Park C Hyung Keun, Lee Jae Won, Lee Sang Yeol, Moon Jungjoon, Shim Se Hoon, Paik Jong Woo, Kim Shin Gyeom, Cho Seong Jin, Kim Min Hyuk, Kim Seokho, Park Jae Hyun, You Sungeun, Jeon Hong Jin, Ahn Yong Min
Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea.
Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, Seoul, Korea.
J Korean Med Sci. 2017 Sep;32(9):1522-1533. doi: 10.3346/jkms.2017.32.9.1522.
In this cross-sectional study, we aimed to identify distinguishing factors between populations with suicidal ideation recruited from hospitals and communities to make an efficient allocation of limited anti-suicidal resources according to group differences. We analyzed the baseline data from 120 individuals in a community-based cohort (CC) and 137 individuals in a hospital-based cohort (HC) with suicidal ideation obtained from the Korean Cohort for the Model Predicting a Suicide and Suicide-related Behavior (K-COMPASS) study. First, their sociodemographic factors, histories of medical and psychiatric illnesses, and suicidal behaviors were compared. Second, diagnosis by the Korean version of the Mini International Neuropsychiatric Interview, scores of psychometric scales were used to assess differences in clinical severity between the groups. The results revealed that the HC had more severe clinical features: more psychiatric diagnosis including current and recurrent major depressive episodes (odds ratio [OR], 4.054; P < 0.001 and OR, 11.432; P < 0.001, respectively), current suicide risk (OR, 4.817; P < 0.001), past manic episodes (OR, 9.500; P < 0.001), past hypomanic episodes (OR, 4.108; P = 0.008), current alcohol abuse (OR, 3.566; P = 0.020), and current mood disorder with psychotic features (OR, 20.342; P < 0.001) besides significantly higher scores in depression, anxiety, alcohol problems, impulsivity, and stress. By comparison, old age, single households, and low socioeconomic status were significantly associated with the CC. These findings indicate the necessity of more clinically oriented support for hospital visitors and more socioeconomic aid for community-dwellers with suicidality.
在这项横断面研究中,我们旨在确定从医院和社区招募的有自杀意念人群之间的区别因素,以便根据群体差异有效分配有限的自杀预防资源。我们分析了韩国自杀及自杀相关行为预测模型队列研究(K-COMPASS)中基于社区队列(CC)的120名有自杀意念个体和基于医院队列(HC)的137名有自杀意念个体的基线数据。首先,比较了他们的社会人口学因素、医学和精神疾病史以及自杀行为。其次,采用韩国版迷你国际神经精神访谈进行诊断,使用心理测量量表得分评估两组之间临床严重程度的差异。结果显示,HC组具有更严重的临床特征:更多的精神疾病诊断,包括当前和复发性重度抑郁发作(优势比[OR]分别为4.054;P<0.001和OR,11.432;P<0.001)、当前自杀风险(OR,4.817;P<0.001)、既往躁狂发作(OR,9.500;P<0.001)、既往轻躁狂发作(OR,4.108;P = 0.008)、当前酒精滥用(OR,3.566;P = 0.020)以及当前伴有精神病性特征的心境障碍(OR,20.342;P<0.001),此外,抑郁、焦虑、酒精问题、冲动性和压力得分也显著更高。相比之下,老年、单身家庭和低社会经济地位与CC组显著相关。这些发现表明,有必要为就诊于医院的人群提供更具临床导向性的支持,为有自杀倾向的社区居民提供更多社会经济援助。