CONCLUSION

In summary, despite the aforementioned limitations, the present study is the first ED-based multicenter trial to evaluate the characteristics of patients with self-inflicted injuries.

Poisoning was the most common method of suicide attempt among all age groups. However, the reasons for self-inflicted injuries varied among the age groups. Male gender, old age, and not having consumed alcohol were predictors of a severe outcome following a suicide attempt. Further studies should be conducted to confirm these results. I suggest the following for suicide prevention:

1. Modification of current dataset

We need to group the patients based on intent and reasons of suicide. First of all, we need to identify the patients with suicidal intents and those who deny their suicide ideation.

Patients with suicidal intents can be divided into two groups: planned suicide and impulsive suicide. Patients who deny their suicide ideation are also classified into two groups:

impulsive self-harm activity and denial of suicidality despite having the intent. Based on the types of problems, patients are divided into three groups. The first is a group of patients who attempt suicide because of chronic problems, and the second is a group of patients who have provocateurs other than chronic problems. The last group consists of patients without chronic problems but are influenced by impulsive factors. Risk assessment for patients can sort out a vulnerable group.

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To understand the patients’ surroundings, we need to survey socioeconomic states such as occupation, income, marital state, relationship with people around them. As this study showed, human relationship is the most common factor for suicide attempts. Also, medical information should be complemented. Previous datasets have not reflected medical history and current condition. The new survey needs a multi-dimensional approach.

2. Education for health care providers in ER

Most data are obtained through interviews. They can be interpreted in various ways depending on the circumstances: patients’ factors, health care providers’ factors and environments. For standardization of data, we need to strengthen education for health care providers.

3. Connection to proper intervention

The current registry system is only for identification of risky groups. To reduce suicide, we have to identify patients who have high risks of committing suicide and help them not to re-attempt. Systemic and financial support systems are required to connect suicide attempters to psychiatrists as well as social workers.

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응급실을 내원한 자해 환자들의 특징

자살 시도자들에 대한 일차적 치료와 자살 위험 인자의 분석은 자살예방을 위한 중요한 요소 중 하나다. 이 연구는 자살 예방을 위해 자해로 응급실을 내원한 환자들의 특징을 파악하는 것에 초점을 맞추고 있다. 2007 년부터 2009 년까지 3 년동안 질병관리본부에서 지정한 3 개의 표본 병원에 방문한 자해환자들을 대상으로 연구를 진행하였다. 대상의 일반적 특징과 자살 시도의 방법, 이유 등에 대해 조사하였다. 3 년간 총 2,996 명의 자해환자가 대상

의료기관의 응급실을 방문하였다. 여자가 남자에 비해 1.38 배

많았으며(P<0.001), 평균연령은 41 세였다. 모든 연령군에서 중독에 의한 자살시도가 가장 많았으나(68.7%) 연령군에 따라 중독물질은 차이를 보였다.

50 세 미만의 연령에서는 치료약물이 가장 많았고, 50 세 이상의 연령에서는 농약이 가장 많았다. 자살시도의 이유는 연령군마다 다르게 나타났다. 중증 손상의 예측인자로는 남자, 노령, 비음주 상태로 나타났다.

핵심어: 자살생각, 자살시도, 자살예방