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Association between new-onset liver cirrhosis and suicide risk in South Korea: A nationwide cohort study

Authors
 Suk-Yong Jang  ;  Woo Sun Rou  ;  Seok Hyun Kim  ;  Byung Seok Lee  ;  Hyuk Soo Eun 
Citation
 CLINICAL AND MOLECULAR HEPATOLOGY, Vol.27(2) : 283-294, 2021-04 
Journal Title
CLINICAL AND MOLECULAR HEPATOLOGY
ISSN
 2287-2728 
Issue Date
2021-04
MeSH
Adolescent ; Adult ; Aged ; Cohort Studies ; Female ; Humans ; Incidence ; Liver Cirrhosis* ; Male ; Middle Aged ; Republic of Korea ; Suicide* ; Young Adult
Keywords
Depression ; Liver cirrhosis ; Psychological distress ; Risk ; Suicide
Abstract
Background/aims: Current evidence suggests that liver cirrhosis (LC) causes severe psychological stress and depression, which are risk factors for suicide. Although previous studies reported the association between LC and suicidal thoughts, little is known of its effect on suicidal deaths. Therefore, this study was undertaken to investigate the effect of new-onset LC on suicide.

Methods: From the National Health Insurance Service-National Sample Cohort of South Korea, 5,809 incident LC patients and 11,618 risk-set controls matched by propensity score were selected for follow-up. The incidence rate of suicide was estimated using a generalized estimating equation with a Poisson distribution. Effect size was presented as a hazard ratio (HR) using Cox's proportional hazards model.

Results: The incidence rate of suicide was 143.3 cases per 100,000 person years (95% confidence interval [CI], 100.2-205.1) among the LC cohort. The LC patients were 2.37 times more likely to commit suicide compared with matched controls (HR, 2.37; 95% CI, 1.44-3.88). Increased suicide risk was evident within the first 2 years of the follow-up period (HR, 2.59; 95% CI, 1.20-5.60) and among the 18-49-year-old age group (HR, 3.72; 95% CI, 1.45-9.56).

Conclusion: Our study found increased risk of suicide in patients with new onset LC, especially during the early period following diagnosis and in younger patients. To decrease this suicide risk, a regular and continuous social support system is required.
DOI
10.3350/cmh.2020.0227
Appears in Collections:
4. Graduate School of Public Health (보건대학원) > Graduate School of Public Health (보건대학원) > 1. Journal Papers
Yonsei Authors
Jang, Suk Yong(장석용)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/190968
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