ObjectiveWe designed a nationwide study with limited exclusion criteria to investigate the prevalence of metabolic syndrome (MetS) in Korea and its relationship with antipsychotic medications.MethodsThis multicenter, cross-sectional, and observational study included patients diagnosed with schizophrenia or schizoaffective disorder. Sixteen hospitals enrolled 845 patients aged 18 to 65 years prescribed any antipsychotic medication between August 2011 and August 2013. MetS was diagnosed using the criteria of the modified Adult Treatment Panel III of the National Cholesterol Education Program with the Korean abdominal obesity definition (waist circumference ≥85 cm in women, ≥90 cm in men).ResultsThe prevalence of MetS in all patients was 36.5% and was significantly higher in men than women (men, 40.8%; women, 32.2%) and was significantly correlated with age [odds ratio (OR) 1.02] and duration of illness (OR 1.03). The prevalence of MetS across antipsychotic drugs in the major monotherapy group was as follows: 18.8% for quetiapine, 22.0% for aripiprazole, 33.3% for both amisulpride and paliperidone, 34.0% for olanzapine, 35% for risperidone, 39.4% for haloperidol, and 44.7% for clozapine.ConclusionThe prevalence of MetS is very high in patients with schizophrenia or schizoaffective disorder. Screening and monitoring of MetS is also strongly recommended.

ObjectivesZZThe aim of this study is to examine the physical, psychological, and social factors influencing suicidal ideation among elderly Koreans.MethodsZZCommunity Health Survey data obtained in 2013 were used for this study with a sample of 4367 elderly who reside in Gangwon province. The data were analyzed using the chisquare test and the logistic regression test to examine the relationship between suicidal ideation and other variables.ResultsZZDepression was the single most influential variable, both directly and indirectly increasing suicidal ideation. In particular, the increase of suicidal ideation among those with severe disease was affected by depression. Perceived poor social support and perceived poor health status were the two highest risk factors after depression, implying that subjective assessment of the elderly affects suicidal ideation significantly. Poor economic status and current smoking showed significantly higher risk for women only, although poor health, poor social support, and poor social activity commonly attributed to the risk of suicidal ideation in both genders.ConclusionZZThis study suggests that suicidal ideation among the elderly should be approached in a multi-perspective way considering depression, social support, and physical health. It is notable that not only lack of resources but also perceived sense of poor social and physical well-being significantly affect suicidal ideation.J Korean Neuropsychiatr Assoc 2015;54(4):459-467 KEY WORDSZZ Elderly · Suicidal ideation · Risk factor.

ObjectivesZZThis study investigated the effects of the grade of residents, sociodemographic variables, and clinical experience with suicidal patients on the knowledge and attitudes toward suicide among psychiatric residents in Korea.MethodsZZA self-reporting survey including 30 questions was conducted together with an investigation of the sociodemographic background of the research subjects. The questionnaire was composed of general knowledge questions on suicide, suicide-related personal experience, attitudes toward suicide, and the treatment experience of suicide attempt patients. Chi-square test and binary logistic regression analysis were used to determine the differences and associations among the attitudes toward suicide, clinical experience of suicide, and sociodemographic characteristics.ResultsZZA significantly higher response rate was presented in the 4th grade on general knowledge of suicide and treatment experience with suicide attempt patients than in the 1st grade. Residents with previous history of psychiatric treatment suicide plans, or attempts presented a significantly higher level of permissive attitude toward suicide. Residents who had a previous history of suicide attempt among their own patients were more likely to think that they were more capable to prevent suicide of patients.ConclusionZZEffective clinical practices are essential considering the fact that the highest suicide risk groups will inevitably be referred to psychiatric clinical services. The authors expect that the study results regarding suicide-related knowledge, attitudes, and the experience of psychiatric residents will contribute to the development of effective resident training programs for suiciderelated clinical practice in Korea.J Korean Neuropsychiatr Assoc 2015;54(4):444-458 KEY WORDSZZ Attitudes toward suicide · Experience in clinical practice of suicide attempters · Psychiatric residents in Korea.

ObjectivesZZThis study was conducted to examine the factors affecting suicide decision and to understand in detail their psychological and behavioral changes with high lethality suicide attempters who were supposed to be similar to suicide completers. MethodsZZTwenty patients who visited Kangwon National University Hospital or Chuncheon National Hospital participated in this study. After applying suicide lethality with Risk-Rescue Rating Scale, high lethality attempters were screened. Each subject participated in an in-depth interview with a semi-structured interview schedule. ResultsZZThe participants had high mean Risk-Rescue Rating Score (45.0±8.7), indicating that the study was conducted with the most lethal suicide attempters. Most attempters had chosen their methods of suicide impulsively without consideration for lethality, and most attempters reported that they chose suicide methods from recall of reports by mass media ; 70% of attempters had more than one previous suicide attempt and their suicide methods have been changed to increase the suicide success rate. Most common accompanying emotions before suicide attempts were hopelessness, helplessness, worthlessness, and loneliness. Most important precipitating factors of suicide were economic difficulties. ConclusionZZThese characteristics regarding suicide attempts led us to a detailed understanding. These results are expected to provide valuable information for development of evidence based suicide prevention policies and strategies.

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