1.Practicability of Suicide Reduction Target in Korean Suicide Prevention Policy: Insights From Time Series Analysis
Seunghyong RYU ; Seon-Hwa BAEK ; Min JHON ; Honey KIM ; Ju-Yeon LEE ; Jae-Min KIM ; Sung-Wan KIM
Journal of Korean Medical Science 2025;40(19):e59-
Background:
This study evaluated the practicability of the suicide rate reduction target set by the current national suicide prevention policy in Korea, the fifth Master Plan for Suicide Prevention (2023–2027). This policy aims to lower the suicide rate from 26/100,000 in 2021 to 18.2/100,000 by 2027.
Methods:
We utilized monthly suicide statistics data from 2011 onwards. Using Bayesian regression and Autoregressive Integrated Moving Average (ARIMA) models, we conducted interrupted time series analyses to estimate the effect of the previous policy, the National Action Plan for Suicide Prevention (2018–2022), on suicide rates. We assumed this as the additional suicide reduction expected from the current policy. We generated point predictions and simulations for suicide rates from 2023 to 2027 using Bayesian regression and ARIMA models.
Results:
The interrupted time series analyses did not reveal a significant reduction in suicides attributable to the previous policy. Point predictions from the two models indicated that the suicide rate would remain approximately 24/100,000 in 2027. Almost all of the simulations of the 2027 suicide rate did not meet the policy target of 18.2/100,000.
Conclusion
The findings suggest that the Korean government’s suicide rate reduction target for 2027 is likely unattainable based on current trends and the limited effectiveness of previous policies. The objectives of suicide prevention policies should be evidence-based, attainable, and accountable.
2.Practicability of Suicide Reduction Target in Korean Suicide Prevention Policy: Insights From Time Series Analysis
Seunghyong RYU ; Seon-Hwa BAEK ; Min JHON ; Honey KIM ; Ju-Yeon LEE ; Jae-Min KIM ; Sung-Wan KIM
Journal of Korean Medical Science 2025;40(19):e59-
Background:
This study evaluated the practicability of the suicide rate reduction target set by the current national suicide prevention policy in Korea, the fifth Master Plan for Suicide Prevention (2023–2027). This policy aims to lower the suicide rate from 26/100,000 in 2021 to 18.2/100,000 by 2027.
Methods:
We utilized monthly suicide statistics data from 2011 onwards. Using Bayesian regression and Autoregressive Integrated Moving Average (ARIMA) models, we conducted interrupted time series analyses to estimate the effect of the previous policy, the National Action Plan for Suicide Prevention (2018–2022), on suicide rates. We assumed this as the additional suicide reduction expected from the current policy. We generated point predictions and simulations for suicide rates from 2023 to 2027 using Bayesian regression and ARIMA models.
Results:
The interrupted time series analyses did not reveal a significant reduction in suicides attributable to the previous policy. Point predictions from the two models indicated that the suicide rate would remain approximately 24/100,000 in 2027. Almost all of the simulations of the 2027 suicide rate did not meet the policy target of 18.2/100,000.
Conclusion
The findings suggest that the Korean government’s suicide rate reduction target for 2027 is likely unattainable based on current trends and the limited effectiveness of previous policies. The objectives of suicide prevention policies should be evidence-based, attainable, and accountable.
3.Practicability of Suicide Reduction Target in Korean Suicide Prevention Policy: Insights From Time Series Analysis
Seunghyong RYU ; Seon-Hwa BAEK ; Min JHON ; Honey KIM ; Ju-Yeon LEE ; Jae-Min KIM ; Sung-Wan KIM
Journal of Korean Medical Science 2025;40(19):e59-
Background:
This study evaluated the practicability of the suicide rate reduction target set by the current national suicide prevention policy in Korea, the fifth Master Plan for Suicide Prevention (2023–2027). This policy aims to lower the suicide rate from 26/100,000 in 2021 to 18.2/100,000 by 2027.
Methods:
We utilized monthly suicide statistics data from 2011 onwards. Using Bayesian regression and Autoregressive Integrated Moving Average (ARIMA) models, we conducted interrupted time series analyses to estimate the effect of the previous policy, the National Action Plan for Suicide Prevention (2018–2022), on suicide rates. We assumed this as the additional suicide reduction expected from the current policy. We generated point predictions and simulations for suicide rates from 2023 to 2027 using Bayesian regression and ARIMA models.
Results:
The interrupted time series analyses did not reveal a significant reduction in suicides attributable to the previous policy. Point predictions from the two models indicated that the suicide rate would remain approximately 24/100,000 in 2027. Almost all of the simulations of the 2027 suicide rate did not meet the policy target of 18.2/100,000.
Conclusion
The findings suggest that the Korean government’s suicide rate reduction target for 2027 is likely unattainable based on current trends and the limited effectiveness of previous policies. The objectives of suicide prevention policies should be evidence-based, attainable, and accountable.
4.Practicability of Suicide Reduction Target in Korean Suicide Prevention Policy: Insights From Time Series Analysis
Seunghyong RYU ; Seon-Hwa BAEK ; Min JHON ; Honey KIM ; Ju-Yeon LEE ; Jae-Min KIM ; Sung-Wan KIM
Journal of Korean Medical Science 2025;40(19):e59-
Background:
This study evaluated the practicability of the suicide rate reduction target set by the current national suicide prevention policy in Korea, the fifth Master Plan for Suicide Prevention (2023–2027). This policy aims to lower the suicide rate from 26/100,000 in 2021 to 18.2/100,000 by 2027.
Methods:
We utilized monthly suicide statistics data from 2011 onwards. Using Bayesian regression and Autoregressive Integrated Moving Average (ARIMA) models, we conducted interrupted time series analyses to estimate the effect of the previous policy, the National Action Plan for Suicide Prevention (2018–2022), on suicide rates. We assumed this as the additional suicide reduction expected from the current policy. We generated point predictions and simulations for suicide rates from 2023 to 2027 using Bayesian regression and ARIMA models.
Results:
The interrupted time series analyses did not reveal a significant reduction in suicides attributable to the previous policy. Point predictions from the two models indicated that the suicide rate would remain approximately 24/100,000 in 2027. Almost all of the simulations of the 2027 suicide rate did not meet the policy target of 18.2/100,000.
Conclusion
The findings suggest that the Korean government’s suicide rate reduction target for 2027 is likely unattainable based on current trends and the limited effectiveness of previous policies. The objectives of suicide prevention policies should be evidence-based, attainable, and accountable.
5.Changes in Suicide Rate Trend After Implementation of Suicide Prevention Policy: An Interrupted Time Series Study on the Fifth Master Plan for Suicide Prevention
Seunghyong RYU ; Seon-Hwa BAEK ; Min JHON ; Honey KIM ; Ju-Yeon LEE ; Jae-Min KIM ; Sung-Wan KIM
Journal of Korean Neuropsychiatric Association 2024;63(4):237-245
Objectives:
This study examined the shifts in the suicide trends in Korea during the initial phase of the Fifth Master Plan for Suicide Prevention, using interrupted time series analyses.
Methods:
Interrupted time series analyses were performed using the monthly suicide data from January 2011 to April 2024. Quasi-Poisson regression models were applied to evaluate the changes in the level and slope of the suicide trend before and after policy implementation. The Autoregressive Integrated Moving Average (ARIMA) and Prophet models were used to compare the actual and predicted counterfactual numbers of suicides during the policy period.
Results:
The quasi-Poisson regression model revealed a significant change in the trend of suicides among men, with an increasing slope during the policy period. For total suicides, the ARIMA and Prophet models suggested that the actual number of suicides was significantly higher than the counterfactual number during the policy period, with excess suicides averaging between 113 and 150 per month. The actual number of suicides among men was significantly higher than the counterfactual number during the policy period, with excess suicides averaging between 86 and 92 per month. No significant changes in the suicide trends among women were observed.
Conclusion
These findings suggest that the initial effects of the Fifth Master Plan for Suicide Prevention were inadequate to curb the rising suicide trends, particularly among men. This study underscores the need for timely policy responses to reverse the current increasing trend in suicides, with particular focus on the male population.
6.Characteristics According to Frailty Status Among Older Korean Patients With Hypertension
Jung-Yeon CHOI ; Hae-Young LEE ; Ju-Hee LEE ; Youjin HONG ; Sue K. PARK ; Dong Ryeol RYU ; Jang Hoon LEE ; Seokjae HWANG ; Kye Hun KIM ; Sun Hwa LEE ; Song-Yi KIM ; Jae-Hyeong PARK ; Sang-Hyun KIM ; Hack-Lyoung KIM ; Jung Hyun CHOI ; Cheol-Ho KIM ; Myeong-Chan CHO ; Kwang-il KIM
Journal of Korean Medical Science 2024;39(10):e84-
Background:
As the prevalence of hypertension increases with age and the proportion of the older population is also on the rise, research on the characteristics of older hypertensive patients and the importance of frailty is necessary. This study aimed to identify clinical characteristics of older hypertension in Korea and to investigate these characteristics based on frailty status.
Methods:
The HOW to Optimize eLDerly systolic BP (HOWOLD-BP) is a prospective, multicenter, open-label, randomized clinical trial that aims to compare intensive (target systolic blood pressure [SBP] ≤ 130 mmHg) with standard (target SBP ≤ 140 mmHg) treatment to reduce cardiovascular events in older hypertensive Korean patients aged ≥ 65 years. Data were analyzed through a screening assessment of 2,085 patients recruited from 11 university hospitals. Demographic, functional (physical and cognitive), medical history, laboratory data, quality of life, and medication history of antihypertensive drugs were assessed.
Results:
The mean age was 73.2 years (standard deviation ± 5.60), and 48.0% (n = 1,001) were male. Prevalent conditions included dyslipidemia (66.5%), obesity (body mass index ≥ 25 kg/m 2 , 53.6%), and diabetes (28.9%). Dizziness and orthostatic hypotension were self-reported by 1.6% (n = 33) and 1.2% (n = 24), respectively. The majority of patients were on two antihypertensive drugs (48.4%), while 27.5% (n = 574) and 20.8% (n = 433) were on 1 and 3 antihypertensive medications, respectively. Frail to pre-frail patients were older and also tended to have dependent instrumental activities of daily living, slower gait speed, weaker grip strength, lower quality of life, and lower cognitive function. The frail to pre-frail group reported more dizziness (2.6% vs. 1.2%, P < 0.001) and had concerning clinical factors, including lower glomerular filtration rate, more comorbidities such as diabetes, stroke, and a history of admission. Frail to pre-frail older hypertensive patients used slightly more antihypertensive medications than robust older hypertensive patients (1.95 vs. 2.06, P = 0.003). Pre-frail to frail patients often chose beta-blockers as a third medication over diuretics.
Conclusion
This study described the general clinical characteristics of older hypertensive patients in Korea. Frail hypertensive patients face challenges in achieving positive clinical outcomes because of multifactorial causes: they are older, have more morbidities, decreased function, lower quality of life and cognitive function, and take more antihypertensive medications. Therefore, it is essential to comprehensively evaluate and monitor diseaserelated or drug-related adverse events more frequently during regular check-ups, which is necessary for pre-frail to frail older patients with hypertension.
7.Changes in Suicide Rate Trend After Implementation of Suicide Prevention Policy: An Interrupted Time Series Study on the Fifth Master Plan for Suicide Prevention
Seunghyong RYU ; Seon-Hwa BAEK ; Min JHON ; Honey KIM ; Ju-Yeon LEE ; Jae-Min KIM ; Sung-Wan KIM
Journal of Korean Neuropsychiatric Association 2024;63(4):237-245
Objectives:
This study examined the shifts in the suicide trends in Korea during the initial phase of the Fifth Master Plan for Suicide Prevention, using interrupted time series analyses.
Methods:
Interrupted time series analyses were performed using the monthly suicide data from January 2011 to April 2024. Quasi-Poisson regression models were applied to evaluate the changes in the level and slope of the suicide trend before and after policy implementation. The Autoregressive Integrated Moving Average (ARIMA) and Prophet models were used to compare the actual and predicted counterfactual numbers of suicides during the policy period.
Results:
The quasi-Poisson regression model revealed a significant change in the trend of suicides among men, with an increasing slope during the policy period. For total suicides, the ARIMA and Prophet models suggested that the actual number of suicides was significantly higher than the counterfactual number during the policy period, with excess suicides averaging between 113 and 150 per month. The actual number of suicides among men was significantly higher than the counterfactual number during the policy period, with excess suicides averaging between 86 and 92 per month. No significant changes in the suicide trends among women were observed.
Conclusion
These findings suggest that the initial effects of the Fifth Master Plan for Suicide Prevention were inadequate to curb the rising suicide trends, particularly among men. This study underscores the need for timely policy responses to reverse the current increasing trend in suicides, with particular focus on the male population.
8.Changes in Suicide Rate Trend After Implementation of Suicide Prevention Policy: An Interrupted Time Series Study on the Fifth Master Plan for Suicide Prevention
Seunghyong RYU ; Seon-Hwa BAEK ; Min JHON ; Honey KIM ; Ju-Yeon LEE ; Jae-Min KIM ; Sung-Wan KIM
Journal of Korean Neuropsychiatric Association 2024;63(4):237-245
Objectives:
This study examined the shifts in the suicide trends in Korea during the initial phase of the Fifth Master Plan for Suicide Prevention, using interrupted time series analyses.
Methods:
Interrupted time series analyses were performed using the monthly suicide data from January 2011 to April 2024. Quasi-Poisson regression models were applied to evaluate the changes in the level and slope of the suicide trend before and after policy implementation. The Autoregressive Integrated Moving Average (ARIMA) and Prophet models were used to compare the actual and predicted counterfactual numbers of suicides during the policy period.
Results:
The quasi-Poisson regression model revealed a significant change in the trend of suicides among men, with an increasing slope during the policy period. For total suicides, the ARIMA and Prophet models suggested that the actual number of suicides was significantly higher than the counterfactual number during the policy period, with excess suicides averaging between 113 and 150 per month. The actual number of suicides among men was significantly higher than the counterfactual number during the policy period, with excess suicides averaging between 86 and 92 per month. No significant changes in the suicide trends among women were observed.
Conclusion
These findings suggest that the initial effects of the Fifth Master Plan for Suicide Prevention were inadequate to curb the rising suicide trends, particularly among men. This study underscores the need for timely policy responses to reverse the current increasing trend in suicides, with particular focus on the male population.
9.Changes in Suicide Rate Trend After Implementation of Suicide Prevention Policy: An Interrupted Time Series Study on the Fifth Master Plan for Suicide Prevention
Seunghyong RYU ; Seon-Hwa BAEK ; Min JHON ; Honey KIM ; Ju-Yeon LEE ; Jae-Min KIM ; Sung-Wan KIM
Journal of Korean Neuropsychiatric Association 2024;63(4):237-245
Objectives:
This study examined the shifts in the suicide trends in Korea during the initial phase of the Fifth Master Plan for Suicide Prevention, using interrupted time series analyses.
Methods:
Interrupted time series analyses were performed using the monthly suicide data from January 2011 to April 2024. Quasi-Poisson regression models were applied to evaluate the changes in the level and slope of the suicide trend before and after policy implementation. The Autoregressive Integrated Moving Average (ARIMA) and Prophet models were used to compare the actual and predicted counterfactual numbers of suicides during the policy period.
Results:
The quasi-Poisson regression model revealed a significant change in the trend of suicides among men, with an increasing slope during the policy period. For total suicides, the ARIMA and Prophet models suggested that the actual number of suicides was significantly higher than the counterfactual number during the policy period, with excess suicides averaging between 113 and 150 per month. The actual number of suicides among men was significantly higher than the counterfactual number during the policy period, with excess suicides averaging between 86 and 92 per month. No significant changes in the suicide trends among women were observed.
Conclusion
These findings suggest that the initial effects of the Fifth Master Plan for Suicide Prevention were inadequate to curb the rising suicide trends, particularly among men. This study underscores the need for timely policy responses to reverse the current increasing trend in suicides, with particular focus on the male population.
10.Study Design and Protocol for a Randomized Controlled Trial to Assess Long-Term Efficacy and Safety of a Triple Combination of Ezetimibe, Fenofibrate, and Moderate-Intensity Statin in Patients with Type 2 Diabetes and Modifiable Cardiovascular Risk Factors (ENSEMBLE)
Nam Hoon KIM ; Juneyoung LEE ; Suk CHON ; Jae Myung YU ; In-Kyung JEONG ; Soo LIM ; Won Jun KIM ; Keeho SONG ; Ho Chan CHO ; Hea Min YU ; Kyoung-Ah KIM ; Sang Soo KIM ; Soon Hee LEE ; Chong Hwa KIM ; Soo Heon KWAK ; Yong‐ho LEE ; Choon Hee CHUNG ; Sihoon LEE ; Heung Yong JIN ; Jae Hyuk LEE ; Gwanpyo KOH ; Sang-Yong KIM ; Jaetaek KIM ; Ju Hee LEE ; Tae Nyun KIM ; Hyun Jeong JEON ; Ji Hyun LEE ; Jae-Han JEON ; Hye Jin YOO ; Hee Kyung KIM ; Hyeong-Kyu PARK ; Il Seong NAM-GOONG ; Seongbin HONG ; Chul Woo AHN ; Ji Hee YU ; Jong Heon PARK ; Keun-Gyu PARK ; Chan Ho PARK ; Kyong Hye JOUNG ; Ohk-Hyun RYU ; Keun Yong PARK ; Eun-Gyoung HONG ; Bong-Soo CHA ; Kyu Chang WON ; Yoon-Sok CHUNG ; Sin Gon KIM
Endocrinology and Metabolism 2024;39(5):722-731
Background:
Atherogenic dyslipidemia, which is frequently associated with type 2 diabetes (T2D) and insulin resistance, contributes to the development of vascular complications. Statin therapy is the primary approach to dyslipidemia management in T2D, however, the role of non-statin therapy remains unclear. Ezetimibe reduces cholesterol burden by inhibiting intestinal cholesterol absorption. Fibrates lower triglyceride levels and increase high-density lipoprotein cholesterol (HDL-C) levels via peroxisome proliferator- activated receptor alpha agonism. Therefore, when combined, these drugs effectively lower non-HDL-C levels. Despite this, few clinical trials have specifically targeted non-HDL-C, and the efficacy of triple combination therapies, including statins, ezetimibe, and fibrates, has yet to be determined.
Methods:
This is a multicenter, prospective, randomized, open-label, active-comparator controlled trial involving 3,958 eligible participants with T2D, cardiovascular risk factors, and elevated non-HDL-C (≥100 mg/dL). Participants, already on moderate-intensity statins, will be randomly assigned to either Ezefeno (ezetimibe/fenofibrate) addition or statin dose-escalation. The primary end point is the development of a composite of major adverse cardiovascular and diabetic microvascular events over 48 months.
Conclusion
This trial aims to assess whether combining statins, ezetimibe, and fenofibrate is as effective as, or possibly superior to, statin monotherapy intensification in lowering cardiovascular and microvascular disease risk for patients with T2D. This could propose a novel therapeutic approach for managing dyslipidemia in T2D.

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