Analysis of risk factors affecting a suicidal attempter exposing suicidal intensions for the development of the active intervention strategy for suicide prevention

Kim, Ji-Min; Lee, Hae-Ju; Ju, Ga-Won; Kim, Sang-Chul; Jeon, Hyuk-Jin; Park, Gwan-Jin; In, Yong-Nam; Kim, Hoon; Lee, Seok-Woo

J Korean Soc Emerg Med > Volume 30(2); 2019 > Article

Original Article

Journal of The Korean Society of Emergency Medicine 2019;30(2): 155-165.

적극적 자살예방 중재 전략 개발을 위한 자살 의도를 노출한 자살시도자의 위험요인 분석

김지민¹

¹충북대학교병원 응급의학과
²충북대학교병원 정신건강의학과
³춘해대학교 응급구조학과

Analysis of risk factors affecting a suicidal attempter exposing suicidal intensions for the development of the active intervention strategy for suicide prevention

¹Department of Emergency Medicine, Chungbuk National University Hospital, Cheongju, Korea
²Department of Psychiatry, Chungbuk National University Hospital, Cheongju, Korea
³Department of Emergency Medical Technology, Choonhae College of Health Sciences, Ulsan, Korea

Correspondence

Sang-Chul Kim ,Tel: 043-269-7853, Fax: 043-269-7810, Email: ooiarahan@nate.com,

Received: August 15, 2018; Revised: October 8, 2018 Accepted: October 10, 2018. Published online: April 30, 2019.

ABSTRACT

Objective:
This study examined the clinical characteristics of suicide attempters who exposed their suicidal intension to suggest an active intervention strategy for suicide prevention based on the regional emergency medical service system.
Method:
A prospective database of suicide attempters who visited the emergency department of Chungbuk National University Hospital between October 2013 and December 2017 was used. All of the adult patients who provided consent for the initial assessment for suicidal attempters were eligible, excluding cases with unknown exposure of suicidal intension. The primary and secondary endpoints were the risk factors affecting exposure to the suicidal intension and characteristics of the exposure group. The adjusted odds ratios (AORs) of exposure to suicidal attempts after adjusting for potential confounders was calculated.
Results:
Of a total 1,035 suicidal attempters enrolled, 332 (32.1%) were included in the exposure group. The exposure group was more likely to have an educational level above high school and no religion, and have suicidal characteristics at night time (18:00-08:00), under the influence of alcohol, suicidal plan before 1 week, and suicidal method involving asphyxia (P<0.05). The exposure group was more likely to have no guardian (AORs, 1.46; 95% confidence interval [CI], 1.00-2.12), use methods involving asphyxia (AORs, 2.07; 95% CI, 1.46-2.91), and attempt suicide at night (18:00 to 08:00) (AORs, 1.38; 95% CI, 1.05-1.83) compared to the no exposure group.
Conclusion:
Models need to be established, where regional mental health welfare center, local government, fire headquarter, and tele-communication companies can participate in the implementation of an active intervention strategy.

Key words: Attempted suicide; Suicidal ideation; Emergency medical services; Prevention and control