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1.
J Korean Med Sci ; 36(39): e244, 2021 Oct 11.
Artigo em Inglês | MEDLINE | ID: mdl-34636501

RESUMO

BACKGROUND: This study investigated trends in the prevalence of major depressive disorder (MDD) by sociodemographic factors in South Korea. METHODS: National samples of the general population aged 18 years or older collected from the nationwide Korean Epidemiologic Catchment Area surveys conducted in 2001 (n = 6,206), 2006 (n = 6,466), and 2011 (n = 5,986) were used. For MDD diagnosis, we conducted face-to-face interviews using the Korean version of the Composite International Diagnostic Interview. We performed logistic regression analyses stratified by gender, after adjusting for other sociodemographic variables, to calculate the 2006-to-2001 odds ratio (OR) and 2011-to-2001 OR by subgroups of sociodemographic factors to explore the association of MDD prevalence with sociodemographic factors over time. RESULTS: The prevalence of MDD in the general population of South Korea increased steadily from 2001, to 2006, and to 2011 (1.6%, 2.5%, and 3.1%, respectively). Among the men, the prevalence of MDD continued to increase significantly in 18-29 years of age group (2006: adjusted OR [AOR], 3.32; 2011: AOR, 7.42), at-risk drinking group (2006: AOR, 3.56; 2011: AOR, 4.77), and not living with a partner group (2006: AOR, 3.24; 2011: AOR, 3.25). Meanwhile, among the women, the prevalence of MDD continued to significantly increase in the below-average household income group (2006: AOR, 2.58; 2011: AOR, 2.59), at-risk drinking group (2006: AOR, 2.02; 2011: AOR, 2.47), and unemployed group (2006: AOR, 1.48; 2011: AOR, 2.04). CONCLUSION: This study may provide significant information for public policymakers to allocate sufficient health resources on MDD to vulnerable groups, particularly, men aged 18-29 years and women living in households with below-average income, and for clinicians to develop appropriate screening and treatment modalities for MDD.

2.
J Korean Med Sci ; 36(37): e240, 2021 Sep 27.
Artigo em Inglês | MEDLINE | ID: mdl-34581520

RESUMO

BACKGROUND: Although childhood maltreatment is a known risk factor for adulthood mental health, the impact of different types of childhood maltreatment on mental disorders is not yet clear. This study explored the association of each type of childhood maltreatment with adulthood mental disorders and suicidality in South Korea. METHODS: A total of 5,102 individuals from the general populations over the age of 18 responded to the Korean version of the Composite International Diagnostic Interview and questions about childhood maltreatment (emotional neglect, psychological abuse, physical abuse, and sexual abuse). To evaluate the odds ratio for mental disorders and suicidality associated with each type of childhood maltreatment, we used logistic regression analysis. RESULTS: About 17.0% of the respondents reported having experienced a type of maltreatment in childhood. According to the type, 9.4% reported physical abuse, 9.3% reported emotional neglect, 7.9% reported psychological abuse, and 3.8% reported sexual abuse. Exposure to each type of childhood maltreatment was associated with most types of mental disorders after adjusting for sociodemographic factors. Each type of childhood maltreatment victim was associated with suicidality (suicidal ideations, suicide plans, and suicide attempts). Dose-response patterns for suicide attempts were observed in all types of victims. Moreover, the respondents who experienced frequent childhood emotional neglect were 14 times more likely to have attempted suicide. CONCLUSION: Childhood maltreatment was associated with mental health in adulthood. The findings show the need for early detection and intervention of victims of childhood maltreatment to minimize its negative impact on adult mental health.

3.
Psychiatry Res ; 304: 114133, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34352593

RESUMO

Smartphone is one of the essential items. However, it may negatively affect a user's mental health when it is overused. The study aimed to investigate associations of smartphone overuse with depression, anxiety, and the relationship with other addictive behaviors and disorders. A total of 2,509 subjects were randomly selected through a one-person-per-household method. Smartphone Overuse Screening Questionnaire (SOS-Q) and the Korean version of the Composite International Diagnostic Interview (K-CIDI) were used. Linear regression and Pearson correlation analyses were performed to evaluate associations of smartphone overuse with depression, anxiety, and relationship with other addictive psychiatric disorders respectively. Among 2509 participants, 138 (14.76%) demonstrated smartphone overuse. Participants who used their smartphones for more than three hours a week were more likely to be single and females compared to those who used their smartphones for less than three hours a week. Smartphone overuse showed significant associations with depression, anxiety disorder, and a significant relationship with internet and game overuse, alcohol dependence, and nicotine dependence disorder. Internet-related behavior showed the strongest relationship with smartphone overuse. Although the sample size was adequate, a large number of subjects did not complete the questionnaire. People with psychiatric disorders should be advised to use smartphones in moderation.

4.
Sci Rep ; 11(1): 15828, 2021 08 04.
Artigo em Inglês | MEDLINE | ID: mdl-34349156

RESUMO

Precise remote evaluation of both suicide risk and psychiatric disorders is critical for suicide prevention as well as for psychiatric well-being. Using questionnaires is an alternative to labor-intensive diagnostic interviews in a large general population, but previous models for predicting suicide attempts suffered from low sensitivity. We developed and validated a deep graph neural network model that increased the prediction sensitivity of suicide risk in young adults (n = 17,482 for training; n = 14,238 for testing) using multi-dimensional questionnaires and suicidal ideation within 2 weeks as the prediction target. The best model achieved a sensitivity of 76.3%, specificity of 83.4%, and an area under curve of 0.878 (95% confidence interval, 0.855-0.899). We demonstrated that multi-dimensional deep features covering depression, anxiety, resilience, self-esteem, and clinico-demographic information contribute to the prediction of suicidal ideation. Our model might be useful for the remote evaluation of suicide risk in the general population of young adults for specific situations such as the COVID-19 pandemic.


Assuntos
Transtornos Mentais/diagnóstico , Transtornos Mentais/psicologia , Redes Neurais de Computação , Ideação Suicida , Tentativa de Suicídio/psicologia , Adolescente , Adulto , Ansiedade/psicologia , Área Sob a Curva , Depressão/psicologia , Feminino , Humanos , Masculino , Transtornos Mentais/prevenção & controle , Prognóstico , Escalas de Graduação Psiquiátrica , República da Coreia , Resiliência Psicológica , Fatores de Risco , Autoimagem , Sensibilidade e Especificidade , Tentativa de Suicídio/prevenção & controle , Inquéritos e Questionários , Adulto Jovem
5.
J Affect Disord ; 294: 786-793, 2021 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-34375203

RESUMO

BACKGROUND: The effect of dynamic changes in metabolic parameters over time on the development of depression has yet to be examined. In this study, we aimed to determine the association between the variability of metabolic parameters and the development of depression using nationally representative data. METHODS: We used health examination data provided by the South Korean National Health Insurance System (NHIS) and included those who underwent the examination ≥ 3 times within five years of enrollment, without a previous history of depression (n = 9,058,424). The variability of each metabolic parameter including weight circumference, blood pressure, fasting blood glucose, high-density lipoprotein cholesterol, and triglyceride levels was estimated using variability independent of mean (VIM) indices. High variability was defined as the highest quartile (Q4) of variability. RESULTS: Each metabolic parameter with high variability was associated with a higher risk of newly diagnosed depression compared to those with low variability, after adjusting for age, sex, smoking, alcohol drinking, regular exercise, income status, baseline diabetes, hypertension, and dyslipidemia. As the number of highly variable metabolic parameters increased, the risk for newly diagnosed depression increased even after adjusting for the aforementioned covariates (hazard ratio (HR) = 1.4, 95% confidence interval (CI): 1.3 - 1.4 in those with five highly variable parameters compared to those with no highly variable parameter). LIMITATIONS: relatively short observation period; no systematic measure of depression severity. CONCLUSIONS: Our results suggest that the variability of metabolic parameters is an independent risk factor for depression.

6.
J Nerv Ment Dis ; 2021 Jul 06.
Artigo em Inglês | MEDLINE | ID: mdl-34238894

RESUMO

ABSTRACT: In this study, we defined obsessive thoughts (OT) as bothersome, unpleasant thoughts about oneself that keep entering the mind against one's will, and compulsive behavior (CB) as behavior that a person repeats against his or her wishes. The study included 12,532 adults selected randomly through a one-person-per-household method. Each subject selected underwent a face-to-face interview using the Korean version of the Composite International Diagnostic Interview with a questionnaire that examines lifetime suicide attempts (LSAs). Among the participants, 341 (2.74%) had OT and 639 (5.14%) had CB. The highest LSA rate was in subjects with both OT and CB, followed by those with either OT or CB; subjects with neither OT nor CB had the lowest LSA rate. In a multivariate logistic regression analysis of OT and CB, OT, ordering, and rituals of repeating words were significantly associated with LSAs. In subjects with OT and CB, those with MDD had a significantly higher risk of LSAs compared with those without, and MDD with both OT and CB showed odds of approximately 27-fold (adjusted odds ratio, 27.24; 13.29-55.82; p < 0.0001) compared with those without MDD, OT, or CB. OT and CB were associated with increased risk of LSAs, and comorbid MDD further increased LSAs.

7.
Aust N Z J Psychiatry ; : 48674211025701, 2021 Jul 07.
Artigo em Inglês | MEDLINE | ID: mdl-34231416

RESUMO

OBJECTIVE: To prevent copycat suicides following media reporting of celebrity suicides, the South Korean government enacted a 'suicide prevention law' in 2012 and revised the media guidelines for suicide reporting in 2013. This study examined how these two regulatory measures affected suicide trends among the general population in South Korea. METHODS: We analyzed the individual effect estimates for the general population within 30 days following the media report of 24 celebrity suicides using multivariate negative binomial regression. We performed a meta-analysis to compute the pooled rate ratios of the two regulations. We examined the trends in daily suicides by month during three time intervals before and after enactment using an autoregressive model and tested their significance using a piecewise linear regression. RESULTS: Total suicides increased by 6.27 daily during the 30-day period after celebrity suicides. Compared with the 30 days prior to the reports on the suicide of 24 celebrities, the number of suicidal deaths in the general population increased by 13% during the 30 days after the reports were announced (pooled rate ratio 1.13, 95% confidence interval: 0.06-0.18; p < 0.001). There was a significant downward trend in the average daily suicide deaths, and no significant increase in suicide rates, after the enactment of the suicide prevention law (p < 0.001) and revision of the media guidelines (p = 0.014). CONCLUSIONS: Suicide prevention and media guidelines were effective in reducing the effect of celebrity suicides. In addition to regulating media reporting of celebrity suicide, measures are needed to address viral republication on social media and to prevent suicide among entertainers.

8.
Sci Rep ; 11(1): 12744, 2021 06 17.
Artigo em Inglês | MEDLINE | ID: mdl-34140560

RESUMO

Patients with vascular diseases are prone to developing postoperative delirium (POD). Ankle brachial index (ABI) is a non-invasive clinical indicator of lower-extremities peripheral arterial disease (PAD) and has been identified as an indicator of cognitive impairment. We investigated the association between ABI and POD. 683 PAD patients who underwent elective leg arterial bypass surgery between October 1998 and August 2019 were collected for retrospective analysis. Demographic information, comorbidities, preoperative ABI and the Rutherford classification within one month prior to surgery were obtained. POD was assessed using the Confusion assessment method -intensive care unit. Logistic regression and receiver operating characteristics (ROC) curve analysis were used to assess the association between ABI and POD. The mean value of ABI was significantly lower in patients with POD than it was those without POD. Older age, more medical comorbidities, longer length of surgery, decreased ABI, and higher Rutherford class were all significantly associated with POD. The area under ROC (0.74) revealed that ABI below 0.35 was associated with development of POD. Lower preoperative ABI was associated with POD in PAD patients who underwent arterial bypass surgery.

9.
Sci Rep ; 11(1): 12139, 2021 06 09.
Artigo em Inglês | MEDLINE | ID: mdl-34108520

RESUMO

The use of virtual reality (VR) in the treatment of psychiatric disorders is increasing, and cybersickness has emerged as an important obstacle to overcome. However, the clinical factors affecting cybersickness are still not well understood. In this study, we investigated clinical predictors and adaptation effect of cybersickness during VR application in highly stressed people. Eighty-three healthy adult participants with high stress level were recruited. At baseline, we conducted psychiatric, ophthalmologic, and otologic evaluations and extracted physiological parameters. We divided the participants into two groups according to the order of exposure to VR videos with different degrees of shaking and repetitively administered the Simulator Sickness Questionnaire (SSQ) and the Fast Motion sickness Scale (FMS). There was no significant difference in changes in the SSQ or the FMS between groups. The 40-59 years age group showed a greater increase in FMS compared to the 19-39 years age group. Smoking was negatively associated with cybersickness, and a high Positive Affect and Negative Affect Schedule score was positively associated with cybersickness. In conclusion, changing the intensity of shaking in VR did not affect cybersickness. While smoking was a protective factor, more expression of affect was a risk factor for cybersickness.

10.
Artigo em Inglês | MEDLINE | ID: mdl-33811661

RESUMO

The majority of suicide decedents die on their initial attempt. To bring attention to suicide decedents without a suicide attempt history, the current study explored their demographic, clinical, and suicide-related characteristics. The data were derived from the Korea National Investigation of Suicide Victims Study, which assessed all suicide cases from 2013 to 2017 recorded in police investigation reports. We compared suicide decedents with and without a history of nonfatal attempts using the Korea Psychological Autopsy Checklist for Police Records (K-PAC). Out of 5228 cases included in our study, 3147 (60.2%) died on their first suicide attempt. Demographically, those who were male, older than 65, employed, and married/widowed were more likely to die on their initial attempt. Clinically, those who died on their initial attempt were more likely to have never been diagnosed with psychiatric disorders, whereas those who died on a repeated attempt were more likely to have been diagnosed with mood disorders. In terms of suicide-related factors, experiencing relationship problems and complaining about physical discomfort were associated with dying on an initial attempt. Depressed affect, self-harming behaviors, and talking about suicide or death were associated with repeated attempts.

11.
J Korean Med Sci ; 36(10): e72, 2021 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-33724739

RESUMO

BACKGROUND: Evidence continues to accumulate that the presence or absence of early trauma (ET) implies unique characteristics in the relationships between suicidal ideation and its risk factors. We examined the relationships among recent stress, depressive symptoms, anxiety symptoms, and suicidal ideation in Korean suicidal women with or without such a history. METHODS: Using data on suicidal adult females, 217 victims and 134 non-victims of ET, from the Korean Cohort for the Model Predicting a Suicide and Suicide-related Behavior, we performed structural equation modeling to investigate the contribution of recent stress, depressive symptoms, and anxiety symptoms on suicidal ideation within each group according to the presence or absence of a history of ET. RESULTS: Structural equation modeling with anxiety and depressive symptoms as potential mediators showed a good fit. Recent stress had a direct effect on both depressive symptoms and anxiety symptoms in both groups. Only anxiety symptoms for victims of ET (standardized regression weight, 0.281; P = 0.005) and depressive symptoms for non-victims of ET (standardized regression weight, 0.326; P = 0.003) were full mediators that increased suicidal ideation. Thus, stress contributed to suicidal ideation by increasing the level of anxiety and depressive symptoms for victims and non-victims, respectively. CONCLUSION: Tailored strategies to reduce suicidal ideation should be implemented according to group type, victims or non-victims of ET. Beyond educating suicidal women in stress-management techniques, it would be effective to decrease anxiety symptoms for those with a history of ET and decrease depressive symptoms for those without such a history.

12.
Artigo em Inglês | MEDLINE | ID: mdl-33638573

RESUMO

OBJECTIVE: Early recognition of a high-risk group impending suicide is important. We aimed to compare warning signs depending on the nature of the psychiatric disorder and whether it was a documented diagnosis. METHODS: Data of suicide decedents were collected from police records from 2013 to 2017. We evaluate psychiatric symptoms and warning signs in three aspects (language, behavior, and affect) using the Korea-Psychological Autopsy Checklist for Police Records (K-PAC-PR). RESULTS: A total of 13,265 suicide decedents were recruited for this study. Of them, 66.9% of females and 46.7% of males diagnosed psychiatric disorders, with depressive disorder being the most common one. Warning signs were observed in 93.0% of suicide decedents. They were observed more in those who were diagnosed with psychiatric disorders, especially in those with a depressive disorder. "Talking about dying or suicide" was the most common warning sign in all groups, and "apathetic behavior" was the most related warning sign for depressive disorder. Especially for "talking about dying or suicide," the proportion of observed "within a week" was high, making it valuable as a warning sign. CONCLUSION: Warning signs were commonly found in suicide decedents regardless of gender. They were more common among the decedents diagnosed with psychiatric disorders, especially among those with a depressive disorder.

13.
J Affect Disord ; 285: 47-54, 2021 04 15.
Artigo em Inglês | MEDLINE | ID: mdl-33631480

RESUMO

BACKGROUND: There is insufficient evidence of the association between oophorectomy and depression. METHODS: A nationwide medical records database of South Korea was used to investigate incidence rate ratios (IRRs) of major depressive disorder before and after oophorectomy (n = 36,284) using a self-controlled case series design. Outcomes before and after hysterectomy (n = 25,415) were identified to compare with those around oophorectomy. RESULTS: In all oophorectomy and hysterectomy groups, the risk of depression was increased before and after surgery, peaking immediately before or after the operation, with no significant difference in the pattern of the results according to type of surgery. In the bilateral oophorectomy group, the IRR was increased between 2-3 months before the surgery, peaking immediately before surgery at 1.39 (95% CI: 1.30-1.49, p < .0001), and remained heightened for one-year postexposure. Subgroup analyses performed according to ovarian cancer, age group, and hormone replacement therapy produced results similar to those of the main outcome. LIMITATIONS: Because we used claims data, the detailed clinical information related to oophorectomy is lacking. There is possibility that time-varying confounder besides age and season might have affected the results CONCLUSIONS: The risk of depression increased before and after oophorectomy. The increase in risk of depression started before oophorectomy and peaked immediately before or after the operation, but no significant differences between unilateral and bilateral surgery and cancer and noncancer or among age groups were noted.


Assuntos
Depressão , Transtorno Depressivo Maior , Estudos de Coortes , Transtorno Depressivo Maior/epidemiologia , Feminino , Humanos , Ovariectomia , República da Coreia/epidemiologia
14.
Psychiatry Investig ; 2021 Jan 19.
Artigo em Inglês | MEDLINE | ID: mdl-33321556

RESUMO

OBJECTIVE: To investigate the association between thyroidectomy and suicide attempt. METHODS: A nationwide population-based electronic medical records database of South Korea between January 1, 2009 and June 30, 2016 was used to investigate incidence rate ratios (IRRs) of suicide attempts and probable suicide attempts before and after thyroidectomy using a self-controlled case series design. RESULTS: In 2,986 patients who attempted suicide or probable suicide, the IRRs of suicidal behaviors during risk periods one year before and after thyroidectomy were investigated. Generally, after thyroidectomy, there was no increase in IRR compared to the non-risk period. When data were analyzed according to thyroidectomy type, after partial thyroidectomy, IRR increased up to 1.43 (95% CI: 1.03-1.98, p=0.032) in the days 91-181 period. In the subgroup with major depressive disorder (MDD), the IRR increased up to 1.74 (95% CI: 1.21-2.51, p=0.003) before thyroidectomy, and increased up to 1.67 (95% CI: 1.16-2.41, p=0.006) after thyroidectomy. CONCLUSION: Although the general risk of suicide attempt was not increased after thyroidectomy, patients with MDD showed increased risk of suicide attempt before and after thyroidectomy. These results suggest that suicidality should be evaluated when depressive symptoms are present in patients who have undergone thyroidectomy.

15.
Psychiatry Investig ; 2021 Jan 19.
Artigo em Inglês | MEDLINE | ID: mdl-33321557

RESUMO

OBJECTIVE: Electro-convulsive therapy (ECT) has been established as a treatment modality for patients with treatment-resistant depression and with some specific subtypes of depression. This narrative review intends to provide psychiatrists with the latest findings on the use of ECT in depression, devided into total eight sub-topics. METHODS: We searched PubMed for English-language articles using combined keywords and tried to analyze journals published from 1995-2020. RESULTS: Pharmacotherapy such as antidepressants or maintenance ECT is more effective than a placebo as prevention of recurrence after ECT. The use of ECT in treatment-resistant depression, depressed patients with suicidal risks, elderly depression, bipolar depression, psychotic depression, and depression during pregnancy or postpartum have therapeutic benefits. As possible mechanisms of ECT, the role of neurotransmitters such as serotonin, dopamine, gamma-aminobutyric acid (GABA), and other findings in the field of neurophysiology, neuro-immunology, and neurogenesis are also supported. CONCLUSION: ECT is evolving toward reducing cognitive side effects and maximizing therapeutic effects. If robust evidence for ECT through randomized controlled studies are more established and the mechanism of ECT gets further clarified, the scope of its use in the treatment of depression will be more expanded in the future.

16.
J Psychiatr Res ; 133: 73-81, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33310645

RESUMO

Previous studies have investigated the role of inflammatory markers in suicidality of patients with major depressive disorder (MDD) or panic disorder (PD). However, few studies have investigated associations between serum inflammatory cytokine levels and suicidality. We hypothesized that MDD and PD status might be significantly associated with serum inflammatory cytokines and that we could predict levels of improvement in suicide ideation intensity using serum inflammatory biomarkers in patients with MDD and PD. For this study, 41 patients with MDD, 52 patients with PD, and 59 healthy control (HC) subjects were enrolled. Psychological measurements and serum inflammatory markers such as interleukin (IL) -6, -10, interferon (IFN)-γ, tumor necrosis factor (TNF)-α, and C reactive protein (CRP) were examined. A total of five visits were completed during 12 weeks. After controlling for confounding factors, log-transformed IL-6 (ln_IL-6) at baseline (MDD: 0.297 ± 0.626; PD: 0.342 ± 0.723; HC: -0.121 ± 0.858; p = 0.007, >0.0017, 0.05/30) and mean ln_IL-6 (MDD: 0.395 ± 0.550, PD: 0.249 ± 0.544, HC: -0.139 ± 0.622, p = 0.002, >0.0017, 0.05/30) levels were trends towards significantly higher in patients with MDD and PD than in HC. In MDD patients, a higher level of basal ln_TNF-α was a significant predictor of ΔSSI (changes in SSI scores between baseline and week 12) even after controlling for changes of depression symptoms and baseline SSI scores (standardized ß = 0.541, p = 0.002 < 0.0028, 0.05/18). In conclusion, we could predict ΔSSI using baseline inflammatory biomarkers for patients with MDD.


Assuntos
Transtorno Depressivo Maior , Transtorno de Pânico , Biomarcadores , Seguimentos , Humanos , Ideação Suicida
17.
Psychiatry Investig ; 17(11): 1118-1125, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33198437

RESUMO

OBJECTIVE: In this study, we aimed to determine clinical correlates of false positive assignment (FPA) on commonly used bipolar screening questionnaires. METHODS: A retrospective chart review was conducted to a total of 3885 psychiatric outpatients. After excluding patients who have bipolar spectrum illnesses, patients who were assigned as having hypomania on the mood disorder questionnaire (MDQ) or the hypomania checklist-32 (HCL-32) were identified as patients who had FPA. Psychiatric diagnoses and severity of emotional symptoms were compared between patients with and without FPA. RESULTS: Patients with FPA on the MDQ showed significant associations with presence of major depressive disorder, generalized anxiety disorder, and alcohol-use disorder, while patients with FPA on the HCL-32 showed associations with presence of panic disorder and agoraphobia. FPA on the MDQ was also associated with greater emotional symptoms and lifetime history of suicide attempts. Logistic regression analysis showed that male sex, younger age, presence of alcohol-use disorder, and severity of depression and obsessive-compulsive symptoms were significantly associated with FPA on the MDQ. CONCLUSION: The FPA for the MDQ was associated with clinical factors linked to trait impulsivity, and the FPA for both the MDQ and the HCL-32 could be related to increased anxiety.

18.
Psychiatry Investig ; 17(11): 1149-1157, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33190455

RESUMO

OBJECTIVE: Suicide is a huge nationwide problem that incurs a lot of socio-economic costs. Suicide also inflicts severe distress on the people left behind. The government of the Republic of Korea has been making many policy efforts to reduce suicide rate. The gatekeeper program, 'Suicide CARE', is one of the meaningful modalities for preventing suicide. METHODS: Multidisciplinary research team collaborated to update the 'Suicide CARE' to version 2.0. RESULTS: In the 'Introductory part', the authors have the time to think about the necessity and significance of the program before conducting full-scale gatekeeper training. In the 'Careful observation' part, trainees learn how to understand and recognize the various linguistic, behavioral, and situational signals that a person shows before committing suicide. In the 'Active listening' part, trainees learn how to ask suicide with a value-neutral attitude as well listening empathetically. In the 'Risk evaluation and Expert referral' part, trainees learn intervening strategies to identify a person's suicidal intention, plan, and past suicide attempts, and connect the person to appropriate institutes or services. CONCLUSION: Subsequent studies should be conducted to verify the efficacy of the gatekeeper program.

19.
J Psychiatr Res ; 131: 1-8, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32891923

RESUMO

Few studies have compared the three suicidality groups-suicidal ideators (SIs), single suicide attempters (SSAs), and multiple suicide attempters (MSAs)-in relation to the suicidal process. This cross-sectional study investigated trends and differences in suicide risk factors across suicidality groups. Using the baseline data of the Korean Cohort for the Model Predicting a Suicide and Suicide-related Behavior, we analyzed trends (Jonckheere-Terpstra or Mantel-Haenszel χ2 test) and differences (analysis of covariance or logistic regression) in sociodemographic and clinical factors, psychiatric diagnoses, as well as clinical rating scores on psychopathology (suicidal ideation, depressive symptoms, anxiety symptoms, and problem drinking), trait impulsiveness, and stress across suicidality groups. Across suicidality groups comprising 193 SIs, 207 SSAs, and 376 MSAs, we observed a decreasing trend in age and increasing trends in history of early trauma, familial histories of suicide attempts and suicide, most diagnoses and psychopathologies (suicidal ideation, anxiety symptoms, and problem drinking), trait impulsiveness, and stress-with MSAs more likely to have histories of early trauma and familial suicide, almost uniformly higher proportions of diagnoses, and higher psychopathology rating scores. Overall, increasing trends in suicide risk factors were found across all suicidality groups. Notably, MSAs presented greater proportions of most psychiatric diagnoses and higher degrees of most psychopathologies, motor impulsiveness, and stress, indicating they were at more severe clinical states and were closer to suicide. Mental health professionals should ascertain the number of suicide attempts to identify MSAs, implement more thorough evaluations, and employ additional measures for reducing motor impulsiveness.


Assuntos
Ideação Suicida , Tentativa de Suicídio , Estudos de Coortes , Estudos Transversais , Humanos , Fatores de Risco
20.
J Korean Med Sci ; 35(37): e319, 2020 Sep 21.
Artigo em Inglês | MEDLINE | ID: mdl-32959544

RESUMO

BACKGROUND: This study investigated the impact of getting older than the mean marriage age on mental disorders and suicidality among never-married people. METHODS: We performed an epidemiological survey, a nationwide study of mental disorders, in 2016. In this study, a multi-stage cluster sampling was adopted. The Korean version of the Composite International Diagnostic Interview was conducted with 5,102 respondents aged 18 years or above. The associations between never-married status, mental disorders, and suicidality were explored according to whether the mean age of first marriage (men = 32.8 years; women = 30.1 years) had passed. RESULTS: Never-married status over the mean marriage age was associated with agoraphobia, obsessive-compulsive disorder, mood disorders, and major depressive disorder after adjusting for sociodemographic factors. Respondents with never-married status above the mean marriage age were associated with suicide attempts (adjusted odds ratio [aOR], 3.21; 95% confidence interval [CI], 1.36-7.60) after controlling for sociodemographic factors and lifetime prevalence of mental disorders, while respondents with never-married status under the mean marriage age were not. Moreover, in respondents with never-married status, getting older than the mean marriage age was associated with suicidal ideations (aOR, 1.49; 95% CI, 1.04-2.15) and suicide attempts (aOR, 3.38; 95% CI, 1.46-7.84) after controlling for sociodemographic factors and lifetime prevalence of mental disorders. CONCLUSION: Never-married status above the mean first marriage age was associated with mental disorders and suicidality. These findings suggest the need for a national strategy to develop an environment where people with never-married status do not suffer even if their marriage is delayed.

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