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Choi H, Lee S, Chun H, Shin JH. Suicidal ideation and attempt among young people living in gosiwons in South Korea. Soc Psychiatry Psychiatr Epidemiol 2024; 59:1543-1549. [PMID: 38305869 DOI: 10.1007/s00127-024-02615-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 01/01/2024] [Indexed: 02/03/2024]
Abstract
INTRODUCTION Young people living in gosiwons could be at high risk for suicide owing to inadequate living conditions and the social stigma towards them. However, this topic has not received adequate academic attention. Gosiwon is a type of small residence consisting of several tiny rooms densely packed together and usually does not meet minimum housing standards. However, gosiwons are favored by low-income groups, especially young people, because they are cheaper than other residences. This study aimed to examine the factors that increase the risk of suicidal ideation and attempt among young people living in gosiwons. METHODS A sample of 300 young people aged 19-34 years living in gosiwons for over 6 months was analyzed. A set of multinomial logistic regression was conducted to examine the factors that differentiate the suicidal ideation and attempt group from the no-suicidal risk group. RESULTS Approximately 30% of the study participants experienced suicidal ideation or attempted suicide. Among several risk factors, social exclusion and depressive symptoms distinguished the group with suicidal ideation from the no-risk group. Depressive symptoms were the only factor that differentiated the group with suicide attempts history from the no-risk group. CONCLUSION The results emphasize the need to focus on social exclusion and depressive symptoms among young people living in poor housing conditions. Interventions to address social exclusion and depressive symptoms may help prevent suicide risk among young people exposed to housing exclusion.
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Affiliation(s)
| | - Somin Lee
- Yonsei University, Seoul, Republic of Korea.
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2
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Bekaroğlu E, Bulut BP, Demirbaş H. Reliability and validity of the Suicide Cognitions Scale-Revised (SCS-R) in emerging adulthood in Turkey. DEATH STUDIES 2024; 48:500-510. [PMID: 37516976 DOI: 10.1080/07481187.2023.2240742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
Abstract
Suicidal thoughts and behaviors (STBs) are a significant public health problem. This study aims to examine the validity and reliability of the Turkish version of the Suicide Cognitions Scale-Revised (SCS-R). Participants (N = 442, age range: 18-29 years) completed the SCS-R, the Beck Depression Inventory, the Inventory of Statements About Self-injury, the Suicide Probability Scale, and the Suicide Rumination Scale. Principal component analysis showed that the SCS-R consisted of a single factor and that the SCS-R could differentiate between participants at high risk and low risk of suicide. High-to-moderate positive associations were found between the measures of depression, suicide probability, suicide rumination, and non-suicidal self-injury and suicide cognition. The Turkish version of the SCS-R has good psychometric properties. This scale can be used to screen for cognitive patterns that are most prone to suicide and to manage such cognitive characteristics, which are important steps for preventive interventions.
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Affiliation(s)
- Ece Bekaroğlu
- Department of Psychology, Ankara Hacı Bayram Veli University, Ankara, Turkey
| | - Burcu Pınar Bulut
- Department of Psychology, Ankara Hacı Bayram Veli University, Ankara, Turkey
| | - Hatice Demirbaş
- Department of Psychology, Ankara Hacı Bayram Veli University, Ankara, Turkey
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Li D, Gao Y, Li S, Zhou C, Wang Y, Li M, Guobule N, Mao H, Zhang X, Li J. Perceived stress and severity of depression mediate the association between alexithymia and suicidal ideation in patients with major depressive disorder. Heliyon 2023; 9:e21986. [PMID: 38027633 PMCID: PMC10665753 DOI: 10.1016/j.heliyon.2023.e21986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Revised: 10/29/2023] [Accepted: 11/01/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Alexithymia and perceived stress have been recognized as risk factors for suicide in patients with major depressive disorder (MDD). However, few studies have been conducted to examine the relationship between these factors. Methods A cross-sectional study was conducted on 105 MDD patients. Alexithymia was assessed by the 20-Item Toronto Alexithymia Scale (TAS), perceived stress was assessed by the Perceived Stress Scale (PSS), severity of depression was assessed by the 17-item Hamilton Depression Rating Scale (HAMD), and suicidal ideation was assessed by the self-report Beck Scale for Suicide Ideation (SSI). A sequential mediation model was established to test the mediating effects of perceived stress and severity of depression on the association between alexithymia and suicidal ideation. Results 81 of the 105 participants (77.14 %) had suicidal ideation. Patients with suicidal ideation had greater difficulty in identifying feelings (DIF) (p = 0.046), higher severity of depression (p = 0.005) and perceived stress (p = 0.003). DIF subscale score of TAS was associated with perceived stress (r = 0.292, p = 0.003), severity of depression (r = 0.349, p < 0.001) and suicidal ideation (r = 0.229, p = 0.012). Sequential mediation model showed that perceived stress and severity of depression mediated the effect of DIF on suicidal ideation. Conclusions This study suggests that perceived stress and severity of depression fully mediate the relationship between difficulty in identifying feelings and suicidal ideation in MDD patients.
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Affiliation(s)
- Dan Li
- Laboratory of Biological Psychiatry, Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, 300222, China
| | - Ying Gao
- Laboratory of Biological Psychiatry, Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, 300222, China
| | - Shuhua Li
- Laboratory of Biological Psychiatry, Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, 300222, China
- Department of Clinical Psychology, Tianjin TEDA Hospital, Tianjin, 300457, China
| | - Chi Zhou
- Laboratory of Biological Psychiatry, Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, 300222, China
| | - Yuting Wang
- Laboratory of Biological Psychiatry, Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, 300222, China
| | - Meijuan Li
- Laboratory of Biological Psychiatry, Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, 300222, China
| | - Nanage Guobule
- Laboratory of Biological Psychiatry, Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, 300222, China
| | - Huan Mao
- Laboratory of Biological Psychiatry, Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, 300222, China
| | - Xiangyang Zhang
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, 100101, China
| | - Jie Li
- Laboratory of Biological Psychiatry, Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, 300222, China
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Kim J, Gwak D, Kim S, Gang M. Identifying the suicidal ideation risk group among older adults in rural areas: Developing a predictive model using machine learning methods. J Adv Nurs 2023; 79:641-651. [PMID: 36534434 DOI: 10.1111/jan.15549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 10/10/2022] [Accepted: 12/05/2022] [Indexed: 12/23/2022]
Abstract
AIMS The aim of this study was to develop a predictive model that can identify the suicidal ideation risk group among older adults in rural areas using machine learning methods. DESIGN This study applied an exploratory, descriptive and cross-sectional design. METHODS The participants were older adults (N = 650) aged over 65 living in rural areas of South Korea. Self-report questionnaires were used to collect the demographics, suicidal ideation, depression, socioeconomic information and basic health information from September to October 2020. The collected data were analysed using machine learning methods with R statistical software 4.1.0. RESULTS The predictive models indicated that depression, pain, age and loneliness were significant factors of suicidal ideation. Good performance was observed based on the area under the receiver operating characteristic curve in the decision tree, random forest and logistic regression. Finally, the evaluation of model performance indicated moderate to high sensitivity and specificity. CONCLUSION The predictive models using machine learning methods may be useful to predict the risk of suicidal ideation. Furthermore, depression with pain, age and feelings of loneliness should be included in the initial screening to assess suicide risk among older adults in rural areas. IMPACT Identifying suicidal risk among older adults is challenging. Thus, employing predictive models that can assess depression, pain, age and loneliness can enable public healthcare providers to detect suicidal risk groups. Particularly, the presented models from this study can facilitate healthcare providers with initiating early interventions to prevent suicide among older adults in clinical and community nursing care settings. REPORTING METHOD The reporting of this study (Observational, cross-sectional study) conforms to the STROBE statement. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution. This study did not involve patients, service users, caregivers or members of the public. IMPLICATION FOR THE PROFESSION AND/OR PATIENTS CARE Applying this model may help to prevent geriatric suicide because the nursing staff will have a greater awareness regarding the suicide ideation risk of older adults, thereby reducing the possibility of their suicide.
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Affiliation(s)
- Junglyun Kim
- College of Nursing, Chungnam National University, Daejeon, South Korea.,Department of Biobehavioral Nursing Science, University of Florida, Gainesville, Florida, USA
| | - DongHyeon Gwak
- College of Nursing, Chungnam National University, Daejeon, South Korea
| | - Seonhee Kim
- Nursing Department, Songwon University, Gwangju, South Korea
| | - Moonhee Gang
- College of Nursing, Chungnam National University, Daejeon, South Korea
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Azizi H, Esmaeili ED, Khodamoradi F, Sarbazi E. Effective suicide prevention strategies in primary healthcare settings: a systematic review. MIDDLE EAST CURRENT PSYCHIATRY 2022. [DOI: 10.1186/s43045-022-00271-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Abstract
Background
There is a fundamental need for health systems, health managers, and policymakers to identify effective components of suicide prevention strategies (SPS) and programs in primary healthcare (PHC) settings. Accordingly, this systematic review aimed to identify and summarize effective and significant evidence on suicide prevention in PHC setting. We systematically searched the published literature in English from PubMed, Web of Science, Scopus, CINAHL, PsychoINFO, and Embase up to 31 July 2022. The study searched all records reporting effective and significant strategies and programs on suicide prevention in PHC settings. A content analysis approach was carried out to extract major components of suicide prevention strategies in PHC settings.
Results
A total of 10 records (8 original articles and 2 reports) with 1,199,986 samples were included. In all the included articles, SPS decreased suicide rates. The majority of studies were conducted among the general population. The content analysis approach emerged five major components to SPS in PHC setting: (1) training and educating healthcare providers, (2) screening and suicide risk assessment, (3) managing depression symptoms and mental disorders, (4) managing suicide attempters and at-risk cases, and (5) prevention strategies at the general population.
Conclusions
This review provided reliable evidence for health systems to develop SPS in PHC and practitioners who are eager to provide brief and effective contact interventions for suicide risk to well-serve their patients.
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Park K, Yoon S, Cho S, Choi Y, Lee SH, Choi KH. Final validation of the mental health screening tool for depressive disorders: A brief online and offline screening tool for major depressive disorder. Front Psychol 2022; 13:992068. [PMID: 36275320 PMCID: PMC9580402 DOI: 10.3389/fpsyg.2022.992068] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 09/13/2022] [Indexed: 12/02/2022] Open
Abstract
Early screening for depressive disorders is crucial given that major depressive disorder (MDD) is one of the main reasons of global burden of disease, and depression is the underlying cause for 60% of suicides. The need for an accurate screening for depression with high diagnostic sensitivity and specificity in a brief and culturally adapted manner has emerged. This study reports the final stage of a 3-year research project for the development of depression screening tool. The developed Mental Health Screening Tool for Depressive Disorders (MHS:D) was designed to be administered in both online and offline environments with a high level of sensitivity and specificity in screening for major depressive disorder. A total of 527 individuals completed two versions (online/offline) of the MHS:D and existing depression scales, including the BDI-II, CES-D, and PHQ-9. The Mini International Neuropsychiatric Interview (MINI) for diagnostic sensitivity/specificity was also administered to all participants. Internal consistency, convergent validity, factor analysis, item response theory analysis, and receiver operating characteristics curve (ROC) analysis were performed. The MHS:D showed an excellent level of internal consistency and convergent validity as well as a one-factor model with a reasonable level of model fit. The MHS:D could screen for major depressive disorder accurately (0.911 sensitivity and 0.878 specificity for both online and paper-pencil versions). Item response theory analysis suggested that items from the MHS:D could provide significantly more information than other existing depression scales. These statistical analyses indicated that the MHS:D is a valid and reliable scale for screening Korean patients with MDD with high diagnostic sensitivity and specificity. Moreover, given that the MHS:D is a considerably brief scale that can be administered in either online or paper-pencil versions, it can be used effectively in various contexts, particularly during the pandemic.
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Affiliation(s)
- Kiho Park
- School of Psychology, Korea University, Seoul, South Korea
| | - Seowon Yoon
- School of Psychology, Korea University, Seoul, South Korea
| | - Surin Cho
- School of Psychology, Korea University, Seoul, South Korea
| | - Younyoung Choi
- Department of Psychology, Ajou University, Seoul, South Korea
| | - Seung-Hwan Lee
- Department of Psychiatry, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, South Korea
| | - Kee-Hong Choi
- School of Psychology, Korea University, Seoul, South Korea
- KU Mind Health Institute, Korea University, Seoul, South Korea
- *Correspondence: Kee-Hong Choi,
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Kim E, Yi JS. Factors Related to Suicidal Ideation and Prediction of High-Risk Groups among Youngest-Old Adults in South Korea. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10028. [PMID: 36011664 PMCID: PMC9408520 DOI: 10.3390/ijerph191610028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 08/06/2022] [Accepted: 08/12/2022] [Indexed: 06/15/2023]
Abstract
(1) Background: The suicide of older adults shows different factors between the youngest-old adults and the old-old adults. This study aimed to identify factors predicting suicidal ideation among youngest-old adults (ages 65 to 74 years) and predict high-risk groups’ characteristics. (2) Methods: The subjects of this study were 970 youngest-old adults who participated in the Korean National Health and Nutrition Examination Survey (KNHANES VIII Year 1, 2019). Logistic regression analysis identified factors related to suicidal ideation, and decision tree analysis identified combined characteristics among high-risk groups. Data were analyzed using SPSS 27.0. (3) Results: Suicidal ideation became more common among those with relatively lower income levels (OR = 1.48, 95% CI = 1.04−2.12), those whom had experienced depression (OR = 9.28, 95% CI = 4.57−18.84), those with relatively higher stress levels (OR = 2.42, 95% CI = 1.11−5.28), and those reporting a relatively worse perceived health (OR = 1.88, 95% CI = 1.23−3.11). Complex characteristics that combined depression, low personal income level, and low perceived health predicted a high risk of suicidal ideation (64.6%, p < 0.05). (4) Conclusions: The findings indicate that this high-risk group should be prioritized when developing suicide prevention strategies.
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Affiliation(s)
- Eungyung Kim
- Department of Nursing, Chungbuk National University, Cheongju 28644, Korea
| | - Jee-Seon Yi
- College of Nursing, Gyeongsang National University, Jinju 52727, Korea
- Institute of Health Sciences, Gyeongsang National University, Jinju 52727, Korea
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Association between Dining with Companions and Depression among Korean Adults. Nutrients 2022; 14:nu14142834. [PMID: 35889790 PMCID: PMC9325312 DOI: 10.3390/nu14142834] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 06/29/2022] [Accepted: 07/08/2022] [Indexed: 12/04/2022] Open
Abstract
We investigated whether dining with companions is correlated with the alleviation of depression and differs by sex among Korean adults. We used 4-year data from the 2014, 2016, 2018, and 2020 Korea National Health and Nutrition Examination Survey. We surveyed 11,055 participants (4699 men, 6356 women) using the Patient Health Questionnaire-9 to measure their depression scores. We evaluated participants’ meal companionship status by asking whether they had usually dined with companions for breakfast, lunch, or dinner during the past year. Statistical analysis was performed using chi-square tests and multivariate/multinomial logistic regression. We found depression to be less prevalent among participants who dined with companions at least once a day (adjusted OR: 0.26, 95% CI: 0.15–0.45, men; adjusted OR: 0.50, 95% CI: 0.34–0.74, women). In the moderate depression subgroup, participants who dined with companions at least once a day showed lower OR (adjusted OR: 0.28, 95% CI: 0.16–0.50, men; adjusted OR: 0.50, 95% CI: 0.32–0.76, women). Among participants who dined together, men’s severe depression dramatically decreased (adjusted OR: 0.05, 95% CI: 0.01–0.31). Thus, we found an association between dining with companions and the prevalence of depression among Korean adults. Dining with companions compared with dining alone signified a lower depression rate, especially among men. This study can provide an initiative to further analyze psychological and physiological effects of dining together and be applied to practical fields as education and societal campaigns.
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Farahbakhsh M, Azizi H, Fakhari A, Esmaeili ED, Barzegar H, Sarbazi E. Developing a Community-based Suicide Prevention Program in Primary Health Care. Community Ment Health J 2022; 58:713-719. [PMID: 34259967 DOI: 10.1007/s10597-021-00875-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Accepted: 07/07/2021] [Indexed: 12/13/2022]
Abstract
Currently, suicide has become one of the most critical public health challenges in low-and middle-income countries facing community mental health more broadly. However, most healthcare systems haven't efficient Suicide Prevention Programs (SPP), and only 18% of countries have a suicide registry system. In Malekan County of Iran, suicidal behaviors were recognized as a serious public health issue via a health community assessment. This study was aimed to describe the developing steps of a community-based SPP in Malekan County including review of systematic reviews, expert testimony, report to the health system, improving suicide registry coverage, conducting research, follow upping of suicide attempters, training gatekeepers, and public education campaign in the hot spots. These suggested the need to reinforce evaluate the effectiveness of the national health perspective in addressing the issues of suicide and suicidal behavior.
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Affiliation(s)
- Mostafa Farahbakhsh
- Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hosein Azizi
- Research Center of Psychiatry and Behavioral Sciences, Tabriz University of Medical Sciences, Tabriz, Iran. .,Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
| | - Ali Fakhari
- Research Center of Psychiatry and Behavioral Science, Tabriz University of Medical Sciences, Tabriz, Iran.,Medical Education Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Habibeh Barzegar
- Research Center of Psychiatry and Behavioral Science, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ehsan Sarbazi
- Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Sayeed A, Rahman MH, Hassan MN, deSteiguer A, Kundu S, Meem AE, Hasan AR, Mallick T, Sultana MS, Hasanuzzaman M, Sahrin S, Hasan MT. Prevalence and associated factors of depression among Bangladeshi university students: A cross-sectional study. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2021:1-6. [PMID: 34469258 DOI: 10.1080/07448481.2021.1944168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Revised: 04/14/2021] [Accepted: 06/09/2021] [Indexed: 06/13/2023]
Abstract
The study aimed to assess the prevalence of depression and its associated factors among university students in Bangladesh. Participants: A total of 403 undergraduate students from Patuakhali Science and Technology University, and Barisal University participated in the study. Method: A cross-sectional study was conducted using Beck's Depression Inventory (BDI). Result: The prevalence of depression (BDI ≥ 14) was 47.14%. Depression was 3.4 times (95% CI: 1.6-7.1), 3.8 times (95% CI: 1.7-8.6), and 3.9 times (95% CI: 1.5-8.9) higher among 2nd, 3rd, and 4th-year students, respectively than 1st-year students. Students with a history of stressful life events (aOR = 2.7, 95% CI: 1.7-4.4), suicidal attempts (aOR = 3.0, 95% CI: 1.2-7.9), and who received inadequate monthly allowance from their family (aOR = 0.53 95% CI: 0.3-0.9) were more likely to develop depressive symptoms. Conclusion: This study reports a high level of depression among university students which needs further discussion, exploration, and calls for designing appropriate interventions.
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Affiliation(s)
- Abu Sayeed
- Department of Post-Harvest Technology and Marketing, Patuakhali Science and Technology University, Patuakhali, Bangladesh
| | - Md Hafizur Rahman
- Department of Environmental Sanitation, Patuakhali Science and Technology University, Patuakhali, Bangladesh
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Mohakhali, Dhaka, Bangladesh
| | - Md Nazmul Hassan
- Department of Environmental Sanitation, Patuakhali Science and Technology University, Patuakhali, Bangladesh
| | - Abby deSteiguer
- Emma Pendleton Bradley Hospital, Providence, Rhode Island, USA
| | - Satyajit Kundu
- Department of Biochemistry and Food Analysis, Patuakhali Science and Technology University, Patuakhali, Bangladesh
| | - Amatul Elah Meem
- Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Patuakhali, Bangladesh
| | - Al-Riaj Hasan
- Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Patuakhali, Bangladesh
| | - Trisha Mallick
- Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Patuakhali, Bangladesh
| | - Mst Sadia Sultana
- Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka, Bangladesh
| | - Md Hasanuzzaman
- Department of Environmental Sanitation, Patuakhali Science and Technology University, Patuakhali, Bangladesh
| | - Sumaia Sahrin
- epartment of Human Nutrition and Dietetics, Patuakhali Science and Technology University, Patuakhali, Bangladesh
| | - M Tasdik Hasan
- Department of Primary Care & Mental Health, University of Liverpool, United Kingdom
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Kim KA, Kim YE, Yoon SJ. Descriptive epidemiology on the trends and sociodemographic risk factors of disease burden in years of life lost due to suicide in South Korea from 2000 to 2018. BMJ Open 2021; 11:e043662. [PMID: 33637545 PMCID: PMC7919599 DOI: 10.1136/bmjopen-2020-043662] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES In 2018, South Korea's suicide mortality rate was 26.59 deaths per 100 000 people; this figure is 2.2 times higher than that of the year 2000, during which 12.22 deaths per 100 000 people were ascribed to suicide. This study aims to observe the trend of disease burden in years of life lost (YLL) due to suicide from 2000 to 2018 in South Korea and investigate the related sociodemographic risk factors. DESIGN This quantitative research used secondary data-including claim data, cause of death statistics, life tables and census data-from national health insurance corporation and Statistics Korea. Based on the methodology of Korean National Burden of Disease study, this study used an incidence-based approach to measure YLL. RESULTS The total YLL due to suicide during the last two decades was 4 298 886 years; the average YLL per death was 18.65 years. The YLL rate per 100 000 people was 482 (male: 664, female: 300) in 2018, 1.7 times higher than the 387 (male 387, female 183) in 2000. Low education levels and non-marital status were shown to be related to the increase in YLL rate. CONCLUSION These results show the increasing disease burden of suicide in South Korea and suggest the necessity of more in-depth research to analyse correlation and causation with sociodemographic risk factors.
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Affiliation(s)
- Keun A Kim
- School of Military Medicine, The Armed Force Medical Command, Daejeon, South Korea
| | - Young-Eun Kim
- Department of Big Data Strategy, National Health Insurance Service, Wonju, South Korea
| | - Seok-Jun Yoon
- Department of Preventive Medicine, Korea University College of Medicine of Seoul, Seoul, South Korea
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Cheung T, Lam SC, Lee PH, Xiang YT, Yip PSF. Global Imperative of Suicidal Ideation in 10 Countries Amid the COVID-19 Pandemic. Front Psychiatry 2021; 11:588781. [PMID: 33519545 PMCID: PMC7838349 DOI: 10.3389/fpsyt.2020.588781] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 12/10/2020] [Indexed: 11/13/2022] Open
Abstract
Background: The novel coronavirus (COVID-19) has had a detrimental impact on individuals' psychological well-being; however, a multi-country comparison on the prevalence of suicidal ideation due to the virus is still lacking. Objectives: To examine the prevalence and correlates of suicidal ideation among the general population across 10 countries during the COVID-19 pandemic. Materials and methods: This was a cross-sectional study which used convenience sampling and collected data by conducting an online survey. Participants were sourced from 10 Eastern and Western countries. The Patient Health Questionnaire (PHQ-9) was used to measure the outcome variable of suicidal ideation. Ordinal regression analysis was used to identify significant predictors associated with suicidal ideation. Results: A total of 25,053 participants (22.7% male) were recruited. Results from the analysis showed that the UK and Brazil had the lowest odds of suicidal ideation compared to Macau (p < 0.05). Furthermore, younger age, male, married, and differences in health beliefs were significantly associated with suicidal ideation (p < 0.05). Conclusions: The findings highlight the need for joint international collaboration to formulate effective suicide prevention strategies in a timely manner and the need to implement online mental health promotion platforms. In doing so, the potential global rising death rates by suicide during the pandemic can be reduced.
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Affiliation(s)
- Teris Cheung
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Simon Ching Lam
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
- Squina International Centre for Infection Control, The Hong Kong Polytechnic University, Hong Kong, China
| | - Paul Hong Lee
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Yu Tao Xiang
- Faculty of Health Sciences, University of Macau, Macau, China
| | - Paul Siu Fai Yip
- Centre for Suicide Research and Prevention, University of Hong Kong, Hong Kong, China
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Panesar B, Rosic T, Rodrigues M, Sanger N, Baptist-Mohseni N, Hillmer A, Chawar C, D'Elia A, Minuzzi L, Thabane L, Samaan Z. The Role of Perceived Social Support in the Association Between Stressful Life Events and Suicidal Behavior. Front Psychiatry 2021; 12:699682. [PMID: 34566710 PMCID: PMC8460765 DOI: 10.3389/fpsyt.2021.699682] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 08/17/2021] [Indexed: 01/05/2023] Open
Abstract
Background: Suicide is a serious public health concern for which there have been well-established protective and risk factors reported in literature. There is a lack of evidence on the indirect effects of other variables on these factors. Specifically, the association between stressful life events and suicidal behavior may be affected by perceived social support, but its role in this association is largely uninvestigated. Objectives: Thus, this paper aims to explore the role of perceived social support in the association between stressful life events and suicidal behavior. Perceived social support will be explored as a mediator and as a moderator in this association. Methods: Data were obtained from the Determinants of Suicidal Behavior Conventional and Emergent Risk (DISCOVER), a study conducted to identify risk factors of suicidal behavior. The study participants are individuals with suicide attempts admitted to hospital. Participants (n = 343) were recruited from hospital setting. Suicidal behavior was measured using two outcomes (1) the occurrence of a suicide attempt (2) level of suicide intent as measured by the Pierce Suicide Intent Scale. Perceived social support was measured using the Sarason Social Support Questionnaire. Results: Stressful life events were significantly associated with suicide attempts (OR 1.440, 95% CI 1.440, 1.682, p < 0.001) and perceived social support (B -0.785, 95% CI -1.501, -0.068, p = 0.032). There was no significant mediation effect by perceived social support in the association between stressful life events and suicide attempts (Sobel's test statistic 1.64, p = 0.100). Perceived social support did not moderate the relationship between stressful life events and suicide attempts [(OR 1.007, 95% CI 0.987, 1.027, p = 0.514] or the relationship between stressful life events and level of suicidal intent (B -0.043, 95% CI -0.132, 0.046, p = 0.343). Conclusion: Stressful life events are associated with increased risk of suicide attempts. The study also identified an inverse relationship between stressful life events and perceived social support. These associations were independent of perceived social support. This study highlights the effects of stressful life events on suicide risk is not affected by perceived social support, requiring further investigation into measures to reduce the impact of social stressors on people with risk of suicide.
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Affiliation(s)
- Balpreet Panesar
- Neuroscience Graduate Program, McMaster University, Hamilton, ON, Canada
| | - Tea Rosic
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, ON, Canada.,Health Research Methodology Graduate Program, McMaster University, Hamilton, ON, Canada
| | - Myanca Rodrigues
- Health Research Methodology Graduate Program, McMaster University, Hamilton, ON, Canada
| | - Nitika Sanger
- Medical Science Graduate Program, McMaster University, Hamilton, ON, Canada
| | | | - Alannah Hillmer
- Neuroscience Graduate Program, McMaster University, Hamilton, ON, Canada
| | - Caroul Chawar
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Alessia D'Elia
- Neuroscience Graduate Program, McMaster University, Hamilton, ON, Canada
| | - Luciano Minuzzi
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Lehana Thabane
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.,Centre for Evaluation of Medicines, Programs for Assessment of Technology in Health (PATH) Research Institute, McMaster University, Hamilton, ON, Canada
| | - Zainab Samaan
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, ON, Canada.,Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.,Centre for Evaluation of Medicines, Programs for Assessment of Technology in Health (PATH) Research Institute, McMaster University, Hamilton, ON, Canada
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14
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Yi SJ, Jeong YM. Factors Influencing Suicidal Ideation Among Adolescents: The Serial Mediating Effect of Depression and Sleep Quality on Attitude Toward Mental Health Services. J Psychosoc Nurs Ment Health Serv 2020; 58:29-36. [PMID: 33119119 DOI: 10.3928/02793695-20201013-05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 06/08/2020] [Indexed: 11/20/2022]
Abstract
The purpose of the current study was to examine the serial mediating effect of sleep quality and depression on the relationship between attitude toward mental health services and suicidal ideation among adolescents attending middle and high school in Daejeon City, South Korea. A total of 151 of 200 surveys were used for serial multiple mediation analysis. Suicidal ideation was positively associated with depression (r = 0.706, p < 0.001) and sleep quality (r = 0.173, p = 0.034), and negatively associated with age (r = -0.19, p = 0.02). Suicidal ideation was positively influenced by attitude toward mental health services (β = 0.261, p = 0.039), which was also influenced by depression (β = 2.805, p < 0.001). Depression was shown to have a significant mediating effect on the relationship of attitude toward mental health services for suicidal ideation (indirect effect = -0.828); however, sleep quality did not have an effect. Regular assessment of and interventions for depression are a priority for overall prevention of adolescent suicide. [Journal of Psychosocial Nursing and Mental Health Services, 58(11), 29-36.].
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15
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Heterogeneous association patterns of depressive subfactors in suicidality: The 2014 and 2016 Korea National Health and Nutrition Examination Surveys. J Affect Disord 2020; 272:183-190. [PMID: 32379614 DOI: 10.1016/j.jad.2020.04.062] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 02/20/2020] [Accepted: 04/27/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND The heterogeneity of depressive symptoms in suicidality is poorly understood. This study examines the heterogeneous association between subfactors of depressive symptoms in suicidality. METHODS The data of 5742 participants aged 19 and older were taken from the 2014 and 2016 Korean National Health and Nutrition Examination Surveys and analyzed. Subfactors of depressive symptoms were identified utilizing factor analyses that yielded two groups (typical- and other-depressive factors). Multivariable logistic regression models were used to estimate the association between each factor and suicidality after adjusting for covariates. RESULTS Typical depressive factors included cardinal and somatic symptoms, whereas other depressive factors contained cognitive and other symptoms. The typical factors were associated with each suicidality in succession, however, others depressive factors were not. The heterogeneity of subfactors made the greatest impact on suicide attempts, controlling for all covariates, followed by suicide plans, with a robust coefficient of typical depressive factors. These differential patterns of subfactors existed especially in females and younger people, suggesting the importance of concerning typical depressive factors for those groups. LIMITATIONS Although a confirmatory factor analysis was performed, depressive subfactors need validation and reliability tests. CONCLUSIONS Our study findings may help to explain why an improved understanding of the typical depressive factors including cardinal and somatic symptoms is important to prevent suicidality, especially in females and younger people.
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16
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Oh BC, Yeon JY, Lee HS, Lee DW, Park EC. Correlation between private education costs and parental depression in South Korea. BMC Public Health 2020; 20:972. [PMID: 32563266 PMCID: PMC7305602 DOI: 10.1186/s12889-020-09058-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 06/04/2020] [Indexed: 11/18/2022] Open
Abstract
Background In Korea, higher education has rapidly grown influenced by sociocultural tradition. Parents invest a significant portion of their household income in their children’s education. Private education has been considered to greatly affect students’ psychology and behavior. However, past research has largely neglected to study parents who pay these costs. Since household income and education level are important determinants of socioeconomic status (SES), education expenditures are likely to cause depressive symptoms. Therefore, the study aimed to investigate the correlation between private education costs and parental depression in South Korea. Methods Data were collected from the Korean Welfare Panel Study (KoWePS, 2015, 2018). The sample analyzed consisted of 397 and 337 fathers and 403 and 370 mothers in 2015 and 2018, respectively. The independent variable in this study was the proportion of private education cost. This proportion was calculated by dividing each household’s private education costs by its equivalized household disposable income (EHDI) and multiplying this number by 100. The main dependent variable was parental responses to the Center for Epidemiologic Studies Depression Scale-11 (CESD-11). Using a generalized linear model, we investigated the effects of the proportion of private education cost on parental depression. Results The results showed that fathers with higher proportions of private education cost exhibited higher CESD-11 scores compared to fathers with lower proportions cost (moderate: β = 0.419, S. E = 0.164, p = 0.0105; high: β = 0.476, S. E = 0.178, p = 0.0076), indicating that a higher ratio of private education cost may negatively affect depression in fathers. However, there was no discernable correlation between mothers’ CESD-11 scores and the proportion of private education cost (moderate: β = − 0.078, S. E = 0.250, p = 0.7555; high: β = 0.003, S. E = 0.215, p = 0.9882). Conclusions These results may be explained by the tendency for fathers to experience greater economic burdens than mothers in patriarchal Korean society.
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Affiliation(s)
- Byeong Cheol Oh
- College of Medicine, Medical Courses, Yonsei University, Seoul, South Korea
| | - Ji-Yoon Yeon
- College of Medicine, Medical Courses, Yonsei University, Seoul, South Korea
| | - Hyo-Sang Lee
- College of Medicine, Medical Courses, Yonsei University, Seoul, South Korea
| | - Doo Woong Lee
- Department of Public Health, Graduate School, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea. .,Institute of Health Services Research, Yonsei University, Seoul, South Korea.
| | - Eun-Cheol Park
- Institute of Health Services Research, Yonsei University, Seoul, South Korea. .,Department of Preventive Medicine & Institute of Health Services Research, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea.
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17
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Affiliation(s)
- Sang-Uk Lee
- National Center for Mental Health, Seoul, Korea
| | - Jong-Ik Park
- Department of Psychiatry, Kangwon National University School of Medicine, Chuncheon, Korea
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Sagon AL, Danitz SB, Suvak MK, Orsillo SM. The Mindful Way through the Semester: Evaluating the feasibility of delivering an acceptance-based behavioral program online. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2018. [DOI: 10.1016/j.jcbs.2018.06.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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19
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Yoo JS, Chang SJ, Kim HS. Prevalence and Predictive Factors of Depression in Community-Dwelling Older Adults in South Korea. Res Theory Nurs Pract 2018; 30:200-211. [PMID: 28304266 DOI: 10.1891/1541-6577.30.3.200] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The aims of the study were to investigate the levels of depression and to identify the predictors of depression among older adults in 3 different environments based on their primary place of leisure time activity, including their homes, small community halls, and senior welfare centers. A convenience sample of 833 older adults participated in the study. Instruments for measuring functional independence, social support, life satisfaction, and depression were used. The data were analyzed using a one-way analysis of variance (ANOVA) and multiple hierarchical regressions. The level of depression in older adults at home was significantly greater than the level of depression in those in both small community halls and senior welfare centers. Life satisfaction was the strongest negative predictor of depression in older adults both at home and in senior welfare centers, whereas employment status was the one in those in small community halls. Across the 3 groups, poor subjective health was the strongest positive predictor of depression. The levels of depression and predictors differed among the settings. Nurses should have a thorough understanding of these differences when planning effective strategies for managing depression in older adults.
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Affiliation(s)
- Jae Soon Yoo
- Department of Nursing Science, Chungbuk National University, Cheongju, South Korea
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20
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Kim JW, Jung HY, Won DY, Noh JH, Shin YS, Kang TI. Suicide Trends According to Age, Gender, and Marital Status in South Korea. OMEGA-JOURNAL OF DEATH AND DYING 2017. [PMID: 28622733 DOI: 10.1177/0030222817715756] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The purpose of this study is to examine suicide trends in South Korea, which has one of the highest suicide rates in the world. The results show that the male suicide rate outweighs that of females, the likelihood of committing suicide increases with age, and that, in regard to marital status, nonmarried people are the most at risk. In addition, several methods of reducing suicide rates are identified: the wider use of social networks to reduce social burden, the development of a social atmosphere where aging is accepted as a natural process, and the development of protection factors within families.
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Affiliation(s)
- Jung Woo Kim
- 1 Department of Social Welfare, Sungkyunkwan University, Seoul, South Korea
| | - Hee Young Jung
- 1 Department of Social Welfare, Sungkyunkwan University, Seoul, South Korea
| | - Do Yeon Won
- 1 Department of Social Welfare, Sungkyunkwan University, Seoul, South Korea
| | - Jae Hyun Noh
- 1 Department of Social Welfare, Sungkyunkwan University, Seoul, South Korea
| | - Yong Seok Shin
- 1 Department of Social Welfare, Sungkyunkwan University, Seoul, South Korea
| | - Tae In Kang
- 1 Department of Social Welfare, Sungkyunkwan University, Seoul, South Korea.,2 Choong Hyun Community Welfare Center, Seoul, South Korea
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21
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Lee TH, Kim TH, Kim W, Park EC. Effects of difference in self-esteem between spouses on depressive symptom: Result from a data nationally representative of South Korean. Psychiatry Res 2016; 246:623-628. [PMID: 27839825 DOI: 10.1016/j.psychres.2016.10.079] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 07/31/2016] [Accepted: 10/27/2016] [Indexed: 11/28/2022]
Abstract
Although there are many studies on self-esteem, no study has analyzed the relationship between depressive symptom and difference in self-esteem between spouses. We aimed to determine how differences in self-esteem between spouses are associated with depressive symptoms. We used data collected from 2011 to 2013 by the Korean Welfare Panel Study. The initial 2011 baseline data included 3257 married couples over 25 years of age. We used linear mixed-effects models, accounting for the longitudinal nature of the data, to analyze the associations between the self-esteem of spouses and CESD-11 scores. About 20% of the respondents had different self-esteem with their intimate partners. Individuals with spouses having lower self-esteem than self significantly higher depression scores. Individuals with spouses having higher self-esteem than self had significantly lower depression scores regardless of sex. Our findings show how different self-esteem with their intimate partners could be associated with depressive symptoms and imply that one's self-esteem could affect the mental health of one's partner. Therefore, we should give more attention to self-esteem, which can affect families and society.
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Affiliation(s)
- Tae-Hoon Lee
- Department of Public Health, Graduate School, Yonsei University, Seoul, South Korea; Institute of Health Services Research, Yonsei University, Seoul, South Korea
| | - Tae Hyun Kim
- Institute of Health Services Research, Yonsei University, Seoul, South Korea; Graduate School of Public Health, Yonsei University, Seoul, South Korea
| | - Woorim Kim
- Department of Public Health, Graduate School, Yonsei University, Seoul, South Korea; Institute of Health Services Research, Yonsei University, Seoul, South Korea
| | - Eun-Cheol Park
- Institute of Health Services Research, Yonsei University, Seoul, South Korea; Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, South Korea.
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22
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McLaughlin LE, McLeish AC, O'Bryan EM. The Role of Body Vigilance in Depression Symptomatology. Int J Cogn Ther 2016. [DOI: 10.1521/ijct_2016_09_05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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23
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Kim W, Kim TH, Lee TH, Ju YJ, Park EC. The effect of childhood and current economic status on depressive symptoms in South Korean individuals: a longitudinal study. Int J Equity Health 2016; 15:111. [PMID: 27430636 PMCID: PMC4950104 DOI: 10.1186/s12939-016-0402-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Accepted: 07/11/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Mental health inequality along the economic strata is prominent in South Korea, particularly as intergenerational material transfer is becoming increasingly important in gaining economic status. Therefore, this study aimed to investigate the relationship between current and childhood economic status and depressive symptoms in adults aged 20 or above. METHODS This study used data from the Korean Welfare Panel Study (KOWEPS), 2010 to 2013. A total of 9,645 individuals aged 20 years or above without depressive symptoms in 2010 were analyzed. The effect of childhood and current economic status, categorized into low, middle, and high groups, on depressive symptoms was investigated using hierarchical logistic regression models. Depressive symptoms were measured using the Center for Epidemiological Studies Depression (CES-D 11) scale. Subgroup analysis was performed based on education level. RESULTS Compared to the middle current-middle childhood economic status group, the low-low group (OR: 1.88, CI: 1.61-2.20), low-middle group (OR: 1.68, CI: 1.43-1.98), and low-high group (OR: 1.64, CI: 1.34-2.01) were more likely to have depressive symptoms. The high-low group (OR: 0.68, CI: 0.55-0.84), high-middle group (OR: 0.67, CI: 0.56-0.81), and high-high group (OR: 0.45, CI: 0.27-0.75) were less likely to have depressive symptoms. This trend was generally maintained with regard to education level, but the effects were not statistically significant in the high current economic status groups among participants with a university degree or above. CONCLUSION Low current economic status was associated with a higher likelihood of depressive symptoms. In particular, the low current-low childhood economic status group showed the highest likelihood of depressive symptoms, suggesting the adverse mental health effects of prolonged poverty. Therefore, the findings reveal that mental health inequalities are present along the economic strata and require proper addressing of the mental health of lower income individuals.
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Affiliation(s)
- Woorim Kim
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea.,Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Tae Hyun Kim
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea.,Graduate School of Public Heath, Yonsei University, Seoul, Republic of Korea
| | - Tae-Hoon Lee
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea.,Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Yeong Jun Ju
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea.,Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Eun-Cheol Park
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea. .,Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea. .,Department of Preventive Medicine & Institute of Health Services Research, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea.
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24
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Lim M, Lee S, Park JI. Differences between Impulsive and Non-Impulsive Suicide Attempts among Individuals Treated in Emergency Rooms of South Korea. Psychiatry Investig 2016; 13:389-96. [PMID: 27482239 PMCID: PMC4965648 DOI: 10.4306/pi.2016.13.4.389] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Revised: 10/19/2015] [Accepted: 11/08/2015] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE A considerable proportion of suicide attempts are the result of sudden desires. Understanding such impulsive suicide attempts is necessary for effective interventions. We evaluated the impulsivity of suicide attempters treated in emergency rooms. The aim of the study was to identify the characteristics of impulsive suicide attempts by comparing these individuals to those who attempted to commit suicide in a non-impulsive manner. METHODS This study analyzed suicide attempters who visited the emergency departments of seven selected university hospitals. A total of 269 medical records in which impulsivity of suicide attempt were confirmed were subject to be analyzed. The impulsivity of the suicide attempt was examined using a summative score of items 6 and 15 on the Suicide Intent Scale. RESULTS A total of 48.0% of the participants were impelled by sudden inclinations to attempt suicide. Impulsive attempters were younger, unmarried and less physical illness than non-impulsive attempters, whereas no significant differences were found on psychiatric history and previous suicide history. Impulsive suicide attempters had suicide ideations that were not as severe (χ(2)=55.33, p<0.001) or intense (t=-8.38, p<0.001) as their counterparts'. Furthermore, medical results of impulsive suicide attempts were better than non-impulsive suicide attempts (t=-3.77, p<0.001). CONCLUSION The results suggested that a considerable proportion of suicide attempts were the result of sudden inclinations. Impulsive attempts were made in relatively earlier stages of suicide ideation; consequently, they have less intent than non-impulsive attempts.
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Affiliation(s)
- Meerae Lim
- St. Andrea Neuropsychiatric Hospital, Icheon, Republic of Korea
| | - Soojung Lee
- Korea Suicide Prevention Center, Seoul, Republic of Korea
| | - Jong-Ik Park
- Korea Suicide Prevention Center, Seoul, Republic of Korea
- Department of Psychiatry, Kangwon National University School of Medicine, Chuncheon, Republic of Korea
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25
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Lee SU, Roh S, Kim YE, Park JI, Jeon B, Oh IH. Impact of disability status on suicide risks in South Korea: Analysis of National Health Insurance cohort data from 2003 to 2013. Disabil Health J 2016; 10:123-130. [PMID: 27492185 DOI: 10.1016/j.dhjo.2016.06.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Revised: 06/12/2016] [Accepted: 06/18/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND The elevated risk of suicide in people with disability has been suggested in the previous studies; however, the majority of study results have been limited to specific disability types, and there is a lack of research comparing the risk of suicide in people with disability in general. OBJECTIVES To examine the hazard ratio of suicide according to the presence and the types of disability and identify patterns in the results. METHODS In this study, we used National Health Insurance Service-National Sample Cohort data on 990,598 people, and performed analysis on the cause of death from 2003 through 2013. A Cox proportional hazard model was used to estimate the hazard ratio of suicide associated with disability and its types. RESULTS The hazard ratio of suicide among people with disability was 1.9-folds higher compared to people without disability. The risk of suicide among different disability types was higher in mental disorder, renal failure, brain injury and physical disability. The hazard ratio of suicide in people with disability was not varied by income. The time to death by suicide for people with disability from the onset of their disability was 39.8 months on average. CONCLUSIONS Our findings suggest that when the government plans suicide prevention policies, early and additional interventions specific to people with disability are needed. Disability due to mental disorder, renal failure should be given priority.
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Affiliation(s)
- Sang-Uk Lee
- Department of Medicine, Graduate School, Kyung Hee University, Seoul, South Korea
| | - Sungwon Roh
- Department of Psychiatry, School of Medicine, Hanyang University, Seoul, South Korea
| | - Young-Eun Kim
- Department of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul, South Korea
| | - Jong-Ik Park
- Department of Psychiatry, School of Medicine, Kangwon National University, Chunchon, Korea
| | - Boyoung Jeon
- Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - In-Hwan Oh
- Department of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul, South Korea.
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26
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Han KM, Won E, Paik JW, Lee MS, Lee HW, Ham BJ. Mental health service use in adults with suicidal ideation within a nationally representative sample of the Korean population. J Affect Disord 2016; 193:339-47. [PMID: 26796234 DOI: 10.1016/j.jad.2016.01.011] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Revised: 12/30/2015] [Accepted: 01/08/2016] [Indexed: 11/15/2022]
Abstract
BACKGROUND Use of mental health services (MHS) by people with suicidal ideation is critical in prevention of suicide, and identification of the factors that influence MHS use may assist in providing efficient interventions and treatments for suicidal individuals. Thus, we investigated the association between socioeconomic factors and use of MHS in people with suicidal ideation. METHOD We analyzed the data of the Fifth Korea National Health and Nutrition Examination Survey 2010-2012, a nationally representative cross-sectional study of the Korean population. Among the 24,173 people from the national health survey, we investigated the socioeconomic, clinical, and health-related characteristics of 2616 participants aged 19 years and older with suicidal ideation within the previous year. RESULTS In the logistic regression analyses, after adjusting for potentially confounding factors, the odds ratio (OR) for nonuse of MHS was significant in the subjects aged 65 years or older (OR=4.90), aged 50-64 years (OR=2.11), with 10-12 years of education (OR=1.87), widowed (OR=2.75), with economic activity (OR=1.60), with an employment status of paid employee (OR=1.97), without depressive mood (OR=2.73), having not attempted suicide (OR=4.04), and with no reported problems in their usual activities (OR=2.17). LIMITATIONS We did not use standardized assessment tools to evaluate suicidal ideation and depressive mood. CONCLUSIONS We observed a significant influence of several socioeconomic factors, depressive mood, and suicide attempts on the MHS use of adults with suicidal ideation, based on a nationally representative sample of the Korean population.
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Affiliation(s)
- Kyu-Man Han
- Department of Psychiatry, Korea University College of Medicine, Seoul, Republic of Korea
| | - Eunsoo Won
- Department of Psychiatry, Korea University College of Medicine, Seoul, Republic of Korea
| | - Jong-Woo Paik
- Department of Neuropsychiatry, College of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Min-Soo Lee
- Department of Psychiatry, Korea University College of Medicine, Seoul, Republic of Korea
| | - Hae-Woo Lee
- Department of Psychiatry, Seoul Medical Center, Seoul, Republic of Korea.
| | - Byung-Joo Ham
- Department of Psychiatry, Korea University College of Medicine, Seoul, Republic of Korea; Brain Convergence Research Center, Korea University Anam Hospital, Seoul, Republic of Korea.
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27
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Jeon SW, Han C, Lee J, Lim J, Jeong HG, Park MH, Ko YH, Pae CU, Kim SH, Joe SH, Steffens DC. Perspectives on the Happiness of Community-Dwelling Elderly in Korea. Psychiatry Investig 2016; 13:50-7. [PMID: 26766946 PMCID: PMC4701685 DOI: 10.4306/pi.2016.13.1.50] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2014] [Revised: 05/17/2015] [Accepted: 05/17/2015] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE A community survey was performed to investigate the factors and perspectives associated with happiness among the elderly in Korea (≥60 years). METHODS Eight hundred volunteers selected from participants in the Ansan Geriatric study (AGE study) were enrolled, and 706 completed the survey. The Happiness Questionnaire (HQ), which asks four questions about happiness, was administered. To explore the relationship between happiness and depression, the Geriatric Depression Scale (GDS) and the Beck Depression Inventory (BDI) also were administered. RESULTS The participants' average level of happiness, determined using a 100-mm visual analogue scale (VAS) of the HQ, was 64.7±26.0. The happiest situations for most people were "getting together with family" (23.8%) and "living in peace with family members (well-being)" (13.2%). Frequent reasons for not being happy were "worsened health condition" (28.7% of the not-happy group), "economic problems of their own" (16.5%), and "economic problems of their children" (14.8%). The participants' choices regarding the essential conditions for happiness were "good health" (65.3%) and "being with family" (20.5%). The BDI and GDS scores were negatively related to the happiness score. A preliminary scale [Happy (Haeng-Bok, ) aging scale] based on the HQ for measuring the happiness level of the Korean elderly was suggested for follow-up studies. CONCLUSION The most important factors determining the happiness of the community-dwelling elderly in Korea were good family relationships, economic stability, and good health. A higher depression score negatively impacted happiness among Korean elders. Further studies on the factors in their happiness are required.
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Affiliation(s)
- Sang Won Jeon
- Department of Psychiatry, Korea University Ansan Hospital, Ansan, Republic of Korea
| | - Changsu Han
- Department of Psychiatry, Korea University Ansan Hospital, Ansan, Republic of Korea
| | - Jongha Lee
- Department of Psychiatry, Korea University Guro Hospital, Seoul, Republic of Korea
| | - JaeHyoung Lim
- Department of Psychiatry, Korea University Ansan Hospital, Ansan, Republic of Korea
| | - Hyun-Ghang Jeong
- Department of Psychiatry, Korea University Guro Hospital, Seoul, Republic of Korea
| | - Moon Ho Park
- Department of Neurology, Korea University Ansan Hospital, Ansan, Republic of Korea
| | - Young-Hoon Ko
- Department of Psychiatry, Korea University Ansan Hospital, Ansan, Republic of Korea
| | - Chi-Un Pae
- Department of Psychiatry, The Catholic University of Korea College of Medicine, Seoul, Republic of Korea
| | - Seung Hyun Kim
- Department of Psychiatry, Korea University Guro Hospital, Seoul, Republic of Korea
| | - Sook-Haeng Joe
- Department of Psychiatry, Korea University Guro Hospital, Seoul, Republic of Korea
| | - David C. Steffens
- Department of Psychiatry, University of Connecticut Health Center, Farmington, CT, USA
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Jung JH, Kim DK, Jung JY, Lee JH, Kwak YH. Risk Factors of Discharged Against Medical Advice among Adolescents Self-inflicted Injury and Attempted Suicide in the Korean Emergency Department. J Korean Med Sci 2015; 30:1466-70. [PMID: 26425044 PMCID: PMC4575936 DOI: 10.3346/jkms.2015.30.10.1466] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Accepted: 06/11/2015] [Indexed: 11/20/2022] Open
Abstract
Suicide is a leading cause of death among Korean adolescents. Many suicide attempting adolescents often are discharged against medical advice in the emergency department. The aim of the present study was to determine the risk factors for discharge against medical advice (DAMA) after self-inflicted injury or attempted suicide in the emergency department. We extracted data on adolescents (10-19 yr old) from the national emergency department information system; we used data from 2007 and 2011. A total of 6,394 adolescents visited EDs after self-inflicted injury or attempted suicide. Among these patients, the median age was 17 yr (Interquatile range, 15-18 yr), 83.2% were between 15-19 yr of age, and 63.3% were female. Poisoning was the most common method of attempted suicide, while hanging and fall were the most common methods of fatality. The rate of DAMA from the ED was 22.8%. Independent risk factors for DAMA included female gender (odds ratio [OR], 1.49), older age adolescents (OR, 1.96), residence in a metropolitan/large city area (OR, 1.49), and discharge at night (OR, 1.38). These risk factors should be considered in establishing management and counseling plans for patients discharged against medical advice by community services and EDs.
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Affiliation(s)
- Jin Hee Jung
- Department of Emergency Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea
| | - Do Kyun Kim
- Department of Emergency Medicine, Seoul National University Hospital, Seoul, Korea
| | - Jae Yun Jung
- Department of Emergency Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Jin Hee Lee
- Department of Emergency Medicine, Seoul National University Hospital, Seoul, Korea
| | - Young Ho Kwak
- Department of Emergency Medicine, Seoul National University Hospital, Seoul, Korea
- Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Korea
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A spontaneous depressive pattern in adult female rhesus macaques. Sci Rep 2015; 5:11267. [PMID: 26059851 PMCID: PMC4462019 DOI: 10.1038/srep11267] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Accepted: 05/20/2015] [Indexed: 02/05/2023] Open
Abstract
Non-human primates offer unique opportunities to study the development of depression rooted in behavioral and physiological abnormalities. This study observed adult female rhesus macaques within social hierarchies and aimed to characterize the physiological and brain abnormalities accompanying depressive-like behavior. The behaviors of 31 female rhesus macaques from 14 different breeding groups were video recorded, and the footage was analyzed using the focal animal technique. There were 13 monkeys who never displayed huddling behavior (non-huddlers). The remaining 18 monkeys were divided into two groups according the mean time spent in the huddle posture. Four monkeys were designated as high huddlers, whereas the other 14 monkeys were low huddlers. An inverse relationship was discovered between social rank and depression. High huddlers spent more time engaging in physical contact and in close proximity to other monkeys, as well as less time spontaneously and reactively locomoting, than low huddlers and/or non-huddlers. Cortisol levels measured from the hair were elevated significantly in high huddlers compared with low huddlers and non-huddlers, and the measured cortisol levels were specifically higher in high huddlers than subordinate or dominant control monkeys. Regional cerebral blood flow data revealed significant and widespread decreases in high huddlers compared with non-huddlers.
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Seo JG, Lee JJ, Cho YW, Lee SJ, Kim JE, Moon HJ, Park SP. Suicidality and Its Risk Factors in Korean People with Epilepsy: A MEPSY Study. J Clin Neurol 2015; 11:32-41. [PMID: 25628735 PMCID: PMC4302177 DOI: 10.3988/jcn.2015.11.1.32] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Revised: 10/20/2014] [Accepted: 10/22/2014] [Indexed: 11/22/2022] Open
Abstract
Background and Purpose People with epilepsy (PWE) are more likely to experience suicidality, with suicidal ideation and attempts, than people without epilepsy (PWoE). The aims of the present study were to determine 1) the characteristics of suicidality in Korean PWE, 2) whether PWE with suicidality receive psychiatric intervention, and 3) the risk factors for suicidality. Methods Patients who consecutively visited epilepsy clinics at secondary- and tertiary-care hospitals were recruited (n=684), along with age- and sex-matched PWoE (n=229). The presence of current major depressive disorder (MDD), generalized anxiety disorder (GAD), and/or suicidality was established using the Mini International Neuropsychiatric Interview-Plus Version 5.0.0. The Korean version of the Liverpool Adverse Events Profile (K-LAEP) was applied to detect adverse effects of antiepileptic drugs (AEDs). Results Suicidality was present in 208 (30.4%) of the 684 PWE. The rate of suicidality was 4.6 times higher among PWE than PWoE, and 108 (15.7%) PWE had suicidal ideation and had attempted suicide. Among those who had attempted suicide, 40.7% had made at least two attempts. The most common method of suicide attempt was drug overdose (34.9%). Unfortunately, of the 208 PWE with suicidality, 136 (65.4%) did not receive psychiatric intervention. The risk factors for suicidality were MDD [odds ratio (OR)=6.448, 95% confidence interval (CI)=3.739-11.120, p<0.001], GAD (OR=3.561, 95% CI=1.966-6.452, p<0.001), item scores of 3 or 4 on the K-LAEP (OR=2.688, 95% CI=1.647-4.387, p<0.001), and a history of febrile convulsion (OR= 2.188, 95% CI=1.318-3.632, p=0.002). Conclusions Suicidality is more prevalent in PWE than in PWoE. Clinicians should monitor psychiatric disorders and the adverse effects of AEDs in PWE in an attempt to reduce the incidence of suicidal ideation or suicide attempts in this patient population.
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Affiliation(s)
- Jong-Geun Seo
- Department of Neurology, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Jang-Joon Lee
- Department of Neurology, Daegu Fatima Hospital, Daegu, Korea
| | - Yong Won Cho
- Department of Neurology, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea
| | - Se-Jin Lee
- Department of Neurology, Yeungnam University College of Medicine, Daegu, Korea
| | - Ji-Eun Kim
- Department of Neurology, Catholic University of Daegu School of Medicine, Daegu, Korea
| | - Hye-Jin Moon
- Department of Neurology, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea
| | - Sung-Pa Park
- Department of Neurology, School of Medicine, Kyungpook National University, Daegu, Korea
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A systematic review of studies of depression prevalence in university students. J Psychiatr Res 2013; 47:391-400. [PMID: 23260171 DOI: 10.1016/j.jpsychires.2012.11.015] [Citation(s) in RCA: 787] [Impact Index Per Article: 71.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2012] [Revised: 11/28/2012] [Accepted: 11/28/2012] [Indexed: 11/23/2022]
Abstract
BACKGROUND Depression is a common health problem, ranking third after cardiac and respiratory diseases as a major cause of disability. There is evidence to suggest that university students are at higher risk of depression, despite being a socially advantaged population, but the reported rates have shown wide variability across settings. PURPOSE To explore the prevalence of depression in university students. METHOD PubMed, PsycINFO, BioMed Central and Medline were searched to identify studies published between 1990 and 2010 reporting on depression prevalence among university students. Searches used a combination of the terms depression, depressive symptoms, depressive disorders, prevalence, university students, college students, undergraduate students, adolescents and/or young adults. Studies were evaluated with a quality rating. RESULTS Twenty-four articles were identified that met the inclusion and exclusion criteria. Reported prevalence rates ranged from 10% to 85% with a weighted mean prevalence of 30.6%. CONCLUSIONS The results suggest that university students experience rates of depression that are substantially higher than those found in the general population. Study quality has not improved since 1990.
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Jeon HJ, Bae J, Woo JM. Recent statistics and risk factors of suicide in children and adolescents. JOURNAL OF THE KOREAN MEDICAL ASSOCIATION 2013. [DOI: 10.5124/jkma.2013.56.2.93] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Hong Jin Jeon
- Depression Center, Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Joomi Bae
- Korea Youth Counselling and Welfare Institute, Seoul, Korea
| | - Jong-Min Woo
- Department of Psychiatry, Seoul Paik Hospital, Inje University School of Medicine, Seoul, Korea
- Stress Research Institute, Inje University, Seoul, Korea
- National Evidence-based Healthcare Collaborating Agency, Seoul, Korea
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Lee CA, Choi SC, Jung KY, Cho SH, Lim KY, Pai KS, Cho JP. Characteristics of patients who visit the emergency department with self-inflicted injury. J Korean Med Sci 2012; 27:307-12. [PMID: 22379343 PMCID: PMC3286779 DOI: 10.3346/jkms.2012.27.3.307] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2011] [Accepted: 12/26/2011] [Indexed: 11/25/2022] Open
Abstract
During visits to emergency medical facilities, the primary care of and risk identification for individuals who have attempted suicide is considered an important element in suicide prevention. With the ultimate goal of helping to prevent suicide, the aim of the present study was to determine the characteristics of patients with self-inflicted injuries who presented in the emergency department. Patients with self-inflicted injuries who visited 1 of 3 sentinel emergency medical centers from 2007 through 2009 were included in the study. The characteristics, methods, and reasons for suicide attempts were evaluated. Moreover, predictors of severe outcomes were evaluated. A total of 2,996 patients with self-inflicted injuries visited the three centers during a period of 3 yr. The male-to-female suicide ratio was 1:1.38 (P < 0.001). The mean age was 41 yr. Poisoning was the most common method of self-inflicted injury (68.7%) among all age groups. Medication was the primary means of injury in the < 50 age group, and the use of agricultural chemicals was the primary means in the ≥ 50 age group. The reasons for attempting suicide varied among the age groups. The predictors of severe outcome are male gender, older age, and not having consumed alcohol.
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Affiliation(s)
- Choung Ah Lee
- Department of Emergency Medicine, Ajou University School of Medicine, Suwon, Korea
| | - Sang Cheon Choi
- Department of Emergency Medicine, Ajou University School of Medicine, Suwon, Korea
| | - Koo Young Jung
- Department of Emergency Medicine, School of Medicine, Ewha Womans University, Seoul, Korea
| | - Soo Hyung Cho
- Department of Emergency Medicine, College of Medicine, Chosun University, Gwangju, Korea
| | - Ki Young Lim
- Department of Psychiatrics, Ajou University School of Medicine, Suwon, Korea
| | - Ki Soo Pai
- Department of Pediatrics, Ajou University School of Medicine, Suwon, Korea
| | - Joon Pil Cho
- Department of Emergency Medicine, Ajou University School of Medicine, Suwon, Korea
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Affiliation(s)
- Hong Jin Jeon
- Depression Center, Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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