Kim, Bora
(Department of Psychiatry, Seoul National University Hospital)
,
Jung, Keum Ji
(Department of Epidemiology and Health Promotion and Institute for Health Promotion, Graduate School of Public Health, Yonsei University)
,
Lee, Sang Uk
(Korea Suicide Prevention Center)
,
Sea, Jonghan
(Department of Psychiatry, Dongguk University Ilsan Hospital, Dongguk University College of Medicine)
,
Kim, Eun Young
(Department of Psychiatry, Seoul National University Hospital)
,
Kim, Se Hyun
(Department of Psychiatry, Dongguk University Ilsan Hospital, Dongguk University College of Medicine)
,
Jee, Sun Ha
(Department of Epidemiology and Health Promotion and Institute for Health Promotion, Graduate School of Public Health, Yonsei University)
,
Park, Jong-Ik
(Department of Psychiatry, School of Medicine, Kangwon National University)
,
Kim, Kyungil
(Department of Psychology, Ajou University)
,
Ahn, Yong Min
(Department of Psychiatry, Seoul National University Hospital)
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...
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.
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.
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문제 정의
Finally, the KNSS can be used for academic purposes as well as to develop national policies to prevent suicide. As members of the KNSS research team are joining the body charged with developing policies for suicide prevention, the results of this research will form the basis of Korean national policies on suicide prevention.
Indeed, the developers of the KNSS attempted to create an integrated model of suicide through meetings among multidisciplinary collaborators. Our aim was to identify the characteristics of suicide attempters and determine the risk factors for death so that these data could be used in efforts to prevent suicide. Statistical data regarding death from suicide were obtained from a large prospective cohort study of Koreans, and were used to identify high-risk groups in the general population.
Statistical data regarding death from suicide were obtained from a large prospective cohort study of Koreans, and were used to identify high-risk groups in the general population. The results of our survey of attitudes toward suicide will be used in efforts to increase the awareness of the general population and to monitor the effects of national programs that intend to promote a life-affirming culture. The psychological autopsies performed as part of the KNSS were the largest performed in Korea to date and provide an in-depth understanding of the reasons for suicide.
가설 설정
In terms of the process of suicide, suicide attempts precede complected suicides, the development of specific suicide plans precedes suicide attempts, and suicidal ideation precedes the development of specific plans. In addition to this stepwise process, we hypothesized that overall prejudicial and negative attitudes toward suicide may influence suicidal ideation. That is, completed suicides are the culmination of a series of steps that occur in the following order : the harboring of certain general attitudes toward suicide, suicidal ideation, the development of a specific suicide plan, the enactment of a suicide attempt and a completed suicide (Fig.
제안 방법
The KCPS study and KMSRI-Seoul were conducted in collaboration with the NHIS. Data regarding the general characteristics of the sample, including age, marital status, educational level, and income were analyzed according to the suicide rate, which was calculated by dividing the number of those who committed suicide by the sum of person years or the number of subjects. Of the 3201169 participants in the KCPS and KMSRI, 245349 of those who were followed to December 2012 died ; 8305 of these deaths were due to suicide.
First, the characteristics of those who were admitted to emergency departments following an attempted suicide were identified. Second, the mortality rates following suicide attempts were explored to identify the risk factors for completed suicides.
The semi-structured interviews inquired about the immediately pre-suicide situation of individuals who committed suicide, as well as their general life history, specific life events, general quality of life, physical illnesses and treatment, mental health problems and related treatment, and family structure and family situations. The format of the psychological autopsy report was designed by the Department of Psychology of Ajou University and the Ministry of Health and Welfare (2013).
대상 데이터
A total of 1359 suicide attempters who received a face-to-face patient care from a psychiatrist during the 6 months from May to November 2013 were admitted to 17 medical centers throughout Korea, including Jeju Island. More than half (59.
We selected eight primary districts based on the distribution of the national population and then included those with the relevant research and performance-monitoring capabilities. Data from 17 medical centers with the appropriate study environment, such as emergency centers and psychiatrists on duty for 24 hours, located in all metropolitan/urban and rural regions were included.
Sixteen of the seventeen medical centers that participated in the aforementioned study were included in this study. We reviewed the charts of all suicide attempters admitted to the emergency departments of 16 medical centers from January 2007 to December 2011.
The following hospitals are joining study 3 for suicide attempters : Seoul National University Hospital, SMG-SNU Boramae Medical Center, Ewha Womans University Medical Center, Seoul National University Bundang Hospital, CHA Bundang Medical Center, The Catholic University of Korea Uijeongbu St. Mary’s Hospital, Wonju Severance Christian Hospital, Eulji University Hospital, Chungbuk National University Hospital, Chonnam National University Hospital, Chonbuk National University Hospital, Pusan National University Hospital, Ulsan University Hospital, Gyeongsang National University Hospital, Jeju National University Hospital.
The prospective cohort study involved subjects aged ≥ 20 years who had visited seven comprehensive medical examination centers or 12 university hospitals within Seoul or Gyeonggi province since April 2006.
The retrospective study utilized data previously obtained from 18 health examination centers in South Korea between 1996 and 2004. These data consisted of the results of screening tests, information from the NHIS about healthcare utilization and prescription drug use, and mortality records from the Korean National Statistical Office.
The sample consisted of cases of suicide that occurred at least 15 months after data from the informants and information obtained during the investigation of deaths due to unnatural causes, recorded at police stations. Information on the contacts of informants, such as friends, family members, cohabitants, and ex-husbands, was identified by reviewing data related to the cases of suicide.
Approximately 1500 adults aged 19-75 years of age were surveyed. The sample was drawn from 150 sample districts distributed throughout the nation ; 10 households were selected from each sample district, and one individual from each sample household was interviewed.
이론/모형
The semi-structured interviews inquired about the immediately pre-suicide situation of individuals who committed suicide, as well as their general life history, specific life events, general quality of life, physical illnesses and treatment, mental health problems and related treatment, and family structure and family situations. The format of the psychological autopsy report was designed by the Department of Psychology of Ajou University and the Ministry of Health and Welfare (2013). Specifically, data regarding 77 categories of life events, including those involving work, school, finances, interpersonal relationships, home situations, domestic life, illnesses and accidents, and business management, were collected.
참고문헌 (9)
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