title: Reasons for desiring death: examining causative factors of suicide attempters treated in emergency rooms in Korea.
abstract: BACKGROUND
  Suicide attempters treated in emergency rooms were studied in order to understand the motives behind this behavior. Disparities between the etiological contributions to suicidal ideation, intention, and action were examined in order to characterize motives in these categories.
  
  
  METHODS
  Suicide attempters who visited the emergency departments of seven university hospitals were analyzed. Attempts leading to mortality were excluded from the analysis. Participants were assessed using semi-structured questionnaires, the results of which were noted on their medical records. These were analyzed retrospectively.
  
  
  RESULTS
  Attempter self-report assessment revealed that participants chose external sources of stress (75.4%) and psychiatric symptoms (19.1%) as their main reasons for attempting suicide. However, assessments by interviewers indicated that stressors contributed to suicide attempts to a lesser degree (52.8%) while psychiatric symptoms were more etiologically relevant (36.6%). Compared to those with stressors that was identified as causal in both self-report and clinician assessed evaluation, the participants-regardless of their self-report evaluation-who identified with causal psychiatric symptoms by psychiatrist had more severe and intense suicidal ideation and more determined suicidal intention.
  
  
  CONCLUSIONS
  We collected samples from only university hospitals, resulting in selection bias. In addition, we did not use psychiatric scales to evaluate the participants׳ symptoms.
  
  
  CONCLUSIONS
  Stress was the greatest motive for attempting suicide, affirmed in both self-report and clinician assessed evaluation. A fair proportion of people were objectively identified as being motivated by psychiatric symptoms, yet were unaware of what they suffered from. Furthermore, suicide severity, intensity, and suicidal intention were stronger in psychiatrically driven cases.
authors.affiliation: Department of Psychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
authors.forename: Meerae
authors.initials: M
authors.lastname: Lim
authors.affiliation: Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea.
authors.forename: Sung-Wan
authors.initials: SW
authors.lastname: Kim
authors.affiliation: National Seoul Hospital, Seoul, Republic of Korea.
authors.forename: Yoon-Young
authors.initials: YY
authors.lastname: Nam
authors.affiliation: Department of Psychiatry, Busan National University Hospital Medical Research Institute, Busan, Republic of Korea.
authors.forename: Eunsoo
authors.initials: E
authors.lastname: Moon
authors.affiliation: Department of Psychiatry, School of Medicine, Eulgi University, Daejeon, Republic of Korea.
authors.forename: Jechun
authors.initials: J
authors.lastname: Yu
authors.affiliation: Korea Suicide Prevention Center, Seoul, Republic of Korea.
authors.forename: Soojung
authors.initials: S
authors.lastname: Lee
authors.affiliation: Department of Psychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
authors.forename: Jae Seung
authors.initials: JS
authors.lastname: Chang
authors.affiliation: Department of Psychiatry, Kangwon National University School of Medicine, Chuncheon, Republic of Korea.
authors.forename: Jin-Hyeong
authors.initials: JH
authors.lastname: Jhoo
authors.affiliation: Department of Psychiatry, Gyeongsang National University College of Medicine, Jinju, Republic of Korea.
authors.forename: Boseok
authors.initials: B
authors.lastname: Cha
authors.affiliation: Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul, Republic of Korea.
authors.forename: Jung-Seok
authors.initials: JS
authors.lastname: Choi
authors.affiliation: Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors.forename: Yong Min
authors.initials: YM
authors.lastname: Ahn
authors.affiliation: Department of Psychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea; National Seoul Hospital, Seoul, Republic of Korea; Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors.forename: Kyooseob
authors.initials: K
authors.lastname: Ha
authors.affiliation: Biomedical Research Institute, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
authors.forename: Jayoun
authors.initials: J
authors.lastname: Kim
authors.affiliation: Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Hong Jin
authors.initials: HJ
authors.lastname: Jeon
authors.affiliation: Korea Suicide Prevention Center, Seoul, Republic of Korea; Department of Psychiatry, Kangwon National University School of Medicine, Chuncheon, Republic of Korea. Electronic address: lugar@kangwon.ac.kr.
authors.forename: Jong-Ik
authors.initials: JI
authors.lastname: Park
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001293:Attitude to Death; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006785:Hospitals, University; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000523:psychology; D008875:Middle Aged; D009042:Motivation; D056910:Republic of Korea; D012189:Retrospective Studies; D013315:Stress, Psychological / Q000453:epidemiology / Q000523:psychology; D013406:Suicide, Attempted / Q000523:psychology* / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Cause of suicide attempt; Psychiatric symptoms; Stress; Suicide; Suicide attempt