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J Affect Disord. 2014 Oct;168:349-56. doi: 10.1016/j.jad.2014.07.026. Epub 2014 Jul 19.

Reasons for desiring death: examining causative factors of suicide attempters treated in emergency rooms in Korea.

Author information

  • 1Department of Psychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
  • 2Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea.
  • 3National Seoul Hospital, Seoul, Republic of Korea.
  • 4Department of Psychiatry, Busan National University Hospital Medical Research Institute, Busan, Republic of Korea.
  • 5Department of Psychiatry, School of Medicine, Eulgi University, Daejeon, Republic of Korea.
  • 6Korea Suicide Prevention Center, Seoul, Republic of Korea.
  • 7Department of Psychiatry, Kangwon National University School of Medicine, Chuncheon, Republic of Korea.
  • 8Department of Psychiatry, Gyeongsang National University College of Medicine, Jinju, Republic of Korea.
  • 9Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul, Republic of Korea.
  • 10Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea.
  • 11Department of Psychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea; National Seoul Hospital, Seoul, Republic of Korea; Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea.
  • 12Biomedical Research Institute, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
  • 13Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
  • 14Korea Suicide Prevention Center, Seoul, Republic of Korea; Department of Psychiatry, Kangwon National University School of Medicine, Chuncheon, Republic of Korea. Electronic address: lugar@kangwon.ac.kr.

Abstract

BACKGROUND:

Suicide attempters treated in emergency rooms were studied in order to understand the motives behind this behavior. Disparities between the etiological contributions to suicidal ideation, intention, and action were examined in order to characterize motives in these categories.

METHODS:

Suicide attempters who visited the emergency departments of seven university hospitals were analyzed. Attempts leading to mortality were excluded from the analysis. Participants were assessed using semi-structured questionnaires, the results of which were noted on their medical records. These were analyzed retrospectively.

RESULTS:

Attempter self-report assessment revealed that participants chose external sources of stress (75.4%) and psychiatric symptoms (19.1%) as their main reasons for attempting suicide. However, assessments by interviewers indicated that stressors contributed to suicide attempts to a lesser degree (52.8%) while psychiatric symptoms were more etiologically relevant (36.6%). Compared to those with stressors that was identified as causal in both self-report and clinician assessed evaluation, the participants-regardless of their self-report evaluation-who identified with causal psychiatric symptoms by psychiatrist had more severe and intense suicidal ideation and more determined suicidal intention.

LIMITATIONS:

We collected samples from only university hospitals, resulting in selection bias. In addition, we did not use psychiatric scales to evaluate the participants׳ symptoms.

CONCLUSIONS:

Stress was the greatest motive for attempting suicide, affirmed in both self-report and clinician assessed evaluation. A fair proportion of people were objectively identified as being motivated by psychiatric symptoms, yet were unaware of what they suffered from. Furthermore, suicide severity, intensity, and suicidal intention were stronger in psychiatrically driven cases.

Copyright © 2014 Elsevier B.V. All rights reserved.

KEYWORDS:

Cause of suicide attempt; Psychiatric symptoms; Stress; Suicide; Suicide attempt

PMID:
25103630
[PubMed - indexed for MEDLINE]
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