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치명적 수단을 사용한 고의적 자해 입원환자 특성

Clinical characteristics of intentional self-harm inpatient with lethal methods

대한응급의학회지 2019년 30권 5호 p.419 ~ 427
차지훈 ( Cha Ji-Hoon ) - 한림대학교 의과대학 응급의학교실

안무업 ( Ahn Moo-Eob ) - 한림대학교 의과대학 응급의학교실
김동원 ( Kim Dong-Won ) - 한림대학교 의과대학 응급의학교실
이상규 (  ) - 한림대학교 의과대학 정신건강의학교실
이창현 ( Lee Chang-Hyun ) - 한림대학교 의과대학 정신건강의학교실
김상미 ( Kim Sang-Mi ) - 이화여자대학교 빅데이터분석과
김정혁 ( Kim Jung-Hyuk ) - 한림대학교 의과대학 응급의학교실
김형기 ( Kim Hyung-Ki ) - 한림대학교 의과대학 응급의학교실
한재현 ( Han Jae-Hyun ) - 한림대학교 원격의료센터
박경숙 ( Park Kyung-Sook ) - 한림대학교 원격의료센터

Abstract


Objective: The aim of this study was to identify the latent class, according to the risk factors, of the patients hospitalized due to intentional self-harm by lethal means.

Method: The risk factors were derived by categorizing the intentional self-harming measures by lethal (hanging, pesticide poisoning, jumping, and drowning) and non-lethal (drug poisoning and stab) measures and comparing the demographics, diseased state, and suicide-related characteristics. Latent class analysis was performed to identify the type of intentional self-harm.

Results: Male (sex), elderly (age), rural (residing location), and comorbid diseases were found to be the risk factors for fatal injuries. For this, four latent classes were modeled. Factors, such as the age group between 20 to 40 years, women, and family conflict were included in the first class. The second class included the age group between 30 to 50 years, men, and financial problems. The third class covered the age group between 60 to 70 years and comorbidity. The fourth class contained the age group of 10 to 50 years, women, and mental problems. The rate of suicide and choice of fatal suicide was ranked in the order of 3 (62.7%, 21.5%), 2 (59.8%, 13.9%), 4 (36.8%, 5.7%), and 1 (29.5%, 5.9%).

Conclusion: A lethal mean access control policy needs to be established for the high-risk group of self-harm. Moreover, establishing an emergency room-community link prevention policy could help reduce the re-suicide attempt among suffering patients.

키워드

Suicide; Self-injurious behavior; Inpatients; Cluster analysis
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