한국노인의 자살사고에 연관된 사회심리학적 요인

Abstract

Objectives : The aim of this study was to analyze psychosocial factors associated with suicidal idea among Korean elderly. Methods : The sociodemographic data and psychopathology were evaluated by questionnaire and psychiatric interview in community-dwelling elderly with age over 60 (N=100) and adults with age 30-49 (N=60). Suicidal idea was assessed by 9th item of Beck Depression Inventory (BDI). To analyze factors associated with suicidal idea in Korean elderly, we assessed family function (Family Adaptation Partnership Growth Affection Resolve, APGAR), alcohol problem (Cut Annoyed Guilty Eye-Opener, CAGE), depressive symptoms (HAM-D, BDI), cognitive function (CDR, MMSE-K, GDS), and functional activities (ADL, I-ADL). Results : 1) The frequency of suicidal idea of the elderly with age over 60 (20.0%) was significantly higher than that of adult with age 30-49 (6.7%)(p<0.05). 2) The factors associated with suicidal idea were major depressive disorder (OR=42.17, 95% C.I. : 2.62-679.03), physical illness (OR=27.01, 95% C.I. : 1.18-616.50), depressive symptoms (OR=12.18, 95% C.I. : 2.91-49.98), poor economic status (OR=7.18, 95% C.I. : 1.05-48.86). 3) The means of variables in the elderly with suicidal idea were ADL 6.4±1.1, HAM-D 17.8±7.7, BDI 30.0±9.5, APGAR 4.8±2.6, which were significantly higher than those of the elderly without suicidal idea (p<0.05, respectively). 4) The HAM-D score in the Korean elderly had statistically significant correlation with APGAR (γ=0.376, p<0.01), BDI (γ=0.808, p<0.01), ADL (γ=0.316, p<0.01), GDS (γ=0.282, p<0.01), CDR (γ=0.258, p<0.01) and education level (γ=-0.208, p<0.05). The BDI score had statistically significant correlation with APGAR (γ=0.341, p<0.01), HAM-D (γ=0.808, p<0.01), GDS(γ=0.340, p<0.01), CDR (γ=0.301, p<0.01), ADL (γ=0.325, p<0.05) and I-ADL (γ=0.206, p<0.05). Conclusion : These results suggested early detection, psychogeriatric intervention of the elderly with high risk factors and active treatment of medical illness could reduce suicidal idea among them.