자살 시도로 응급실에 내원한 적응 장애 환자의 특성: 적응 장애의 중요성과 자살 = Characteristics of Adjustment Disorder Patients as Suicidal Attempters Visited Emergency Department: Significance of Adjustment Disorder and Suicide

다국어 초록 (Multilingual Abstract)

Purpose: The aim of the current study was to examine the characteristics of suicidal attempters who visited the emergency department (ED) with a psychiatric diagnosis of adjustment disorder.
Methods: Suicidal attempters who had visited the ED were retrospectively selected between January 2015 and December 2015. Sex, age, marital status, psychiatric diagnosis, causes of suicidal attempt, methods of suicidal attempt, influence of alcohol, and results of ED management were reviewed in the medical records.
Results: A total of 468 suicide attempters who had visited the ED were interviewed by psychiatrists, and 323 cases were included. Adjustment disorder is the most common diagnosis among these patients (N=202, 62.5%). There was no statistical difference between the adjustment disorder group and the non-adjustment disorder group with respect to marital status, psychiatric diagnosis, causes of suicidal attempt, methods of suicidal attempt, and results of ED management.
The number of patients under the influence of alcohol who visited the ED was higher in the adjustment disorder group (p=0.04).
Conclusion: Adjustment disorder is the most common diagnosis among suicidal attempters who visit the ED. Suicidal attempt in the adjustment disorder group is likely an impulsive decision, but their admission results are just as poor as the non-adjust disorder group.

참고문헌 (Reference)

1 임용균, "정신과 치료 거부 중독 자살 시도 환자의 특성과 중재 치료로서 응급의학과 입원의 효과" 대한응급의학회 27 (27): 75-81, 2016

2 김혜영, "응급실 방문 자살기도자들의 기도 원인, 방법, 정신과적 진단에 대한 다기관 분석" 대한생물정신의학회 22 (22): 187-194, 2015

3 "http://www.oecd-ilibrary.org/social-issuesmigration-health/health-at-a-glance-2015_health_glance-2015-en"

4 "http://www.mohw.go.kr/front_new/jb/sjb030301vw.jsp?PAR_MENU_ID=03&MENU_ID=0321&CONT_SEQ=274852&page=1"

5 "http://www.index.go.kr/potal/main/EachDtlPageDetail.do?idx_cd=1012"

6 Gradus JL, "The association between adjustment disorder diagnosed at psychiatric treatment facilities and completed suicide" 2 : 23-28, 2010

7 Baraff LJ, "Survey of California emergency departments about practices for management of suicidal patients and resources available for their care" 48 : 452-458, 2006

8 Hawton K, "Suicide" 373 : 1372-1381, 2009

9 Casey P, "Suicidal behaviours in adjustment disorder and depressive episode" 174 : 441-446, 2015

10 Beautrais AL, "Subsequent mortality in medically serious suicide attempts: a 5 year follow-up" 37 : 595-599, 2003

11 Hawton K, "Risk factors for suicide in individuals with depression: a systematic review" 147 : 17-28, 2013

12 Bernal M, "Risk factors for suicidality in Europe:results from the ESEMED study" 101 : 27-34, 2007

13 Bolton JM, "Predicting suicide attempts with the SAD PERSONS scale: a longitudinal analysis" 73 : e735-e741, 2012

14 Whitlock J, "Nonsuicidal self-injury as a gateway to suicide in young adults" 52 : 486-492, 2013

15 Elnour AA, "Lethality of suicide methods" 14 : 39-45, 2008

16 American Psychiatric Association, "Diagnostic and statistical manual of mental disorders" American Psychiatric Assoc 286-287, 2013

17 Beck RW, "Cross-validation of the suicidal intent scale" 34 : 445-446, 1974

18 Polyakova I, "Characteristics of suicidal attempts in major depression versus adjustment reactions" 47 : 159-167, 1998

19 이정아, "Characteristics of Patients Who Visit the Emergency Department with Self-Inflicted Injury" 대한의학회 27 (27): 307-312, 2012

20 Luxton DD, "Can postdischarge follow-up contacts prevent suicide and suicidal behavior? A review of the evidence" 34 : 32-41, 2013

21 Greenberg WM, "Adjustment disorder as an admission diagnosis" 152 : 459-461, 1995

22 Yost DA, "Acute care for alcohol intoxication. Be prepared to consider clinical dilemmas" 112 : 14-16, 2002