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

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. METHODS: 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.

Survey of Influencing Factors on Depression and Anxiety in Vietnamese Marriage Immigrant Women

OBJECTIVES: The number of marriage immigrant women has been increasing in the past several years in Korea and their adaptations to the new environment have been an important social issue. The aims of this study were to evaluate the psychosocial and mental health statuses of Vietnamese marriage immigrant women (VMIW). We intended to compare the mental health of VMIW with married Vietnamese women living in Vietnam and reveal the demographic or psychosocial factors affecting their mental health. METHOD: Subjects comprised one-hundred-forty-three VMIW who enrolled in multiculture family support centers in Chungbuk Province and forty-eight women from Vinh Phuc province in Vietnam. Marital satisfaction, domestic violence and social support were evaluated as psychosocial factors, and the Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI) and General Health Questionnaire (GHQ) were used to evaluate mental health. RESULTS: VMIW had a larger age gap with their husbands but better psychosocial statuses. BDI (p = 0.20), BAI (p = 0.08), GHQ (p = 0.13) scores of VMIW were not significantly different compared to Vietnamese residents. Marriage duration of VMIW affects significantly their marital satisfaction, social support and depressive levels (p < 0.01). The level of domestic violence showed a significant difference according to the educational levels of their husbands, composition of family members and marriage process (p < 0.05). VMIW with older husbands and jobless VMIW had low levels of anxiety (p < 0.01). CONCLUSION: The results suggest that VMIW have no difference in mental health compared to Vietnamese women living in Vietnam which is contrary to general expectations. However, various environmental factors, such as marriage duration, have an effect on the mental health of VMIW. As marriage duration is proven to be important factor on mental health of VMIW, more extended duration of care and interventions are needed to maintain good mental health. Networking system connecting mental health screenings by the multiculture family support center to the local mental healthcare center is needed to care those with poor screening outcomes.

The Role of Job Stress and Brain-Derived Neurotrophic Factor Gene Polymorphism on the Severity of Alcohol Drinking in Korean Office Workers in Their Twenties

OBJECTIVES: The aim of this study was to examine the effects of brain-derived neurotrophic factor (BDNF) genetic polymorphism and job stress on the severity of alcohol drinking. It was hypothesized that individuals with the Met/Met BDNF genotype would be more vulnerable than those carrying the Val allele. METHODS: Participants were 133 healthy Korean adults (mean age 28.2 +/- 1.1). Job stress and the severity index of drinking were investigated through self-reported questionnaires. BDNF (rs6265) gene was genotyped. RESULTS: There was no significant association between job stress and the severity of alcohol drinking. Although the severity of alcohol drinking was not associated with BDNF genetic polymorphism, there was a significant difference in men according to genotype and job stress. Men with homozygous BDNF Met allele were more severe in alcohol drinking when job stress was high, less severe in alcohol drinking when job stress was low than those carrying the Val allele (F = 4.47, p = 0.038). Also higher level of job stress was correlated with higher severity of alcohol drinking in men homozygous for BDNF Met allele (rs = 0.620, p = 0.005). CONCLUSIONS: These findings suggest the possibility that Met allele could have differential susceptibility, with men homozygous for BDNF Met allele being more susceptible to both more adverse and less adverse environmental influences.

The Effects of Triallelic Serotonin Transporter Gene Polymorphism and Stressful Life Event on Depression in Patients with Alcohol Dependence

OBJECTIVES: The purpose of this study is to investigate the relationship between the triallelic serotonin transporter gene and stressful life events to determine their effect on depression with alcohol dependence. METHODS: Ninety-five hospitalized patients with alcohol dependence (73 male, 22 female) were enrolled in this study. Thirty-two (33.7%) of the total patients were diagnosed with major depressive disorder and dysthymic disorder by Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders-IV. The characteristics of stress were evaluated using the stressful life events scale, and depressive symptoms were assessed using the depression scale (Beck Depression Inventory, BDI). Alcoholism with depression (n = 32) and alcoholism without depression (n = 63) were genotyped for the triallelic serotonin transporter gene (LA : higher expressing allele, LG/S : lower expressing allele). RESULTS: There was no significant difference in the allele frequency between the depression group and the non-depression group (chi2 = 0.345, p = 0.619). LG/S alleles had more comorbid depression in the higher score of stressful life events scale [Mental-Haenszel (MH)-chi2 = 4.477, p = 0.034]. But there was no significant difference in the comorbidity according to the scores from the stressful life event scale in the LA alleles (MH-chi2 = 0.741, p = 0.399). In the results, alcohol-dependent individuals with LG/S alleles had more comorbid depression than those with LA alleles when they had experienced severe stressful life events (MH-odds ratio = 2.699, p = 0.028). CONCLUSIONS: These results suggest that there is no direct relationship between triallelic serotonin transporter gene and depression in the alcohol dependent patients. But alcohol dependent individuals with the lower expressing alleles of the serotonin transporter gene were more susceptible to depression than those with the higher expressing alleles in response to stressful life events.

A Study of Covert Narcissism in Adolescent Internet Addiction : Relationshipto Anonymity, Presence, Interactivity, and Achievement Motivation

OBJECTIVES: This study compared covert narcissistic propensity in adolescents with internet addiction tendency to normal adolescents. Further, we investigated the correlation between such propensities and anonymity in cyberspace, presence feeling and interactivity in internet gaming, and achievement motivation in adolescents with internet addiction tendencies. METHODS: Male middle school students with internet addiction tendencies (Addiction Tendency Group, N=27) and normal students (Control Group, N=29) were recruited. The scale of internet use, Covert Narcissism Scale, scale of achievement motivation, scale of anonymity in cyberspace, scale of presence feeling in internet games, and the scale of interactivity in internet games were administered. A comparison of the average scores and correlation analyses were performed. RESULTS: 1) Compared with Control Group, the Addiction Tendency Group showed significantly higher scores on all subscales of the Covert Narcissism Scale, and both the scale of presence feeling and that of interactivity in internet games. Further, the score on the scale of achievement motivation for the Addiction Tendency Group was significantly lower than that of the Control Group. 2) In the Addiction Tendency Group, the scores on several subscales of the Covert Narcissism Scale were significantly positively correlated with the scores on the scale of presence feeling in internet games, anonymity in cyberspace, and interactivity in internet games. However, in the Control Group, the scores of several subscales on the Covert Narcissism Scale were significantly negatively correlated with the score on the scale of achievement motivation, and was significantly positively correlated with the score on the scale of interactivity in internet games. There were no other significant correlations between the scores on the subscales of the Covert Narcissism Scale and the scores of either presence feeling in internet games or anonymity in cyberspace. CONCLUSION: These results suggested that adolescents with a tendency to be addicted to the internet exhibited higher covert narcissistic propensities than normal adolescents and that the covert narcissistic tendencies were related with presence feeling in cyber games as well as with anonymity in cyberspace.