RESUMO
OBJECTIVES: This study was conducted to examine the factors affecting suicide decision and to understand in detail their psychological and behavioral changes with high lethality suicide attempters who were supposed to be similar to suicide completers. METHODS: Twenty patients who visited Kangwon National University Hospital or Chuncheon National Hospital participated in this study. After applying suicide lethality with Risk-Rescue Rating Scale, high lethality attempters were screened. Each subject participated in an in-depth interview with a semi-structured interview schedule. RESULTS: The participants had high mean Risk-Rescue Rating Score (45.0+/-8.7), indicating that the study was conducted with the most lethal suicide attempters. Most attempters had chosen their methods of suicide impulsively without consideration for lethality, and most attempters reported that they chose suicide methods from recall of reports by mass media ; 70% of attempters had more than one previous suicide attempt and their suicide methods have been changed to increase the suicide success rate. Most common accompanying emotions before suicide attempts were hopelessness, helplessness, worthlessness, and loneliness. Most important precipitating factors of suicide were economic difficulties. CONCLUSION: These characteristics regarding suicide attempts led us to a detailed understanding. These results are expected to provide valuable information for development of evidence based suicide prevention policies and strategies.