A Study on Factors Affecting Suicidal Tendency of the Elderly Living Alone on Care Services

OBJECTIVES: The high suicide rate has risen as a main concern in South Korea. Given the complexity of the mechanism resulting in complete suicide, studies targeting various populations are needed for broader understanding of its risk factors. This study aims to analyze the factors affecting the suicidal tendency in the population of the elderly living alone in Seoul depending on basic elderly-care services. METHODS: A total number of 415 people participated in the study. Home-visit interviews were administered by trained interviewers. Suicidal tendency was measured by the Korean version of mini international neuropsychiatric interview (K-MINI). Health-related quality of life was measured by a brief version of the World Health Organization Quality-of-life Scale (WHOQOL-BREF). Alcohol problem was assessed by the Korean version of the alcohol use disorders identification test (AUDIT-K). Among total subjects of 415 interviewees, the actual responses of 408 people were used for the final analysis. RESULTS: The result showed that the suicide risk was high in persons isolated from social support [odds ratio (OR) = 4.49], having depression (OR = 14.85), and having low quality of life (OR = 4.39). CONCLUSIONS: We found that social support, depression and health-related quality of life are associated with suicidal tendency in the elderly living alone on basic services. Our evidence will contribute to suicide prevention policy for the elderly living alone on care services.

Efficacy of Case Management for the Community Dwelling Schizophrenia Patients : A 36-Month Prospective Follow-Up Study / 신경정신의학

OBJECTIVES: This study was conducted to observe a longitudinal course of patients with schizophrenia enrolled in a community mental health center (CMHC) in Seoul, Korea, and to evaluate the clinical efficacy of case management provided for them. METHODS: Study subjects, including 50 patients in a case-managed group, and 34 patients in the control group, were enrolled from a CMHC and followed up for 36 months. Annual length of hospitalization was compared between two groups by t-tests and time until hospitalization by Kaplan-Meier survival analysis. RESULTS: For the first year of observation, there was no significant difference in annual length of hospitalization between two groups (3.4 weeks vs. 2.9 weeks), but annual length of hospitalization of the case-managed group became significantly shorter for the second (1.7 weeks vs. 7.2 weeks) and third year (1.4 weeks vs. 7.8 weeks). In Kaplan-Meier survival analysis, no difference in time until hospitalization was observed between two groups, but time until hospitalization more than 3 months was significantly shorter in the control group. CONCLUSION: At least two years of case management was required to reduce the length of hospitalization. Reduction in length of hospitalization was achieved by preventing long-term hospitalization.