자살 및 자살시도자의 임상적 특성과 2~4년내 재시도율 (Clinical Characteristics of Completed versus Non-Completed Suicide and Re-Attempt Rates in 2-4 Years)

서지정보

· 발행기관 : 대한신경정신의학회
· 수록지 정보 : 신경정신의학 / 48권 / 6호 / 487 ~ 494페이지
· 저자명 : 정우영, 강철중, 이병대, 이영민, 박제민

초록

자살로 사망한 군의 2/3는 첫 번째 자살시도로 사망하였다. 이들은 자살시도 이전에 정신과에서 진료를 받은 적이 없으며, 자살시도 이후에도 정신과에 의뢰되지 않았다. 보다 효과적인 자살 선별도구 및 예방 프로그램을 만들기 위해 정신의학적 부검이 필요하다.

영어초록

Objectives: We compared demographic and some clinical characteristics of completed and noncompleted suicide victims with those of non-completed. Additionally, we analyzed Re-attempt rates of non-completed suicides’ in 22-4 years re-attempt ratesfrom index-attempt were also analyzed.
Methods: Subjects were 198 suicide victims visited admitted to the Pusan National University Hospital Eemergency medical center after attempting suicide of Pusan national university hospital during 2005.1.1-to 2006.12.31. Data In February 2009, we retrospectively collected the data on these persons were collected retrospectively in Feb. 2009 fromvia medical records and telephone interviews. We analyzed their demographic data, history of previous suicide attempts, psychiatric treatments, if any, and number of re-attempts in during the 2-4 years after the index-attempt were analyzed.
Results: Thirty-three were deadvictims were killed by the attempt (completed suicides), and 165 were discharged alive (non-completed suicides). Only 94 cases victims (47.5%) were consulted referred to the psychiatric department. Among the 121 survivors followedsurvivors we followed-up on, 17 (14.0%) re-attempted within 2-4 years and 2 (1.2%) were dead eventuallydied within that
time frame. Twenty one (63.6%) of the 33 completed suicidesuicides, 21 (63.6%) were making their were dead by the first suicide attempt. No psychiatrist was contacted regarding these victims and did not received any psychiatric evaluation nor treatment. The completed group was characterized
ascharacteristically consisted of men who were‘older, married, and/or physically ill men’. Fortyfive (27.3%) of 165 non-completed suicides had previous historiesy of suicide attempts. The noncompleted group was characterized by higher rates of previous history of psychiatric treatment, psychiatric referrals, and re-attempts during the followed-up period. Sixty-five (53.7%) of the survivors received psychiatric treatments for 8.9±15.4 months (mean±SD), but their re-attempt rate (16.9%) in over 2-4 years did not significantly differ from that (10.7%) of those who did not receive treatment (10.7%).
Conclusion: About 2/3 of completed suicides occurs at the first attempt. These cases were on in psychiatry’ the blind spot, of psychiatry because most of them did not visited psychiatry receive psychiatric attention when they were alive and were not reported to the psychiatry department after death. Psychiatric autopsies on such victims arey is necessary to develop more effective suicide screening tools and preventionve programs.

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