Risk factors of passive suicidal ideation among outpatients in traditional medicine clinics: The case of Korean medicine in South Korea

Suicide is the leading cause of death worldwide, especially in South Korea. Individuals using Korean medicine (KM) clinics are common in this country, but KM doctor is not yet used in the country's suicide prevention policy. In this study, we investigated the prevalence and risk factors of passive suicidal ideation (SI) among outpatients at KM clinics, and attempted to develop a predictive model of SI through multivariate analysis. The Korea Health Panel Annual Data 2019, a nationally representative survey in South Korea, was analyzed. In this study, 1924 (weighted n:5,958,666) people aged 19 or older who used the KM outpatient service at least once in 2019 were set as study subjects. The authors calculated the weighted prevalence of passive SI and identified significant sociodemographic, physical, and mental factors using the Rao-Scott chisquare test and weighted logistic regression. A suicide risk scorecard was developed using the point to double the odds method to quantify individual risk, resulting in a score range of 0-100. We found high prevalence of passive SI among KM outpatients (7.5 %), and the annual prevalence of passive SI tended to be higher with increasing age (4.6 % in young adults, 6.7 % in middleaged, and 12.4 % in old age). Also, the prevalence increased as stress worsened (2.0 % in hardly, 3.9 % in a little, 13.7 % in a lot, and 24.8 % in very much). By using multiple logistic regression analysis, SI risk prediction score model was developed, including basic livelihood security recipients, presence of chronic diseases, perceived stress, depression, and low quality of life. According to our findings, passive SI is not uncommon among KM outpatients. Based on current findings, the potential role of KMDs in the country's suicide prevention strategy can be discussed focusing on specific groups such as socioeconomically vulnerable groups, the elderly population, and those with physical illnesses.