났다. 본 연구결과는 노인자살률을 낮추기 위해서는 노인이 살고 있는 사회적 환경의 질적 수준을 좀 더 관대하고, 따뜻하고, 친절하게 만들어 감으로써 자살생각을 줄이는 것에 우선순위를 둘 때 자살예방정책이 실효성을 거둘 수 있음을 시사한다.

• 한국사회복지학
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• 제65권1호
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• pp.127-146
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• 2013

최근 노인 자살이 심각한 사회문제가 되면서 노인 자살예방을 위한 학문적 실천적 노력이 절실히 요구되고 있다. 노인 자살의 위험요인 파악에 치중한 기존 연구와 달리, 본 연구는 내부자 시각에서 자살행동을 극복하게 도움이 되는 것을 살펴보고자 하였다. 본 질적 연구의 목적은 자살시도 후 노인의 삶이 어떻게 전개되며 무엇이 이들에게 삶의 희망을 주는지에 관해 이해하는 것이다. 중심주제분석(thematic analysis)방법을 활용하여 자살시도 노인 35명과의 심층면담 및 연구노트를 통해 얻은 자료를 분석하였다. 연구 결과에 의하면, 참여자의 '다시 살아보자'의 경험은 마음 기울기의 방향과 깊은 관련이 있다. 또한 그 경험은 생각의 전환과 행동이 수반되는 과정이며, 자살행동을 저지하는 요인과 힘을 내서 살게 하는 요인들이 함께 작동한다. 연구 결과를 바탕으로 보호요인 향상에 초점을 맞춘 노인 자살예방을 제언하였다. 그것은 일상의 소소함을 회복시키는 개입, 사회적 지지망을 돈독하게 하는 개입, 강점관점에 따른 개입, 그리고, 자기 의지를 세우게 하는 마음지원 개입이다.

• International journal of advanced smart convergence
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• 제8권3호
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• pp.151-160
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• 2019

Korea has the highest suicide rate among the OECD countries, and the suicide rate is highest among young adults in their 20s, most of whom are university students. Therefore, suicide among Korean university students is a public health issue that is of interest to us. The purpose of this study is to investigate the factors affecting the suicidal ideation of university students in Korea, and to use them as a basis to establish effective intervention for university suicide prevention through it. This was a cross-sectional descriptive study using convenience sampling method. The participants were 344 university students at universities in S and G cities. Data were collected with a structured questionnaire and analyzed using descriptive analysis, t-test, ANOVA, Pearson correlation coefficients, and hierarchical regression analysis using with the SPSS/Win 23.0 program. There was a significant correlation between depression (r=.45, p<.001), drinking alcohol (r=.14, p=.008), social support (r=-.26, p<.001), quality of life (r=-.46, p<.001), and suicidal ideation. In the first step of hierarchical regression analysis, satisfaction of school life (${\beta}=.198$, p<.001) was the significant factor influencing the suicidal ideation. Explanatory power was 25.2%. In the second step of the hierarchical regression analysis, absence of parents (${\beta}=-.095$, p=.044), depression (${\beta}=.247$, p<.001), quality of life (${\beta}=-.280$, p<.001), and explanatory power were increased to 42.0%. The results of the study indicate the need to actively identify the group of university students in their 20s with high risk of suicide through continuous evaluation of depression, and to improve the quality of life as a method of preventing suicide. In addition, the effect of absence of parents on the suicidal ideation among Korean university students suggests that parental support may play an important role in suicide prevention.