Psychiatry Investig.  2019 Apr;16(4):314-324. 10.30773/pi.2019.02.19.

Risks of Completed Suicide of Community Individuals with ICD-10 Disorders Across Age Groups: A Nationwide Population-Based Nested Case-Control Study in South Korea

Affiliations
  • 1Korea Psychological Autopsy Center (KPAC), Seoul, Republic of Korea. jeonhj@skku.edu
  • 2Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
  • 3Institute of Health and Environment, Seoul National University, Seoul, Republic of Korea. hokim@snu.ac.kr
  • 4Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
  • 5Depression Clinical and Research Program, Massachusetts General Hospital, Harvard Medical School, Boston, USA.
  • 6Department of Psychiatry, Kyung Hee University College of Medicine, Seoul, Republic of Korea.
  • 7Department of Psychiatry, Anam Hospital, Korea University College of Medicine and School of Medicine, Seoul, Republic of Korea.
  • 8Department of Public Health Science Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea.
  • 9Department of Health Sciences & Technology, Department of Medical Device Management & Research, and Department of Clinical Research Design & Evaluation, Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Seoul, Republic of Korea.

Abstract


OBJECTIVE
Suicide is the leading cause of death in 10-39-year-olds in South Korea, and the second highest rate among the OECD countries. However, few studies have investigated the particularity of completed suicide in South Korea.
METHODS
Study subjects consisted of 2,838 suicide cases and 56,758 age and sex matched living controls from a national representative sample of 1,025,340 South Koreans. They were obtained from the Korean National Health Insurance Service-National Sample Cohort (NHIS-NSC) with follow-up up to 12 years. We obtained information on primary diagnosis of any ICD-10 disorder along with suicide cases during their lifetime.
RESULTS
Among ICD-10 disorders, depression was the most common disorder (19.10%, n=542), found in victims of completed suicides except for common medical disorders such as hypertensive crisis, respiratory tract infection or arthropathies. After adjusting for sex, age, economic status, disability, and disorders, schizophrenia showed the strongest association with suicide (AOR: 28.56, 95% CI: 19.58-41.66) among all ICD-10 disorders, followed by psoriasis, multiple body injury, epilepsy, sleep disorder, depression, and bipolar disorder. For age groups, ≤19 years was associated with anxiety disorder (AOR=80.65, 95% CI: 13.33-487.93), 20-34 years with epilepsy (AOR=134.92, 95% CI: 33.69-540.37), both 35-49 years (AOR=108.57, 95% CI: 37.17-317.09) and 50-65 years (AOR=189.41 95% CI: 26.59-1349.31), with schizophrenia, and >65 years (AOR=44.7, 95% CI: 8.93-223.63) with psoriasis.
CONCLUSION
Psychiatric and physical disorders carried greatly increased risks and numbers of suicides in South Korea. Schizophrenia was the strongest risk factor, especially 35-65 years, and depression was the most common in suicide victims among ICD-10 disorders in South Korea.

Keyword

Suicide; Schizophrenia; Depressions; Health insurance; Multiple body injury

MeSH Terms

Anxiety Disorders
Bipolar Disorder
Case-Control Studies*
Cause of Death
Cohort Studies
Depression
Diagnosis
Epilepsy
Follow-Up Studies
Humans
Insurance, Health
International Classification of Diseases*
Korea*
National Health Programs
Organisation for Economic Co-Operation and Development
Psoriasis
Respiratory Tract Infections
Risk Factors
Schizophrenia
Sleep Wake Disorders
Suicide*
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