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Original Articles
- Mental Disorders Mediate the Relationship Between Adverse Childhood Experiences and Suicidal Behavior in a High-risk Population: A Counterfactual Analysis From Jeju Island
- Yeon Woo Oh, Dongkyu Lee, Young-Eun Jung, Sun Jae Jung
- J Prev Med Public Health. 2025;58(5):505-515. Published online May 7, 2025
- DOI: https://doi.org/10.3961/jpmph.25.120
- 5,237 View
- 234 Download
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Abstract
Summary
PDF
Supplementary Material - Objectives
Jeju Island, Korea, is characterized by a significantly higher prevalence of adverse childhood experiences (ACE, 32.4%), elevated rates of mental disorders (34.6 vs. 22.9%), and lifetime suicidal thoughts (20.6 vs. 10.7%) compared to national averages. We investigated the mediating role of mental disorders in the pathway from ACE to suicidal behavior in Jeju.
Methods
Data from the Jeju Special Self-Governing Province Mental Health Survey 2023 (n=703) were analyzed. Exposure was defined as experiencing at least one ACE from the 10-item Adverse Childhood Experience International Questionnaire. Depressive disorder, anxiety disorder, and alcohol use disorder were diagnosed using the Korean-Composite International Diagnostic Interview. Suicidal behavior was defined as experiencing suicidal ideation, planning, or attempts. A counterfactual mediation model was used to evaluate the natural direct effect and natural indirect effect (NIE) of mental disorders.
Results
The total effect of ACE on suicidal behavior showed a risk difference of 35.3 percntage points (%p). When considering all three mental disorders simultaneously, the NIE was 27.6%p, accounting for 78.1% of the total effect. Stratification analyses revealed stronger total effects in women and older adults, while the proportion mediated was higher in women and younger adults.
Conclusions
In this ACE-prevalent population, mental disorders collectively mediated approximately three-quarters of the pathway from ACE to suicidal behavior. These findings, derived through robust counterfactual analysis, suggest that strengthening screening and management protocols for mental disorders among adults with a history of ACE may effectively prevent suicide in populations with high ACE prevalence. -
SummaryKorean summary
이 연구는 제주도 성인 인구를 대상으로 아동기 역경 경험(ACE)이 자살 행동에 미치는 영향 중 정신질환(우울, 불안, 알코올 사용장애)이 약 78%를 매개한다는 것을 확인했다. 이는 ACE가 높은 지역사회에서 정신질환 대한 체계적인 선별검사와 관리가 자살 예방에 효과적일 수 있음을 시사한다.Key Message
This study found that mental disorders(depression, anxiety, and alcohol use disorders) mediate approximately 78% of the pathway from adverse childhood experiences (ACE) to suicidal behavior in Jeju Island's adult population. The findings suggest that systematic screening and management of mental disorders could effectively prevent suicide in communities with high ACE prevalence.
- The Relationship Between Thiamine Intake and Long Sleep Duration: Results From the Korea National Health and Nutrition Examination Survey
- Dongkyu Lee, Kwanghyun Kim, Youngrong Lee, Kyungwon Oh, Sun Jae Jung
- J Prev Med Public Health. 2022;55(6):520-528. Published online October 14, 2022
- DOI: https://doi.org/10.3961/jpmph.22.313
- 13,636 View
- 175 Download
- 5 Web of Science
- 5 Crossref
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Abstract
Summary
PDFSupplementary Material
- Objectives
Thiamine is thought to modify sleeping patterns, while alcohol use diminishes internal thiamine levels. We investigated the association between thiamine intake and sleep duration and explored possible heterogeneity in the effect according to alcohol use.
Methods
In total, 15 384 participants aged 19-64 were obtained from the Korea National Health and Nutrition Examination Survey 2012-2016. Nutrient intake, including thiamine, was measured using a food frequency questionnaire. Sleep duration was measured by a self-reported questionnaire. The highest thiamine intake quartile was set as the reference group. Participants were divided into 3 groups, with 7-8 hours of daily sleep as a reference group and those who slept more or less than that as “oversleeping” and “insufficient sleeping,” respectively. Multivariate logistic regression was used, adjusting for socioeconomic, medical, and nutritional factors. Additionally, participants were stratified according to high-risk alcohol use defined by the World Health Organization standards on alcohol use.
Results
Low thiamine intake was associated with oversleeping (Q3: odds ratio [OR], 1.06; 95% confidence interval [CI], 0.86 to 1.32; Q2: OR, 1.24; 95% CI, 0.99 to 1.55; Q1: OR, 1.49; 95% CI, 1.16 to 1.91) and showed a significant trend for higher ORs at lower intake levels (p-trend<0.001). The effect was stronger in the high-risk alcohol use group (Q1: OR, 1.78; 95% CI, 1.28 to 2.49).
Conclusions
Low thiamine intake was associated with oversleeping, and alcohol use intensified that association. These results were found in a context where overt clinical symptoms due to thiamine deficiency are considered rare. More awareness of the potential relationship of thiamine intake with oversleeping and its related risks should be considered. -
SummaryKorean summary
국민건강영양조사 자료에서 낮은 비타민 B1 섭취가 과도한 수면시간과 연관성이 있으며, 고위험 알코올 섭취군에서 더 큰 상관성을 보였다. 현저한 임상 증상이 나타나지 않는 선에서의 섭취부족도 잠재적으로 과도한 수면시간 및 이와 관련된 건강에 대한 부정적 효과들과 관련이 있을 수 있어 주의가 필요하다. -
Citations
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- Sleep Disturbances and Vitamin D in Celiac Patients Under a Gluten Free Diet: A Cross-Sectional Study
Giuseppe Losurdo, Francesco Squeo, Angela Marotti, Antonio Giangaspero, Enzo Ierardi, Mariabeatrice Principi
Diseases.2026; 14(8): 279. CrossRef - Host–Gut Microbiota Interactions: Exploring the Potential Role of Vitamin B1 and B2 in the Microbiota–Gut–Brain Axis and Anxiety, Stress, and Sleep Quality
Yingxuan Tao, Murong Wu, Boyao Su, Heng Lin, Qianzi Li, Yuhong He, Tian Zhong, Ying Xiao, Xi Yu
Nutrients.2025; 17(11): 1894. CrossRef - Daytime-Dependent Effects of Thiamine on the Thiamine Pool and Pyruvate Dehydrogenase Regulation in the Brain and Heart
Vasily Aleshin, Nadejda Borisova, Artem Artiukhov, Kurban Tagirov, Olga Solovjeva, Eva Lavrenteva, Nikolay Panin, Maria Maslova, Anastasia Graf
International Journal of Molecular Sciences.2025; 26(17): 8296. CrossRef - The Therapeutic Potential of Vitamins B1, B3 and B6 in Charcot–Marie–Tooth Disease with the Compromised Status of Vitamin-Dependent Processes
Victoria Bunik
Biology.2023; 12(7): 897. CrossRef - Enhancing Sleep Quality: Assessing the Efficacy of a Fixed Combination of Linden, Hawthorn, Vitamin B1, and Melatonin
Matteo De Simone, Rosario De Feo, Anis Choucha, Elena Ciaglia, Francis Fezeu
Medical Sciences.2023; 12(1): 2. CrossRef
- Sleep Disturbances and Vitamin D in Celiac Patients Under a Gluten Free Diet: A Cross-Sectional Study
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