Korean Journal of Psychosomatic Medicine (정신신체의학)

Korean Psychosomatic Society (한국정신신체의학회)
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Factors Affecting Emotional Status and Suicidal Risk in Hospitalized Medical Patients

일 종합병원 입원 환자의 자살 위험도 및 정서 상태에 영향을 미치는 요인 연구

  • Lee, Jeon-Ho (Department of Psychiatry, Korea University Guro Hospital) ;
  • Lee, Jong-Ha (Department of Psychiatry, Korea University Guro Hospital) ;
  • Mok, Young-Eun (Department of Psychiatry, Korea University Guro Hospital) ;
  • Lee, Ho-Jun (Department of Psychiatry, Korea University Guro Hospital) ;
  • Jung, Hyun-Gang (Department of Psychiatry, Korea University Guro Hospital) ;
  • Kim, Seung-Hyun (Department of Psychiatry, Korea University Guro Hospital) ;
  • Lee, Moon-Soo (Department of Psychiatry, Korea University Guro Hospital)
  • 이전호 (고려대학교 의과대학 구로병원 정신건강의학교실) ;
  • 이종하 (고려대학교 의과대학 구로병원 정신건강의학교실) ;
  • 목영은 (고려대학교 의과대학 구로병원 정신건강의학교실) ;
  • 이호준 (고려대학교 의과대학 구로병원 정신건강의학교실) ;
  • 정현강 (고려대학교 의과대학 구로병원 정신건강의학교실) ;
  • 김승현 (고려대학교 의과대학 구로병원 정신건강의학교실) ;
  • 이문수 (고려대학교 의과대학 구로병원 정신건강의학교실)
  • Received : 2018.09.20
  • Accepted : 2018.12.15
  • Published : 2018.12.31
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Abstract

Objectives : This study aimed to identify the group with high risk of suicide in general hospital inpatient by comparing the depression, anxiety, and distress and their clinical characteristics. Methods : The study included all patients admitted to a general hospital between January 2016 and December 2017, and the final 41,249 patients were analyzed. Distress thermometer (DT) and hospital anxiety-depression scale (HADS) were used for emotional state evaluation. Group with high risk of suicide was defined as showing more than 4 in the DT and more than 8 in one of the two subscales (anxiety and depression) of the HADS. Results : Among the subjects, 3,603 patients (8.7%) met the high-risk criteria for suicide. The group with high risk of suicide experienced more severe pain than the control patient group, and it was found that there was more underlying disease. Patients who reported pain showed higher scores than those who reported no pain on the DT and HADS subscales. Conclusions : Group with high risk of suicide showed more severe pain and more underlying disease. Therefore, suicide prevention program specifically targeted for the group with high risk of suicide should be developed according to the risk of the patient evaluated at the time of the admission.

연구목적 본 연구는 일 종합병원 입원 환자를 대상으로 우울, 불안, 디스트레스 등을 비교 분석하여 자살 고위험군을 선별하고, 이들의 임상적 특징을 파악하고자 하였다. 방 법 일 종합병원에 2016년 1월로부터 2017년 12월까지 입원한 전체 환자를 대상으로 하여, 최종 41,249명의 정서상태, 통증, 기저질환 및 기능수준과 관련된 의무기록을 분석하였다. 정서상태 평가를 위해 디스트레스 온도계, 병원 불안-우울 척도를 사용하였다. 자살에 대한 고위험군은 디스트레스 온도계 점수 4점 이상이면서, 병원 불안-우울 척도의 불안, 우울 하위 척도 중 하나라도 8점 이상인 환자로 정의하였다. 결 과 대상자 중 자살에 대한 고위험군 기준에 부합하는 환자는 3,603명(8.7%)였다. 자살 고위험군은 일반군에 비해 더 심한 통증을 경험하고 있었으며, 기저질환을 가진 경우가 더 많은 것으로 나타났다. 통증을 보고한 환자들에서는 디스트레스 온도계 점수, 병원 불안-우울 척도의 불안, 우울 하위 척도 모두에서 통증이 없다고 보고한 환자들에 비해 더 높은 점수를 보였다. 결 론 자살 고위험군은 더 심한 통증과, 더 많은 기저질환을 갖는 것으로 나타났다. 따라서 입원 시 환자의 위험도에 따른 선별 및 선별된 환자들을 대상으로 하는 적극적인 자살 예방 방안이 필요하다.

Keywords

Table 1. General characteristics of the patients (n=41,249)

JSSCBG_2018_v26n2_127_t0001.png 이미지

Table 2. Degree of pain, chronic medical condition, functional impairment, distress thermometer, hospital anxiety and depression scale

JSSCBG_2018_v26n2_127_t0002.png 이미지

Table 3. Differences in Pain score according to high risk of suicide

JSSCBG_2018_v26n2_127_t0003.png 이미지

Table 4. Differences in health characteristics according to high risk of suicide

JSSCBG_2018_v26n2_127_t0004.png 이미지

Table 5. Differences in Distress thermometer, Hospital anxiety and depression scale according to pain

JSSCBG_2018_v26n2_127_t0005.png 이미지

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