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정신건강의학과 입원환자에서 자살행동 관련 요인

Factors Associated with Suicidal Behavior of Psychiatric Inpatients

신경정신의학 2019년 58권 3호 p.202 ~ 208
김하늬 ( Kim Ho-Ney ) - 전남대학교 의과대학 정신건강의학교실

김주완 ( Kim Ju-Wan ) - 전남대학교 의과대학 정신건강의학교실
강희주 ( Kang Hee-Ju ) - 전남대학교 의과대학 정신건강의학교실
김선영 ( Kim Seon-Young ) - 전남대학교 의과대학 정신건강의학교실
이주연 ( Lee Ju-Yeon ) - 전남대학교 의과대학 정신건강의학교실
김재민 ( Kim Jae-Min ) - 전남대학교 의과대학 정신건강의학교실
신일선 ( Shin Il-Seon ) - 전남대학교 의과대학 정신건강의학교실
윤진상 ( Yoon Jin-Sang ) - 전남대학교 의과대학 정신건강의학교실
김성완 ( Kim Sung-Wan ) - 전남대학교 의과대학 정신건강의학교실

Abstract


Objectives: This study examined the factors associated with suicidal behavior in psychiatric inpatients.

Methods: The medical records of 208 psychiatric inpatients were reviewed retrospectively. The factors related to suicide attempts and ideation at the time of admission, and during outpatient follow-up, were investigated.

Results: In total, 120 patients (57.7%) with a history of at least one suicide attempt, and 163 patients (78.4%) who reported active suicide ideation (e.g., a suicide plan or intention to commit suicide) at the time of admission were reviewed. Being unmarried or divorced, substance abuse, impulsivity, and a poor social support system were associated with a history of suicide attempts. The suicidal ideation group had significantly higher rates of coexisting depression, severe depressive symptoms, hopelessness, and impulsivity, as well as a lower incidence of moral objection to suicide and high religiosity. In total, 15 out of 193 patients (7.8%) who were followed-up at outpatient clinics attempted suicide after discharge. Patients who attempted suicide or reported suicidal ideation at the outpatient clinic after discharge were significantly more likely to have a history of previous suicide attempts, or have had active suicide ideation at the time of admission. Good social support and high responsibility to family were inversely associated with suicidal ideation as an outpatient.

Conclusion: A history of suicide attempts and ideation at the time of hospital admission were the risk factors for future outpatient suicidal behavior. Further study is warranted to develop a checklist and assessment measures of the various risk and protective factors associated with suicidal behavior.

키워드

Suicide; Suicidal ideation; Risk factor; Protective factor; Inpatients
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