• 제목/요약/키워드: suicide rate

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Systematic Review of Suicidal Behaviors Related to Methylphenidate and Atomoxetine in Patients With Attention Deficit Hyperactivity Disorder

  • Jae Heon Kim;Suyeon Park;Yeon Jung Lee
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제34권2호
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    • pp.125-132
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    • 2023
  • Objectives: This study investigated the relationship between suicidal behavior and the use of methylphenidate (MPH) or atomoxetine (ATX) in patients with attention deficit hyperactivity disorder (ADHD). Methods: The Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines were used to conduct a meta-analysis. The Physiotherapy Evidence Database scale was used to score the quality of the studies. Results: Nine studies were included in this quantitative analysis. The analysis included 602864 patients with ADHD (521125 and 81739 patients were taking methylphenidate [MPH group] and atomoxetine [ATX group], respectively) and 19230 healthy controls. The overall estimates were in the order of the control, MPH, and ATX groups; however, no statistically significant between-group difference was observed in the incidence of events (p=0.553 for control vs. MPH; p=1.000 for control vs. ATX; p=1.000 for MPH vs. ATX). Conclusion: The rate of suicidal behavior was higher in the ADHD groups treated with MPH and ATX than in the control group. However, no statistically significant difference was observed between the ADHD groups treated with MPH and ATX, and the control group. Therefore, MPH and ATX did not increase suicidal behavior.

일산화탄소 중독의 역학적 특징: 전국 20개 병원 응급실 손상환자 표본 심층조사 (Epidemiologic Characteristics of Carbon Monoxide Poisoning: Emergency Department Based Injury In-depth Surveillance of Twenty Hospitals)

  • 배소현;이지숙;김경환;박준석;신동운;김현종;박준민;김훈;전우찬
    • 대한임상독성학회지
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    • 제14권2호
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    • pp.122-128
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    • 2016
  • Purpose: This study was conducted to describe the characteristics of patients with carbon monoxide (CO) poisoning. Methods: We retrospectively surveyed data from the Emergency Department based Injury In-depth Surveillance of 20 hospitals (2011-2014). We included patients whose mechanism of injury was acute CO poisoning caused by inhalation of gases from charcoal or briquettes. We surveyed the annual frequency, gender, age, result of emergency treatment, rate of intensive care unit (ICU) admission, result of admission, association with alcohol, and place of accident. We also surveyed the cause and experience of past suicide attempts by intentional poisoning. Results: A total of 3,405 patients were included (2,015 (59.2%) and 1,390 (40.8%) males and females, respectively) with a mean age of $39.83{\pm}18.51$ year old. The results revealed that the annual frequency of CO poisoning had increased and the frequency of unintentional CO poisoning was higher than that of intentional CO poisoning in January, February and December. The mean age of intentional CO poisoning was younger than that of unintentional CO poisoning ($38.41{\pm}13.03$ vs $40.95{\pm}21.83$) (p<0.001). The rates of discharge against medical advice (DAMA), ICU care and alcohol association for intentional CO poisoning were higher than for unintentional CO poisoning (36.4% vs 14.0%, 17.8% vs 4.7%, 45.2% vs 5.6%) (p<0.001). The most common place of CO poisoning was in one's residence. Conclusion: The annual frequency of total CO poisoning has increased, and unintentional CO poisoning showed seasonal variation. DAMA, ICU care, and alcohol association of intentional CO poisoning were higher than those of unintentional CO poisoning.

간호사고와 관련판례에 대한 임상간호사의 지각 (Perception of the Nurse on the Nursing Malpractice and Its Case)

  • 정지연;이명하
    • 간호행정학회지
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    • 제5권3호
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    • pp.445-462
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    • 1999
  • The purpose of this study is to provide some basic data for the direction of nursing education and practice to prevent nursing malpractice as investgating perception of the nurse on the nursing malpractice and its case. Data were collected from 450 nurse working in four general hospitals which were located in Chonbuk province from November 9 to 21, 1998 through questionnare. The structured instruments developed by the reseacher were used for collecting data. The Results were as follows: 1) As for the cognition of the nursing malpractice case, the transfusion accident was 37.3%, the side-effects of KCL injection(19.3%), hymen rupture by uterus cancer test, the side-effects of aminophyllin injections on dyspnea patient and the others were 10% below. 2) With regard to the channel of the perception of the nursing malpractice case, mass-communication was taken first and followed through by neighbors, In-service education, school education, continuing education 3) As for the direct${\cdot}$indirect experience of the nursing malpractice case, transfusion accident was 51.3%, the fall of NPO patient after an operation 40.1%, the side-effect of KCL injection 32.5%, suicide of the psychiatric patient 32.5%, and the others were 30% below. 4) The possibility of nursing malpractice case was an average 2.57(${\pm}$0.91) and the highest was the fall of the NPO patient after an operation. 5) The perception on the responsibility of the nursing malpractice in its case was indicated as a joint-fault in ten nursing malpractice instances. As compared to the real decision, nurse's perception of the responsibility in the fall of the NPO patient after an operation, the side-effect of KCL injection, the tracheal edema of the patient who had a thyroid operation, the suicide of psychiatric patient, the hymen rupture by uterus cancer test accorded real decisions. But the other cases were different from the real decisions. These cases were perceived as ones of joint fault even in cases determined as Dr's single fault cases or those in which both doctor and nurse were declared free of fault. 6) Knowledge levels of the nursing malpractice, school education and In-service education were perceived as low but anxiety levels of the malpractice were high. 7) With regard to the countmeasure of the hospital after nursing malpractice, the rate answered as "the practice settled the accident temporarily and forced the person in charge to be punished" was highest. In conclusion, the level of the cognition of the clinical nurse on nursing malpractice cases was low. As nurses' perception on the responsibility of the nursing malpractice case was compared to the real decision, there was a difference in five cases out of the ten cases.

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20세 이상 성인의 수면시간과 자살생각과의 관련성 (The Association between Total Sleep Time and Suicidal Ideation in Adults over the Age of 20)

  • 황은희;박민희
    • 한국콘텐츠학회논문지
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    • 제16권5호
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    • pp.420-427
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    • 2016
  • 본 연구의 목적은 우리나라 일반 성인과 정신건강 문제를 가진 성인의 수면시간과 자살생각과의 관련성을 파악하는 것이다. 본 연구는 질병관리본부가 실시한 제 5기 국민건강영양조사의 원시자료를 사용하여 SPSS 21.0 프로그램으로 복합표본분석을 하였다. 본 연구의 대상자는 6,199명으로 이중 880명(13.7%)이 자살 생각을 하고 있었다. 우울을 경험한 적이 있는 성인은 846명(13.3%)이었으며 이중 329명(43.1%)이 자살생각을 하고 있었으며, 정신건강 상담을 받은 적이 있는 성인은 164명(2.7%)으로 이 중 63명(40.2%)이 자살 생각을 하고 있었다. 6시간 이상 수면을 취하는 경우와 비교해서 1~5시간의 짧은 수면을 취할 때, 일반성인 그룹에서는 자살생각을 할 위험이 1.33배 높았으며, 우울을 겪은 그룹에서는 자살생각의 위험이 1.92배, 정신건강 상담을 받은 적 있는 그룹에서는 자살생각을 할 위험이 7.10배 높았다. 본 연구를 통해서 짧은 수면시간이 우울 경험이나 정신건강 문제를 매개하지 않아도 자살의 위험요인임이 확인되었다. 따라서 우울 등 정신건강 문제를 가진 성인뿐 만 아니라 일반 성인의 수면장애도 자살예방 차원에서 중재되어야 할 것이다.

청소년 병동에 입원한 비행 청소년의 특성에 관한 연구 (CHARACTERISTICS OF UNRULY & DELINQUENT ADOLESCENTS ADMITTED TO A PSYCHIATRIC INPATIENT UNIT)

  • 이영식;김원정
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제8권1호
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    • pp.70-82
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    • 1997
  • 본 연구는 비행청소년의 사회심리적 특성을 파악하고 비행을 직접적으로 유발시키는 요소를 알아보고자 실시되었다. 청소년 병동에 입원한 환자 중 정신증 진단을 제외한 210명을 비행의 정도에 따라 경찰체포후 훈방된군(60명), 재판 판결을 받은군(35명), 이러한 사실이 없는 정서적으로 혼란된 비교군(105명)으로 나누어 인지-학습, 감정상태, 자살사고, 성격특성, 가족구조, 생활사건 영역에 관한 표준화된 검사를 실시하고 그 결과를 비교분석하였다. 공유진단을 파악하고자 이중 무작위로 60명은 구조화된 면담을 실시하였다. 연구결과 비행청소년은 비교군에 비해 1) 입양, 성생활의 문란, 가출, 정신과 입원력이 높았으며, 2) 언어성 지능지수 및 학습능력이 떨어지고, 3) 성격구조상 충동적이고 사회순응도가 낮으며, 강압적이며, 4) 가족단위의 여가활동이 적고, 낮은 종교 도덕관을 가진 가족의 특성을 보였으며, 5) 부정적 생활 경험이 많았고, 6) 품행자애, 반항장애, 주의력 결핍 과잉행동장애 진단율이 높았다. 우울, 불안, 자살사고는 3군중 훈방된군에서 가장 낮게 나왔다. 따라서 비행청소년을 다룰 때 비행에 관여하는 인지학습측면, 충동적인 성격구조, 가족구조, 부정적 생활경험, 파탄적 행동장애 측면에 관한 보다 집중적인 대처방안이 강구되어져야 하겠다.

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일부 농촌지역 청소년들의 건강행태 관련요인 분석 (Factors related to the Health Behavior of Rural Adolescents)

  • 조희숙;이선희
    • 농촌의학ㆍ지역보건
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    • 제25권2호
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    • pp.315-326
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    • 2000
  • 본 연구는 농촌지역 청소년들의 건강 행태와 최근 청소년들에게 중요한 문제가 되고있는 성 문제, 약물 남용, 청소년 폭력과 정신 보건 관련 문제를 전반적으로 파악하고 이들간의 관련성을 분석하고자 시도되었다. 본 연구에서 얻은 연구 결과를 요약하면 다음과 같다. 첫째, 조사 대상 학생들의 대부분이 자신의 건강상태를 건강하다고 인지하고 있었으나 건강에 대한 관심도는 70% 정도만이 관심을 가지고 있었다. 둘째, 대상 학생들의 건강행태와 비행행태 조사결과 타지역에 비하여 성경험률, 약물 사용률은 낮았으나 흡연률, 음주율은 오히려 높았으며 수면 시간도 부족한 것으로 나타났다. 셋째, 건강관련 행태와의 관련 요인을 분석한 결과 인구 사회학적 특성 중에서는 남자인 경우에서, 중학생에서, 용돈이 적은 경우와 성적이 높은 경우에서 건강행태 실천률이 높았고 건강에 대한 관심이 높을수록, 자살시도를 한 경우보다는 자살 시도 경험이 없는 경우에서, 중학생에서, 건강행태가 양호하였다. 이러한 결과를 종합할 때 농촌 지역 청소년들이 다양한 건강관련 문제점에 직면하고 있음을 알 수 있다. 따라서 대상지역 학생들의 다양한 건강관련 문제점을 파악하고 이를 바탕으로 사업의 우선순위를 선정하여 건강행태를 긍정적으로 개선하고 관리 해나자는 한편 건강에 대한 관심을 증대시키려는 노력이 더욱 활성화되어져야 하겠다.

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Chlorophenoxy계 제초제 중독 환자 임상 양상 (Clinical Aspects of the Chlorophenoxy Herbicide Intoxicated Patients)

  • 조영순;김호중;오범진;서주현;권운용;박준석;어은경;이미진;이성우;노형근;임훈
    • 대한임상독성학회지
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    • 제5권2호
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    • pp.112-118
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    • 2007
  • Purpose: There have been relatively few reports of chlorophenoxy herbicide poisoning. The purpose of this study is to analyze the general characteristics and clinical aspects of the chlorophenoxy herbicide intoxicated patients in Korea. Methods: We prospectively evaluated the chlorophenoxy herbicide intoxicated patients visiting to the 38 emergency medical centers in Korea from the 1 August 2005 to the 31 July 2006. Results: 24 patients were enrolled during the study periods. Their mean age was 55.7 years old. The median amount of the chlorophenoxy herbicide intoxicated is 150 mL. The most frequent location where the patients obtained and took the chlorophenoxy herbicide was their home. Frequent compounds involving chlorophenoxy herbicide poisoning were dicamba(66.7%), MCPP(16.7%), and 2,4-D(12.5%). The most common symptom of the patients was confusion and vomiting. 16 patients(66.7%) intended to suicide. 3 patients out of 24 patients(13.0%) were died. Conclusion: There were 24 patients intoxicated by the chlorophenoxy herbicide during the study periods. The mortality rate was 13.0%. The suicidal attempts and the numbers of death involving chlorophenoxy herbicide were high in Korea.

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한국 성인의 사회경제적 박탈과 자살생각의 연관성: 주관적 건강상태 및 성별 간 차이 (Association between Socioeconomic Deprivation and Suicidal Ideation in Korean Adults: Differences by Subjective Health Status and Gender)

  • 김경미;남진영;정승원;이건희
    • 보건행정학회지
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    • 제34권1호
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    • pp.59-67
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    • 2024
  • 연구배경: 최근 우리나라의 자살문제는 전 세계적으로 가장 심각하다. 본 연구는 한국 성인의 자살생각과 관련된 요인을 확인하고 사회경제적 박탈과의 연관성을 파악하기 위해 수행되었다. 방법: 제17차 한국복지패널(2022) 원자료를 사용하였고, 모든 질문에 응답한 20세 이상 성인 10,065명을 연구대상으로 선정하였다. 자료분석은 SAS ver. 9.4 프로그램(SAS Institute Inc., USA)을 사용하였다. 사회경제적 박탈과 자살생각의 연관성을 알아보기 위하여 다중 로지스틱 회귀분석을 실시하였다. 주관적 건강상태와 성별에 따른 차이를 확인하기 위하여 층화 분석을 실시하였다. 결과: 사회경제적 박탈이 1단위 증가할 때마다 자살생각은 1.5배 증가하였다(odds ratio [OR], 1.48; 95% confidence interval [CI], 1.37-1.61). 주관적 건강상태가 좋은 사람은 사회경제적 박탈이 증가한 각 단위별로 자살생각이 1.3배 높은 것으로 나타났으며(OR, 1.30; 95% CI, 1.12-1.52), 주관적 건강상태가 좋지 않은 사람은 1.6배 높은 것으로 나타났다(OR, 1.58; 95% CI, 1.43-1.75). 결론: 사회경제적 박탈이 증가할수록 자살생각은 증가하는 것으로 나타났다. 따라서 우리나라 성인의 자살률을 낮추기 위해서는 보다 다차원적인 박탈감 수준과 주관적 건강상태를 개선할 수 있는 정책방안이 마련되어야 할 것이다.

일개 도농복합지역 지역응급의료기관 환자의 급성 중독 실태 (Research of Acute Poisoning on a Local Emergency Medical Facility in an Urban-Rural Area)

  • 최효선;최대해;이관
    • 농촌의학ㆍ지역보건
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    • 제33권2호
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    • pp.193-203
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    • 2008
  • Objectives: The aim of this study was to investigate the characteristics of acute poisoning cases admitted to a local emergency department in an urban-rural area. Methods: This retrospective study included all patients with acute poisoning who admitted the emergency department between June 2004 and May 2005. We analyzed the medical records for etiological and demographical characteristics of the acutely poisoned patients. Results: There were 155(1.0%) poisoning cases among 15,457 admitted to the emergency department. Of the admitted cases, 51.0% were female and 49.0% male. The poisoning made a peak in the age range of 30-39 and over 60. The seasonal distribution in poisoning patients suggested a peak in spring(38.1%) and summer(24.5%). The majority of exposures(95.5%) occurred in patient's home, 81.8% were deliberate. The most common agents of acute poisoning in deliberate causes were drugs(p<0.01). All of deliberate cases were suicidal attempts. The most common poisoning cases were pesticides in male, but in female were medications(p<0.01). Overall mortality rate of total cases were 12.9%. The overall mortality rate was higher in male(p<0.05), increasing age(p<0.05) and intentional ingestion(p<0.05), pesticides poisoning(p<0.05). Conclusions: The study forms a foundation for future work on poisoning epidemiology which hopefully will facilitate the allocation of preventive services in order to reduce the incidence as well as morbidity and mortality of toxic exposures.

청소년의 학교생활적응과 자살생각에 관한 종단적 관계연구: 한국아동·청소년패널조사를 중심으로 (A Longitudinal Study on the Correlation between School-life Adjustment and Suicidal Ideation in Adolescents based on the Korean Children and Youth Panel Survey)

  • 양수정;이종은
    • 지역사회간호학회지
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    • 제31권1호
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    • pp.86-95
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    • 2020
  • Purpose: The aim of this study was to examine the correlation between school-life adjustment and suicidal ideation in adolescents by applying the latent growth curve models to the longitudinal data. Methods: This study analyzed three waves of data from the Korean Children & Youth Panel Survey (2014~2016). A total of 1,534 students were included in the analysis. In the application of the latent growth curve models to the longitudinal survey data, we analyzed the initial status and growth changes for each wave, identified individual differences in the general characteristics, and examined the direct relationship between the two latent constructs. Results: The analysis revealed that variations in the initial status and rate of school-life adjustment were significant with respect to parents' education level, household income and academic satisfaction. Variations in the initial status and growth rate of suicidal ideation were significantly associated with household income and family structure. The relationship between school-life adjustment and suicidal ideation showed a negative correlation in which the starting value of the former increased and that of the latter decreased and vice versa. Conclusion: The results confirmed that school-life adjustment and suicidal ideation varied according to students' general characteristics. In addition, school-life adjustment was negatively correlated with suicidal ideation, thereby highlighting students' ability to adjust as an important factor influencing their suicidal thinking.