• The Journal of Korean Academic Society of Nursing Education
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• v.29 no.1
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• pp.31-60
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• 2023

Purpose: This study explored the influencing factors on suicide-related behaviors (ideation, plans, and attempts) focusing on mental health problems (anxiety, depression, and loneliness) among Korean adolescents. Methods: A secondary analysis was conducted with data from the 16th Korean Youth Health Behavior Survey collected from in 2020 by the Korea Centers for Disease Control and Prevention. Chi-square tests and multivariate logistic regression analyses were performed. Results: After the adjustment of demographic characteristics and health risk behaviors, the influences of mental health problems on suicidal ideation, plans, and attempts showed the anxiety odds ratio (OR) for severe anxiety vs. minimal (OR 4.65, 4.67, and 3.75), depression (OR 4.27, 3.69, and 4.49), loneliness (OR 2.18, 1.96, and 1.96). Health risk behaviors (violence experience, drug use, stress, smoking, and drinking alcohol) and demographic variables (gender, school record, and socioeconomic status) were also significantly associated with suicide-related behaviors. Conclusion: Anxiety, depression, and loneliness were strong predictors of suicide-related behaviors. Early detection of suicide risks through screening for comprehensive mental health problems was recommended. Suicide prevention that considers the risk factors, including mental health problems and other risk factors, needs to be developed and implemented to reduce suicide risks among adolescents.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.35 no.1
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• pp.75-81
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• 2024

Objectives: Although adolescents appear less vulnerable to coronavirus disease (COVID-19), the side effects of this pandemic can still be devastating. Bullying and suicidality are significant global issues with detrimental effects on young people, particularly during school closure. This study aimed to identify the relationship between bullying and suicide risk among adolescents in Indonesia during the COVID-19 pandemic. Methods: A cross-sectional study was conducted on adolescents aged 14-18 years in May 2020 in Bandung, Indonesia, using a web-based closed survey. The Adolescent Peer Relations Instrument and the Suicide Behavior Questionnaire-Revised were used to measure bullying and risk of suicide. Multinomial logistic regression analysis was performed. Results: This study included 268 participants in 2020 and 175 participants in 2019. In 2020, the prevalence of perpetrators and victims of bullying combined was 74.6%. Meanwhile, in 2019, the prevalence of perpetrators and victims of bullying combined was 82.9%. Risk of suicide increased from 26.1% in 2019 (before the COVID-19 pandemic) to 36.5% in 2020 (during the first wave of the COVID-19 pandemic). The risk of perpetrators and suicide victims was higher than that of perpetrators and victims alone (odds ratio [OR]=4.0, 95% confidence interval [CI]=1.5-6.6 vs. OR=1.3, 95% CI=1.0-2.9 and OR=1.6, 95% CI=1.1-2.8, respectively). Conclusion: Bullying can enhance the likelihood of suicide among adolescents in Indonesia, and the risk was highest for the combination of victims and perpetrators. It is very important to provide early risk prediction for youths with bullying behavior and improve the knowledge and understanding of families and schools regarding the negative effects of bullying behavior.

• Research in Community and Public Health Nursing
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• v.28 no.3
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• pp.240-250
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• 2017

Purpose: In South Korea, suicide mortality has rapidly increased, so it has become a major public health concern. Multicultural adolescents are regarded as a high-risk group due to their situation. In this study, we compared the prevalence and risk factors of suicide ideation between Korean and multicultural adolescents. Methods: Data from the eleventh Korean Youth Risk Behavior Web-based Survey (2015), collected by the Korean Centers for Disease Control and Prevention, were statistically analyzed using the descriptive statistics and multivariate logistic regression. The total participants were 63,376 in numbers. They were composed of 62,649 (98.9%) Korean and 727 (1.1%) multicultural adolescents. Results: I found that the prevalence of suicide ideation was significantly higher among the multicultural adolescents (15.8%) compared with those of Korean (11.3%). The risk factors of suicide ideation in the Korean group were co-residence without family, poor perceived health status, depressive mood, high stress level, poor perceived happiness level, and experience of violence. Conversely, the risk factors of the multicultural group were smoking, depressive mood, and experience of violence. Conclusion: These findings suggest that appropriate and practical prevention strategies should focus on psychological and environmental factors in order to prevent suicide ideation and reduce suicide behavior in Korean and multicultural adolescents.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.26 no.3
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• pp.149-158
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• 2015

Objectives : The objective of this study was to identify the risky behavior subtypes in adolescents with depression, and the relationship between those subtypes and suicide attempt. Methods : Ninety adolescents who met the Diagnostic and Statistical Manual of Mental Disorders-4th edition criteria for major depressive disorder, dysthymia, or depressive disorder not otherwise specified participated in the study. Participants were interviewed about suicidal attempts, non-suicidal self-injuries. Smoking, drinking behaviors, and searching for the word "suicide" on the internet, negative life events including bulling-bullied experiences, and history of abuse were also included with questionnaires. Results : The results of cluster analysis showed that four risky behaviors were divided into three clusters : non-risky type, characterized by few risky behaviors ; delinquency type, which was characterized by smoking and drinking ; non-suicidal self-injury type. In non-suicidal self-injury type, percentage of girls was higher and clinical symptoms were more severe than delinquency type. In addition, delinquency type members could be a bully, while non-suicidal self-injury type members could be abused by a family member. Logistic regression analysis showed that both risky behavior subtypes were significant predictors of suicide attempt. Conclusion : These results suggest that two types of risky behaviors of depressed adolescents have an effect on the suicide attempts independently. Then, the implications and limitations of the study were discussed and directions for future studies were suggested.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.31 no.1
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• pp.33-40
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• 2020

Objectives: There is an increasing number of North Korean adolescents in South Korea. These adolescents need clinical attention as they experience a high risk of suicidal behavior because of the childhood adversity and acculturative challenges that they face before and after arriving in South Korea. This study assessed the risk of suicide attempts among North Korean adolescents compared to South Korean adolescents, and investigated the contributing factors for each group. Methods: We used data from the Korean Youth Risk Behavior Web-Based Survey (KYRBS) spanning 2011 to 2018, in which 404 adolescents had a father and/or mother who was a North Korean native. Data on 1,212 propensity-matched South Korean adolescents were extracted from the 2011 to 2018 KYRBS. Prevalence was calculated and compared by group. Separate odds ratios were calculated by group. Results: The North Korean group had a significantly higher suicide attempt rate [unadjusted odds ratio (OR)=8.27; adjusted OR=8.45]. Multivariate analysis indicated that having a low or high socioeconomic status and depressive symptoms were significantly associated with suicide attempts in North Korean adolescents, while being female, having a high socioeconomic status, alcohol use, and depressive symptoms were significantly related to suicide attempts in South Korean adolescents. Conclusion: The results found similarities and differences in the factors associated with the likelihood of suicide attempts in the two groups. From these results, different approaches are needed when planning interventions for each group.

• The Journal of Korean Society for School & Community Health Education
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• v.22 no.2
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• pp.1-14
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• 2021

Objectives: The study aimed to analyze the effects of household financial difficulties caused by COVID-19 (2019 coronavirus disease) on suicidal tendencies of adolescents. Methods: We selected 54,948 middle and high school students who were surveyed based on the Korean Youth Risk Behavior Web-based Survey 2020. To analyze the data, we used the STATA 16.0 program to conduct propensity score matching (PSM). Results: After controlling for selection effects by using PSM, the household financial difficulties caused by COVID-19 maintained a significant predictive effect on increasing suicidal ideation, suicide attempts, and decreasing tendency in hospital-treated after suicide attempts. However, depressive symptoms and suicide plan did not show a significant correlation with household financial difficulties associated with COVID-19. Conclusions: It was found that the rate of suicidal ideation and suicide attempts among adolescents who experienced a household financial difficulties due to COVID-19. Therefore, It can provide empirical evidence for estimating the impact of COVID-19 on adolescent suicide rates.

• Sleep Medicine and Psychophysiology
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• v.23 no.1
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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.

• Anxiety and mood
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• v.4 no.2
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• pp.111-120
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• 2008

Objective : This study investigated the temperament and character traits associated with suicide attempts in patients with mood disorders. Methods : The temperament and character inventory (TCI) was administered to 150 patients who visited psychiatric clinics seeking treatment for mood symptoms. The patients were divided into three groups as follows : non-suicide ideation, suicide ideation and suicide attempt. We also gathered socio-economic data in order to rule out confounding variables. MANOVA was performed to analyze differences in personal temperament and character scores on the TCI between the three groups. Results : The self-directedness and cooperativeness subscales of the TCI are most influenced by the clinical symptoms rated by Beck Suicide Ideation Scale and Hamilton Depression Rating Scale. In the temperament scale, the suicide attempt group scored higher on the novelty seeking and harm avoidance items than the other two groups. The specific temperaments associated with suicidal behavior in patients with depression are impulsivity (NS2) and anticipatory anxiety or pessimism (HA1). Conclusion : In this study, we found that more risky patients who had previously attempted suicide had a temperament of impulsivity or pessimism. This finding suggests that a more cautious approach is needed to assess mood disorder patients with impulsive or pessimistic temperaments in order to prevent suicide attempts.

• Health Policy and Management
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• v.25 no.4
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• pp.285-294
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• 2015

Background: Suicide is one of important health problems in Korea. Previous studies showed factors associated with suicide in individual levels. However, suicide was influenced by society that individuals belong to, so it was required to analyze suicide in local levels. The purpose of this study was to analyze the regional disparities of suicide mortality by gender and the association between local characteristics and suicide mortality. Methods: This study included 229 city county district administrative districts in Korea. Age- and sex-standardized suicide mortality and age-standardized suicide mortality (male/female) were used as dependent variables. City county district types, socio-demographics (number of divorces per 1,000 population, number of marriages per 1,000 population, and single households), financial variable (financial independence), welfare variable (welfare budget), and health behavior/status (perceived health status scores and EuroQol-5 dimension [EQ-5D]) were used to represent the local characteristics. We used hot-spot analysis to identify the spatial patterns of suicide mortality and negative binomial regression analysis to examine factors affecting suicide mortality. Results: There were differences in distribution of suicide mortality and hot-spot regions of suicide mortality by gender. Negative binomial regression analysis provided that city county district types (city), number of divorces per 1,000 population, financial independence, and EQ-5D had significant influences on the age- and sex-standardized suicide mortality per 100,000. Factor influencing suicide mortality was the number of divorces per 1,000 population in both male and female. Conclusion: Study results provided evidences that suicide mortality among regions was differed by gender. Health policy makers will need to consider gender and local characteristics when making policies for suicides.

• Korean Journal of Biological Psychiatry
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• v.22 no.1
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• pp.1-6
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• 2015

Suicide, the fourth leading cause of death in Korea, is a serious national problem. The Korea National Suicide Survey (KNSS) is the result of the first legislation to address this issue, "Article 11 of THE ACT FOR THE PREVENTION OF SUICIDE AND THE CREATION OF A CULTURE OF RESPECT FOR LIFE" (the "Act for the Prevention of Suicide"). To overcome the limitations of previous studies, the KNSS was designed by collaborators from a variety of fields : psychology, epidemiology, social welfare, and psychiatry. The KNSS was composed of four substudies that addressed the multifaceted process involved in suicide-related behavior over time, exploring general attitudes toward suicide and suicidal ideation, suicide planning, suicide attempts, and completed suicides. Study 1 examined the risk factors for suicide based on data regarding completed suicides ; Study 2 adopted the approach of a psychological autopsy ; Study 3 focused on suicide attempters ; and Study 4 explored attitudes toward suicide in the general population. The KNSS was designed to provide a comprehensive understanding of suicide from a longitudinal, multifaceted perspective to serve as a basis for policies aimed at suicide prevention.