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응급실로 내원한 약물중독 자살시도자의 자살 진정성에 미치는 사회적 요인 분석: 응급실 기반 자살 시도자 관리시스템 자료를 이용한 후향적 연구

Analysis of social factors influencing authenticity of suicide for patient who attempt to suicide in emergency department: Retrospective study based Post-suicidal Care Program data

  • 지재구 (인제대학교 부산백병원 응급의학과) ;
  • 김양원 (인제대학교 부산백병원 응급의학과) ;
  • 강지훈 (인제대학교 부산백병원 응급의학과) ;
  • 장윤덕 (인제대학교 부산백병원 응급의학과)
  • Ji, Jae-Gu (Department of Emergency Medicine Inje University Busan Paik Hospital) ;
  • Kim, Yang-Weon (Department of Emergency Medicine Inje University Busan Paik Hospital) ;
  • Kang, Ji-Hun (Department of Emergency Medicine Inje University Busan Paik Hospital) ;
  • Jang, Yun-Deok (Department of Emergency Medicine Inje University Busan Paik Hospital)
  • 투고 : 2020.10.06
  • 심사 : 2021.01.14
  • 발행 : 2021.06.30

초록

Purpose: This study was conducted to analyze the social factors influencing the 'authenticity of suicidal ideation' based post-suicidal care programs in emergency departments (EDs). Methods: This retrospective study was an analysis using the data of patients who had attempted suicide and visited the ED in tertiary urban hospitals from January 1, 2016, to December 31, 2018. The variables examined included gender, age, history of previous psychiatric disease, suicide method, and the number of previous attempts. Univariate and multivariate logistic regression analyses were conducted to identify factors influencing the registration rate for the community-based post-suicide care program. Results: Overall,1,460 suicides were analyzed, 177 (1.16%) showed a high authenticity of suicide. The social factors influencing the authenticity of suicide intent were the unmarried status of men and women, joblessness, history of mental illnesses, more than two previous suicide attempts, the influence of alcohol, and an attempt to commit suicide after midnight more specifically between 24:00 to 6:00 hours in the morning (p<.05). The factors influencing the severity of the condition of high authenticity suicide patients were low Glasgow coma scores (12 points or less), lactate levels, and oxygen saturation observed in the patients who were admitted to the intensive care unit for treatment and died (p<.05). Conclusion: The need for evidence-based preventive measures and early assessment tools at the emergency medicine level is emphasized to reduce the rate of suicide attempts. If the results of this study are used in the management of suicide prevention, the evaluation of the authenticity of suicide intent will be more likely to be made at the emergency medicine level, allowing the severity to be assessed earlier.

키워드

참고문헌

  1. 곽문환, 강현영, 이시진, et al. 자살 예방을 위한 집중관리 대상으로서의 중독. 대한임상독성학회지 2018;16(2):93-101.
  2. 최진희, 서완석, 구본훈, et al. 응급실에 내원한 자살 시도자의 특성과 반복 자살 시도에 영향을 미치는 요인. 생물치료정신의학 2020;26(1):31-43. https://doi.org/10.22802/JKSBTP.2020.26.1.31
  3. 조준호, 정성필, 이명수, et al. 자살시도자에 대한 진료 체계 및 응급의학과-정신과 의료진의 인식 비교. 2008.
  4. 모지환, 배진희. 자살행동 영향 요인: 성별, 연령별 집단 비교를 중심으로. 보건사회연구 2011;31(2):121-45. https://doi.org/10.15709/HSWR.2011.31.2.121
  5. 허재민, 전우찬, 민영기, et al. 응급실을 경유하여 입원한 자살시도자들의 분석-정신병력, 자살시도력 및 정신과적 진단을 중심으로. 대한임상독성학회지 2004;2(2):106-15.
  6. 신희준, 김호중. 구연 18-1: 일개 대도시의 자살 시도 현황과 자살시도자의 자의퇴원에 대한 연구. 대한응급의학회 학술대회초록집 2016;2016(2):507.
  7. 민현규, 최한성, 권오영, et al. 비 자살목적 의도적 음독환자의 정신과 진료 의뢰가 필요한가? 대한응급의학회지 2010;21(6):878-86.
  8. Jeon HJ, Lee J-Y, Lee YM, et al. Lifetime prevalence and correlates of suicidal ideation, plan, and single and multiple attempts in a Korean nationwide study. The Journal of nervous and mental disease 2010;198(9):643-6. https://doi.org/10.1097/NMD.0b013e3181ef3ecf
  9. Kim J, Seo W, Lee J, et al. Characteristics of suicide attempters admitted to the emergency departments of university hospitals: demographic and psychosocial data. J Korean Soc Biol Ther Psychiatry 2015;21(2):95-104.
  10. Cho MS. Use of Alcohol, Tobacco, and Caffeine and Suicide Attempts: Findings From a Nationally Representative Cross-sectional Study. J Prim Care Community Health 2020;11:2150132720913720.
  11. Crawford MJ, Wessely S. Does initial management affect the rate of repetition of deliberate self harm? cohort study. BMJ 1998;317(7164):985-90. https://doi.org/10.1136/bmj.317.7164.985
  12. Kim J, Oh J. Characteristics of self-injury, suicide by sex, age, educational attainments and occupation. Journal of The Korean Society of Emergency Medicine 2014;25(2):152-8. https://doi.org/10.3346/jkms.2010.25.1.152
  13. Cooper J, Kapur N, Dunning J, et al. A clinical tool for assessing risk after self-harm. Annals of emergency medicine 2006;48(4):459-66. https://doi.org/10.1016/j.annemergmed.2006.07.944
  14. Kennedy SP, Baraff LJ, Suddath RL, et al. Emergency department management of suicidal adolescents. Annals of emergency medicine 2004;43(4):452-60. https://doi.org/10.1016/j.annemergmed.2003.09.009