J Korean Med Sci.  2023 Dec;38(49):e376. 10.3346/jkms.2023.38.e376.

Factors Related to Suicidal Ideation by Gender and Age Group in Korean Adults

Affiliations
  • 1Department of Biomedical Laboratory Science, Songho University, Hoengseong, Korea
  • 2Department of Medical Informatics and Biostatistics, Graduate School, Yonsei University, Seoul, Korea
  • 3Department of Precision Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea

Abstract

Background
According to the results of the age-standardized suicide rate (suicide deaths per 100,000 population) published by Organization for Economic Cooperation and Development countries from 2003 to 2019, the suicide rate in Korea is ranked first almost every year, so it should be managed at the national level. To reduce the suicide rate, many scholars are studying suicide. The suicidal process begins with suicidal ideation, progresses through suicide attempts, and ends with suicide. Among them, the frequency of suicidal thoughts was found to be highly correlated with suicide plans and attempts, and it is said that 60% of those who change from suicidal ideation to attempts appear within one year. Therefore, research related to suicidal ideation to lower the suicide rate will contribute to preventing suicide at an early stage.
Methods
This study used data from the Korea National Health and Nutrition Examination Survey (KNHANES). Among them, data from 2013, 2015, 2017, and 2019 surveyed adults were compared for suicidal ideation among 18,339 adults. Considering the characteristics of the KNHANES data, complex sample analysis was performed considering the primary extraction unit (region), stratification variables, and weights. The Rao-Scott χ 2 test was stratified by age group to confirm the distribution of suicidal ideation according to general characteristics. Univariate and multiple logistic regression analyses were performed to understand the effect on suicidal ideation.
Results
Among all subjects, the rate of suicidal ideation was 4.75%, and among the age groups, the rate of suicidal thoughts was the highest among those over 80 years old (10.39%). Compared to those who were 50s, those in their 30s had the lowest suicidal ideation (odds ratio [OR], 0.52; 95% confidence interval [CI], 0.39–0.70), and those in their 80s had the highest rate of suicidal ideation (OR, 1.97; 95% CI, 1.38–2.82). Except for those in their 20s, the rate of suicidal ideation tends to increase with age. Overall, the lower 25% of the Euro Quality of Life–5 Dimensions (EQ-5D) index, depression lasting more than two weeks, and subjects with poor subjective health or high stress were more likely to have suicidal ideation. In particular, EQ-5D Index (OR, 5.86; 95% CI, 3.73–9.20), depressive symptoms (OR, 19.65; 95% CI, 9.94–38.83) in 20s, and stress in 80s (OR, 10.87; 95% CI, 5.63–20.96) was the highest, and those had the good subjective health perception in 30s (OR, 0.10; 95% CI, 0.05–0.20) was lowest. Participants in their 30s, 40s, and 60s who were divorced or widowed and those in their 50s and 60s who had never married or lived together were more likely to consider suicide ideation. Except for those in their 20s and 80s, the rate of suicidal ideation tends to increase with lower household income levels.
Conclusions
In the results of this study, it can be seen that a combination of factors such as a person’s personality traits, stress or coping ability to various events, social support, and mental or physical limitations influence suicidal behavior. Suicidal ideation is not simply affected by a single factor but may be influenced by multiple factors.

Keyword

Suicidal Ideation; KNHANES; Logistic Regression Analysis

Figure

  • Fig. 1 Flow chart.KNHANES = Korea National Health and Nutrition Examination Survey.

  • Fig. 2 Logistic regression for suicidal ideation according to age group.

  • Fig. 3 Univariate logistic regression result for all characteristics according to suicidal ideation stratified by age group.


Reference

1. Organization for Economic Cooperation and Development (OECD). OECD health statistics 2021. Updated 2021. Accessed September 6, 2022. https://www.oecd.org .
2. Rabani ST, Khan QR, Khanday AM. Detection of suicidal ideation on Twitter using machine learning & ensemble approaches. Baghdad Sci J. 2020; 17(4):1328–1339.
3. ten Have M, de Graaf R, van Dorsselaer S, Verdurmen J, van ’t Land H, Vollebergh W, et al. Incidence and course of suicidal ideation and suicide attempts in the general population. Can J Psychiatry. 2009; 54(12):824–833. PMID: 20047721.
4. Silverman MM, Meyer PM, Sloane F, Raffel M, Pratt DM. The Big Ten Student Suicide Study: a 10-year study of suicides on midwestern university campuses. Suicide Life Threat Behav. 1997; 27(3):285–303. PMID: 9357084.
5. Lee JW. Gender differences in suicide ideation. J Health Inform Stat . 2022; 47(4):250–257.
6. van Spijker BA, Batterham PJ, Calear AL, Farrer L, Christensen H, Reynolds J, et al. The suicidal ideation attributes scale (SIDAS): Community-based validation study of a new scale for the measurement of suicidal ideation. Suicide Life Threat Behav. 2014; 44(4):408–419. PMID: 24612048.
7. Nock MK, Borges G, Bromet EJ, Alonso J, Angermeyer M, Beautrais A, et al. Cross-national prevalence and risk factors for suicidal ideation, plans and attempts. Br J Psychiatry. 2008; 192(2):98–105. PMID: 18245022.
8. Klonsky ED, May AM, Saffer BY. Suicide, suicide attempts, and suicidal ideation. Annu Rev Clin Psychol. 2016; 12(1):307–330. PMID: 26772209.
9. Arria AM, O’Grady KE, Caldeira KM, Vincent KB, Wilcox HC, Wish ED. Suicide ideation among college students: a multivariate analysis. Arch Suicide Res. 2009; 13(3):230–246. PMID: 19590997.
10. Gibb BE, Andover MS, Beach SR. Suicidal ideation and attitudes toward suicide. Suicide Life Threat Behav. 2006; 36(1):12–18. PMID: 16676621.
11. Ponte C, Almeida V, Fernandes L. Suicidal ideation, depression and quality of life in the elderly: study in a gerontopsychiatric consultation. Span J Psychol. 2014; 17:E14. PMID: 25011955.
12. Kovess-Masfety V, Pilowsky DJ, Goelitz D, Kuijpers R, Otten R, Moro MF, et al. Suicidal ideation and mental health disorders in young school children across Europe. J Affect Disord. 2015; 177:28–35. PMID: 25745832.
13. Barzilay S, Brunstein Klomek A, Apter A, Carli V, Wasserman C, Hadlaczky G, et al. Bullying victimization and suicide ideation and behavior among adolescents in Europe: a 10-country study. J Adolesc Health. 2017; 61(2):179–186. PMID: 28391968.
14. Takada M, Suzuki A, Shima S, Inoue K, Kazukawa S, Hojoh M. Associations between lifestyle factors, working environment, depressive symptoms and suicidal ideation: a large-scale study in Japan. Ind Health. 2009; 47(6):649–655. PMID: 19996541.
15. Stolz E, Fux B, Mayerl H, Rásky É, Freidl W. Passive suicide ideation among older adults in Europe: a multilevel regression analysis of individual and societal determinants in 12 countries (SHARE). J Gerontol B Psychol Sci Soc Sci. 2016; 71(5):947–958. PMID: 27048569.
16. Park HS, Schepp KG, Jang EH, Koo HY. Predictors of suicidal ideation among high school students by gender in South Korea. J Sch Health. 2006; 76(5):181–188. PMID: 16635202.
17. Kim K, Ryu E, Chon MY, Yeun EJ, Choi SY, Seo JS, et al. Internet addiction in Korean adolescents and its relation to depression and suicidal ideation: a questionnaire survey. Int J Nurs Stud. 2006; 43(2):185–192. PMID: 16427966.
18. Koo CY, Kim JS, Yu J. A study on factors influencing elders’ suicidal ideation: Focused on comparison of gender differences. J Korean Acad Community Health Nurs. 2014; 25(1):24–32.
19. Bae SM, Lee YJ, Cho IH, Kim SJ, Im JS, Cho SJ. Risk factors for suicidal ideation of the general population. J Korean Med Sci. 2013; 28(4):602–607. PMID: 23579548.
20. Kwon M. Factors affecting suicidal ideation of depressed adults by age. J Digit Converg. 2018; 16(4):267–276.
21. Kim KH. Youth Suicide Prevention Policy Research. Seoul, Korea: Korea Youth Policy Research Institute;2013.
22. Ministry of Health and Welfare, Korea Foundation for Suicide Prevention. 2013-2017 National Suicide Death Analysis Result Report. Seoul, Korea: Korea Foundation for Suicide Prevention;2021.
23. Obegi JH. Rethinking suicidal behavior disorder. Crisis. 2019; 40(3):209–219. PMID: 30109964.
24. Bernert RA, Hom MA, Roberts LW. A review of multidisciplinary clinical practice guidelines in suicide prevention: toward an emerging standard in suicide risk assessment and management, training and practice. Acad Psychiatry. 2014; 38(5):585–592. PMID: 25142247.
25. Ministry of Health and Welfare, Korea Foundation for Suicide Prevention. 2022 White Paper on Suicide Prevention. Seoul, Korea: Korea Foundation for Suicide Prevention;2022.
26. Ministry of Health and Welfare, Korea Disease Control and Prevention Agency. Korea Health Statistics 2019: Korea National Health and Nutrition Examination Survey (KNHANES VIII-1). Cheongju, Korea: Korea Disease Control and Prevention Agency;2020.
27. Meltzer H, Bebbington P, Brugha T, Jenkins R, McManus S, Dennis MS. Personal debt and suicidal ideation. Psychol Med. 2011; 41(4):771–778. PMID: 20550757.
28. Kim EY, Lee SJ, Park SJ, Lee S, Rhim KH. Adolescents at risk: suicide ideation, plans and attempts in South Korea. Korean Public Health Res. 2014; 40(3):93–104.
29. Hwang JY, Park IS. Analysis of risk factors affecting suicidal ideation in South Korea by life cycle stage. Osong Public Health Res Perspect. 2021; 12(5):314–323. PMID: 34719223.
30. Son YH, Oh SS, Jang SI, Park EC, Park SH. Association between commensality with depression and suicidal ideation of Korean adults: the sixth and seventh Korean National Health and Nutrition Examination Survey, 2013, 2015, 2017. Nutr J. 2020; 19(1):131. PMID: 33267833.
31. Kim Y, Lee E, Lee H. Characteristics of eating alone affecting the stress, depression, and suicidal ideation. Community Ment Health J. 2020; 56(8):1603–1609. PMID: 32318925.
32. Wie JH, Nam SK, Ko HS, Shin JC, Park IY, Lee Y. The association between abortion experience and postmenopausal suicidal ideation and mental health: results from the 5th Korean National Health and Nutrition Examination Survey (KNHANES V). Taiwan J Obstet Gynecol. 2019; 58(1):153–158. PMID: 30638471.
33. Harmer B, Lee S, Duong TH, Saadabadi A. Suicidal ideation. Updated May 18, 2022. Accessed September 6, 2022. https://www.ncbi.nlm.nih.gov/books/NBK565877/ .
34. Ribeiro JD, Huang X, Fox KR, Walsh CG, Linthicum KP. Predicting imminent suicidal thoughts and nonfatal attempts: the role of complexity. Clin Psychol Sci. 2019; 7(5):941–957.
35. van Mens K, de Schepper C, Wijnen B, Koldijk SJ, Schnack H, de Looff P, et al. Predicting future suicidal behaviour in young adults, with different machine learning techniques: a population-based longitudinal study. J Affect Disord. 2020; 271:169–177. PMID: 32479313.
36. Ryu S, Lee H, Lee DK, Park K. Use of a machine learning algorithm to predict individuals with suicide ideation in the general population. Psychiatry Investig. 2018; 15(11):1030–1036.
37. Oh B, Yun JY, Yeo EC, Kim DH, Kim J, Cho BJ. Prediction of suicidal ideation among Korean adults using machine learning: a cross-sectional study. Psychiatry Investig. 2020; 17(4):331–340.
38. Kimura T, Iso H, Honjo K, Ikehara S, Sawada N, Iwasaki M, et al. Educational levels and risk of suicide in Japan: the Japan Public Health Center study (JPHC) cohort I. J Epidemiol. 2016; 26(6):315–321. PMID: 27064129.
39. Ki M, Seong Sohn E, An B, Lim J. Differentiation of direct and indirect socioeconomic effects on suicide attempts in South Korea. Medicine (Baltimore). 2017; 96(51):e9331. PMID: 29390510.
40. Kim GH. Family changes seen in statistics. Updated May 2020. Accessed September 6, 2022. http://www.kcti.re.kr/webzine2/webzineView.action?issue_count=108&menu_seq=7&board_seq=1 .
41. Ministry of Health and Welfare, Korea Institute for Health and Social Affairs. Social Security Factbook 2020. Sejong, Korea: Korea Institute for Health and Social Affairs;2020.
42. Fairweather AK, Anstey KJ, Rodgers B, Jorm AF, Christensen H. Age and gender differences among Australian suicide ideators: prevalence and correlates. J Nerv Ment Dis. 2007; 195(2):130–136. PMID: 17299300.
43. Kim MH, Jung-Choi K, Jun HJ, Kawachi I. Socioeconomic inequalities in suicidal ideation, parasuicides, and completed suicides in South Korea. Soc Sci Med. 2010; 70(8):1254–1261. PMID: 20163900.
44. Cabello M, Rico-Uribe LA, Martinez-Ávila JC, Sánchez-Niubò A, Caballero FF, Borges G, et al. The role of ageing in the wish to be dead: disentangling age, period and cohort effects in suicide ideation in European population. Epidemiol Psychiatr Sci. 2021; 30:e17. PMID: 33597061.
45. National Health Insurance Service (KR). Health iN: Heart, are you okay? Updated October 1, 2021. Accessed September 6, 2022. https://www.nhis.or.kr/magazin/174/html/sub1.html .
46. Lee YM. The most unfortunate woman in her twenties, who is less than “ordinary happiness”. Updated April 9, 2019. Accessed September 6, 2022. http://news.heraldcorp.com/view.php?ud=20190409000541 .
47. Oh HJ. Young female workers, who are they? Updated June 10, 2022. Accessed September 6, 2022. http://www.ohmynews.com/NWS_Web/View/at_pg.aspx?CNTN_CD=A0002842123 .
48. Korean Statistical Information Service. Key indicators of the OECD country. Updated September 30, 2019. Accessed September 6, 2022. https://kosis.kr/statHtml/statHtml.do?orgId=101&tblId=DT_2KAAG01&conn_path=I2 .
49. Hwang J. Low fertility and gender politics of motherhood in Korea. J Korean Womens Stud. 2005; 21(3):99–132.
50. Lim SH, Park SH. The relation of mothers’ socioeconomic status and a number of children to parenting stress and toddler’s expressive vocabulary. J Future Early Child Educ. 2010; 17(1):251–278.
51. Kim EJ. Analysis on the relationship between the suicidal ideation of the married woman and the characteristics of their children [master’s thesis]. Seoul, Korea: Yonsei University;2011.
52. Kim DH, Rodríguez Andrés A, Leigh JP. Sex-specific impact of changes in job status on suicidal ideation. Crisis. 2020; 41(2):89–96. PMID: 31140318.
53. Cleary A. Suicidal action, emotional expression, and the performance of masculinities. Soc Sci Med. 2012; 74(4):498–505. PMID: 21930333.
54. Norström T, Rossow I. Alcohol consumption as a risk factor for suicidal behavior: a systematic review of associations at the individual and at the population level. Arch Suicide Res. 2016; 20(4):489–506. PMID: 26953621.
55. Nolen-Hoeksema S, Hilt L. Possible contributors to the gender differences in alcohol use and problems. J Gen Psychol. 2006; 133(4):357–374. PMID: 17128956.
56. Wilsnack RW, Vogeltanz ND, Wilsnack SC, Harris TR, Ahlström S, Bondy S, et al. Gender differences in alcohol consumption and adverse drinking consequences: cross-cultural patterns. Addiction. 2000; 95(2):251–265. PMID: 10723854.
57. Park BR. Characteristics of single-person households. Updated December 31, 2017. Accessed September 6, 2022. https://www.khan.co.kr/economy/economy-general/article/201712311814001/?med_id=khan .
58. National Assembly Budget Office. NABO Economic Trends & Issues. Seoul, Korea: National Assembly Budget Office;2017.
59. Jorm AF, Henderson AS, Scott R, Korten AE, Christensen H, Mackinnon AJ. Factors associated with the wish to die in elderly people. Age Ageing. 1995; 24(5):389–392. PMID: 8669340.
60. Awata S, Seki T, Koizumi Y, Sato S, Hozawa A, Omori K, et al. Factors associated with suicidal ideation in an elderly urban Japanese population: a community-based, cross-sectional study. Psychiatry Clin Neurosci. 2005; 59(3):327–336. PMID: 15896227.
61. Park S, Park SY, Jang SY, Oh G, Oh IH. The neglected role of physical education participation on suicidal ideation and stress in high school adolescents from South Korea. Int J Environ Res Public Health. 2020; 17(8):2838. PMID: 32326078.
62. Hwang EH, Park MH. The association between total sleep time and suicidal ideation in adults over the age of 20. J Korea Contents Assoc. 2016; 16(5):420–427.
63. Bea SS. Relationships between sleep duration and depression or suicidal thoughts in Korean adults. Korean J Health Serv Manag. 2018; 12(4):219–228.
64. Chae H. Relationships between sleep time and depression and suicidal ideation in middle aged women. J Digit Converg. 2020; 18(4):263–272.
65. Breus M. Sleep and depression. Updated September 9, 2022. Accessed October 1, 2022. https://www.sleepassociation.org/sleep-disorders/more-sleep-disorders/sleep-and-depression/ .
66. Jang MH, Kim YH. The relationship of stress, depression and suicidal ideation in the elderly. J Korean Acad Psychiatr Ment Health Nurs. 2005; 14(1):33–42.
67. Kim DH. National Assembly Suicide Prevention Forum announces results of “Suicide prevention activity survey of 229 local governments nationwide”. Updated December 2, 2021. Accessed September 6, 2022. https://www.youthdaily.co.kr/news/article.html?no=87375 .
68. Ministry of Health and Welfare. Health and Welfare Counseling Center. Updated 2022. Accessed July 8, 2022. https://www.129.go.kr/1393/ .
69. Yoon YH. Ministry of Welfare, ‘2022 White Paper on Suicide Prevention’ published. Updated June 14, 2022. Accessed September 6, 2022. https://www.akomnews.com/bbs/board.php?bo_table=news&wr_id=49482 .
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