1.Comparison of Suicide Completion Rate in Korean Students Pre- and Post-COVID-19 Pandemics
Kyungjin LEE ; Boram NAM ; Kyoil SEO ; Eunkyung JO ; Seohyun KIM ; Deokyong SHIN ; Aeju KIM ; Youngil JEONG ; Yeni KIM
Psychiatry Investigation 2025;22(2):204-211
Objective:
This study compared the incidence of suicide cases among Korean students before and after the coronavirus disease-2019 (COVID-19) pandemic.
Methods:
Aggregated case reports of all known suicide victims attending elementary, middle, and high school in South Korea from 2017 to 2022 were analyzed. These reports, compiled by teachers under the directive of the South Korean Department of Education, surveyed the circumstances surrounding each suicide and identified associated risk factors posthumously.
Results:
The completed suicide rate was 2.37 per 100,000 students pre-COVID-19 (2017–2019), significantly increasing to 3.37 per 100,000 students post-COVID-19 (2020–2022; odds ratio [OR] 1.42, p<0.001). The rate began to rise approximately 6 months into the pandemic and continued to worsen throughout 2021 and 2022. Fair attendance significantly increased in 2020 (74.83%, p=0.003) during the initial stage of school closure measures compared to 2019 (58.27%) among students prior to suicide completion. However, as social distancing measures continued, “absence due to medical reasons” showed a significant increase in 2022 (23.56%) compared to 2019 (13.67%, p=0.025) and 2020 (9.52%, p<0.001) among these students. Among those who completed suicide, teachers reported increased signs of depression and anxiety posthumously compared to pre-COVID-19 periods.
Conclusion
The incidence of completed suicide among students was significantly higher in the post-COVID-19 years compared to pre-COVID-19. Attendance records and teachers’ reports indicated a deterioration in mental health among these students before suicide completion, highlighting the need to consider mental health impacts when implementing future quarantine policies.
2.Metabolic Dysfunction-Associated Steatotic Liver Disease and All-Cause and Cause-Specific Mortality
Rosa OH ; Seohyun KIM ; So Hyun CHO ; Jiyoon KIM ; You-Bin LEE ; Sang-Man JIN ; Kyu Yeon HUR ; Gyuri KIM ; Jae Hyeon KIM
Diabetes & Metabolism Journal 2025;49(1):80-91
Background:
Given the association between nonalcoholic fatty liver disease and metabolic risks, a new term, metabolic dysfunction- associated steatotic liver disease (MASLD) has been proposed. We aimed to explore the association between MASLD and all-cause, cause-specific mortalities.
Methods:
We included individuals with steatotic liver disease (SLD) from the Korean National Health Insurance Service. Moreover, SLD was defined as a fatty liver index ≥30. Furthermore, MASLD, metabolic alcohol-associated liver disease (MetALD), and alcoholic liver disease (ALD) with metabolic dysfunction (MD) were categorized based on alcohol consumption and MD. We also analyzed all-cause, liver-, cancer-, hepatocellular carcinoma (HCC)- and cardiovascular (CV)-related mortalities.
Results:
This retrospective nationwide cohort study included 1,298,993 individuals aged 40 to 79 years for a mean follow-up duration of 9.04 years. The prevalence of MASLD, MetALD, and ALD with MD was 33.11%, 3.93%, and 1.00%, respectively. Relative to the “no SLD” group, multivariable analysis identified that MASLD (adjusted hazard ratio [aHR], 1.28; 95% confidence interval [CI], 1.26 to 1.31), MetALD (aHR, 1.38; 95% CI, 1.32 to 1.44), and ALD with MD group (aHR, 1.80; 95% CI, 1.68 to 1.93) have a significantly higher risk of all-cause mortality. Furthermore, MASLD, MetALD, ALD with MD groups showed higher liver-, cancer- and HCC-related mortality than “no SLD” group. While all-cause specific mortalities increase from MASLD to MetALD to ALD with MD, the MetALD group shows a lower risk of CV-related mortality compared to MASLD. However, ALD with MD group still have a higher risk of CV-related mortality compared to MASLD.
Conclusion
SLD is associated with an increased risk of all-cause, liver-, cancer-, HCC-, and CV-related mortalities.
3.Comparison of Suicide Completion Rate in Korean Students Pre- and Post-COVID-19 Pandemics
Kyungjin LEE ; Boram NAM ; Kyoil SEO ; Eunkyung JO ; Seohyun KIM ; Deokyong SHIN ; Aeju KIM ; Youngil JEONG ; Yeni KIM
Psychiatry Investigation 2025;22(2):204-211
Objective:
This study compared the incidence of suicide cases among Korean students before and after the coronavirus disease-2019 (COVID-19) pandemic.
Methods:
Aggregated case reports of all known suicide victims attending elementary, middle, and high school in South Korea from 2017 to 2022 were analyzed. These reports, compiled by teachers under the directive of the South Korean Department of Education, surveyed the circumstances surrounding each suicide and identified associated risk factors posthumously.
Results:
The completed suicide rate was 2.37 per 100,000 students pre-COVID-19 (2017–2019), significantly increasing to 3.37 per 100,000 students post-COVID-19 (2020–2022; odds ratio [OR] 1.42, p<0.001). The rate began to rise approximately 6 months into the pandemic and continued to worsen throughout 2021 and 2022. Fair attendance significantly increased in 2020 (74.83%, p=0.003) during the initial stage of school closure measures compared to 2019 (58.27%) among students prior to suicide completion. However, as social distancing measures continued, “absence due to medical reasons” showed a significant increase in 2022 (23.56%) compared to 2019 (13.67%, p=0.025) and 2020 (9.52%, p<0.001) among these students. Among those who completed suicide, teachers reported increased signs of depression and anxiety posthumously compared to pre-COVID-19 periods.
Conclusion
The incidence of completed suicide among students was significantly higher in the post-COVID-19 years compared to pre-COVID-19. Attendance records and teachers’ reports indicated a deterioration in mental health among these students before suicide completion, highlighting the need to consider mental health impacts when implementing future quarantine policies.
4.Comparison of Suicide Completion Rate in Korean Students Pre- and Post-COVID-19 Pandemics
Kyungjin LEE ; Boram NAM ; Kyoil SEO ; Eunkyung JO ; Seohyun KIM ; Deokyong SHIN ; Aeju KIM ; Youngil JEONG ; Yeni KIM
Psychiatry Investigation 2025;22(2):204-211
Objective:
This study compared the incidence of suicide cases among Korean students before and after the coronavirus disease-2019 (COVID-19) pandemic.
Methods:
Aggregated case reports of all known suicide victims attending elementary, middle, and high school in South Korea from 2017 to 2022 were analyzed. These reports, compiled by teachers under the directive of the South Korean Department of Education, surveyed the circumstances surrounding each suicide and identified associated risk factors posthumously.
Results:
The completed suicide rate was 2.37 per 100,000 students pre-COVID-19 (2017–2019), significantly increasing to 3.37 per 100,000 students post-COVID-19 (2020–2022; odds ratio [OR] 1.42, p<0.001). The rate began to rise approximately 6 months into the pandemic and continued to worsen throughout 2021 and 2022. Fair attendance significantly increased in 2020 (74.83%, p=0.003) during the initial stage of school closure measures compared to 2019 (58.27%) among students prior to suicide completion. However, as social distancing measures continued, “absence due to medical reasons” showed a significant increase in 2022 (23.56%) compared to 2019 (13.67%, p=0.025) and 2020 (9.52%, p<0.001) among these students. Among those who completed suicide, teachers reported increased signs of depression and anxiety posthumously compared to pre-COVID-19 periods.
Conclusion
The incidence of completed suicide among students was significantly higher in the post-COVID-19 years compared to pre-COVID-19. Attendance records and teachers’ reports indicated a deterioration in mental health among these students before suicide completion, highlighting the need to consider mental health impacts when implementing future quarantine policies.
5.Metabolic Dysfunction-Associated Steatotic Liver Disease and All-Cause and Cause-Specific Mortality
Rosa OH ; Seohyun KIM ; So Hyun CHO ; Jiyoon KIM ; You-Bin LEE ; Sang-Man JIN ; Kyu Yeon HUR ; Gyuri KIM ; Jae Hyeon KIM
Diabetes & Metabolism Journal 2025;49(1):80-91
Background:
Given the association between nonalcoholic fatty liver disease and metabolic risks, a new term, metabolic dysfunction- associated steatotic liver disease (MASLD) has been proposed. We aimed to explore the association between MASLD and all-cause, cause-specific mortalities.
Methods:
We included individuals with steatotic liver disease (SLD) from the Korean National Health Insurance Service. Moreover, SLD was defined as a fatty liver index ≥30. Furthermore, MASLD, metabolic alcohol-associated liver disease (MetALD), and alcoholic liver disease (ALD) with metabolic dysfunction (MD) were categorized based on alcohol consumption and MD. We also analyzed all-cause, liver-, cancer-, hepatocellular carcinoma (HCC)- and cardiovascular (CV)-related mortalities.
Results:
This retrospective nationwide cohort study included 1,298,993 individuals aged 40 to 79 years for a mean follow-up duration of 9.04 years. The prevalence of MASLD, MetALD, and ALD with MD was 33.11%, 3.93%, and 1.00%, respectively. Relative to the “no SLD” group, multivariable analysis identified that MASLD (adjusted hazard ratio [aHR], 1.28; 95% confidence interval [CI], 1.26 to 1.31), MetALD (aHR, 1.38; 95% CI, 1.32 to 1.44), and ALD with MD group (aHR, 1.80; 95% CI, 1.68 to 1.93) have a significantly higher risk of all-cause mortality. Furthermore, MASLD, MetALD, ALD with MD groups showed higher liver-, cancer- and HCC-related mortality than “no SLD” group. While all-cause specific mortalities increase from MASLD to MetALD to ALD with MD, the MetALD group shows a lower risk of CV-related mortality compared to MASLD. However, ALD with MD group still have a higher risk of CV-related mortality compared to MASLD.
Conclusion
SLD is associated with an increased risk of all-cause, liver-, cancer-, HCC-, and CV-related mortalities.
6.Metabolic Dysfunction-Associated Steatotic Liver Disease and All-Cause and Cause-Specific Mortality
Rosa OH ; Seohyun KIM ; So Hyun CHO ; Jiyoon KIM ; You-Bin LEE ; Sang-Man JIN ; Kyu Yeon HUR ; Gyuri KIM ; Jae Hyeon KIM
Diabetes & Metabolism Journal 2025;49(1):80-91
Background:
Given the association between nonalcoholic fatty liver disease and metabolic risks, a new term, metabolic dysfunction- associated steatotic liver disease (MASLD) has been proposed. We aimed to explore the association between MASLD and all-cause, cause-specific mortalities.
Methods:
We included individuals with steatotic liver disease (SLD) from the Korean National Health Insurance Service. Moreover, SLD was defined as a fatty liver index ≥30. Furthermore, MASLD, metabolic alcohol-associated liver disease (MetALD), and alcoholic liver disease (ALD) with metabolic dysfunction (MD) were categorized based on alcohol consumption and MD. We also analyzed all-cause, liver-, cancer-, hepatocellular carcinoma (HCC)- and cardiovascular (CV)-related mortalities.
Results:
This retrospective nationwide cohort study included 1,298,993 individuals aged 40 to 79 years for a mean follow-up duration of 9.04 years. The prevalence of MASLD, MetALD, and ALD with MD was 33.11%, 3.93%, and 1.00%, respectively. Relative to the “no SLD” group, multivariable analysis identified that MASLD (adjusted hazard ratio [aHR], 1.28; 95% confidence interval [CI], 1.26 to 1.31), MetALD (aHR, 1.38; 95% CI, 1.32 to 1.44), and ALD with MD group (aHR, 1.80; 95% CI, 1.68 to 1.93) have a significantly higher risk of all-cause mortality. Furthermore, MASLD, MetALD, ALD with MD groups showed higher liver-, cancer- and HCC-related mortality than “no SLD” group. While all-cause specific mortalities increase from MASLD to MetALD to ALD with MD, the MetALD group shows a lower risk of CV-related mortality compared to MASLD. However, ALD with MD group still have a higher risk of CV-related mortality compared to MASLD.
Conclusion
SLD is associated with an increased risk of all-cause, liver-, cancer-, HCC-, and CV-related mortalities.
7.Comparison of Suicide Completion Rate in Korean Students Pre- and Post-COVID-19 Pandemics
Kyungjin LEE ; Boram NAM ; Kyoil SEO ; Eunkyung JO ; Seohyun KIM ; Deokyong SHIN ; Aeju KIM ; Youngil JEONG ; Yeni KIM
Psychiatry Investigation 2025;22(2):204-211
Objective:
This study compared the incidence of suicide cases among Korean students before and after the coronavirus disease-2019 (COVID-19) pandemic.
Methods:
Aggregated case reports of all known suicide victims attending elementary, middle, and high school in South Korea from 2017 to 2022 were analyzed. These reports, compiled by teachers under the directive of the South Korean Department of Education, surveyed the circumstances surrounding each suicide and identified associated risk factors posthumously.
Results:
The completed suicide rate was 2.37 per 100,000 students pre-COVID-19 (2017–2019), significantly increasing to 3.37 per 100,000 students post-COVID-19 (2020–2022; odds ratio [OR] 1.42, p<0.001). The rate began to rise approximately 6 months into the pandemic and continued to worsen throughout 2021 and 2022. Fair attendance significantly increased in 2020 (74.83%, p=0.003) during the initial stage of school closure measures compared to 2019 (58.27%) among students prior to suicide completion. However, as social distancing measures continued, “absence due to medical reasons” showed a significant increase in 2022 (23.56%) compared to 2019 (13.67%, p=0.025) and 2020 (9.52%, p<0.001) among these students. Among those who completed suicide, teachers reported increased signs of depression and anxiety posthumously compared to pre-COVID-19 periods.
Conclusion
The incidence of completed suicide among students was significantly higher in the post-COVID-19 years compared to pre-COVID-19. Attendance records and teachers’ reports indicated a deterioration in mental health among these students before suicide completion, highlighting the need to consider mental health impacts when implementing future quarantine policies.
8.Metabolic Dysfunction-Associated Steatotic Liver Disease and All-Cause and Cause-Specific Mortality
Rosa OH ; Seohyun KIM ; So Hyun CHO ; Jiyoon KIM ; You-Bin LEE ; Sang-Man JIN ; Kyu Yeon HUR ; Gyuri KIM ; Jae Hyeon KIM
Diabetes & Metabolism Journal 2025;49(1):80-91
Background:
Given the association between nonalcoholic fatty liver disease and metabolic risks, a new term, metabolic dysfunction- associated steatotic liver disease (MASLD) has been proposed. We aimed to explore the association between MASLD and all-cause, cause-specific mortalities.
Methods:
We included individuals with steatotic liver disease (SLD) from the Korean National Health Insurance Service. Moreover, SLD was defined as a fatty liver index ≥30. Furthermore, MASLD, metabolic alcohol-associated liver disease (MetALD), and alcoholic liver disease (ALD) with metabolic dysfunction (MD) were categorized based on alcohol consumption and MD. We also analyzed all-cause, liver-, cancer-, hepatocellular carcinoma (HCC)- and cardiovascular (CV)-related mortalities.
Results:
This retrospective nationwide cohort study included 1,298,993 individuals aged 40 to 79 years for a mean follow-up duration of 9.04 years. The prevalence of MASLD, MetALD, and ALD with MD was 33.11%, 3.93%, and 1.00%, respectively. Relative to the “no SLD” group, multivariable analysis identified that MASLD (adjusted hazard ratio [aHR], 1.28; 95% confidence interval [CI], 1.26 to 1.31), MetALD (aHR, 1.38; 95% CI, 1.32 to 1.44), and ALD with MD group (aHR, 1.80; 95% CI, 1.68 to 1.93) have a significantly higher risk of all-cause mortality. Furthermore, MASLD, MetALD, ALD with MD groups showed higher liver-, cancer- and HCC-related mortality than “no SLD” group. While all-cause specific mortalities increase from MASLD to MetALD to ALD with MD, the MetALD group shows a lower risk of CV-related mortality compared to MASLD. However, ALD with MD group still have a higher risk of CV-related mortality compared to MASLD.
Conclusion
SLD is associated with an increased risk of all-cause, liver-, cancer-, HCC-, and CV-related mortalities.
9.Comparison of Suicide Completion Rate in Korean Students Pre- and Post-COVID-19 Pandemics
Kyungjin LEE ; Boram NAM ; Kyoil SEO ; Eunkyung JO ; Seohyun KIM ; Deokyong SHIN ; Aeju KIM ; Youngil JEONG ; Yeni KIM
Psychiatry Investigation 2025;22(2):204-211
Objective:
This study compared the incidence of suicide cases among Korean students before and after the coronavirus disease-2019 (COVID-19) pandemic.
Methods:
Aggregated case reports of all known suicide victims attending elementary, middle, and high school in South Korea from 2017 to 2022 were analyzed. These reports, compiled by teachers under the directive of the South Korean Department of Education, surveyed the circumstances surrounding each suicide and identified associated risk factors posthumously.
Results:
The completed suicide rate was 2.37 per 100,000 students pre-COVID-19 (2017–2019), significantly increasing to 3.37 per 100,000 students post-COVID-19 (2020–2022; odds ratio [OR] 1.42, p<0.001). The rate began to rise approximately 6 months into the pandemic and continued to worsen throughout 2021 and 2022. Fair attendance significantly increased in 2020 (74.83%, p=0.003) during the initial stage of school closure measures compared to 2019 (58.27%) among students prior to suicide completion. However, as social distancing measures continued, “absence due to medical reasons” showed a significant increase in 2022 (23.56%) compared to 2019 (13.67%, p=0.025) and 2020 (9.52%, p<0.001) among these students. Among those who completed suicide, teachers reported increased signs of depression and anxiety posthumously compared to pre-COVID-19 periods.
Conclusion
The incidence of completed suicide among students was significantly higher in the post-COVID-19 years compared to pre-COVID-19. Attendance records and teachers’ reports indicated a deterioration in mental health among these students before suicide completion, highlighting the need to consider mental health impacts when implementing future quarantine policies.
10.Adverse health effects of climate change and air pollution in people with disabilities: a systematic review
Nakyung RHIM ; Seohyun LEE ; Kyung-Hwa CHOI
Epidemiology and Health 2024;46(1):e2024080-
Global warming and air pollution adversely affect the health of the entire human population, particularly older adults, people with disabilities (PWDs), and children. In this systematic review, we investigated the adverse health effects of climate change and air pollution in PWDs. We conducted a comprehensive literature search of the PubMed database using the terms “disab*,” “air pollution,” and “climate change” on July 4, 2023, and August 8, 2023 and searched the Web of Science (WOS) database on December 28, 2023. We identified 425 and 1,169 studies on climate change cited in PubMed and WOS, respectively, as well as 333 studies on air pollution in PubMed and 495 studies on air pollution in WOS. The studies were classified by type of exposure, and full-text screening was conducted to confirm that the population, intervention or exposure, comparator, outcome statement, and inclusion and exclusion criteria were met. The Newcastle-Ottawa Scale was used to assess the quality of the included cohort and case-control studies and for data analysis. In extreme temperatures, PWDs experienced higher rates of injury, heat-related illness, functional impairment, heart disease, mental disorders, and mortality than people who were non-disabled (ND). Exposure to air pollution resulted in higher rates of obesity, cardiovascular disease, poststroke neurological and functional disability, and mortality in PWDs than in people who were ND. Therefore, because PWDs were more affected by climate change and air pollution than people who were ND, sensitive policies and preparedness measures should be developed for PWDs.

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