Psychiatry Investig > Volume 19(6); 2022 > Article |
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Availability of Data and Material
The datasets generated or analyzed during the study are available from the corresponding author on reasonable request.
Conflicts of Interest
The authors have no potential conflicts of interest to disclose.
Author Contributions
Conceptualization: Min Ji Kim, Hyunju Lee. Data curation: Minseok Hong. Formal analysis: Min Ji Kim. Funding acquisition: Jong-Ik Park, Yong Min Ahn. Investigation: Min Ji Kim, Hyunju Lee. Methodology: Min Ji Kim, Hyunju Lee. Software: Yong Min Ahn. Supervision: Sang Jin Rhee, Jong-Ik Park, Yong Min Ahn. Writing—original draft: Min Ji Kim. Writing—review & editing: Daun Shin, Sang Jin Rhee.
Funding Statement
This research was supported by a grant from the Korea Ministry of Health & Welfare, Republic of Korea.
No suicidal idea (N=2,380) (79.3%) |
Suicide behavior (N=620) (20.7%) |
||||
---|---|---|---|---|---|
Suicidal idea only (N=477) (15.9%) | Suicidal plan (N=85) (2.8%) | Suicide attempt (N=58) (1.9%) | p-value | ||
Sex | 0.430 | ||||
Male | 1,151 (48.4) | 216 (45.3) | 38 (44.7) | 24 (41.4) | |
Female | 1,229 (51.6) | 261 (54.7) | 47 (55.3) | 34 (58.6) | |
Age (yr) | 0.375 | ||||
19-29 | 410 (17.2) | 77 (16.1) | 12 (14.1) | 11 (19.0) | |
30-39 | 471 (19.8) | 86 (18.0) | 19 (22.4) | 9 (15.5) | |
40-49 | 516 (21.7) | 101 (21.2) | 21 (24.7) | 15 (25.9) | |
50-59 | 472 (19.8) | 109 (22.9) | 15 (17.6) | 18 (31.0) | |
≥60 | 511 (21.5) | 104 (21.8) | 18 (21.2) | 5 (8.6) | |
Marital status | <0.001 | ||||
Married | 524 (22.0) | 109 (22.9) | 18 (21.2) | 14 (24.1) | |
Unmarried | 1,705 (71.6) | 318 (66.7) | 52 (61.2) | 31 (53.4) | |
Divorced/Deceased | 151 (6.3) | 50 (10.5) | 15 (17.6) | 13 (22.4) | |
Education level (yr) | 0.047 | ||||
≤9 | 400 (16.8) | 99 (20.8) | 13 (15.3) | 12 (20.7) | |
10-12 | 988 (41.5) | 207 (43.4) | 44 (51.8) | 28 (48.3) | |
≥13 | 992 (41.7) | 171 (35.8) | 28 (32.9) | 18 (31.0) | |
Monthly income (million KW)* | 0.010 | ||||
<200 | 472 (19.8) | 123 (25.8) | 19 (22.4) | 21 (36.2) | |
200-399 | 1,082 (45.5) | 197 (41.3) | 37 (43.5) | 22 (37.9) | |
≥400 | 824 (34.7) | 157 (32.9) | 29 (34.1) | 15 (25.9) | |
Urbanicity | 0.917 | ||||
Urban | 1,914 (80.4) | 389 (81.6) | 69 (81.2) | 48 (82.8) | |
Rural | 466 (19.6) | 88 (18.4) | 16 (18.8) | 10 (17.2) | |
Employment | 0.917 | ||||
Employed | 1,030 (43.3) | 201 (42.1) | 36 (42.4) | 27 (46.6) | |
Unemployed | 1,350 (56.7) | 276 (57.9) | 49 (57.6) | 31 (53.4) | |
Religion | 0.006 | ||||
Yes | 1,064 (44.7) | 245 (51.4) | 45 (52.9) | 34 (58.6) | |
No | 1,316 (55.3) | 232 (48.6) | 40 (47.1) | 24 (41.4) | |
Year | 0.113 | ||||
2013 | 1,165 (48.9) | 258 (54.1) | 43 (50.6) | 34 (58.6) | |
2018 | 1,215 (51.1) | 219 (45.9) | 42 (49.4) | 24 (41.4) |
Factor | Explained variance (%) | Factor loadings | Cronbach’s α |
---|---|---|---|
Factor 1. Permissiveness | 10.47 | 0.733 | |
18. Suicide a relief | 0.676 | ||
16. Situations where suicide is the only solution | 0.611 | ||
20. Consider suicide if incurable disease-myself. | 0.608 | ||
36. Get help to commit suicide if incurable disease-myself | 0.607 | ||
17. Could express suicide wish without meaning it-myself | 0.552 | ||
32. Suicide understandable if incurable disease-people | 0.508 | ||
29. Give help to commit suicide if incurable disease-people | 0.460 | ||
5. Suicide acceptable means to end incurable disease | 0.456 | ||
Factor 2. Unjustified behavior | 7.27 | 0.593 | |
2. Suicide can never be justified | 0.728 | ||
3. Suicide among the worst thing to do to relatives | 0.712 | ||
19. Suicides among younger people particularly puzzling | 0.526 | ||
9. Duty to restrain a suicidal act | 0.472 | ||
Factor 3. Call for help | 5.51 | 0.266 | |
26. Suicides basically signal for help | 0.651 | ||
24. Suicide one’s own business* | 0.555 | ||
13. Should or would rather not talk about suicide* | 0.431 | ||
Factor 4. Preventability/Readiness to help | 5.40 | 0.473 | |
30. Prepared to help a suicidal person-myself | 0.736 | ||
1. Can always help | 0.720 | ||
37. Suicide can be prevented. | 0.422 | ||
Factor 5. Loneliness | 5.32 | 0.496 | |
25. Loneliness that drives people to suicide | 0.777 | ||
14. Loneliness can be a reason for suicide | 0.640 | ||
Factor 6. Reasons for suicide | 5.21 | 0.365 | |
7. Attempts due to revenge and punishment | 0.597 | ||
4. Attempts are impulsive actions | 0.573 | ||
35. Attempts due to interpersonal conflicts | 0.528 | ||
Factor 7. Incomprehensibility | 4.54 | 0.326 | |
22. Suicide happens without warning | 0.736 | ||
28. Relatives have no idea about what is going on | 0.622 | ||
27. Could express suicide wish without meaning it-myself | 0.440 | ||
Factor 8. Unreliable | 4.33 | 0.289 | |
12. Communication not serious | 0.692 | ||
33. People who make threats seldom complete suicide | 0.593 | ||
Factor 9. Nonreversible | 3.88 | - | |
6. Suicide decision can’t be reversed. | 0.840 | ||
Total | 51.94 |
The English expression for each Attitudes Toward Suicide Scale (ATTS) item is the same as the expression in Renberg et al. [17] Reprinted with permission from reference article 17. Modifed from Renberg et al., [17] Development of a questionnaire on attitudes towards suicide (ATTS) and its application in a Swedish population. Suicide Life Threat Behav 2003;33:52-64.
No suicidal idea (Mean [SD]) |
Suicidal behavior (Mean [SD]) |
Trend |
Group comparison |
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---|---|---|---|---|---|---|---|---|---|
Suicidal idea only | Suicidal plan | Suicide attempt | J-T statistic | p-value | F | p-value | Post-hoc* | ||
Permissiveness | 2.76 (0.61) | 2.93 (0.61) | 3.09 (0.59) | 3.19 (0.70) | 7.824 | <0.001 | 25.322 | <0.001 | a<b<d |
Unjustified behavior | 4.01 (0.62) | 3.91 (0.65) | 3.89 (0.80) | 3.85 (0.77) | -3.004 | 0.003 | 5.016 | 0.002 | a<c, a>b |
Preventability/Readiness to help | 3.54 (0.65) | 3.56 (0.65) | 3.44 (0.64) | 3.67 (0.74) | 0.052 | 0.959 | 1.571 | 0.194 | - |
Loneliness | 3.26 (0.87) | 3.38 (0.85) | 3.35 (0.82) | 3.70 (0.82) | 4.155 | <0.001 | 7.491 | <0.001 | a<b<d |
Univariate model |
Multivariate model* |
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---|---|---|---|---|---|---|---|---|---|---|---|---|
Suicidal idea only |
Suicidal plan |
Suicide attempt |
Suicidal idea only |
Suicidal plan |
Suicide attempt |
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OR (95% CI) | p-value | OR (95% CI) | p-value | OR (95% CI) | p-value | aOR (95% CI) | p-value | aOR (95% CI) | p-value | aOR (95% CI) | p-value | |
Permissiveness | 1.60 (1.35-1.89) | <0.001 | 2.60 (1.18-3.79) | <0.001 | 3.42 (2.17-5.38) | <0.001 | 1.49 (1.25-1.79) | <0.001 | 2.79 (1.84-4.25) | <0.001 | 2.67 (1.65-4.33) | <0.001 |
Unjustified behavior | 0.78 (0.67-0.91) | 0.001 | 0.75 (0.54-1.03) | 0.079 | 0.68 (0.46-1.00) | 0.055 | 0.79 (0.67-0.94) | 0.006 | 0.93 (0.65-1.33) | 0.689 | 0.64 (0.42-0.99) | 0.043 |
Preventability/Readiness to help | 1.30 (1.11-1.52) | 0.001 | 0.78 (0.57-1.09) | 0.147 | 1.37 (0.91-2.07) | 0.137 | 1.11 (0.94-1.30) | 0.220 | 0.78 (0.55-1.12) | 0.179 | 1.38 (0.88-2.17) | 0.166 |
Loneliness | 1.19 (1.06-1.33) | 0.004 | 1.14 (0.89-1.47) | 0.307 | 1.93 (1.37-2.71) | <0.001 | 1.08 (0.95-1.22) | 0.259 | 0.91 (0.68-1.21) | 0.501 | 1.50 (1.03-2.20) | 0.036 |