Meerae Lim1, Sung-Wan Kim2, Yoon-Young Nam3, Eunsoo Moon4, Jechun Yu5, Soojung Lee6, Jae Seung Chang1, Jin-Hyeong Jhoo7, Boseok Cha8, Jung-Seok Choi9, Yong Min Ahn10, Kyooseob Ha11, Jayoun Kim12, Hong Jin Jeon13, Jong-Ik Park14. 1. Department of Psychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea. 2. Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea. 3. National Seoul Hospital, Seoul, Republic of Korea. 4. Department of Psychiatry, Busan National University Hospital Medical Research Institute, Busan, Republic of Korea. 5. Department of Psychiatry, School of Medicine, Eulgi University, Daejeon, Republic of Korea. 6. Korea Suicide Prevention Center, Seoul, Republic of Korea. 7. Department of Psychiatry, Kangwon National University School of Medicine, Chuncheon, Republic of Korea. 8. Department of Psychiatry, Gyeongsang National University College of Medicine, Jinju, Republic of Korea. 9. Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul, Republic of Korea. 10. Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea. 11. Department 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. 12. Biomedical Research Institute, Seoul National University Bundang Hospital, Seongnam, Republic of Korea. 13. Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. 14. Korea 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.
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.
Authors: Suppawong Tuarob; Conrad S Tucker; Soundar Kumara; C Lee Giles; Aaron L Pincus; David E Conroy; Nilam Ram Journal: J Biomed Inform Date: 2017-02-15 Impact factor: 6.317
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