Psychological Versus Somatic Correlates of Adolescent Suicide Attempts: A 21-Year National Time-Series and Path-Analytic Study in South Korea (2005-2025).

Background

South Korea reports one of the highest adolescent suicide rates among OECD countries. Both psychological factors (perceived stress, depression) and somatic/behavioral factors (atopic disease, obesity, diet, physical activity) have been proposed as correlates of adolescent suicidality, but the extent to which their co-occurring long-term national trends reflect genuine, independent associations-rather than a shared secular (time) trend-has rarely been tested at the population level.

Methods

We compiled national annual prevalence estimates (2005-2025) from the Korea Youth Risk Behavior Survey (KYRBS), disseminated via the Korean Statistical Information Service (KOSIS), for eleven indicators. We computed (1) raw Pearson correlations, (2) year-detrended partial correlations, (3) multiple and hierarchical regression, and (4) an exploratory observed-variable path model on the year-adjusted series.

Results

In raw correlations, nearly all indicators were significantly associated with the suicide attempt rate (|r| = 0.30-0.92). After removing the shared time trend, only perceived stress (partial r = 0.82, p < 0.001) and depressive mood (partial r = 0.81, p < 0.001) remained strongly and independently associated with suicide attempts. Detrended residuals were approximately normal (Shapiro-Wilk p > 0.26), and the two psychological associations were confirmed by Spearman rank-based partial correlations and permutation tests (both p ≤ 0.0002). A joint regression (suicide ~ stress + depression, year-adjusted) explained 93.5% of variance (adjusted R2 = 0.923), and stress and depression added significant explanatory power beyond calendar year (ΔR2 = 0.229, p < 0.001).

Conclusions

Among the indicators examined, perceived stress and depressive mood show a robust population-level association with adolescent suicide attempts that is not attributable to a shared secular trend, whereas most somatic and behavioral correlates do not. The path model is exploratory and descriptive only and does not test causal mechanisms. Findings are ecological (population-level) and cannot establish-or exclude-individual-level causation.