Suicide In Korea Research Articles

Determinants of Mental Health Care Utilization in a Suicide High-risk Group With Suicidal Ideation.

Objectives:The suicide rate in Korea is increasing every year, and is the highest among the Organization for Economic Cooperation and Development countries. Psychiatric patients in particular have a higher risk of suicide than other patients. This study was performed to evaluate determinants of mental health care utilization among individuals at high risk for suicide.Methods:Korea Health Panel data from 2009 to 2011 were used. Subjects were individuals at high risk of suicide who had suicidal ideation, a past history of psychiatric illness, or had utilized outpatient services for a psychiatric disorder associated with suicidal ideation within the past year. The chi-square test and hierarchical logistic regression were used to identify significant determinants of mental health care utilization.Results:The total number of subjects with complete data on the variables in our model was 989. Individuals suffering from three or more chronic diseases used mental health care more frequently. Mental health care utilization was higher in subjects who had middle or high levels of educational attainment, were receiving Medical Aid, or had a large family size.Conclusions:It is important to control risk factors in high-risk groups as part of suicide prevention strategies. The clinical approach, which includes community-based intervention, entails the management of reduction of suicidal risk. Our study identified demographic characteristics that have a significant impact on mental health care utilization and should be considered in the development of suicide prevention strategies. Further studies should examine the effect of mental health care utilization on reducing suicidal ideation.

착화탄 연소에 의한 일산화탄소 중독사에서 자살입증에 관한 사례연구

Carbon monoxide (CO) intoxication, arising from CO from an ignited charcoal briquette (ICB), is a popular means of committing suicide in Korea. Most CO intoxications are related to suicide attempts; however, the possibility of a homicide disguised as a suicide cannot be ruled out. Therefore, forensic investigation of the deceased and the crime scene is crucial to confirm that the deceased committed suicide. Detection of the components of an ICB on the objects suspected of being contacted by the deceased, such as the hands, nostrils, and doorknobs, is essential for linking the crime scene to the victim in the case of suicides by ignited ICBs. The traces from an ICB were analyzed by investigating the morphological characteristics and obtaining elemental compositions. The ICBs were completely different from blackened wood, as detected by discriminant analysis with the elements of carbon and oxygen. We analyzed one case of CO intoxication to demonstrate an excellent procedure for verifying whether a suicide occurred with an ICB. We employed SEM-EDX for the analysis of an ICB, microscope-FT/IR and pyrolysis-GC/MS for a partly burnt resin-type substance, GC/MS for diphenhydramine (a sleeping drug), and GC/TCD for the CO-Hb level. We detected traces of an ICB on the hands, nostrils, and doorknobs, which were all discriminated into an ICB group. Detection of ICB traces from the nostrils could indicate that the deceased started the fire themselves to commit suicide. The partially burnt black material was analyzed as an acrylronitrilestyrene polymer, which is normally used to make bags for carrying or wrapping and could be assumed to have been used to transport the ICB. Diphenhydramine, a sleeping drug, was detected at a level of 2.3 mg/L in the blood, which was lower than that in fatal cases (8-31 mg/L; mean 16 mg/L). A CO-Hb level of 79% was found in the blood, which means that the cause of death was CO intoxication. The steps shown here could represent an ideal method for reaching a verdict of suicide by CO intoxication produced by burning an ICB in a sealed room or a car.

Changes in South Korean urbanicity and suicide rates, 1992 to 2012

ObjectivesStudies have highlighted the association between the degree of urbanicity and spatial disparities in suicide, but few have evaluated its changes across time. We explored the geospatial trends of suicide...

Impact of paraquat regulation on suicide in South Korea.

Ingestion of pesticides (mainly paraquat) accounted for one-fifth of suicides in South Korea in 2006-10. We investigated the effect on suicide mortality of regulatory action, culminating in a ban on paraquat in South Korea in 2011-12. We calculated age-standardized method-specific suicide mortality rates among people aged ≥15 in South Korea (1983-2013) using registered death data. Negative binomial regression was used to estimate changes in the rate and number of pesticide suicides in 2013, compared with those expected based on previous trends (2003-11). Pesticide suicide mortality halved from 5.26 to 2.67 per 100 000 population between 2011 and 2013. Compared with the number expected based on previous trends, the regulations were followed by an estimated 847 [95% confidence interval (CI) -1180 to -533] fewer pesticide suicides, a 37% reduction in rates (rate ratio = 0.63, 95% CI 0.55 to 0.73) in 2013. The decline in pesticide suicides after the regulations was seen in all age/sex/geographical groups. The absolute reduction in the number of suicides was greatest among men, the elderly and in rural areas. The reduction in pesticide suicides contributed to 56% of the decline in overall suicides that occurred between 2011 and 2013. There was no impact of the regulations on crop yield. The regulation of paraquat in South Korea in 2011-12 was associated with a reduction in pesticide suicide. Further legislative interventions to prevent the easy availability of highly lethal suicide methods are recommended for reducing the number of suicides worldwide.

Copycat Suicide Induced by Entertainment Celebrity Suicides in South Korea.

ObjectiveThroughout the past several years, there have been a number of entertainment celebrity suicides in South Korea. The aim of this study was to investigate the clustering of suicides following celebrities' suicides in South Korea from 2005 to 2008, particularly according to certain characteristics.MethodsSeven celebrity suicides were examined and defined using the Korean Integrated Newspaper Database System (KINDS) and from these, we considered four affected periods occurring 28 days after each celebrity's suicide. A Poisson time-series autoregression model was used to estimate the relative risk of the total suicide number for each affected period from 2005 to 2008. Logistic regression analysis was performed to investigate whether there were specific increases in the numbers of suicides in subgroups matching each celebrity.ResultsThere were significant increases in the risk of suicide during the affected periods. Remarkable increases were found in the subgroups matching each celebrity, especially in the group in which all factors (sex, age, and method) were similar.ConclusionThis study provides confirmation that a significant copycat effect was induced by these celebrities' suicides, especially among people who identified more with the celebrities. This implies that countermeasures for upright media coverage of celebrity suicides should be discussed and practiced properly in South Korea.

The usefulness of S100 protein as a predictive factor in patients with hanging injury

Hanging is one of the leading method of suicide in South Korea [1]. Brain injury due to hanging leads to the high mortality rate and the severe neurological sequelae [2, 3]. Serum S100 for predicting the brain injury in hanging injury is not evaluated.

Biomechanical analysis of biphasic distribution of skull injury in falls from height

Fall from height is one of the most common ways of suicide in Korea. Skull fractures are typically accompanied with these cases, but several autopsy cases show absence of skull fracture even with serious body injuries including sternal and vertebral fracture. The mechanism of this pattern of injury can be explained by impact of facial part on chest or abdomen when the back of the body touches the ground first. We tried to figure out the relevance of this pattern of injury to the height of fall using a computer simulation tool (MADYMO 7.5). For this experiment, a condition of initial pose was limited to leaning forward. The simulation showed that when the body rotated forward, the body parts which got injured by the ground depended on the height of fall. For relatively lower height, head got injured, but as the height was set higher, the point of first impact area changed to the back, hip and then legs. When the body struck first around hip area on supine position, the impact made forceful flexion of lumbar, thoracic and cervical vertebrae, leading to folding the body in two, which resulted in collision between the part of face and the anterior part of body. Through the current investigation, it was explained that the biphasic distribution of the number of head injury cases versus the height distribution was attributed to the forward rotation of the body during the fall.

Paraquat prohibition and change in the suicide rate and methods in South Korea.

The annual suicide rate in South Korea is the highest among the developed countries. Paraquat is a highly lethal herbicide, commonly used in South Korea as a means for suicide. We have studied the effect of the 2011 paraquat prohibition on the national suicide rate and method of suicide in South Korea. We obtained the monthly suicide rate from 2005 to 2013 in South Korea. In our analyses, we adjusted for the effects of celebrity suicides, and economic, meteorological, and seasonal factors on suicide rate. We employed change point analysis to determine the effect of paraquat prohibition on suicide rate over time, and the results were verified by structural change analysis, an alternative statistical method. After the paraquat prohibition period in South Korea, there was a significant reduction in the total suicide rate and suicide rate by poisoning with herbicides or fungicides in all age groups and in both genders. The estimated suicide rates during this period decreased by 10.0% and 46.1% for total suicides and suicides by poisoning of herbicides or fungicides, respectively. In addition, method substitution effect of paraquat prohibition was found in suicide by poisoning by carbon monoxide, which did not exceed the reduction in the suicide rate of poisoning with herbicides or fungicides. In South Korea, paraquat prohibition led to a lower rate of suicide by paraquat poisoning, as well as a reduction in the overall suicide rate. Paraquat prohibition should be considered as a national suicide prevention strategy in developing and developed countries alongside careful observation for method substitution effects.

베이지안 모형을 활용한 국내 노인 자살률 질병지도

Elderly suicide rates tend to be high in Korea. Suicide by the elderly is no longer a personal problem; consequently, further research on risk and regional factors is necessary. Disease mapping in epidemiology estimates spatial patterns for disease risk over a geographical region. In this study, we use a simultaneous conditional autoregressive model for spatial correlations between neighboring areas to estimate standard mortality ratios and mapping. The method is illustrated with cause of death data from 2006 and 2010 to analyze regional patterns of elderly suicide in Korea. By considering spatial correlations, the Bayesian spatial models, mean educational attainment and percentage of the elderly who live alone was the significant regional characteristic for elderly suicide. Gibbs sampling and grid method are used for computation.

Association between air pollution and suicide in South Korea: a nationwide study.

Suggestive associations of suicide with air pollutant concentrations have been reported. Recognizing regional and temporal variability of pollutant concentrations and of suicide, we undertook a detailed meta-analysis of completed suicides in relation to 5 major pollutants over 6 years in the 16 administrative regions of the Republic of Korea, while also controlling for other established influences on suicide rates. Of the 5 major pollutants examined, ozone concentrations had a powerful association with suicide rate, extending back to 4 weeks. Over the range of 2 standard deviations (SD) around the annual mean ozone concentration, the adjusted suicide rate increased by an estimated 7.8% of the annual mean rate. Particulate matter pollution also had a significant effect, strongest with a 4-week lag, equivalent to 3.6% of the annual mean rate over the same 2 SD range that approximated the half of annual observed range. These results strongly suggest deleterious effects of ozone and particulate matter pollution on the major public health problem of suicide.

AHP기법을 이용한 우리나라 자살예방정책의 우선순위 설정

우리나라는 2004년부터 지금까지 OECD 국가 가운데 자살사망률 1위이며, 지속적으로 자살자 수와 자살사망률이 증가하고 있다. 효과적인 자살정책을 확인하기 위해 AHP(Analytic Hierarchy Process) 기법을 이용하여 자살예방의 주요 접근방법별 세부정책들의 우선순위를 조사하였다. 설문은 2013년 8월 23일, 26일 두 차례에 걸쳐 총 30명을 대상으로 워크숍 형식으로 실시하였다. 이중 학계는 20명(사회복지사 4명, 정신보건학자 7명, 정신의학자 5명, 임상심리학자 4명), 정책결정자는 5명, 공급자는 5명이였다. 2013년 9월 9일부터 12일까지 4일간 이메일로 사회복지분야와 임상심리분야에서 각각 5명씩 추가하여 총 40명을 대상으로 조사를 하였다. 세부 정책들의 중요도는 '자살시도자 관리,' '공공자살예방서비스 인프라 구축,' '유가족 지원사업,' '위험집단의 위기관리' 등의 정책에서 높은 것으로 나타났다. Since 2004 suicide in Korea was the number 1 cause of mortality among OECD countries, the suicides and suicide mortality rate is constantly increasing. Using AHP(Analytic Hierarchy Process), we examined the main approaches and detailed policies of suicide prevention to confirm an effective suicide policy. A workshop and survey were conducted on August 23rd and 26th, 2013, with 30 people. There were 20 academics (4 social workers, 7 mental health workers, 5 psychiatrists, 4 clinical psychologists), and 5 policymakers and 5 administrative staff. In additional 5 people from social welfare and 5 from clinical psychology fields were survey from september 9 to 12 by e-mail. The research found 4 priorities. They include, suicide attempt management, building up public infrastructure for suicide prevention, support to bereaved families, and crisis management of high risk groups in society.

Association between Media Reporting and a Lower Suicide Rate in 2012

Objectives ZZA recent study conducted by the Korea National Statistical Office (KNSO) reported that the suicide rate in Korea decreased in 2012. The aim of this study was to investigate the association between the decrease in suicide rate and media reporting of suicide events. MethodsZZData on suicide rates were obtained from the KNSO. Correlation between suicide rate and celebrity suicide events, number of media reports on suicide, and suicide searches was compared. Data were analyzed using Pearson’s correlation coefficient. ResultsZZThe number of celebrity suicide events and recognition of celebrity decreased in 2012. Pearson’s correlation test showed a significant positive correlation between the monthly number of media reports on suicide and the suicide rate (daily newspaper r=0.619, p<0.001 ; broadcast r=0.393, p<0.001). The number of suicide searches showed association with celebrity suicide events. ConclusionZZThe suicide rate may be influenced by the number of media reports on suicide events. Establishing guidelines for media reporting on these events could help to decrease the suicide rates.

Understanding Suicide in South Korea: Social Integration in the Time of Uncertainty

Understanding Suicide in South Korea: Social Integration in the Time of Uncertainty

Difference in suicide methods used between suicide attempters and suicide completers

BackgroundIn light of the increased suicide rate in Korea, it has become important for researchers to examine the various factors associated with it. The purpose of this study is to compare and analyze the difference between suicide attempters and completers in terms of the suicide methods used and the lethality of these methods. In addition, we investigated certain demographic factors that are associated with the choice of suicide method by evaluating their lethality.FindingThe most frequently used methods of suicide were different in the two groups of attempters and completers. Drug poisoning was the most frequent method in suicide attempters, whereas hanging was the most common method among suicide completers. Drug poisoning, stabbing, and other chemical poisoning were evaluated as relatively non-lethal compared to other suicide methods. While about 70.0% of the suicide attempters used relatively non-lethal methods, almost all suicide completers used lethal methods, based on our classification of the lethality of the method. In terms of gender, males used more lethal methods of suicide.ConclusionsSuicide completers’ choice of suicide methods are different from those of suicide attempters and tend to be more lethal. Interventions to restrict access to more lethal suicidal methods could be a useful strategy to reduce the suicide rates in South Korea.

People on the verge of death: evidence from impacts of celebrity suicides

We attempt to identify the population who are vulnerable to emotional shocks by exploiting an unprecedented series of celebrity suicides in South Korea during the last decade, including one of the most famous actresses, as well as a former president. Our conservative estimates show that for 5 out of 11 celebrity suicides observed, 1 celebrity suicide on average yielded to more than 10 excessive suicides per day over a time frame of at least 2 weeks. The results indicate that a significant number of people are very much mentally unstable to end their life by emotional shocks that should be irrelevant to their economic status.

Economic Hardship, Social Welfare and Suicide in Korea

Economic Hardship, Social Welfare and Suicide in Korea

문화시설과 도시공원이 지역별 자살률에 미치는 영향

Abstract This study examined the effects of cultural facilities and city parts on the regional suicide rates in Korea.Data of theaters, exhibition facilities, libraries and city parts was collected in 143 local areas governments. The number of theaters and the size of city parts had a significant effect on decreasing the regional suicide rates in the areas, and the number of exhibition facilities had partial impacts. This result suggests that the dynamic components of a culture and arts environments may work more effectively to relieve depression and stress and decrease the suicide rates. This study suggests that the cultural welfare environments can be found to solve the problem of the high suiciderates in Korea. Key Words : Suicide Rates; Cultural Welfare Environments; Cultural Facilities; City Parks 이 논문은 2014학년도 홍익대학교 학술연구진흥비에 의하여 지원되었음 * Corresponding Author : Hyung-Deok Shin(Hongik. Univ.)Tel: +82-10-3742-4700 email: shinhd@hongik.ac.krReceived May 14, 2014 Revised (1st June 27, 2014, 2nd July 10, 2014) Accepted August 7, 2014

To what extent does the reporting behavior of the media regarding a celebrity suicide influence subsequent suicides in South Korea?

This study investigated the nature of media coverage of a national entertainer's suicide and its impact on subsequent suicides. After the celebrity suicide, the number of suicide-related articles reported surged around 80 times in the week after the suicide compared with the week prior. Many articles (37.1%) violated several critical items on the World Health Organization suicide reporting guidelines, like containing a detailed suicide method. Most gender and age subgroups were at significantly higher risk of suicide during the 4 weeks after the celebrity suicide. Results imply that massive and noncompliant media coverage of a celebrity suicide can cause a large-scale copycat effect.

Rapid spread of suicide by charcoal burning from 2007 to 2011 in Korea

Despite rapid increase of suicide by charcoal burning within 5 years, little is known about the characteristics of charcoal burning suicide in Korea. This study aimed to examine the trends and risk factors in the spread of suicide using this method. We identified an association between media reporting of suicide by charcoal burning and its incidence. Data on suicide from 2007 to 2011 were obtained from the Korean National Statistical Office. Cross-correlation analysis was used. Increasing incidence of suicide by charcoal burning was correlated with higher education levels, male sex, and the latter half of the year. Victims of charcoal burning suicide were more likely to be young, male, single, highly educated, professional, urban-based, and to die between October and December. Internet reports of suicide via charcoal burning tended to precede the increased incidence of suicide using this method, but only during the early period of the suicide epidemic. Our findings suggest that one episode of heavy media coverage of a novel method, such as charcoal burning, is sufficient to increase the prevalence of suicide by that method even after media coverage decreases. These findings are expected to contribute to the prevention of increasing rates of suicide by charcoal burning.

Suicide from carbon monoxide poisoning in South Korea: 2006–2012

BackgroundsSuicide from carbon monoxide poisoning by burning coal briquette or barbecue charcoal increased rapidly in some East Asian countries in the recent decade. The purpose of this study was to examine trends in suicides from carbon monoxide poisoning in South Korea and their epidemiologic characteristics. MethodsWe presented age-standardized mortality rates of carbon monoxide suicide and compared them with those of suicide by other methods using registered death data from Statistics Korea (South Korea) from 2006 to 2012. Logistic regression analysis was conducted to estimate odds ratios of carbon monoxide suicide by socio-demographic characteristics before and after the marked increase in carbon monoxide suicide in September 2008. ResultsThe number of carbon monoxide suicides in South Korea was only 34 in 2006 but rapidly increased to 267 in 2008 and was 1125 in 2012, with the age-standardized rates of 0.06 (2006), 0.48 (2008), and 1.97 (2012) per 100,000 population respectively (a striking 3,183% increase in 2006–2012). Suicide by carbon monoxide poisoning showed greater odds ratios among men, younger age groups, single or the divorced, and those with high education and non-manual jobs compared with suicides by other methods. LimitationsThis study only used data for fatal self-poisoning by carbon monoxide (non-fatal cases not included) and had no information on the sources of carbon monoxide. ConclusionsCarbon monoxide suicides substantially increased in South Korea over the relatively short study period and showed some distinct socio-demographic characteristics compared with suicides by other methods.