• Journal of Korean Academy of Nursing
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• v.51 no.1
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• pp.40-53
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• 2021

Purpose: The purpose of this study was to develop and compare the prediction model for suicide attempts by Korean adolescents using logistic regression and decision tree analysis. Methods: This study utilized secondary data drawn from the 2019 Youth Health Risk Behavior web-based survey. A total of 20 items were selected as the explanatory variables (5 of sociodemographic characteristics, 10 of health-related behaviors, and 5 of psychosocial characteristics). For data analysis, descriptive statistics and logistic regression with complex samples and decision tree analysis were performed using IBM SPSS ver. 25.0 and Stata ver. 16.0. Results: A total of 1,731 participants (3.0%) out of 57,303 responded that they had attempted suicide. The most significant predictors of suicide attempts as determined using the logistic regression model were experience of sadness and hopelessness, substance abuse, and violent victimization. Girls who have experience of sadness and hopelessness, and experience of substance abuse have been identified as the most vulnerable group in suicide attempts in the decision tree model. Conclusion: Experiences of sadness and hopelessness, experiences of substance abuse, and experiences of violent victimization are the common major predictors of suicide attempts in both logistic regression and decision tree models, and the predict rates of both models were similar. We suggest to provide programs considering combination of high-risk predictors for adolescents to prevent suicide attempt.

• Journal of Environmental Health Sciences
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• v.46 no.4
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• pp.388-397
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• 2020

Objectives: The aim of this study was to assess the association between the use of heated tobacco products (HTP) and suicidal behaviors such as suicidal ideation, suicide planning, and suicide attempts among adolescents in South Korea. Methods: The study used a cross-sectional design. Data was from the 15th Korea Youth Risk Behavior Web-based Survey (KYRBS) performed in 2019 by the Ministry of Education, Ministry of Health and Welfare, and Korean Center for Disease Control and Prevention. Heated tobacco product use was used as a main independent variable and suicide-related behaviors such as suicidal ideation, planning, and attempts were applied as dependent variables. Out of 60,100 students, 57,303 responded. Results: HTP use significantly increased the odds of a suicide attempt and suicide planning among adolescents. After controlling for confounders, when comparing 'current HTP users' with 'never HTP users', the adjusted odds ratio (OR) was 1.78 (95% confidence interval (CI): 1.38-2.30) for suicide attempts among adolescents. After controlling the confounders, comparing 'current HTP users' with 'never HTP users', the adjusted OR was 1.36 (95% CI: 1.06-1.73) for suicide planning among adolescents. For sadness/despair among adolescents, when comparing 'current HTP users' with 'never HTP users', the adjusted OR was 1.29 (95% CI: 1.11-1.50). However, HTP use had no significant association with suicidal ideation among adolescents. Conclusions: Current HTP users were more likely to attempt to commit suicide, and more likely to plan to commit suicide than never HTP users among adolescents. These results may be useful in developing a scientific basis for designing suicide prevention programs targeting adolescents.

• Research in Community and Public Health Nursing
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• v.17 no.3
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• pp.387-396
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• 2006

Purpose: This cross-sectional study was conducted to investigate the prevalence of health risk behaviors by gender and grade and to examine the correlation between health risk behaviors and self-efficacy in early adolescents. Method: The sample of this study consisted of 1.693 early adolescents recruited from 7 middle schools in S-Gu, Seoul, Korea. Health risk behaviors were measured by the Youth Risk Behavior Surveillance Survey (YRBS). Self-Efficacy was assessed by General Self-Efficacy (GSE). Results: About a third of the subjects had experience in drinking behavior about 19.4% in cigarette smoking (including cases of just one or two puffs), 25.9% in physical fight, 29.1% in thought about killing themselves (suicide-related behavior), 1.5% in drug. More than a half (60.5%) experienced at least one health risk behavior. Female students were more likely to report drinking experience and suicide-related experience. Health risk behaviors were not significantly correlated with self-efficacy in early adolescents. Conclusions: Many early adolescents had experience in health risk behaviors in the past. The findings of this research suggest the necessity of intensive prevention programs in middle school to motivate and prepare students to avoid these behaviors. In addition, these results may help health professionals plan appropriate screening and counselling for health problems in early adolescents.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.31 no.4
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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.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.32 no.3
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• pp.104-111
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• 2021

Objectives: Adolescent suicide is a serious national issue in Korea. Recently, life satisfaction has been recognized as a major factor related to this issue. The main purpose of this study was to identify the domains of life satisfaction that affect suicidal behavior in adolescence. Methods: Data were collected from eight middle schools in Incheon, Korea. A total of 1297 students answered questions regarding their demographic characteristics, happiness, self-related life satisfaction domains (appearance, leisure time, physical health, and mental health), depressive symptoms, and suicidal behavior. Results: In the Spearman correlation analysis, female sex, perceived socioeconomic status (SES), happiness, and all four self-related satisfaction scores showed significant correlations with depression and suicidality. Multivariate regression analysis suggested that suicidality was significantly affected by perceived SES, satisfaction with appearance, mental health satisfaction, and depression. Finally, depression was identified as a partial mediator of the association between mental health satisfaction and suicidality, and a complete mediator of the association between female sex and suicidality. Conclusion: Perceived SES, satisfaction with appearance, and mental health satisfaction significantly affected students' suicidality, with or without the effect of depression. Health authorities, educators, and family members must be aware of this to identify adolescents at suicide risk earlier.

• Journal of The Korea Institute of Healthcare Architecture
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• v.27 no.3
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• pp.51-60
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• 2021

Purpose: The purpose of this study is to derive the residential environment design elements that affect suicide, and then analyze the actual situation in terms of suicide prevention and suggest implications. Methods: The study was conducted through literature analysis, field surveys, and interviews with stakeholders. Results: As a result of extracting the variables related to the residential environment that affect suicide suggested in a total of 18 papers, 15 variables were extracted and organized into major categories such as housing type, health and welfare facilities, leisure and cultural facilities, and living environment. Next, we selected a public rental housing complex with a relatively high suicide rate among multi-family housing as the case, and conducted a empirical analysis. It was investigated that the facilities were insufficient, and apart from the quantitative satisfaction of the rest, various problems were exposed, such as the classification of users according to age and insufficient management in terms of the actual use of residents including suicide attempters. Implications: First, it is necessary to search for the design direction of the residential environment for suicide prevention. Second, it is necessary to find a way to solve the exclusion phenomenon that appears in space and programs. Third, when planning a space for suicide prevention, understanding of the behavior of high-risk groups should be reflected.

• Korean Journal of Psychosomatic Medicine
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• v.26 no.2
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• pp.164-171
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• 2018

Objectives : Depression is a common mental illness and a major cause of suicide. Although serum lipids have been associated with depression and suicide, there has been much debate. In this study, we investigated the relationship between depression, suicide, and serum lipids in patients admitted with depressed mood. Methods : A total of 134 subjects were divided into 86 non-suicide patients and 48 suicide attempters. The serum lipid levels and sub-scores of the Korean Symptom Checklist-95 (KSCL95) were compared. We also investigated the relationship between serum lipids and sub-scores of KSCL95 and investigated whether serum lipids were risk factors for suicide attempts. Results : There was no difference in serum lipids between the two groups. Among the sub-items of KSCL95, obsession was higher in non-suicide group. Triglyceride showed positive correlations with anxiety, phobic anxiety, agoraphobia, schizophrenia, and self-regulation problem. High triglyceride was a risk factor for suicide attempts. Conclusions : Triglyceride is associated with depression, anxiety, and self - regulation, and high serum triglyceride levels may be a risk factor for suicide attempts.

• Korean Journal of Psychosomatic Medicine
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• v.29 no.2
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• pp.199-206
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• 2021

Objectives : This study aimed to compare the characteristics of suicide attempts among Korean patients with mixed and non-mixed depression. Methods : Patients who visited the emergency room due to a suicide attempt and participated in the Korean Cohort for the Model Predicting a Suicide and Suicide-related Behavior study were included. Using the Montgomery-Asberg Depression Rating Scale (MADRS) and Young Mania Rating Scale (YMRS), 111 patients were classified into the mixed depression (n=46) and non-mixed depression groups (n=65). The Koukopoulos Mixed Depression Rating Scale (KMDRS) score was calculated using the MADRS and YMRS scores. Suicide attempt characteristics were evaluated using the Columbia Suicidal Severity Rating Scale (C-SSRS) and Suicide Intent Scale (SIS). Results : In the mixed depression group, the reason item among the ideation intensity score of the C-SSRS was higher, and the deterrent item score was lower. Scores on the timing and suicide note items of the SIS were higher, and scores for overt communication items were lower in the mixed depression group. The KMDRS score was positively correlated with the C-SSRS ideation intensity and total SIS score. After adjusting for additional variables, the KMDRS scores had a significant effect on the C-SSRS ideation intensity and total SIS scores. Conclusions : The mixed depression group showed a difference in the intensity of suicidal ideation and suicidal intention compared to those in the non-mixed depression group. The overall suicidal ideation intensity and suicidal intention increased according to the degree of mixed depression.

• Journal of Korean Home Economics Education Association
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• v.32 no.4
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• pp.67-79
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• 2020

The purpose of the study were to analyze the patterns of adolescent suicide attempts, and to explore the effects of personal psychology (subjective depression, subjective stress), health status (BMI, subjective health perception), and subjective academic performance on the types of youth suicide attempts. For this research, data of 'The 15th Korea Youth Risk Behavior Survey' were analyzed employing a hierarchical logistic regression analysis. The findings are as follows. First, out of 1,731 youth suicide attempts 156 (9%) were impulsive and 1,575 (91%) were planned. Girls(67.3%) attempted suicide more than boys (32.5%), and middle school students (62%) attempted suicide more than high school students (38%). Second, the variables that significantly affect suicide attempt types were subjective depression, subjective stress, and subjective health perception, after controlling for gender, grade level, school type, and SES. The rate of planned suicide attempts was higher among those who experienced depression than among those who did not. In the case of subjective stress, adolescents who felt stressed were likely to commit planned suicide attempts. Those who attempted impulsive suicide showed 1.32 times higher subjective health perception scores than those who attempted planned suicide, indicating adolescents who perceived they were not healthy were more likely to attempt planned suicide. BMI and subjective academic performance did not have a significant effect on the types of youth suicide attempts. These findings suggested the necessity of systematic intervention in Home Economics classes or extra-curricular programs, to prevent potential youth suicide attempts.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.27 no.4
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• pp.306-312
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• 2016

Objectives: We aimed to compare the smoking behaviors in adolescents from monocultural and multicultural families and to evaluate the associations between their smoking behavior and number of suicide attempts. Methods: The data used in this study was collected from The Tenth Korea Youth Risk Behavior Web-based Survey. The differences in the sociodemographic characteristics between the adolescents in the multicultural and monocultural families were analyzed through the ${\chi}^2$-test, and a logistic regression was conducted to evaluate the relationships between the smoking behavior and number of suicide attempts of the adolescents in multicultural families. The process involved an analysis using a complex sample design. Results: There was significant difference in the weighted rates of the current smoking behavior (13.3% vs. 8.4%, p<0.001), experience of violence (6.8% vs. 2.3%, p<0.001), and number of suicide attempts (5.4% vs. 2.7%, p<0.001) between the adolescents from the multicultural and monocultural families. In both groups, the current smoking behavior was associated with the number of suicide attempts (multicultural families OR=6.5, p=0.005; monocultural families OR=1.5, p<0.001). Conclusion: Our results showed that the percentage of current smokers in the adolescents from multicultural families was higher than that in the monocultural families and that current smoking behavior is related to the number of suicide attempts in both groups, after adjustment for age, sex, socioeconomic status, academic achievement, current smoking behavior, depressive mood and experience of violence.