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韓國人 自殺에 關한 社會精神醫學的 硏究

A Social Psychiatric Evaluation on the Problems Contributing to Suicide Among Koreans

중앙의학 1963년 5권 4호 p.367 ~ 370
김종은,
소속 상세정보
김종은 (  ) - 가톨릭대학 의학부 예방학교실

Abstract


in contrast with many suggestive evidences that support the high ratio of suicide among Koreans, evaluations on the problems related to suicide by means of scientific observation have rarely been carried out up to date. In an attempt to elucidate some basic factors which were thought to be contributing to suicide in this society, this study is designed to examine the problems from three different angles namely. 1) social hygienic points of view, 2) mental hygienic points of view and 3) from the viewpoints of a clinical consideration.
Method of Study
A) Selection of Patients.
During a six month period (Jan 1, 1963 through June 30, 1963) 415 patients who attempted suicide were brought in to the receiving room of our Suicide Prevention Center. Of the 415 patients, 372 cases were interviewed and results were included in this study. The remaining 43 cases were not included after failing interviews due to various reasons such as patient´ s or family´ s rejection of interview or other unintentional reasons.
B) Obtainment of opinions related to suicide.
In order to obtain general opinions in regard to the attitudes toward various forms of suicide as well as other opinions related suicide, a questionaire was issued to some 3.000 people of various social classes including students and laborers. Of the 3,000 responders, 2, 201 responses were analized and results were included in this study. The remaining 799 responses were excluded from the study as those, were statistically thought to be invalid.
Results
Part I. Social Hygienic Factors Contributing to the Problems of Suicide
A) Socio-environmental Factors.
1) Occupations : Of the 372 attempted suicide cases, 117(31.5%) cases were either the unemployed or those jobs were of unstable nature. (Table 1, Figure 1, 2.) Of the 372 attempted cases, 42 (11. %) cases were the students. (Table 1. Figure 1, 2.)
2) Religious Affiliation : The attitudes toward various forms of suicide based on the religious background were observed and compared with those who are not affiliated to any kind of religion in the general population group as well as attempted suicide group. The results indicate that all kinds of religions are considered to be helpful to prevent people from posessing or planning to committ suicide. (Table 2, 3. )
B) Individual and Family Environmental Factors.
1) Social and Developmental History : Reviewing social and developmental history of the 372 attempted suicide group, 96.2% of the group shows evidences of adjustment difficulties in their school history as well as social and military service history including 61 cases who has history of being arrested for various antisocial behaviors. (Table 4,5.)
2) Age Distribution : Of the 372 attempted suicide cases, 77(20.7%) cases were those who were under the age of 20. 81.2% of the entire cases were under the age of 30 and 93.6% of the entire cases were under the age of 40. The ratio of attempted suicid eby those who were over the age of 40 was consisted of only 6.4%. (Table 6.)
3) Incidence of parental loss : 130(34.9%) cases of the 372 attempted suicide cases reveal to be non-defective in the existence of parents. Of the remaining defective group, 30.6% were those who lost their parents before the age of 12 years old. (Table 7, 8. Fig. 4, 5, 6. )
4) In respect to the order of siblings : Ratio of suicidal attempt among first child and last child and only child were considered to be high compared to those middle child group. (Table 9, 10. Fig. 7, 8.)
5) History of previous suicidal attempts : 17.2% of the 372 attempted suicide group has history of previous suicidal attempt. (Table 11, 12.)
6) Current marital status : Relatively high ratio of divorce, illegal marriage life experience were observed in the attempted suicide group and particularly the female group is higher compared to the male group. (Table 15, Fig.9.)
C) Natural Environmental Factors.
1) Investigation as to the incidence of possessing suicidal wishes among general. population reveal to be between 30%--40% and that the ratio among female is higher compared to male group. Occupationwise, laborers are the highest group among the entire occupational groups. (Table 16.)
2) Seasonal influence Investigation as to the occurrence of suicidal wish analized by seasons reveal that the Spring and Autumn are much higher than other seasons. (Fig .10.)
3) Methods employed : 52.2% of the entire cases attempted suicide by taking seconal tablets and 83.4% of the entire cases attempted by taking either seconal or other tranquilizers which they obtained from the drug stores without doctor´s prescriptions. (Table 19.)
Part If. A Mental Hygienic Survey on the Factors Related to Suicide
1) 106 (28.5%) cases of the entire attempted suicidal cases reveal that they have possessed the wishes to be killed by someone and ratio of the incidences of these drives among attempted suicide group were revealed to be much higher compared-to the normal group studied. (Table 1, 2. Fig.1. )
2) The direct motives which had led to the attempt were observed and results were such that psychological reasons such as inferiority as´ well as frustrated love relationship were the main reasons rather than sociological factors such as. loss of job or" economical difficulties. (Table 4. Fig. 2. )
3) Family history among those attempted suicidal group reveal that 11.8% of the group has had psychotic cases in the family member. (Table 3.)
4) Attitudes toward various forms of suicide among general population reveal-that attitude of conditional approval is higher than that of absolute disapproval and-these trends were found to be much more evident in the laborers group. (Table-5,6,7.)
5) Opinions regarding the causing factors for suicide among general population reveal that individual´s attitude toward the life (weak mindedness) as well as family circumstances were to be major opinions interpreted by peopel in this society.. (Table 8. Fig. 3. )
6) On the reasons for serious suicidal wishes or attempts among general population group and those leprosy patients group reveal that family trouble characterized. by unusual family structure or disagreement on the attitude toward life situation with family members among general. population and depression due to the incurable disease among the leprosy patients were of major causes they responded. (Table 9.)
Part Ⅲ. A Clinical Consideration on the Attempted Suicide From the Viewpoints of Preventive Psychiatry
1) Ratio of psychotic illness among the attempted suicidal cases were found to be :130 (35.0%) cases including 91 (24.5/0) cases of manic-depressive psychosis, -depressive type and 34 (10.4%) cases of schizophrenic reactions. (Table 1. Fig. 1)
2) 84 (22,6%) out of the 372 cases reveals to be free from any apparent psychiatric diseases. (Table 1. Fig.1. )
3) In regard to the seriousness in their attempts, 233 (62.6%) were considered to be serious in their attempts while 86 (23.2%) cases were considered to be not serious in the attempts. (Table 2,3.)
4) Investigation on the relationship with physicians of the entire attempted group reveals that 98 (26.3%) cases have had experiences visiting physicians prior to the attempt during the period of one year. (Table 6.)
5) 117 (31.5%) case have informed of either their intent or plan to someone ..around him prior to the attempt. (Table 7, 8.)

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