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Suicidal ideation and its determinants in Korean adults: The role of physical activity and functional limitations S.M. Park

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Department of Health Administration, Hanyang Women’s University, Seoul, Republic of Korea Published online: 01 Dec 2014.

To cite this article: S.M. Park (2014): Suicidal ideation and its determinants in Korean adults: The role of physical activity and functional limitations, Psychology, Health & Medicine, DOI: 10.1080/13548506.2014.986144 To link to this article: http://dx.doi.org/10.1080/13548506.2014.986144

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Psychology, Health & Medicine, 2014 http://dx.doi.org/10.1080/13548506.2014.986144

Suicidal ideation and its determinants in Korean adults: The role of physical activity and functional limitations

Downloaded by [The University of Manchester Library] at 14:09 02 December 2014

S.M. Park* Department of Health Administration, Hanyang Women’s University, Seoul, Republic of Korea (Received 21 July 2014; accepted 4 November 2014) The recognition of suicide as a major public health problem has suggested the need to identify risk factors that have implications for preventive intervention. In the suicidal process, suicidal ideation is a key stage in the pathway leading to eventual suicide. This study investigated the influence of physical activity and functional limitations on suicidal ideation among young and middle-aged adults in a high suicidal society. Data for the current study were obtained from the Fourth Korea National Health and Nutrition Examination Survey 2007–2009 (KNHANES), a cross-sectional study conducted by the Korea Centers for Disease Control and Prevention. The survey conducted face-to-face interviews with young adults (n = 2326) and middle-aged adults (n = 3396). Using multivariate logistic regression analysis, the relationship of physical activity and functional limitations with suicidal ideation in young and middle-aged adults was assessed. A notable outcome was that the absence of a regular walking was correlated with increased suicidal ideation in middle-aged women. The other major finding was that young women and middle-aged adults with functional limitations had a high rate of suicidal thoughts. Multiple intervention approaches, including informational, social and behavioural approaches, are needed to promote regular walking in middle-aged women. For instance, mass media campaigns, community walking groups and individually adapted health behaviour modification may provide opportunities for positive intervention. Additionally, another important public health implication from these findings is the need for a suicide-intervention support system that includes screening for suicide risk in healthcare settings, especially among young women with physical limitations. Keywords: suicidal ideation; physical activity; functional limitations; physical disability; middle-aged; young adults

Introduction Suicide is a major public health concern in South Korea. Since the late 1990s, suicide rates have risen sharply from 10.8 per 100,000 individuals in 1995 to 28.4 per 100,000 individuals in 2009 and 33.5 per 100,000 individuals in 2010 (Organisation for Economic Cooperation and Development [OECD], 2011). The suicidal process is described as a progressive behaviour that gradually increases in seriousness: thoughts of taking one’s life, suicidal planning, suicidal attempt and completed suicide (Tyssen, Hem, Vaglum, Gronvold, & Ekeberg, 2004). During the 5–10-year follow-up period, 6.7% (n = 14) of the 207 individuals who had suicidal ideation committed suicide (Kovacs & Garrison, 1985). Similarly, 6.9% (n = 94) of the 1362 individuals who addressed *Email: [email protected] © 2014 Taylor & Francis

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S.M. Park

suicidal behaviour reported having had suicidal thoughts within the past year (Kjøller & Helweg-Larsen, 2000). Therefore, suicidal ideation is a key stage in the pathway leading to eventual suicide (Brown, Beck, Steer, & Grisham, 2000). Previous studies have associated physical illness with the risk for suicidal ideation (Duberstein, Conwell, Conner, Eberly, & Caine, 2004; Fairweather, Anstey, Rodgers, & Butterworth, 2006; Waern, 2003); however, the potential relevance of functional limitations, as distinct from diseases and traumas that give rise to disability, has received relatively little attention. Previous studies, focusing mostly on the elderly, indicated that the impact of functional impairment on suicide is inconsistent; for instance, several studies demonstrated that functional disability was significantly associated with completed suicide in the elderly (Conwell et al., 2000; Waern et al., 2002), whereas others did not find any association (Grabbe, Demi, Camann, & Potter, 1997; Suominen, Isometsä, Ostamo, & Lönnqvist, 2004). The association between physical activity and suicidal ideation has not been investigated. Earlier studies have demonstrated a relationship between the lack of participation in physical activity and suicidal attempts in adolescents (Brosnahan, Steffen, Lytle, Patterson, & Boostrom, 2004; Brown & Blanton, 2002; Brown et al., 2007; Simon, Powell, & Swann, 2004) and college students (Taliaferro, Rienzo, Pigg, Miller, & Dodd, 2009; Thome & Espelage, 2004). The aim of this study was to investigate the influence of physical activity and functional limitations on suicidal ideation among young and middle-aged adults. Hypotheses Hypothesis 1: There is a strong association between suicidal ideation and both functional limitation and physical inactivity among young and middle-aged adults. Hypothesis 2: There are age and gender differences in the relationships between suicidal ideation and functional limitation and physical inactivity among young and middle-aged adults.

Methods Study design and participants This study analysed data from the Fourth Korea National Health and Nutrition Examination Survey 2007–2009 (KNHANES), a cross-sectional study conducted by the Korea Centers for Disease Control and Prevention. KNHANES IV (fourth survey since 1998) comprised four sections: Health Attitude and Practice, Health Examination, Health Interview and Nutrition. To acquire a representative sample of the population, this survey used a stratified multistage probability sampling method. A total of 10,105 individuals completed faceto-face interviews for a response rate of 79.4%. The sample was weighted to adjust for non-responders and over-sampling. These 10,105 individuals included 2640 individuals

Suicidal ideation and its determinants in Korean adults: The role of physical activity and functional limitations.

The recognition of suicide as a major public health problem has suggested the need to identify risk factors that have implications for preventive inte...
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