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Identification of the Characteristics and Risk Factors of Suicide Death Among Self-Harm Attempters in South Korea: A Longitudinal National Cohort Study in South Korea
17 Pages Posted: 7 Apr 2023
More...Abstract
Background: Self-harm attempters are a high-risk group for suicide and require continuous intervention. There are insufficient studies on the characteristics of self-harm attempters and the factors that affect suicide deaths nationally. This study aimed to identify the demographic, clinical, and socioeconomic factors of suicide attempters concerning suicide mortality.
Methods: We analyzed data from the Korean National Health Insurance Service between January 2002 and December 2020. Descriptive statistical analysis was performed to compare the characteristics of suicide attempters with those of the general population. The Kaplan-Meier method and Cox proportional hazard model explored the factors of suicide attempters regarding suicide deaths.
Findings: We found that older age, female sex, lower socioeconomic status, and psychiatric conditions or disabilities were associated with higher rates of self-harm attempts than the general population. Suicidal deaths were more frequent among males with mild disabilities, fatal self-harm methods, and higher CCI scores among suicide attempters. Notably, socioeconomic factors that were highly significant indicators in the self-harm attempt characteristics analysis became relatively less significant in the suicide survival analysis. Additionally, male gender, older age, use of a fatal self-harm method, high CCI score, psychiatric diagnosis, and drinking habit were significantly associated with lower survival rates for suicide.
Interpretation: the self-harm attempters group comprises demographically, socioeconomically, and clinically vulnerable individuals compared to the general population. In contrast, the suicide group after self-harm was composed of males, had fatal self-harm methods, and was clinically vulnerable. The characteristics identified may assist in developing targeted prevention strategies for each population.
Funding: This work was supported by the Institute of Information and Communications Technology Planning and Evaluation (IITP 2022-0-00064) grant funded by the Korean government (Ministry of Science and ICT [MSIT]).
Declaration of Interest: All authors declare no competing interests
Ethical Approval: This retrospective study was approved by the Institutional Review Board of Severance Hospital, Yonsei University College of Medicine. The requirement ofor informed consent was waived (IRB no. 4-2021-0950).
Keywords: Self-harm attempter, Suicidal death, Longitudinal national cohort
Suggested Citation: Suggested Citation