Investigation of Knowledge, Attitudes, and Experience Regarding Suicidal Behaviors among Psychiatric Residents in Korea : A Cross-Sectional Study / 신경정신의학

OBJECTIVES: This study investigated the effects of the grade of residents, sociodemographic variables, and clinical experience with suicidal patients on the knowledge and attitudes toward suicide among psychiatric residents in Korea. METHODS: A self-reporting survey including 30 questions was conducted together with an investigation of the sociodemographic background of the research subjects. The questionnaire was composed of general knowledge questions on suicide, suicide-related personal experience, attitudes toward suicide, and the treatment experience of suicide attempt patients. Chi-square test and binary logistic regression analysis were used to determine the differences and associations among the attitudes toward suicide, clinical experience of suicide, and sociodemographic characteristics. RESULTS: A significantly higher response rate was presented in the 4th grade on general knowledge of suicide and treatment experience with suicide attempt patients than in the 1st grade. Residents with previous history of psychiatric treatment suicide plans, or attempts presented a significantly higher level of permissive attitude toward suicide. Residents who had a previous history of suicide attempt among their own patients were more likely to think that they were more capable to prevent suicide of patients. CONCLUSION: Effective clinical practices are essential considering the fact that the highest suicide risk groups will inevitably be referred to psychiatric clinical services. The authors expect that the study results regarding suicide-related knowledge, attitudes, and the experience of psychiatric residents will contribute to the development of effective resident training programs for suicide-related clinical practice in Korea.

A Controlled Study to Analyze Psychological Aspects and Psychiatric Morbidity Amongst People who Attempt Suicide.

Background : Suicide is a complex, multidimensional phenomenon. Attempted suicide has a bearing on future attempts/completion, a correlation with psychosocial factors and psychiatric disorders and these factors have an effect on suicide prevention. Aim : To compare people who attempt suicide and controls in regard to psychosocial aspects and psychiatric morbidity and to find out the factors leading to attempted suicide. Methods : Consecutive 40 cases of attempted suicide and 40 controls of either sex between 16-35 years of age studied till tenth standard referred to the department of Psychiatry from various super speciality departments in Sir Ganga Ram Hospital were recruited in the study over a period of 18 months after ensuring their medical stability and after obtaining their consent. The subjects were assessed using semistructured proforma covering socio-demographic and clinical characteristics of patient and his/her illness and by using the following tools : Cattelle’s 16 personality factors test(16 PF), Frustration test, Family relationship inventory, Presumptive Stressful life event scale, Beck’s depression inventory, Beck’s suicidal intent scale, Smith’s lethality of suicide attempt scale, MINI-plus and Kuppuswamy’s Socio-economic Status Scale. Results : The study showed female preponderance amongst attempters and 67.5% came from a nuclear family background (p=0.000). 25% of the suicide attempters had made an earlier past suicide attempt and 15% had a family history of attempted or completed suicide (p=0.011). Benzodiazepine overdose was the most common method (37.5%) of attempting suicide followed by organophosphorus poisoning (30%).For attempters, mean scores for frustration, and acceptance and concentration variables on family relationship inventory were statistically significant (p=0.000).Psychiatric disorders were present in 65% of the attempted suicide cases and results were statistically significant for undesirable life events in the past and lifetime in attempters.Conclusions : The present study revealed that lack of family cohesion and relationship/marital problems with more undesirable life events in the past and lifetime are important factors for attempted suicide. High levels of frustration, low family acceptance and high family concentration are predictors of attempting suicide later.

O perfil epidemiológico dos pacientes que tentaram suicídio com intoxicação exógena no município de Formiga - MG / The epidemiological profile of patients who attempted suicide with exogenous poisoning in the city of Formiga - MG, Brazil

Trata-se de uma pesquisa de campo de caráter exploratório, retrospectivo e quantitativo. O objetivo foi traçar o perfil epidemiológico dos pacientes intoxicados por substâncias exógenas, de abril de 2007 a setembro de 2008, residentes no município de Formiga, Minas Gerais. Os dados foram coletados das fichas de notificação de intoxicação exógena e expressos em frequência simples (N) e frequência relativa (%). O perfil da população formiguense que tentou suicídio no período em estudo é em sua maioria mulheres, com idade de 15 a 49 anos, com o ensino médio incompleto, empregadas e que ingeriram em sua maior parte medicamentos, e foi a primeira tentativa. A maioria dos pacientes não foi hospitalizada e evoluiu sem complicações. Contudo, há de se reconhecer que por meio do perfil levantado seja possível ao órgão de saúde responsável elaborar ações para detecção e diminuição dos fatores de risco, e até mesmo o reconhecimento da população de risco, com o intuito de estabelecer estratégias que previnam o surgimento de novos casos e de reicidências.

This is a field research with an exploratory, retrospective, quantitative approach. The objective was to establish the epidemiological profile of patients poisoned by exogenous substances, from April 2007 to September 2008, residents in the city of Formiga, Minas Gerais. Data were collected from reporting of exogenous intoxication and expressed in simple frequency (n) and relative frequency (%). The profile of the people who attempted suicide during the study period is mostly women, aged 15 to 49 years, with incomplete high school, employed and who ingested mostly medicines, and the occurrence was the first attempt. Most of the patients was not hospitalized and recovered with no complications. However, it must be noted that, through the profile, it is possible for the responsible health agency to develop actions in order to detect and mitigate risk factors, and even the recognition of at-risk population in order to develop strategies to prevent the emergence of new cases and relapses.

Esta es una investigación de campo exploratoria, retrospectiva, cuantitativa. El objetivo fue establecer el perfil epidemiológico de los pacientes intoxicados por sustancias exógenas, de abril 2007 a septiembre 2008, entre los residentes en la ciudad de Formiga, Minas Gerais. Se recogieron datos de la presentación de informes de intoxicación exógena, que se expresa en frecuencia simple (n) y la frecuencia relativa (%). El perfil del intento de suicidio Formiguense durante el período de estudio es en su mayoría mujeres de entre 15 y 49 años con la secundaria incompleta, empleadas y que han ingerido medicamentos en su mayoría, y este fue el primer intento. La mayoría de los pacientes no fue hospitalizada y se recuperó sin complicaciones. Sin embargo, cabe señalar que, a través del perfil, se puede elevar a la agencia de salud responsable acciones para desarrollar la detección y mitigación de los factores de riesgo, e incluso el reconocimiento de la población en situación de riesgo a fin de desarrollar estrategias para prevenir la aparición de casos nuevos y recaídas.

Preliminary Study on the Clinical Characteristics between Suicide Attempters and Suicide Completers Who had Visited Emergency Room / 신경정신의학

OBJECTIVES: There is increasing evidence of an association between suicide and psychiatric disorders. This is the first report in Korea that investigated the differences of clinical and demographic characteristics between suicide completers and suicide attempters who had visited emergency room. METHODS: For this study, we enrolled patients who had visited the emergency rooms of university-affiliated medical centers or hospitals, due to psychiatric problems, between January 2003 and December 2006. In October 2007, we used the Korea national statistical office to identify the suicide completers among these enrollees. We then conducted a retrospective chart review comparing clinical and demographic characteristics between suicide attempters and completers. RESULTS: During the study period, 1106 subjects visited the emergency room of a university affiliated medical center or hospital. Among these subjects, the number of suicide attempters and suicide completers was 162 and 13, respectively. The proportion of suicide completion in the suicide related behavior was higher in patients with schizophrenia (27.3%) and anxiety/somatoform disorder (50.0%) compared with those with other psychiatric disorders. Suicide completers used more violent methods of suicide. CONCLUSION: These results suggest that patients with schizophrenia and anxiety/somatoform disorder make more fatal suicide attempts. The proportion of suicide completion within the suicide-related behaviors of these patients was higher than found in other psychiatric disorders. A greater number of risk factors should be elucidated to provide effective suicide prevention programs in Korea.