Journal of Preventive Medicine and Public Health

Original Articles

Epidemiology of Suicide by Hanging in Fars Province, Iran (2011-2019): A Population-based Cross-sectional Study: Leila Moftakhar, Alireza Mirahmadizadeh, Sanaz Amiri, Fariba Rezaei, Habibollah Azarbakhsh; J Prev Med Public Health. 2023;56(3):264-271. Published online April 20, 2023; DOI: https://doi.org/10.3961/jpmph.22.519

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Objectives
Hanging is a common method of attempted suicide. This study investigated the epidemiological profile of attempted and completed suicides by hanging in southern Iran.
Methods
This cross-sectional study was performed on 1167 suicide attempts by hanging between 2011 and 2019. All data related to suicide attempts by hanging were collected from the Fars Suicide Surveillance System. The trends in suicide cases and the mean age of attempted and completed suicides were plotted. The chi-square test was used to identify suicide-related factors. Crude rates of incidence, mortality, and standardized fatality during the study period were calculated. Finally, logistic regression was used to identify the predictors of death in individuals who attempted suicide.
Results
The mean age of those who attempted suicide was 33.21±16.82 years; the majority were male (80.5%). The rate of attempted and completed suicide by hanging were 3.50 and 2.79 per 100 000 people, respectively. The case-fatality rate was calculated as 79.34%. The results of our study indicated an increasing trend in suicide attempts by hanging. The likelihood of death was 2.28 times higher in individuals with a previous history of suicide attempts and 1.85 times higher in those with a psychological disorder.
Conclusions
The findings of this study suggest an increasing trend in attempted and completed suicide by hanging, especially among individuals with a history of suicide attempts and psychological disorders. It is necessary to take action to reduce the rate of suicide attempts and identify the underlying causes of suicide attempts by hanging.

Summary

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Assessing the knot in a noose position by thyrohyoid and cervical spine fracture patterns in suicidal hangings using machine learning algorithms: A new insight into old dilemmas
Aleksa Leković, Arso Vukićević, Slobodan Nikolić
Forensic Science International.2024; 357: 111973. CrossRef

Spatio-temporal Distribution of Suicide Risk in Iran: A Bayesian Hierarchical Analysis of Repeated Cross-sectional Data: Seyed Saeed Hashemi Nazari, Kamyar Mansori, Hajar Nazari Kangavari, Ahmad Shojaei, Shahram Arsang-Jang; J Prev Med Public Health. 2022;55(2):164-172. Published online February 10, 2022; DOI: https://doi.org/10.3961/jpmph.21.385

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Abstract PDF Supplementary Material

Objectives
We aimed to estimate the space-time distribution of the risk of suicide mortality in Iran from 2006 to 2016.
Methods
In this repeated cross-sectional study, the age-standardized risk of suicide mortality from 2006 to 2016 was determined. To estimate the cumulative and temporal risk, the Besag, York, and Mollié and Bernardinelli models were used.
Results
The relative risk of suicide mortality was greater than 1 in 43.0% of Iran’s provinces (posterior probability >0.8; range, 0.46 to 3.93). The spatio-temporal model indicated a high risk of suicide in 36.7% of Iran’s provinces. In addition, significant upward temporal trends in suicide risk were observed in the provinces of Tehran, Fars, Kermanshah, and Gilan. A significantly decreasing pattern of risk was observed for men (β, -0.013; 95% credible interval [CrI], -0.010 to -0.007), and a stable pattern of risk was observed for women (β, -0.001; 95% CrI, -0.010 to 0.007). A decreasing pattern of suicide risk was observed for those aged 15-29 years (β, -0.006; 95% CrI, -0.010 to -0.0001) and 30-49 years (β, -0.001; 95% CrI, -0.018 to -0.002). The risk was stable for those aged >50 years.
Conclusions
The highest risk of suicide mortality was observed in Iran’s northwestern provinces and among Kurdish women. Although a low risk of suicide mortality was observed in the provinces of Tehran, Fars, and Gilan, the risk in these provinces is increasing rapidly compared to other regions.

Summary

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Spatial, geographic, and demographic factors associated with adolescent and youth suicide: a systematic review study
Masoud Ghadipasha, Ramin Talaie, Zohreh Mahmoodi, Salah Eddin Karimi, Mehdi Forouzesh, Masoud Morsalpour, Seyed Amirhosein Mahdavi, Seyed Shahram Mousavi, Shayesteh Ashrafiesfahani, Roya Kordrostami, Nahid Dadashzadehasl
Frontiers in Psychiatry.2024;[Epub] CrossRef

Brief Report

Depressive Symptoms on the Geriatric Depression Scale and Suicide Deaths in Older Middle-aged Men: A Prospective Cohort Study: Sang-Wook Yi; J Prev Med Public Health. 2016;49(3):176-182. Published online April 12, 2016; DOI: https://doi.org/10.3961/jpmph.16.012

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Abstract PDF

Objectives
Prospective evaluations of the associations between depressive symptoms and suicide deaths have been mainly performed in high-risk populations, such as individuals with psychiatric disorders or histories of self-harm. The purpose of this study was to prospectively examine whether more severe depressive symptoms assessed using the Geriatric Depression Scale (GDS) were associated with a greater risk of death from suicide in a general-risk population.
Methods
A total of 113 478 men from the Korean Veterans Health Study (mean age, 58.9 years) who participated in a postal survey in 2004 were followed up for suicide mortality until 2010.
Results
Over 6.4 years of follow-up, 400 men died by suicide (56.7 deaths per 100 000 person-years). More severe depressive symptoms were associated with greater risk of suicide death (p for trend <0.001). The unadjusted hazard ratios (HRs) in comparison to the absence of depression were 2.18 for mild depression, 2.13 for moderate depression, 3.33 for severe depression, and 3.67 for extreme depression. After adjusting for potential confounders, men with a potential depressive disorder had an approximate 90% higher mortality from suicide (adjusted HR, 1.92; 95% confidence interval [CI], 1.38 to 2.68; p<0.001) than men without depression. Each five-point increase in the GDS score was associated with a higher risk of death by suicide (adjusted HR, 1.22; p<0.001). The value of the area under the receiver operating characteristics curve of GDS scores for suicide deaths was 0.61 (95% CI, 0.58 to 0.64).
Conclusions
Depressive symptoms assessed using the GDS were found to be a strong independent predictor of future suicide. However, the estimate of relative risk was weaker than would be expected based on retrospective psychological autopsy studies.

Summary

Citations

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Association of perceived childhood socio-economic status and health with depressive symptoms among middle-aged and older adults in India: using data from LASI Wave I, 2017–2018
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Association between accelerometer-derived physical activity and depression: a cross-sectional study using isotemporal substitution analysis
Jungmi Park, Hee-Kyoung Nam, Sung-Il Cho
BMJ Open.2024; 14(4): e078199. CrossRef
Implications of helplessness in depression: diagnosing mild cognitive impairment and analyzing its effects on cognitive decline in older adults
Boung Chul Lee, Young Min Choe, Guk-Hee Suh, Musung Keum, Shin Gyeom Kim, Hyun Soo Kim, Jaeuk Hwang, Dahyun Yi, Jee Wook Kim
Frontiers in Aging Neuroscience.2024;[Epub] CrossRef
The effect of childhood socioeconomic status on depressive symptoms in middle-old age: the mediating role of life satisfaction
Lei Tang, Ruoyun Yin, Qian Hu, Zhaoya Fan, Fan Zhang
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The Aassociation Between the Basic Old-Age Pension and Depression of the Older Adults in Korea
Jaewon Kim, Tae-Jin Lee, Cheong-Seok Kim
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The Assessment Effect of Spiritual Care on Hopelessness and Depression in Suicide Attempts
Mohammad Heidari, Mansureh Ghodusi Borujeni, Hossein Rafiei
Journal of Religion and Health.2019; 58(4): 1453. CrossRef
Suicide in the Elderly
Steven E. Brooks, Sigrid K. Burruss, Kaushik Mukherjee
Clinics in Geriatric Medicine.2019; 35(1): 133. CrossRef
Association of low blood pressure with suicidal ideation: a cross-sectional study of 10,708 adults with normal or low blood pressure in Korea
Kyung-in Joung, Sung-il Cho
BMC Public Health.2018;[Epub] CrossRef
Salud mental de hombres mayores en Chile: una realidad por priorizar
José M. Aravena, Jean Gajardo, Rodrigo Saguez
Revista Panamericana de Salud Pública.2018; 42: 1. CrossRef

Original Articles

Patterns of Alcohol Consumption and Suicidal Behavior: Findings From the Fourth and Fifth Korea National Health and Nutritional Examination Survey (2007–2011): Hong-Chul Bae, Seri Hong, Sung-In Jang, Kwang-Sig Lee, Eun-Cheol Park; J Prev Med Public Health. 2015;48(3):142-150. Published online May 21, 2015; DOI: https://doi.org/10.3961/jpmph.14.027

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Abstract PDF

Objectives
The purpose of this study was to investigate the association between suicidal behavior and patterns of alcohol consumption in Korean adults.
Methods
This study was based on data provided by the Korea National Health and Nutritional Examination Survey from 2007 to 2011. A total of 42 347 subjects were included in the study, of whom 19 292 were male and 23 055 were female. Logistic regression analysis was performed to assess the association between patterns of alcohol consumption and suicidal behavior.
Results
Among the study subjects, 1426 males (11.3%) and 3599 females (21.2%) had experienced suicidal ideation, and 106 males (0.8%) and 190 females (1.1%) had attempted suicide during the previous 12 months. Alcohol Use Disorders Identification Test (AUDIT) scores were found to be associated with suicidal ideation in males and associated with both suicidal ideation and suicide attempts in females. Alcoholic blackouts were associated with suicidal ideation and suicide attempts in males, and were also associated with suicidal ideation in females.
Conclusions
In this study, we found that certain patterns of alcohol consumption were associated with suicidal behaviors. In particular, only alcoholic blackouts and categorized AUDIT scores were found to be associated with suicidal behavior in males. We therefore suggest that further research is needed to examine this relationship prospectively and in other settings.

Summary

Citations

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Prevalence and correlates of alcohol‐induced blackout in a diverse sample of veterans
Mary Beth Miller, Lindsey K. Freeman, Amaya Aranda, Sydney Shoemaker, Delaney Sisk, Sofia Rubi, Adam T. Everson, Lisa Y. Flores, Michael S. Williams, Marjorie L. Dorimé‐Williams, Christina S. McCrae, Brian Borsari
Alcohol: Clinical and Experimental Research.2023; 47(2): 395. CrossRef
Prevalence and Factors Associated with Alcohol Use among Dayak Adolescents in Sarawak, Malaysia
Mohd Faiz Gahamat, Md Mizanur Rahman, Razitasham Safii
Malaysian Journal of Medicine and Health Sciences.2023; 19(1): 215. CrossRef
The Interaction of Cannabis Consumption with Heavy Episodic Drinking and Alcohol-Induced Blackouts in Relation to Cannabis Use Consequences Among Recent Undergraduate College Cannabis Users
Ying Guo, Chia-Liang Dai, Rose Marie Ward, W. Alex Mason
Cannabis.2023;[Epub] CrossRef
Spatio-temporal Distribution of Suicide Risk in Iran: A Bayesian Hierarchical Analysis of Repeated Cross-sectional Data
Seyed Saeed Hashemi Nazari, Kamyar Mansori, Hajar Nazari Kangavari, Ahmad Shojaei, Shahram Arsang-Jang
Journal of Preventive Medicine and Public Health.2022; 55(2): 164. CrossRef
Alcohol use and its association with suicide attempt, suicidal thoughts and non-suicidal self-harm in two successive, nationally representative English household samples
Sarah Ledden, Paul Moran, David Osborn, Alexandra Pitman
BJPsych Open.2022;[Epub] CrossRef
A systematic review of suicidal behaviour in men: A narrative synthesis of risk factors
Cara Richardson, Kathryn A. Robb, Rory C. O'Connor
Social Science & Medicine.2021; 276: 113831. CrossRef
The relationship between alcohol abuse and suicide risk according to smoking status: A cross-sectional study
Myoungjee Jung
Journal of Affective Disorders.2019; 244: 164. CrossRef
Alcohol‐induced blackouts at age 20 predict the incidence, maintenance and severity of alcohol dependence at age 25: a prospective study in a sample of young Swiss men
Joseph Studer, Gerhard Gmel, Nicolas Bertholet, Simon Marmet, Jean‐Bernard Daeppen
Addiction.2019; 114(9): 1556. CrossRef
Blackouts among male and female youth seeking emergency department care
Diana M. Voloshyna, Erin E. Bonar, Rebecca M. Cunningham, Mark A. Ilgen, Frederic C. Blow, Maureen A. Walton
The American Journal of Drug and Alcohol Abuse.2018; 44(1): 129. CrossRef
Association between obesity and suicide in woman, but not in man: a population-based study of young adults
Jerônimo Costa Branco, Janaína Motta, Carolina Wiener, Jean Pierre Oses, Fernanda Pedrotti Moreira, Barbara Spessato, Luciano Dias, Ricardo da Silva
Psychology, Health & Medicine.2017; 22(3): 275. CrossRef
Association between FKBP5 and CRHR1 genes with suicidal behavior: A systematic review
Eduardo De la Cruz-Cano
Behavioural Brain Research.2017; 317: 46. CrossRef
Factors influencing suicidal tendencies in patients with diagnosis of attempted suicide in medical history and relapse prevention
Kvetoslava Kotrbová, Ivan Dóci, Lidmila Hamplová, Vít Dvořák, Šárka Selingerová, Veronika Růžičková, Šárka Chmelařová
Central European Journal of Public Health.2017; 25(4): 271. CrossRef
Age–period–cohort analysis of the suicide rate in Korea
Chiho Park, Yon Ho Jee, Keum Ji Jung
Journal of Affective Disorders.2016; 194: 16. CrossRef
Alcohol-Induced Blackouts: A Review of Recent Clinical Research with Practical Implications and Recommendations for Future Studies
Reagan R. Wetherill, Kim Fromme
Alcoholism: Clinical and Experimental Research.2016; 40(5): 922. CrossRef
Combined Influence of Smoking and Alcohol Drinking on Suicidal Ideation and Attempts among Korean Adults: Using Data from the Korean National Health and Nutrition Examination Survey 2008~2011
Hyun Sook Kim, Yunmi Kim, Yoon Hee Cho
Korean Journal of Adult Nursing.2016; 28(6): 609. CrossRef
Comorbidity Between Psychiatric Diseases and Alcohol Use Disorders: Impact of Adolescent Alcohol Consumption
Jérôme Jeanblanc
Current Addiction Reports.2015; 2(4): 293. CrossRef

The Combined Effect of Subjective Body Image and Body Mass Index (Distorted Body Weight Perception) on Suicidal Ideation: Jaeyong Shin, Young Choi, Kyu-Tae Han, Sung-Youn Cheon, Jae-Hyun Kim, Sang Gyu Lee, Eun-Cheol Park; J Prev Med Public Health. 2015;48(2):94-104. Published online March 14, 2015; DOI: https://doi.org/10.3961/jpmph.14.055

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Abstract PDF

Objectives
Mental health disorders and suicide are an important and growing public health concern in Korea. Evidence has shown that both globally and in Korea, obesity is associated with an increased risk of developing some psychiatric disorders. Therefore, we examined the association between distorted body weight perception (BWP) and suicidal ideation.
Methods
Data were obtained from the 2007-2012 Korea National Health and Nutritional Evaluation Survey (KNHANES), an annual cross-sectional nationwide survey that included 14 276 men and 19 428 women. Multiple logistic regression analyses were conducted to investigate the associations between nine BWP categories, which combined body image (BI) and body mass index (BMI) categories, and suicidal ideation. Moreover, the fitness of our models was verified using the Akaike information criterion.
Results
Consistent with previous studies, suicidal ideation was associated with marital status, household income, education level, and perceived health status in both genders. Only women were significantly more likely to have distorted BWP; there was no relationship among men. In category B1 (low BMI and normal BI), women (odds ratio [OR], 2.25; 95% confidence interval [CI], 1.48 to 3.42) were more likely to express suicidal ideation than women in category B2 (normal BMI and normal BI) were. Women in overweight BWP category C2 (normal BMI and fat BI) also had an increased OR for suicidal ideation (OR, 2.25; 95% CI, 1.48 to 3.42). Those in normal BWP categories were not likely to have suicidal ideation. Among women in the underweight BWP categories, only the OR for those in category A2 (normal BMI and thin BI) was significant (OR, 1.34; 95% CI, 1.13 to 1.59).
Conclusions
Distorted BWP should be considered an important factor in the prevention of suicide and for the improvement of mental health among Korean adults, especially Korean women with distorted BWPs.

Summary

Citations

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Sex Differences in Suicide Attempts: A Cross‐Sectional Study in Patients with First‐Episode and Drug‐Naïve Major Depression Disorder
Yingzhao Zhu, Jun Zhang, Junjun Liu, Fengnan Jia, Zhe Li, Xueli Zhao, Chuanwei Li, Hanxu Deng, Yue Zhou, Xingzhi Xia, Ruchang Yang, Xiangdong Du, Xiangyang Zhang, Sizhi Ai
Depression and Anxiety.2024;[Epub] CrossRef
Association between lifestyle-related risk behaviors, chronic diseases, and body image distortion: gender differences in follow-up 1 of the ELSA-Brasil cohort
Ana Luísa Patrão, Sheila Maria Alvim Matos, Emanuelle Goes, Conceição Nogueira, Rosane Harter Griep, Maria de Jesus Mendes da Fonseca, Liliana Rodrigues, Estela M. L. Aquino, Maria da Conceição Chagas de Almeida
Health Psychology and Behavioral Medicine.2024;[Epub] CrossRef
Association between Weight Status and Mental Health among Korean Adolescents: A Nationwide Cross-Sectional Study
Youngha Choi, Jeana Hong
Children.2023; 10(4): 620. CrossRef
Association between body shape misperception and unhealthy eating behaviors among Korean adolescents
Yejin Kim, Bomgyeol Kim, Vasuki Rajaguru, Sang Gyu Lee, Tae Hyun Kim
Nutrition Research and Practice.2023; 17(6): 1143. CrossRef
Effects of metabolic syndrome and obesity on suicidality in individuals with bipolar disorder
Christoph Stenzel, Nina Dalkner, Human-Friedrich Unterrainer, Armin Birner, Susanne A. Bengesser, Frederike T. Fellendorf, Andreas Fink, Eva Fleischmann, Melanie Lenger, Alexander Maget, Martina Platzer, Robert Queissner, Elena Schönthaler, Adelina Tmava-
Journal of Affective Disorders.2022; 311: 1. CrossRef
Body image distortion among Brazilian and Portuguese women with children: A comparative study between the ELSA-Brasil and Generation XXI cohorts
Ana Luísa Patrão, Maria da Conceição Almeida, Ana Henriques, Sheila M. Alvim Matos, Henrique Barros, Rosane Harter Griep, Estela M.L. Aquino
Preventive Medicine.2022; 164: 107316. CrossRef
Prevalence and factors associated with suicidal ideation amongst college students in the Nelson Mandela Bay Municipality, South Africa
Adeyinka A. Alabi, Olawumi K. Oladimeji, Oladele V. Adeniyi
South African Family Practice.2021;[Epub] CrossRef
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Yueyun Zhang, Baozhong Liu, Long Sun
Healthcare.2021; 9(10): 1299. CrossRef
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Yejin Cheon, Jinju Park, Bo Yoon Jeong, Eun Young Park, Jin-Kyoung Oh, E Hwa Yun, Min Kyung Lim
Scientific Reports.2020;[Epub] CrossRef
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Romy Freigang, Anne-Kathrin Geier, Gordian Lukas Schmid, Thomas Frese, Andreas Klement, Susanne Unverzagt
Deutsches Ärzteblatt international.2020;[Epub] CrossRef
Self-perceptions of body weight status according to age-groups among Korean women: A nationwide population-based survey
Boyoung Park, Ha Na Cho, Eunji Choi, Da Hea Seo, Sue Kim, Yeong-Ran Park, Kui Son Choi, Yumie Rhee, Yongjoo Kim
PLOS ONE.2019; 14(1): e0210486. CrossRef
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Ashleigh Haynes, Inge Kersbergen, Angelina Sutin, Michael Daly, Eric Robinson
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Secular trends in the prevalence of weight misperception among Korean adults, 2001–2013
Seonho Kim, Wi-Young So
Obesity Research & Clinical Practice.2018; 12(4): 346. CrossRef
Association between body mass index and suicidal ideation among seniors in Shandong, China
Long Sun, Chengchao Zhou
Comprehensive Psychiatry.2018; 82: 68. CrossRef
Body weight misperception and psychological distress among young South Korean adults: the role of physical activity
Eun-Young Lee, Maxine Myre, Jongnam Hwang, Heeran Chun, Eunchul Seo, Roman Pabayo, John C. Spence
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Sang Ah Lee, Suk-Yong Jang, JaeYong Shin, Yeong Jun Ju, Jin Young Nam, Eun-Cheol Park
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Factors That Affect Suicidal Attempt Risk Among Korean Elderly Adults: A Path Analysis: Junsoo Ro, Jongheon Park, Jinsuk Lee, Hyemin Jung; J Prev Med Public Health. 2015;48(1):28-37. Published online January 14, 2015; DOI: https://doi.org/10.3961/jpmph.14.030

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Abstract PDF

Objectives
Among the Korean elderly (those 65 years of age and older), the suicide rate is 80.3/100 000 people, which is ten times higher than the Organization for Economic Cooperation and Development average. Because South Korea is rapidly becoming an aging population, this high elderly suicidal rate will only get worse. Although the size of the elderly suicide problem is quite large, previous research in South Korea has surveyed restricted areas and not the entire country. Even though the factors that affect elderly suicide are complicated, there has been little research into these influencing factors. Thus, this research uses the national survey data (Community Health Survey) that was obtained in 2009. Additionally, we analyze factors affecting elderly suicidal ideation and attempts as well as the paths of these effects.
Methods
Community Health Survey data obtained by the Korea Centers for Disease Control and Prevention in 2009 was used for this study. We additionally examined the factors that affect suicide with chi-squared tests, t-tests, Pearson’s correlation test, and path analysis.
Results
Depressive symptoms and suicidal ideation are the only factors that directly affect suicidal attempts. Demographic, behavioral, and physical activity factors have indirect effects on suicidal attempts.
Conclusions
Depression has the strongest influence on suicidal ideation and attempts. Demographic, behavioral, and physical activity factors affect suicidal attempts mostly through depressive symptoms. In addition, there is a path that suggests that demographic, behavioral, and physical activity factors affect suicidal attempts not through depression symptoms but only through suicidal ideation. This means that the elderly who do not have depression symptoms attempt suicide according to their own situations and characteristics.

Summary

Citations

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Socioeconomic factors associated with suicidal behaviors in South Korea: systematic review on the current state of evidence
Nicolas Raschke, Amir Mohsenpour, Leona Aschentrup, Florian Fischer, Kamil J. Wrona
BMC Public Health.2022;[Epub] CrossRef
Suicidal Behavior Among Elderly Inpatients: its Relation to Functional Disability and Pain
Suzaily Wahab, Tien Yong Chua, Rosdinom Razali, Zanariah Mat Saher, Iman Hakimi Zamzam, Mohamad Adam Bujang
Psychology Research and Behavior Management.2022; Volume 15: 737. CrossRef
Parks and green areas and the risk for depression and suicidal indicators
Kyoung-bok Min, Hyun-Jin Kim, Hye-Jin Kim, Jin-young Min
International Journal of Public Health.2017; 62(6): 647. CrossRef
Prevalence and Predictive Factors of Depression in Community-Dwelling Older Adults in South Korea
Jae Soon Yoo, Sun Ju Chang, Hyun Sook Kim
Research and Theory for Nursing Practice.2016; 30(3): 200. CrossRef

Medical Care Expenditure in Suicides From Non-illness-related Causes: Jungwoo Sohn, Jaelim Cho, Ki Tae Moon, Mina Suh, Kyoung Hwa Ha, Changsoo Kim, Dong Chun Shin, Sang Hyuk Jung; J Prev Med Public Health. 2014;47(6):327-335. Published online November 4, 2014; DOI: https://doi.org/10.3961/jpmph.14.038

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Abstract PDF

Objectives
Several epidemiological studies on medical care utilization prior to suicide have considered the motivation of suicide, but focused on the influence of physical illnesses. Medical care expenditure in suicide completers with non-illness-related causes has not been investigated.
Methods
Suicides motivated by non-illness-related factors were identified using the investigator’s note from the National Police Agency, which was then linked to the Health Insurance Review and Assessment data. We investigated the medical care expenditures of cases one year prior to committing suicide and conducted a case-control study using conditional logistic regression analysis after adjusting for age, gender, area of residence, and socioeconomic status.
Results
Among the 4515 suicides motivated by non-illness-related causes, medical care expenditures increased in only the last 3 months prior to suicide in the adolescent group. In the younger group, the proportion of total medical expenditure for external injuries was higher than that in the older groups. Conditional logistic regression analysis showed significant associations with being a suicide completer and having a rural residence, low socioeconomic status, and high medical care expenditure. After stratification into the four age groups, a significant positive association with medical care expenditures and being a suicide completer was found in the adolescent and young adult groups, but no significant results were found in the elderly groups for both men and women.
Conclusions
Younger adults who committed suicide motivated by non-illness-related causes had a higher proportion of external injuries and more medical care expenditures than their controls did. This reinforces the notion that suicide prevention strategies for young people with suicidal risk factors are needed.

Summary

Citations

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Socioeconomic factors associated with suicidal behaviors in South Korea: systematic review on the current state of evidence
Nicolas Raschke, Amir Mohsenpour, Leona Aschentrup, Florian Fischer, Kamil J. Wrona
BMC Public Health.2022;[Epub] CrossRef
Impact of intergenerational support and medical expenditures on depression: Evidence from rural older adults in China
Congrong Li, Qing Han, Jinrong Hu, Zeyu Han, Hongjuan Yang
Frontiers in Public Health.2022;[Epub] CrossRef

Medical Care Utilization During 1 Year Prior to Death in Suicides Motivated by Physical Illnesses: Jaelim Cho, Won Joon Lee, Ki Tae Moon, Mina Suh, Jungwoo Sohn, Kyoung Hwa Ha, Changsoo Kim, Dong Chun Shin, Sang Hyuk Jung; J Prev Med Public Health. 2013;46(3):147-154. Published online May 31, 2013; DOI: https://doi.org/10.3961/jpmph.2013.46.3.147

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Abstract PDF

Objectives

Many epidemiological studies have suggested that a variety of medical illnesses are associated with suicide. Investigating the time-varying pattern of medical care utilization prior to death in suicides motivated by physical illnesses would be helpful for developing suicide prevention programs for patients with physical illnesses.

Methods

Suicides motivated by physical illnesses were identified by the investigator's note from the National Police Agency, which was linked to the data from the Health Insurance Review and Assessment. We investigated the time-varying patterns of medical care utilization during 1 year prior to suicide using repeated-measures data analysis after adjustment for age, gender, area of residence, and socioeconomic status.

Results

Among 1994 suicides for physical illness, 1893 (94.9%) suicides contacted any medical care services and 445 (22.3%) suicides contacted mental health care during 1 year prior to suicide. The number of medical care visits and individual medical expenditures increased as the date of suicide approached (p<0.001). The number of medical care visits for psychiatric disorders prior to suicide significantly increased only in 40- to 64-year-old men (p=0.002), women <40 years old (p=0.011) and women 40 to 64 years old (p=0.021) after adjustment for residence, socioeconomic status, and morbidity.

Conclusions

Most of the suicides motivated by physical illnesses contacted medical care during 1 year prior to suicide, but many of them did not undergo psychiatric evaluation. This underscores the need for programs to provide psychosocial support to patients with physical illnesses.

Summary

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Areum Song, Emily Jiali Koh, Weon-Young Lee, Shusen Chang, Jiseun Lim, Minjae Choi, Myung Ki
Journal of Affective Disorders.2024; 349: 431. CrossRef
Variations in healthcare utilization for mental health problems prior to suicide by socioeconomic status: a Norwegian register-based population study
Carine Øien-Ødegaard, Solveig Tobie Glestad Christiansen, Lars Johan Hauge, Kim Stene-Larsen, Sissel Marguerite Bélanger, Espen Bjertness, Anne Reneflot
BMC Health Services Research.2024;[Epub] CrossRef
Late-life suicide in an aging world
Diego De Leo
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D.P. Ponomareva, M.S. Artemieva M.S. Artemieva
Vestnik nevrologii, psihiatrii i nejrohirurgii (Bulletin of Neurology, Psychiatry and Neurosurgery).2022; (1): 18. CrossRef
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Hannah S. Szlyk, Jia Tan, Rebecca Lengnick-Hall
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Suicide Rate Differences by Sex, Age, and Urbanicity, and Related Regional Factors in Korea: Kyu-Seok Cheong, Min-Hyeok Choi, Byung-Mann Cho, Tae-Ho Yoon, Chang-Hun Kim, Yu-Mi Kim, In-Kyung Hwang; J Prev Med Public Health. 2012;45(2):70-77. Published online March 31, 2012; DOI: https://doi.org/10.3961/jpmph.2012.45.2.70; Correction in: J Prev Med Public Health 2012;45(3):209

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Abstract PDF

Objectives

Identify the characteristics related to the suicide rates in rural and urban areas of Korea and discover the factors that influence the suicide rate of the rural and urban areas.

Methods

Using the data on causes of death from 2006 to 2008, the suicide rates were calculated and compared after age-standardization based on gender, age group and urbanicity. And, in order to understand the factors that influence suicide rate, total 10 local characteristics in four domains - public service, social integration, residential environment, and economic status - were selected for multiple regression analysis.

Results

The suicide rates were higher in men than women, in rural areas than urban, and in older people than the younger. Generally, although there were variations according to age group and urbanicity, suicide rates were significantly related to residential environment and regional economic status but not related to regional welfare spending and social integration. In addition, the population over the age of 65 years, only regional economic status has significantly influence on their suicide rates.

Conclusions

The influence of characteristics of regions on suicide rate is various by age-group, gender, and urbanicity. Therefore, in order to lower suicide rate and reduce the gap between regions, various approaches must be adopted by taking into account the socioeconomic characteristics of the regions.

Summary

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Trend of Mortality Rate and Injury Burden of Transport Accidents, Suicides, and Falls: Ki Sook Kim, Soon Duck Kim, Sang Hee Lee; J Prev Med Public Health. 2012;45(1):8-13. Published online January 31, 2012; DOI: https://doi.org/10.3961/jpmph.2012.45.1.8

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Abstract PDF

Objectives

Recently injury has become a major world-wide health problem. But studies in Korea about injuries were very few. Thus, this study was conducted to analyze the trend of major injuries from 1991 to 2006 and to provide basic data for preventing injuries.

Methods

This study was based on the National Statistical Office data from 1991 to 2006 and calculated to estimate the burden of major injuries by using the standard expected years of life lost (SEYLL) and total lost earnings equation.

Results

For transport accidents, mortality, SEYLL and total lost earnings were increased from 1991 to 1996 and decreased from 2000 to 2006. On the other hand, for suicides, these were increased gradually. Since 2003, falls were included in ten leading causes of death. This study showed that injury causes major social and economical losses.

Conclusions

We could reduce injury related premature death through active interest in injury prevention program.

Summary

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Trend in Disability-Adjusted Life Years (DALYs) for Injuries in Korea: 2004–2012
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English Abstracts

Awareness and Attitude Toward Suicide in Community Mental Health Professionals and Hospital Workers.: Soung Nam Kim, Kang Sook Lee, Seon Young Lee, Jae Hee Yu, A Rum Hong; J Prev Med Public Health. 2009;42(3):183-189.; DOI: https://doi.org/10.3961/jpmph.2009.42.3.183

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Abstract PDF

OBJECTIVES
The purpose of this study was to evaluate community mental health professionals and hospital workers attitude and awareness towards suicide. METHODS: This study investigated 264 community mental health professionals and 228 hospital workers. SOQs (Suicidal Opinion Questionnaires) were used from July 2007 to September 2007. After a factor analysis for the attitude towards suicide, the items on ethics, mental illness, religion, risk, and motivation were included in the subsequent analysis. RESULTS: There were significant differences in the attitude towards suicide according to religion, age, educational background, the marriage status, the economic position, and different professional licenses. Hospital workers' view was different from the community workers'. The hospital workers judged that suicide was due to mental illness, and suicide was high for the people in a special environment and who lacked motivation, which caused them to fall in a dangerous situation. For the lower educational group, they thought that suicide was attributable to mental illness. The awareness for suicide was significantly higher in the group with a postgraduate education, unmarried people, mental health professionals and the persons who had concern and experience with suicide. The factors that had an influence on the awareness of suicide were the items of mental illness, religion, risk and motivational factors. CONCLUSIONS: This study suggested that the factors to increase the awareness and attitude for suicide were the experience of increased education and case management of suicide. Therefore, education dealing with suicide and reinforcement of crisis management programs should be developed.

Summary

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Aimi Izwani Mohd Nazli, Yit Tyse Ooi, Dandaithapani Thyagarajan, Ruzita Jamaluddin
Malaysian Journal Of Psychiatry.2022; 31(1): 1. CrossRef
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Gurappa Puttanna Gururaj, Navya Aswatha Gopalli, Reddy M Mohan, Ruth Sneha Chandrakumar
Indian Journal of Social Psychiatry.2021; 37(2): 191. CrossRef
The Attitude of Psychiatric and Non-psychiatric Health-care Workers Toward Suicide in Malaysian Hospitals and Its Implications for Training
Ching Sin Siau, Lei-Hum Wee, Sapini Yacob, Seen Heng Yeoh, Tassha Hilda binti Adnan, Jamaiyah Haniff, Komathi Perialathan, Aziman Mahdi, Abu Bakar Rahman, Choon Leng Eu, Suzaily binti Wahab
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Hye-Jin Kim, Jun-Won Hwang, Jin Hyeong Jhoo, Haak-Seon Kim, Semi Hwang, Kanguk Lee
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Case study of posts before and after a suicide on a Swedish internet forum
Michael Westerlund, Gergö Hadlaczky, Danuta Wasserman
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Psychological Health in Residents Participating in Clean-up Works of Hebei Spirit Oil Spill.: Minkyo Song, Yun Chul Hong, Hae Kwan Cheong, Mina Ha, Hojang Kwon, Eun Hee Ha, Yeyong Choi, Woo Chul Jeong, Jongil Hur, Seung Min Lee, Eun Jung Kim; J Prev Med Public Health. 2009;42(2):82-88.; DOI: https://doi.org/10.3961/jpmph.2009.42.2.82

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Abstract PDF

OBJECTIVES
Our objective was to examine and evaluate the psychological health of the residents of Taean during the cleanup of the Hebei Spirit (HS) oil spill and to review some factors associated with the results. METHODS: A community survey of 71 men and women was conducted 8 weeks after the HS oil spill. Questionnaires used were the PWI (Psychological Well-being Index) scale for psychosocial distress, the CES-D (Center for Epidemiologic Studies-Depression) scale for depressive symptoms, and a questionnaire created to assess suicidal impulses. RESULTS: The overall prevalence of high-risk psychosocial distress among the study group was 64.2%. The percentages of respondents with scores on the CES-D Scale above 16 and above 21 were 77.6% and 62.7%, respectively. The percentage of respondents categorized as having suicidal impulses was 18.3%. When compared with unexposed groups in the general population taken from various sources, the residents of Taean were 6.5 times as likely to have high stress and 9.4-9.7 times as likely to be depressed. No significant difference in the rate of suicidal impulse was found between the residents of Taean and the general population. Factors associated with high stress, depression, and suicidal impulses were age, a change in income, educational level, number of days working on the cleanup, and positive responses to questions about "affected daily activity" and "hospital visit due to work on cleanup." CONCLUSIONS: The results suggest that the HS oil spill had a significant impact on the psychological health of residents of Taean, but the comparability of the unexposed groups is a limitation of the study.

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The Association Between Public Social Expenditure and Suicides: Evidence from OECD Countries.: Yoojin Park, Myoung hee Kim, Soonman Kown, Young jeon Shin; J Prev Med Public Health. 2009;42(2):123-129.; DOI: https://doi.org/10.3961/jpmph.2009.42.2.123

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Abstract PDF

OBJECTIVES
This study aimed to examine the association between public social expenditure (PSE) and suicides in the 27 countries of the Organization for Economic Cooperation and Development (OECD) from 1980 to 2003. METHODS: The age-standardized suicide rates and their annual change (%) were obtained from the OECD Health Data 2007. As a measure of social protection, the PSE (% GDP) was used. The covariates included the annual divorce rate (/100,000 population), fertility rate (number of children/woman aged 15 to 49 years), GDP per capita (US$PPP), male unemployment rate (%), life expectancy (years) and alcohol consumption (liter/capita) for each country, which were all obtained from the OECD Health Data 2007 and the OECD Social Indicators 2006. Using hierarchical linear models that included these covariates, the effects of PSE on suicides (Model 1) and the annual percent change (Model 2) were examined (Model 3). Also, sub-sample analyses were done for six countries that experienced political/economic transition. RESULTS: We could not find significant effects of PSE on suicides (Model 1), but we observed significantly negative effects on the annual percent change for men and women (Model 2). Such findings were replicated in the sub-sample analysis, and moreover, the effect size was much larger (Model 3). CONCLUSIONS: Our finding suggests that social welfare protection can be a pivotal factor for suicide epidemiology, and especially in countries experiencing a social crisis or transition.

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Abstract PDF

OBJECTIVES
We examined the effect of sociodemographic factors, cancer, and psychiatric disorders on suicide by gender and age-specific patterns in South Korea. METHODS: The study is a case-control study. Claim data was obtained from the national health insurance database and national death registration database. The number of people who committed suicide was 11,523, which was matched with a control group consisting of ten times as many people at 115,230 selected from the national health insurance and medical aids beneficiaries. The medical utilization of the case group was one year before death and that of the control group was from July 1,2003 to June 30, 2004. Four variables-address, economic status, presence of a psychiatric disease, and cancer-were used in multiple logistic regression analyses. RESULTS: Living in cities or in rural areas showed a greater risk for suicide than living in a metropolitan city. Low economic status, the presence of a psychiatric disorder, and cancer were also statistically meaningful risk factors for suicide. The three major psychiatric diseases, schizophrenia, alcohol abuse, and bipolar disorder, were meaningful in all age groups, but the scale of the odds ratio differed by the age group. Only the psychiatric disorder variable was meaningful in the adolescent group, whereas a psychiatric disorder and economic status were meaningful for the young adult group, and all variables were meaningful for the middle-aged group. A psychiatric disorder and cancer were meaningful in the elderly group, economic status was meaningful for male subjects, and address was meaningful for female subjects. CONCLSIONS: Factors such as living in city or rural areas, low economic status, the presence of a psychiatric disorder, and cancer were statistically meaningful risk factors in suicide. These factors also differed by age group. Therefore, policymakers should establish policies for suicide prevention that are relevant for each age group.

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Original Article

A Study for Effects of Economic Growth Rate and Unemployment Rate to Suicide Rate in Korea.: Jong Soon Park, June Young Lee, Soon Duck Kim; Korean J Prev Med. 2003;36(1):85-91.

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Abstract PDF: OBJECTIVES
We investigated the effects of the economic growth and unemployment rates on the suicide rate in Korea, between 1983 and 2000, using a time-series regression model. The purpose of this study was to model and test the magnitude of the rate of suicide, with the Korean unemployment rate and GDP. METHODS: Using suicide rate per 100, 000 Koreans and the unemployment rates between 1983 and 2000, as published by the Korea National Statistical Office, and the rate of fluctuation of the Korean GDP (Gross Domestic Product), as provided by the Bank of Korea, as an index of the economic growth rate, a time-series regression analysis, with a first-order autoregressive regression model, was performed. RESULTS: An 81.5% of the variability in the suicide rate was explained by GDP, and 82.6% of that was explained by the unemployment rate. It was also observed that the GDP negatively correlated with the suicide rate, while the unemployment and suicide rates were positively correlated. For subjects aged over 20, both the GDP and unemployment rate were found to be a significant factors in explaining suicide rates, with coefficients of determination of 86.5 and 87.9%, respectively. For subjects aged under 20, however, only the GDP was found to be a significant factor in explaning suicide rates (the coeficient of determination is 38.4%). CONCLUSION: It was found that the suicide rate was closely related to the National's economic status of Korea, which is similar to the results found in studies in other countries. We expected, therefore, that this study could be used as the basis for further suicide-related studies.; Summary

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