suicidal ideation, suicide plans and attempts in...
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Suicidal ideation, Suicide plans and attempts
in Korean adolescents
Ju Young Ha1
1 College of Nursing, Pusan National University, Busandaehak-ro 49,
Yangsan-si, 626-870, Gyeongsangnam-do, Korea
Abstract. The aim of this study was to investigate the prevalence of suicidal
ideation, suicide plans and attempts among Korean adolescents. A total sample
of 72,435 adolescents aged 12~18 years who responded to the 2013 Korea
Youth Risk Behavior Web-based Survey (KYRBS). The prevalence of suicidal
ideation, suicide plans and suicide attempts were 16.7%, 5.8% and 4.2%
respectively. The suicidal ideation, suicide plan and suicide attempts
significantly differed according to general characteristics. Based on study
findings, prevention interventions should be tailored to specific gender, school
grades, socioeconomic and psychiatric status.
Keywords: Adolescent, Suicide, Prevalence
1 Introduction
In South Korea, suicide rate was 31.7 deaths per 100,000 in 2011, which was the
highest rate among the OECD (Organization for Economic Co-operation and
Development) [1]. The suicide rate in adolescents has been rising rapidly. According
to the result of sixth Korea Youth Risk Behavior Web-based Survey, 19.1% of the
total participants (72,623 of total adolescents aged 13~18years old) had experienced
suicidal ideation and 4.9% actually attempted suicide [2]. The probability of death
resulting from a suicidal act is 100 times higher in the attempters than in the general
population [3]. Research indicates that suicide itself represents a heterogeneous
spectrum of risk, ranging from suicidal thinking (e.g. repeated thoughts and plans
related to suicide) to suicidal behaviors such as making verbal suicide threats and
engaging in suicide attempts [4-6]. Moreover, non-fatal suicidal behavior, including
suicide attempts, is recognized as one of the strongest predictors of subsequent suicide
[7]. Therefore, the timely strategies of suicide prevention for adolescents could
contribute to reduce the risk of suicide effectively. The purpose of this study was to
investigate the prevalence of suicidal ideation, suicide plans and suicide attempts
among Korean adolescents.
Advanced Science and Technology Letters Vol.72 (Healthcare and Nursing 2014), pp.117-122
http://dx.doi.org/10.14257/astl.2014.72.29
ISSN: 2287-1233 ASTL Copyright © 2014 SERSC
2 Method
2.1 Samples
The subjects were participants in the 2013 Korea Youth Risk Behavior Web-based
Survey (KYRBS). The survey has been conducted annually since 2005 by the Korea
Centers for Disease Control and Prevention (KCDC) and the Ministry of Education,
Science and Technology, in order to monitor the prevalence of the health behaviors
among the adolescents. The data were collected with an ongoing, web-based survey
conducted on a nationally representative sample of middle and high school students
with a stratified, clustered, multistage probability sampling design. After the survey
was fully explained, only participants who provided informed consent completed the
online anonymous self-report questionnaires in a school computer room. The number
of study subjects was 72,435 who were aged between 12 and 18 years old (36,655 for
boys and 35,780 girls).
2.2 Measures
The general characteristics examined included age, gender, school, perceived
academic performance, perceived socioeconomic status (SES), and living status.
Health-related factors were subjective feeling of happiness, stress perception, and
subjective feeling depression (“Were you feeling so sad or hopeless for at least two
weeks or more that you stopped doing some usual activities during the last 12
months?”).
Suicidal ideation was assessed by asking „Have you ever seriously thought about
committing suicide in the past 12 months?‟, suicide plan was assessed by asking
„Have you ever concrete plan about committing suicide in the past 12 months?‟ and
suicide attempt was assessed by asking „Have you ever attempted suicide in the past
12 months?‟.
2.3 Data analysis
The collected data was analyzed with descriptive statistics and chi-square tests using
IBM SPSS Statistics 20.0 and p<0.5 was considered statistically significant.
Advanced Science and Technology Letters Vol.72 (Healthcare and Nursing 2014)
118 Copyright © 2014 SERSC
3 Results
3.1 Participant Characteristics
Participants were 72,435 adolescents aged from 12 to 18 (M=14.90, SD=1.76). The
general characteristics of the study population are shown in Table 1. The proportion
of boys was 50.6%, and about half of the subjects were middle school students.
Table 1. General characteristics of the study population (N=72,435)
Variable n %
Gender Boys 36,655 50.6
Girls 35,780 49.4
School Middle 36,530 50.4
High 35,905 49.6
Perceived Excellent 7942 11.0
Academic Good 17,053 23.5
Performance Average 20,148 27.8
Fair 18,107 25.0
Poor 9,185 12.7
Perceived High 5,222 7.2
Socioeconomic Mid-high 17,525 24.2
Status Middle 34,494 47.6
Mid-low 11,806 16.3
Low 3,388 4.7
Living status With family 69,006 95.3
With relatives 776 1.1
Dormitory 2,250 3.1
Nursery facilities 403 0.6
Subjective High 42,127 58.2
Happiness Middle 21,943 30.3
Low 8,365 11.5
Stress High 30,192 41.7
Perception Middle 29,841 41.2
Low 12,402 17.1
History of feeling No 50,005 69.0
depressed Yes 22,430 31.0
3.2 Prevalence of Suicidal Ideation, Plan and Attempts
In the past 12 months, the prevalence of suicidal ideation, suicide plan and suicide
attempts was 16.7% , 5.8% and 4.2% respectively (Table 2).
Advanced Science and Technology Letters Vol.72 (Healthcare and Nursing 2014)
Copyright © 2014 SERSC 119
Table 2. Suicidal Ideation, Suicide Plan and Suicide Attempts (N=72,345)
Variable n %
Suicidal Ideation No 60,365 83.3
Yes 12,070 16.7
Suicide Plan No 68,267 94.2
Yes 4,168 5.8
Suicide Attempts No 69,414 95.8
Yes 3,021 4.2
3.3 Differences in Suicidal Ideation, Plan and Attempts by Variables
Table 3 shows the differences in suicidal ideation, suicide plan and suicide attempts
according to general characteristics. There were significant differences in suicidal
ideation, plan and attempts by all variables of general characteristics.
Table 3. Suicidal Ideation, Suicide Plan and Suicide Attempts by general characteristics
(N=72,345)
Variables Categories
Suicidal ideation Suicide plan Suicide attempts
No Yes χ 2
No Yes χ 2
No Yes χ 2
n(%) n(%) (p) n(%) n(%) (p) n(%) n(%) (p)
Gender Boys 31885 (87.0)
4770 (13.0)
711.91 (<.001)
34900
(95.2) 1755 (4.8)
127.75 (<.001)
35590 (97.1)
1065 (2.9)
297.19 (<.001)
Girls 28480 (79.6)
7300 (20.4)
33367
(93.3) 2413 (6.7)
33824 (94.5)
1956 (5.5)
School Middle 30186 (82.6)
6344 (17.4)
26.25 (<.001)
34099
(93.3) 2431 (6.7)
110.24 (<.001)
34680 (94.9)
1850 (5.1)
147.27 (<.001)
High 30179 (84.1)
5726 (15.9)
34168
(95.2) 1737 (4.8)
34734 (96.7)
1171 (3.3)
Perceived Excellent 6803 (85.7)
1139 (14.3)
441.16 (<.001)
7524 (94.7)
418 (5.3)
247.69 (<.001)
7668 (96.5)
274 (3.5)
329.96 (<.001)
Academic Good 14548 (85.3)
2505 (14.7)
16223
(95.1) 830
(4.9) 16493
(96.7) 560
(3.3)
Performance Average 17173 (85.2)
2975 (14.8)
19191
(95.3) 957
(4.7) 19487
(96.7) 661
(3.3)
Fair 14774 (81.6)
3333 (18.4)
16965
(93.7) 1142 (6.3)
17257 (95.3)
850 (4.7)
Poor 7067 (76.9)
12070 (16.7)
8364 (91.1)
821 (8.9)
8509 (92.6)
676 (7.4)
Perceived High 4370 (83.7)
852 (16.3)
725.72 (<.001)
4798 (91.9)
424 (8.1)
463.66 (<.001)
4923 (94.3)
299 (5.7)
365.36 (<.001)
Socioeconomic Mid-high 14993 (85.6)
2532 (14.4)
16678 (95.2)
847 (4.8)
16922 (96.6)
603 (3.4)
Advanced Science and Technology Letters Vol.72 (Healthcare and Nursing 2014)
120 Copyright © 2014 SERSC
Status Middle 29289 (84.9)
5205 (15.1)
32790
(95.1) 1704 (4.9)
33262 (96.4)
1232 (3.6)
Mid-low 9354 (79.2)
2452 (20.8)
11055 (93.6)
751 (6.4)
11252 (95.3)
554 (4.7)
Low 2359 (69.6)
1029 (30.4)
2946 (87.0)
442 (13.0)
3055 (90.2)
333 (9.8)
Living status With family 57651 (83.5)
1135 (16.5)
127.77 (<.001)
65189
(94.5) 3817 (5.5)
384.80 (<.001)
66243 (96.0)
2763 (4.0)
330.92 (<.001)
With
relatives
573 (73.8)
203 (26.2)
664 (85.6)
112 (14.4)
692 (89.2)
84 (10.8)
Dormitory 1870 (83.1)
380 (16.9)
2111 (93.8)
139 (6.2)
2155 (95.8)
95 (4.2)
Nursery
facilities
271 (67.2)
132 (32.8)
303 (75.2)
100 (24.8)
324 (80.4)
79 (19.6)
Subjective High 38546 (91.5)
3581 (8.5)
9278.53 (<.001)
40918
(97.1) 1209 (2.9)
3808.49 (<.001)
41278 (98.0)
849 (2.0)
2685.05 (<.001)
Happiness Middle 17731 (80.8)
4212 (19.2)
20663
(94.2) 1280 (5.8)
20976 (95.6)
967 (4.4)
Low 4088 (48.9)
4277 (51.1)
6686 (79.9)
1679 (20.1)
7160 (85.6)
1205 (14.4)
Stress High 20937 (69.3)
9255 (30.7)
7408.29 (<.001)
27095
(89.7) 3097
(10.3) 1937.70 (<.001)
27924 (92.5)
2268 (7.5)
1448.56 (<.001)
Perception Middle 27485 (92.1)
2356 (7.9)
29058
(97.4) 783
(2.6) 29280
(98.1) 561
(1.9)
Low 11943 (96.3)
459 (3.7)
12114
(97.7) 288
(2.3) 12210
(98.5) 192
(1.5)
History of
feeling No 47207
(94.4) 2798 (5.6)
14244.8 (<.001)
49153
(98.3) 852
(1.7) 4884.99 (<.001)
49467 (98.9)
538 (1.1)
3869.73 (<.001)
depressed Yes 13158 (58.7)
9272 (41.3)
19114 (85.2)
3316 (14.8)
19947 (88.9)
2483 (11.1)
4 Conclusion
Suicide is an important public health issue. The prevalence of suicidal ideation,
suicide plans, and suicide attempts is high when compared with other countries. The
results of this study suggest that to improve suicide prevention strategies it is
necessary to define their targets. Suicide prevention interventions for adolescents
should be tailored to gender, age, socioeconomic status and psychiatric aspects.
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