Accordingly, management of suicide attempters to prevent suicide is considered to be a very important factor, and the findings of Woo et al.,4 which presented specific characteristics of high-intent suicide attempters who visited the emergency department from a clinical perspective, appear to be very important. Their findings are consistent with those of previous studies in that high suicidal intent was positively correlated with age, Hamilton Depression Rating Scale (HAM-D) scores, existence of a suicide plan, and persistence of suicidal ideation. In particular, because the results of multiple logistic regression analysis showed that depression, existence of a suicide plan, and HAM-D scores significantly contribute to high suicidal intent, these findings are expected to be useful for future national suicide prevention policies and management programs for suicide attempters.

However, caution should be exercised in interpreting the findings because the study was focused on a specific area and the sample size was small. First, in the logistic regression analysis, age was not a significant risk factor of high-intent suicide attempters. It is well known that the lower the age, the higher the impulsiveness.5 Therefore, in the association between suicidal intent and age, the confounding variables of impulsivity should be taken into account. Since cutting and overdosing have been reported to be highly associated with non-lethal self-injury in terms of the relationship between the method of suicide and suicidal intent,6 further investigation appears to be necessary. Furthermore, the finding of non-significant effect of income level among demographic characteristics on suicidal intent should be interpreted with care because a previous study reported the influence of income level on suicide risk.7 In particular, future research on the effect of the strength of suicidal intent on actual suicide risk appears to be crucial since suicide attempts do not necessarily lead to suicide.8 Lastly, further spread of emergency department-based suicide prevention program across country should be made to reflect intervention systems that consider the evaluation results of suicidal intent and the characteristics of high-intent suicide attempters.