J Korean Med Sci.  2015 Oct;30(10):1490-1495. 10.3346/jkms.2015.30.10.1490.

Clinical Characteristics of the Suicide Attempters Who Refused to Participate in a Suicide Prevention Case Management Program

Affiliations
  • 1Department of Psychiatry, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea. mindcure@catholic.ac.kr
  • 2Department of Psychology, Sogang University, Seoul, Korea.
  • 3Department of Emergency Medicine Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.

Abstract

Case management interventions for suicide attempters aimed at helping adjust their social life to prevent reattempts have high nonparticipation and dropout rates. We analyzed the clinical characteristics of the group who refused to participate in the suicide prevention program in Korea. A total of 489 patients with a suicide attempt who visited Uijeongbu St. Mary's Hospital, the Catholic University of Korea, from December 2009 to December 2013 were analyzed. All patients were divided into the participation group (n = 262) and the refusal group (n = 227) according to their participation in the case management program. Demographic and clinical characteristics of each group were examined. Results showed that the refusal group had low risks for suicide in terms of risk factors related with psychopathologies and presenting suicide behavior. That is, the refusal group had less patients with co-morbid medical illnesses and more patients with mild severity of depression compared to the participation group. However, the refusal group had more interpersonal conflict, more isolation of social integrity, and more impaired insight about suicide attempt. The results suggest that nonparticipation in the case management program may depend upon the patient's impaired insight about the riskiness of suicide and lack of social support.

Keyword

Suicide; Case Management; Prevention; Nonparticipation

MeSH Terms

Adult
Case Management
Female
Humans
Male
Mental Disorders/diagnosis/*psychology
Middle Aged
Republic of Korea
Suicide, Attempted/*prevention & control/*psychology
Treatment Refusal/*psychology
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