Suicidal ideation in Korean persons with spinal cord injury

Abstract

Study design: Cross-sectional survey. Objectives: To investigate the prevalence of suicidal ideation and attempt in Korean persons with spinal cord injury (SCI) and the factors related with suicidal ideation in comparison with a control group (CG). Settings: Community-dwelling persons with chronic SCI in Korea. Methods: A total of 382 persons with chronic SCI and 1104 able-bodied persons randomly selected from the general population and matched for age, sex and education level were compared. Suicidal ideation and attempt were recorded positive if the subjects had that experience during the past year. Psychosocial variables and injury-related factors were also evaluated. Results: Suicidal ideation was found in 34.8% (127/365) of SCI persons and 10.4% (115/1104) in the CG (Po0.001). The rate of suicidal attempt among those with suicidal ideation was 17.3% (22/127) in SCI and 8.7% (10/115) in CG (P ¼ 0.048). Multiple logistic regression revealed that SCI itself (odds ratio (OR) 2.865) was a significant risk factor of suicidal ideation. However, completeness of injury and injury level were not significantly associated with suicidal ideation. Depressive mood (OR 11.194 Kishi et al. 4 found that 7.3% of patients with acute medical illness and 11.7% of acute SCI persons had clinically significant suicidal ideation and that suicidal ideation occurred mostly among patients with depressive mood.Psychosocial adjustment difficulties are known to be closely related to suicide in the SCI population. Hartkopp et al. 3 reported that suicide rate in their group of marginally disabled persons with SCI was nearly twice as high as those with functionally complete tetraplegia. This suggests that psychosocial adjustment is related to degree of physical impairment.The prevalence of suicidality and related factors can differ according to specific racial or cultural groups. For example, suicide is an urgent health issue in Korea with the rate of suicide increasing rapidly. 5 However, data regarding suicidality of SCI persons in nonwestern cultures are still lacking.This study was conducted to reveal the prevalence of suicidal ideation and attempt in community-dwelling SCI persons in Korea.

Self-harm and suicide before and after spinal cord injury: a systematic review

“…19 In addition, one study reported no difference between differing levels of injury. 24 It is therefore not possible to draw an accurate conclusion from these findings. However, one suggestion is that isolation may have a role in increasing the risk of suicidal behaviour.…”

“…18,24 In the study by Hagen et al, 18 cause-specific standardised mortality rate for suicide was 3.7 in males and 37.6 in females. Nam et al 24 reported female gender to be a significant risk factor for suicidal ideation, with an odds ratio of 3.7. However, interestingly, in one study, all those who committed suicide were male.…”

“…Suicidal ideation post SCI. Nam et al 24 explored suicidal ideation in a sample of 368 individuals with SCI and in a matched control group of 1104 individuals without SCI. Suicidal ideation was found in 35% of the SCI group and in 10% of the non-SCI control group.…”

Risk Factors for Suicidality in Individuals With Spinal Cord Injury: A Focus on Physical and Functional Characteristics

“…Understanding suicidality in the SCI population is of utmost importance, as individuals with SCI reportedly have more than a three-fold higher suicide incidence than those without SCI [ 3 , 4 ]. It has also been observed that 34.8% of individuals with chronic SCI experience suicidal ideation, with 17.3% having attempted suicide and a maximum of 11% resulting in fatalities [ 5 ].…”

Risk Factors Associated With Suicidal Ideation in Individuals With Spinal Cord Injury

“… 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 In addition to experiencing significant physiological concerns and impairments to everyday functioning, individuals with SCI are also at increased risk of experiencing psychological distress, including increased depression, anxiety, post-traumatic stress disorder, and social isolation, which may contribute to higher rates of suicidal ideation (SI) in individuals with SCI compared with the general population. 10 , 11 , 12 , 13 , 14 , 15 , 16 Indeed, research suggests that the experience of SI is significantly more common among persons with SCI, with an estimated 13.3% prevalence of SI within 2 weeks of screening, than among individuals of the general US population, who have an estimated annual prevalence of 3.7%. 10 , 17 , 18…”