Suicidal ideation, Suicide plans and attempts

in Korean adolescents

Ju Young Ha1

1 College of Nursing, Pusan National University, Busandaehak-ro 49,

Yangsan-si, 626-870, Gyeongsangnam-do, Korea

jyha1028@pusan.ac.kr

Abstract. The aim of this study was to investigate the prevalence of suicidal

ideation, suicide plans and attempts among Korean adolescents. A total sample

of 72,435 adolescents aged 12~18 years who responded to the 2013 Korea

Youth Risk Behavior Web-based Survey (KYRBS). The prevalence of suicidal

ideation, suicide plans and suicide attempts were 16.7%, 5.8% and 4.2%

respectively. The suicidal ideation, suicide plan and suicide attempts

significantly differed according to general characteristics. Based on study

findings, prevention interventions should be tailored to specific gender, school

grades, socioeconomic and psychiatric status.

Keywords: Adolescent, Suicide, Prevalence

1 Introduction

In South Korea, suicide rate was 31.7 deaths per 100,000 in 2011, which was the

highest rate among the OECD (Organization for Economic Co-operation and

Development) [1]. The suicide rate in adolescents has been rising rapidly. According

to the result of sixth Korea Youth Risk Behavior Web-based Survey, 19.1% of the

total participants (72,623 of total adolescents aged 13~18years old) had experienced

suicidal ideation and 4.9% actually attempted suicide [2]. The probability of death

resulting from a suicidal act is 100 times higher in the attempters than in the general

population [3]. Research indicates that suicide itself represents a heterogeneous

spectrum of risk, ranging from suicidal thinking (e.g. repeated thoughts and plans

related to suicide) to suicidal behaviors such as making verbal suicide threats and

engaging in suicide attempts [4-6]. Moreover, non-fatal suicidal behavior, including

suicide attempts, is recognized as one of the strongest predictors of subsequent suicide

[7]. Therefore, the timely strategies of suicide prevention for adolescents could

contribute to reduce the risk of suicide effectively. The purpose of this study was to

investigate the prevalence of suicidal ideation, suicide plans and suicide attempts

among Korean adolescents.

Advanced Science and Technology Letters Vol.72 (Healthcare and Nursing 2014), pp.117-122

http://dx.doi.org/10.14257/astl.2014.72.29

ISSN: 2287-1233 ASTL Copyright © 2014 SERSC

2 Method

2.1 Samples

The subjects were participants in the 2013 Korea Youth Risk Behavior Web-based

Survey (KYRBS). The survey has been conducted annually since 2005 by the Korea

Centers for Disease Control and Prevention (KCDC) and the Ministry of Education,

Science and Technology, in order to monitor the prevalence of the health behaviors

among the adolescents. The data were collected with an ongoing, web-based survey

conducted on a nationally representative sample of middle and high school students

with a stratified, clustered, multistage probability sampling design. After the survey

was fully explained, only participants who provided informed consent completed the

online anonymous self-report questionnaires in a school computer room. The number

of study subjects was 72,435 who were aged between 12 and 18 years old (36,655 for

boys and 35,780 girls).

2.2 Measures

The general characteristics examined included age, gender, school, perceived

academic performance, perceived socioeconomic status (SES), and living status.

Health-related factors were subjective feeling of happiness, stress perception, and

subjective feeling depression (“Were you feeling so sad or hopeless for at least two

weeks or more that you stopped doing some usual activities during the last 12

months?”).

Suicidal ideation was assessed by asking „Have you ever seriously thought about

committing suicide in the past 12 months?‟, suicide plan was assessed by asking

„Have you ever concrete plan about committing suicide in the past 12 months?‟ and

suicide attempt was assessed by asking „Have you ever attempted suicide in the past

12 months?‟.

2.3 Data analysis

The collected data was analyzed with descriptive statistics and chi-square tests using

IBM SPSS Statistics 20.0 and p<0.5 was considered statistically significant.

Advanced Science and Technology Letters Vol.72 (Healthcare and Nursing 2014)

118 Copyright © 2014 SERSC

3 Results

3.1 Participant Characteristics

Participants were 72,435 adolescents aged from 12 to 18 (M=14.90, SD=1.76). The

general characteristics of the study population are shown in Table 1. The proportion

of boys was 50.6%, and about half of the subjects were middle school students.

Table 1. General characteristics of the study population (N=72,435)

Variable n %

Gender Boys 36,655 50.6

Girls 35,780 49.4

School Middle 36,530 50.4

High 35,905 49.6

Perceived Excellent 7942 11.0

Academic Good 17,053 23.5

Performance Average 20,148 27.8

Fair 18,107 25.0

Poor 9,185 12.7

Perceived High 5,222 7.2

Socioeconomic Mid-high 17,525 24.2

Status Middle 34,494 47.6

Mid-low 11,806 16.3

Low 3,388 4.7

Living status With family 69,006 95.3

With relatives 776 1.1

Dormitory 2,250 3.1

Nursery facilities 403 0.6

Subjective High 42,127 58.2

Happiness Middle 21,943 30.3

Low 8,365 11.5

Stress High 30,192 41.7

Perception Middle 29,841 41.2

Low 12,402 17.1

History of feeling No 50,005 69.0

depressed Yes 22,430 31.0

3.2 Prevalence of Suicidal Ideation, Plan and Attempts

In the past 12 months, the prevalence of suicidal ideation, suicide plan and suicide

attempts was 16.7% , 5.8% and 4.2% respectively (Table 2).

Advanced Science and Technology Letters Vol.72 (Healthcare and Nursing 2014)

Copyright © 2014 SERSC 119

Table 2. Suicidal Ideation, Suicide Plan and Suicide Attempts (N=72,345)

Variable n %

Suicidal Ideation No 60,365 83.3

Yes 12,070 16.7

Suicide Plan No 68,267 94.2

Yes 4,168 5.8

Suicide Attempts No 69,414 95.8

Yes 3,021 4.2

3.3 Differences in Suicidal Ideation, Plan and Attempts by Variables

Table 3 shows the differences in suicidal ideation, suicide plan and suicide attempts

according to general characteristics. There were significant differences in suicidal

ideation, plan and attempts by all variables of general characteristics.

Table 3. Suicidal Ideation, Suicide Plan and Suicide Attempts by general characteristics

(N=72,345)

Variables Categories

Suicidal ideation Suicide plan Suicide attempts

No Yes χ 2

No Yes χ 2

No Yes χ 2

n(%) n(%) (p) n(%) n(%) (p) n(%) n(%) (p)

Gender Boys 31885 (87.0)

4770 (13.0)

711.91 (<.001)

34900

(95.2) 1755 (4.8)

127.75 (<.001)

35590 (97.1)

1065 (2.9)

297.19 (<.001)

Girls 28480 (79.6)

7300 (20.4)

33367

(93.3) 2413 (6.7)

33824 (94.5)

1956 (5.5)

School Middle 30186 (82.6)

6344 (17.4)

26.25 (<.001)

34099

(93.3) 2431 (6.7)

110.24 (<.001)

34680 (94.9)

1850 (5.1)

147.27 (<.001)

High 30179 (84.1)

5726 (15.9)

34168

(95.2) 1737 (4.8)

34734 (96.7)

1171 (3.3)

Perceived Excellent 6803 (85.7)

1139 (14.3)

441.16 (<.001)

7524 (94.7)

418 (5.3)

247.69 (<.001)

7668 (96.5)

274 (3.5)

329.96 (<.001)

Academic Good 14548 (85.3)

2505 (14.7)

16223

(95.1) 830

(4.9) 16493

(96.7) 560

(3.3)

Performance Average 17173 (85.2)

2975 (14.8)

19191

(95.3) 957

(4.7) 19487

(96.7) 661

(3.3)

Fair 14774 (81.6)

3333 (18.4)

16965

(93.7) 1142 (6.3)

17257 (95.3)

850 (4.7)

Poor 7067 (76.9)

12070 (16.7)

8364 (91.1)

821 (8.9)

8509 (92.6)

676 (7.4)

Perceived High 4370 (83.7)

852 (16.3)

725.72 (<.001)

4798 (91.9)

424 (8.1)

463.66 (<.001)

4923 (94.3)

299 (5.7)

365.36 (<.001)

Socioeconomic Mid-high 14993 (85.6)

2532 (14.4)

16678 (95.2)

847 (4.8)

16922 (96.6)

603 (3.4)

Advanced Science and Technology Letters Vol.72 (Healthcare and Nursing 2014)

120 Copyright © 2014 SERSC

Status Middle 29289 (84.9)

5205 (15.1)

32790

(95.1) 1704 (4.9)

33262 (96.4)

1232 (3.6)

Mid-low 9354 (79.2)

2452 (20.8)

11055 (93.6)

751 (6.4)

11252 (95.3)

554 (4.7)

Low 2359 (69.6)

1029 (30.4)

2946 (87.0)

442 (13.0)

3055 (90.2)

333 (9.8)

Living status With family 57651 (83.5)

1135 (16.5)

127.77 (<.001)

65189

(94.5) 3817 (5.5)

384.80 (<.001)

66243 (96.0)

2763 (4.0)

330.92 (<.001)

With

relatives

573 (73.8)

203 (26.2)

664 (85.6)

112 (14.4)

692 (89.2)

84 (10.8)

Dormitory 1870 (83.1)

380 (16.9)

2111 (93.8)

139 (6.2)

2155 (95.8)

95 (4.2)

Nursery

facilities

271 (67.2)

132 (32.8)

303 (75.2)

100 (24.8)

324 (80.4)

79 (19.6)

Subjective High 38546 (91.5)

3581 (8.5)

9278.53 (<.001)

40918

(97.1) 1209 (2.9)

3808.49 (<.001)

41278 (98.0)

849 (2.0)

2685.05 (<.001)

Happiness Middle 17731 (80.8)

4212 (19.2)

20663

(94.2) 1280 (5.8)

20976 (95.6)

967 (4.4)

Low 4088 (48.9)

4277 (51.1)

6686 (79.9)

1679 (20.1)

7160 (85.6)

1205 (14.4)

Stress High 20937 (69.3)

9255 (30.7)

7408.29 (<.001)

27095

(89.7) 3097

(10.3) 1937.70 (<.001)

27924 (92.5)

2268 (7.5)

1448.56 (<.001)

Perception Middle 27485 (92.1)

2356 (7.9)

29058

(97.4) 783

(2.6) 29280

(98.1) 561

(1.9)

Low 11943 (96.3)

459 (3.7)

12114

(97.7) 288

(2.3) 12210

(98.5) 192

(1.5)

History of

feeling No 47207

(94.4) 2798 (5.6)

14244.8 (<.001)

49153

(98.3) 852

(1.7) 4884.99 (<.001)

49467 (98.9)

538 (1.1)

3869.73 (<.001)

depressed Yes 13158 (58.7)

9272 (41.3)

19114 (85.2)

3316 (14.8)

19947 (88.9)

2483 (11.1)

4 Conclusion

Suicide is an important public health issue. The prevalence of suicidal ideation,

suicide plans, and suicide attempts is high when compared with other countries. The

results of this study suggest that to improve suicide prevention strategies it is

necessary to define their targets. Suicide prevention interventions for adolescents

should be tailored to gender, age, socioeconomic status and psychiatric aspects.

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