Risk Factors for Suicidal Ideation among Middle Class Korean: Focusing on Psychosocial Comparison - An Analysis of a Nationwide Survey of the 8th Korea Health Panel Data

Article information

Res Community Public Health Nurs. 2018;29(1):1-10
Publication date (electronic) : 2018 March 12
doi : https://doi.org/10.12799/jkachn.2018.29.1.1
1Graduate School of Nursing, Eulji University, Daejeon, Korea
2Hospital of Eulji University, Daejeon, Korea
3Department of Nursing, Institute of Science and Technology, Daejeon, Korea
4College of Nursing, Eulji University, Daejeon, Korea
Corresponding author: Oh, Heeyoung College of Nursing, Eulji University, 77 Gyeryoung-ro, 771 beon-gil, Jung-gu, Daejeon 34824, Korea. Tel: +82-42-259-1713, Fax: +82-42-259-1709, E-mail: hoh123@eulji.ac.kr
Received 2017 April 12; Revised 2017 November 26; Accepted 2018 January 26.

Abstract

Abstract

Purpose

The purpose of this study was to examine the prevalence and risk factors of suicidal ideation among middle class Korean.

Methods

Cross sectional study was designed for secondary data analysis. From the 8th Korea Health Panel survey (2008~2013), a total of 6,037 data was drawn and analyzed by developmental stage using descriptive statistics including frequency, percentage, x2 test, and logistic regression analysis.

Results

Across all age groups, high physical-mental stress, frustration, anxiety about the future and low self-perceived health status or social class were found to be the risk factors of suicidal ideation. Peer-compared subjective health status and frustration significantly influenced the adolescents. The young adults‘suicidal ideation was mainly influenced by physical and mental stress, frustration and absence of economic activity. For the middle-aged, physical and mental stress, frustration, future anxiety, low peer-compared subjective health status were found to be the major influencing factors. The predominant risk factors for the elderly were frustration and low peer-compared subjective health status.

Conclusion

Making comparisons to others significantly influence suicidal ideation throughout all life cycles. Improvement of mental health and suicide prevention can be enhanced by avoiding negative comparison to others.

Comparison of Suicidal Ideation Rate by Demographic Factors among Middle-class Korean Adolescents, Young Adults, Middle-aged and the Elderly who able doing Independent Activities of Daily Living

Comparison of Suicidal Ideation Rate by Psychosocial Factors among Middle-class Korean Adolescents, Young Adults, Middle-aged and the Elderly who able doing Independent Activities of Daily Living

Factors Influencing Suicidal Ideation among Middle-class Korean Adolescents, Young Adults, Middle-aged and the Elderly who able doing Independent Activities of Daily Living

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Article information Continued

Table 1.

Comparison of Suicidal Ideation Rate by Demographic Factors among Middle-class Korean Adolescents, Young Adults, Middle-aged and the Elderly who able doing Independent Activities of Daily Living

Variables Adolescent (<20 years) Young adult (20~39 years) Middle aged (40~64 years) Elderly (≥65 years)
Total n=1,468 SI (yes) n=66 x2 (p) Total n=1,363 SI (yes) n=59 x2 (p) Total n=2,206 SI (Yes) n=98 x2 (p) Total n=1,000 SI (Yes) n=65 x2 (p)
n (%) n (%) n (%) n (%) n (%) n (%) n (%) n (%)
Gender
 Male 733 (49.9) 25 (3.4) 4.02 654 (48.0) 29 (4.4) 0.03 1,091 (49.5) 49 (4.5) 0.01 483 (48.3) 34 (7.0) 0.45
 Female 735 (50.1) 41 (5.6) (.045) 709 (52.0) 30 (4.2) (.854) 1,115 (50.5) 49 (4.4) (.912) 517 (51.7) 31 (6.0) (.504)
Spouse
 Yes 0 (0.0) 0 (0.0) - 540 (39.6) 29 (5.4) 2.34 1,939 (87.9) 86 (4.4) 0.01 724 (72.4) 45 (6.2) 0.35
 No 1,468 (100.0) 66 (4.5) 823 (60.4) 30 (3.6) (.126) 267 (12.1) 12 (4.5) (.965) 276 (27.6) 20 (7.2) (.554)
Education level
 ≤Middle school 1,100 (74.9) 46 (4.2) 4.51 21 (1.5) 3 (14.3) 6.36 618 (28.0) 24 (3.9) 0.63 682 (68.2) 46 (6.7) 0.66
 High school 295 (20.1) 19 (6.4) (.105) 344 (25.2) 18 (5.2) (.042) 1,005 (45.6) 47 (4.7) (.728) 229 (22.9) 15 (6.6) (.720)
 ≥College 73 (5.0) 1 (1.4) 998 (73.3) 38 (3.8) 583 (26.4) 27 (4.6) 89 (8.9) 4 (4.5)
Economic activity
 Yes 9 (0.6) 66 (4.5) 0.43* 729 (53.5) 40 (5.5) 5.08 1.664 (75.4) 80 (4.8) 2.13 362 (36.2) 21 (5.8) 0.46
 No 1,459 (99.4) 66 (4.5) (.660) 634 (46.5) 19 (3.0) (.024) 542 (24.6) 18 (3.3) (.145) 638 (63.8) 44 (6.9) (.499)
Chronic illness
 Yes 478 (32.6) 21 (4.4) 0.02 381 (28.0) 19 (5.0) 0.55 1.430 (64.8) 58 (4.1) 1.43 945 (94.5) 60 (6.3) 0.64*
 No 990 (67.4) 45 (4.5) (.895) 982 (72.0) 40 (4.1) (.457) 776 (35.2) 40 (5.2) (.232) 55 (5.5) 5 (9.1) (.396)

Fisher's exact test; SI=suicidal ideation.

Table 2.

Comparison of Suicidal Ideation Rate by Psychosocial Factors among Middle-class Korean Adolescents, Young Adults, Middle-aged and the Elderly who able doing Independent Activities of Daily Living

Variables Adolescent (<20 years) Young adult (20~39 years) Middle aged (40~64 years) Elderly (≥65 years)
Total n=1,468 SI (yes) n=66 x2 (p) Total n=1,363 SI (yes) n=59 x2 (p) Total n=2,206 SI (yes) n=98 x2 (p) Total n=1,000 SI (yes) n=65 x2 (p)
n (%) n (%) n (%) n (%) n (%) n (%) n (%) n (%)
Stress-mental/physical
 Yes 800 (54.5) 58 (7.3) 31.06 735 (53.9) 56 (7.6) 41.70 1,215 (55.1) 89 (7.3) 52.94 560 (56.0) 58(10.4) 31.16
 No 668 (45.5) 8 (1.2) (<.001) 628 (46.1) 3 (0.5) (<.001) 991 (44.9) 9 (0.9) (<.001) 440 (44.0) 7(1.6) (<.001)
Frustration
 Yes 463 (31.5) 57 (12.3) 96.20 440 (32.3) 50 (11.4) 77.65 735 (33.3) 78 (10.6) 98.84 360 (36.0) 52(14.4) 58.42
 No 1,005 (68.5) 9 (0.9) (<.001) 923 (67.7) 9 (1.0) (<.001) 1,471 (66.7) 20 (1.4) (<.001) 640 (64.0) 13(2.0) (<.001)
Anxiety about the future
 Yes 818 (55.7) 59 (7.2) 31.76 767 (56.3) 53 (6.9) 28.22 1,223 (55.4) 87 (7.1) 46.13 594 (59.4) 55(9.3) 18.33
 No 650 (44.3) 7 (1.1) (<.001) 596 (43.7) 6 (1.0) (<.001) 983 (44.6) 11 (1.1) (<.001) 406 (40.6) 10(2.5) (<.001)
Strain from excessive work
 Yes 435 (29.6) 34 (7.8) 15.87 423 (31.0) 35 (8.3) 23.06 636 (28.8) 46 (7.2) 16.39 326 (32.6) 28(8.6) 3.47
 No 1,033 (70.4) 32 (3.1) (<.001) 940 (69.0) 24 (2.6) (<.001) 1,570 (71.2) 52 (3.3) (<.001) 674 (67.4) 37(5.5) (.062)
Subjective health status compared with peers
 Better 639 (43.6) 14 (2.2) 17.62 572 (42.0) 15 (2.6) 9.88 959 (43.5) 17 (1.8) 45.50 422 (42.2) 10(2.4) 53.62
 Same 676 (46.0) 38 (5.6) (<.001) 644 (47.2) 32 (5.0) (.007) 1,012 (45.9) 54 (5.3) (<.001) 467 (46.7) 31(6.6) (<.001)
 Worse 153 (10.4) 14 (9.2) 147 (10.8) 12 (8.2) 235 (10.6) 27 (11.5) 111 (11.1) 24(21.6)
Have a chance to succeed when make the effort
 Yes 900 (61.3) 29 (3.2) 8.79 843 (61.8) 23 (2.7) 13.67 1,365 (61.9) 43 (3.2) 14.09 648 (64.8) 37(5.7) 1.89
 No 568 (38.7) 37 (6.5) (.003) 520 (38.2) 36 (6.9) (<.001) 841 (38.1) 55 (6.5) (<.001) 352 (35.2) 28(8.0) (.169)
Gap between the rich and the poor is getting bigger
 Yes 1,406 (95.8) 65 (4.6) 1.25* 1,305 (95.7) 56 (4.3) 0.10* 2,120 (96.1) 94 (4.4) 0.01* 958 (95.8) 61(6.4) 0.66*
 No 62 (4.2) 1 (1.6) (.523) 58 (4.3) 3 (5.2) (.736) 75 (3.9) 4 (4.7) (.791) 42 (4.2) 4(9.5) (.345)
Perceived social class of own High (7~10) Middle (4~6) Low(1~3)
 High (7~10) 97 (6.6) 2 (2.1) 19.29 77 (5.6) 4 (5.2) 27.11 117 (5.3) 4 (3.4) 14.40 69 (6.9) 3(4.3) 11.82
 Middle (4~6) 907 (61.8) 27 (3.0) (<.001) 861 (63.2) 19 (2.2) (<.001) 1,373 (62.2) 45 (3.3) (.001) 628 (62.8) 30(4.8) (.003)
 Low(1~3) 464 (31.6) 37 (8.0) 425 (31.2) 36 (8.5) 716 (32.5) 49 (6.8) 303 (30.3) 32(10.6)

Fisher's exact test; SI=suicidal ideation.

Table 3.

Factors Influencing Suicidal Ideation among Middle-class Korean Adolescents, Young Adults, Middle-aged and the Elderly who able doing Independent Activities of Daily Living

Variables Adolescent (<20 years) n=1,468 Young adult (20~39 years) n=1,363 Middle aged (40~64 years) n=2,206 Elderly (≥65 years) n=1,000
SI (yes) n=66 p SI (yes) n=59 p SI (yes) n=98 p SI (yes) n=65 p
OR 95% CI OR 95% CI OR 95% CI OR 95% CI
Stress-mental/physical
 Yes 1.27 0.53~3.04 .589 4.74 1.37~16.44 .014 2.61 1.22~5.58 .013 2.21 0.90~5.42 .084
 No 1.00 1.00 1.00 1.00
Frustration
 Yes 8.87 3.91~20.09 <.001 4.78 2.16~10.56 <.001 3.78 2.15~6.65 <.001 4.56 2.24~9.29 <.001
 No 1.00 1.00 1.00 1.00
Anxiety about the future
 Yes 1.87 0.77~4.50 .165 2.01 0.78~5.20 .148 2.09 1.04~4.19 .038 1.45 0.67~3.12 .346
 No 1.00 1.00 1.00 1.00
Strain from excessive work
Yes No 1.44 0.84~2.46 .180 1.64 0.90~2.96 .104 1.17 0.75~1.83 .488 - - -
No 1.00 1.00 1.00 - - -
Subjective health status compared with peers
 Better 1.00 1.00 1.00 1.00
 Same 2.01 1.05~3.87 .036 1.49 0.76~2.93 .248 2.40 1.36~4.22 .002 2.26 1.08~4.77 .032
 Worse 2.55 1.12~5.79 .026 1.83 0.79~4.28 .161 4.45 2.32~8.57 <.001 7.81 3.43~17.77 <.001
Have a chance to succeed when make the effort
 Yes 1.00 1.00 1.00 - - -
 No 1.24 0.73~2.13 .427 1.68 0.94~3.03 .082 1.41 0.91~2.17 .127 - - -
Perceived social class of own
 High (7~10) 1.00 1.00 1.00 1.00
 Middle (4~6) 0.88 0.20~3.94 .865 0.30 0.09~1.01 .051 0.64 0.21~1.92 .421 0.91 0.26~3.22 .878
 Low (1~3) 1.83 0.41~8.25 .431 1.05 0.32~3.50 .934 0.86 0.28~2.60 .785 1.40 0.39~5.04 .607
Gender
 Male 1.65 0.97~2.83 .067 - - - - - - - - -
 Female 1.00 - - - - - - - - -
Education level
 ≤Middle school - - - 2.33 0.60~9.12 .224 - - - - - -
 High School - - - 1.41 0.75~2.68 .284 - - - - - -
 ≥College - - - 1.00 - - - - - -
Economic activity
 Yes - - - 1.93 1.06~3.52 .032 - - - - - -
 No - - - 1.00 - - - - - -

SI=suicidal ideation; OR=odds ratio; CI=confidence interval.