Citation

Jang J, Lee G, Seo J, Na EJ, Park JY, Jeon HJ. J. Affect. Disord. 2020; 272: 423-431.

Affiliation

Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea; Korea Psychological Autopsy Center (KPAC), Seoul, South Korea; Department of Health Sciences & Technology, Department of Medical Device Management & Research, and Department of Clinical Research Design & Evaluation, Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Seoul, South Korea. Electronic address: jeonhj@skku.edu.

Copyright

(Copyright © 2020, Elsevier Publishing)

DOI

10.1016/j.jad.2020.04.021

PMID

32553386

Abstract

BACKGROUND: Suicide survivors are defined as victims who experienced suicide of siblings or parents, spouses, or lineal relatives within the fourth degree who had lived with them. We compared the effects of major depressive disorder (MDD), symptoms of posttraumatic stress disorder (PTSD), and impulsivity on lifetime suicide attempts among suicide survivors.

METHODS: Participants included 272 suicide survivors. We compared them to 5,200 members from the general population who were matched by age, sex, and years of education. We evaluated participants using the Patient Health Questionnaire-9 (PHQ-9), the EuroQuality of Life (EuroQol) scale, the Impact of Events Scale-Revised (IES-R), the Barratt Impulsiveness Scale-11 (BIS-11), and the Composite International Diagnostic Interview (K-CIDI).

RESULTS: Among the 272 suicide survivors, MDD was nine times higher (47.1% vs. 5.3%), and suicidal attempts were six times higher (20.5% vs. 3.3%) than reported among the general population. The suicide survivors showed more severe depression, greater impulsivity, and poorer quality of life than did the general population. In multivariate logistic regression analyses performed to evaluate each IES-R item, "trouble staying asleep" was the only PTSD symptom item that was significantly associated with suicide attempts among suicide survivors. Suicide survivors who had both MDD with insomnia and high impulsivity were at four times higher risk for suicide attempts than the general population with no MDD (AOR = 4.04, 95% CI: 1.25-13.09).

CONCLUSIONS: Surviving suicide by family members is an important risk factor for suicide attempts. In particular, MDD with insomnia and impulsivity are associated with suicide attempts among suicide survivors.

Copyright © 2020 Elsevier B.V. All rights reserved.

Language: en

Keywords

Impulsivity; PTSD; South Korea; Suicidal attempt; Suicide survivors