Kwon Chan-Young
Department of Oriental Neuropsychiatry, College of Korean Medicine, Dong-Eui University, Busan, Republic of Korea.
Front Psychol. 2024 Dec 9;15:1461750. doi: 10.3389/fpsyg.2024.1461750. eCollection 2024.
Suicide is a critical global public health issue, with South Korea exhibiting the highest suicide rate among OECD countries at 24.1 per 100,000 people in 2020. This study focuses on suicidal ideation (SI) within South Korea's Millennials and Generation Z (Generation MZ) by examining the impact of anger and hwa-byung (HB), a culture-bound anger syndrome.
The online survey was conducted between June 7 and 12, 2024. The inclusion criteria for this study were the following: (1) generation MZ (i.e., those born between 1980 and 2005); (2) those without a history of mood disorders (i.e., depressive disorders or bipolar disorder); (3) those of Korean nationality and residing in South Korea. Demographic variables and clinical variables including SI, HB, and depression were investigated. The chi-square test or t-test was used to compare the differences between the SI and non-SI groups. Additionally, binary logistic regression analysis was performed to analyze factors associated with the presence of SI. Finally, Pearson's correlation coefficients were calculated to explore HB symptoms that were highly associated with SI.
Total 457 participants were included. The survey revealed an overall prevalence of SI of 38.07%, with 18.82% reporting "much" or more SI and 4.81% reporting "very much" SI. Significant differences were found between the SI and non-SI groups in HB symptoms, depression, anxiety, perceived stress, trait anger, state anger, anger-in, and anger-out (all < 0.001). Logistic regression analysis identified HB symptoms (odds ratio [OR], 1.05; 95% CI, 1.00-1.11; = 0.050), depression (OR, 1.41; 95% CI, 1.23-1.62; < 0.001), and state anger (OR, 1.14; 95% CI, 1.05-1.24; = 0.002) as significant factors for SI. The mediating factors confirmed the direct and indirect effects of HB symptoms on the presence of SI. Pearson's correlation coefficients between HB symptoms and SI severity ranged from 0.241 to 0.536, with physical symptoms, such as heat sensation and chest pressure, showing high correlations (0.426 to 0.476).
These findings highlight the need for mental health policies that integrate Korean medical approaches into suicide prevention. Future research should confirm these results using larger, nationally representative samples to improve generalizability and further explore HB and suicidality in diverse populations.
自杀是一个严峻的全球公共卫生问题，韩国在经合组织国家中自杀率最高，2020年每10万人中有24.1人自杀。本研究聚焦于韩国千禧一代和Z世代（MZ世代）的自杀意念（SI），通过考察愤怒和火病（HB，一种与文化相关的愤怒综合征）的影响来进行研究。
于2024年6月7日至12日进行了在线调查。本研究的纳入标准如下：（1）MZ世代（即1980年至2005年出生的人）；（2）无情绪障碍病史（即抑郁症或双相情感障碍）；（3）韩国国籍且居住在韩国。对人口统计学变量以及包括自杀意念、火病和抑郁在内的临床变量进行了调查。采用卡方检验或t检验比较自杀意念组和非自杀意念组之间的差异。此外，进行了二元逻辑回归分析以分析与自杀意念存在相关的因素。最后，计算了皮尔逊相关系数以探究与自杀意念高度相关的火病症状。
共纳入457名参与者。调查显示自杀意念的总体患病率为38.07%，其中18.82%报告有“较多”或更多的自杀意念，4.81%报告有“非常多”的自杀意念。在火病症状、抑郁、焦虑、感知压力、特质愤怒、状态愤怒、向内愤怒和向外愤怒方面，自杀意念组和非自杀意念组之间存在显著差异（均P<0.001）。逻辑回归分析确定火病症状（比值比[OR]，1.05；95%置信区间，1.00 - 1.11；P = 0.050）、抑郁（OR，1.41；95%置信区间，1.23 - 1.62；P<0.001）和状态愤怒（OR，1.14；95%置信区间，1.05 - 1.24；P = 0.002）是自杀意念的重要因素。中介因素证实了火病症状对自杀意念存在的直接和间接影响。火病症状与自杀意念严重程度之间的皮尔逊相关系数在0.241至0.536之间，其中热感和胸部压迫等身体症状显示出高度相关性（0.426至0.476）。
这些发现凸显了将韩国医学方法纳入自杀预防的心理健康政策的必要性。未来的研究应使用更大规模、具有全国代表性的样本证实这些结果，以提高普遍性，并进一步探索不同人群中的火病和自杀倾向。
