RESUMO
BACKGROUND: One of the population groups at higher risk of suicide is that of people who attend mental health institutions. OBJECTIVE: To know the demographic and clinical characteristics of people admitted for suicidal ideation and suicide attempt to the observation area of a psychiatric hospital in a period of 10 non-consecutive months. MATERIAL AND METHODS: Retrospective, descriptive, correlational study. A total of 439 medical records were collected, out of which 62.9% (n = 276) corresponded to women, 36.7% (n = 161) to men and 0.5% (n = 2) to transgender people; age ranged from 17 to 74 years. RESULTS: The highest incidence of cases was observed between 18 and 25 years of age; the most frequent diagnosis was depressive disorder, and 45.5% (n = 200) of the cases had a suicide attempt. The main method for committing a suicidal act was poisoning by taking various medications, followed by self-inflicted injuries with sharp objects. A positive correlation was found between suicide attempt and self-harm (c² = 1.965, p < 0.05). CONCLUSIONS: The findings highlight the importance of early identification of risk factors that may contribute to an increase in suicidal behaviors.
ANTECEDENTES: Uno de los grupos poblacionales en mayor riesgo de suicidio lo constituyen las personas que asisten a instituciones de salud mental. OBJETIVO: Conocer las características demográficas y clínicas de las personas ingresadas por ideación e intento suicida al área de observación de un hospital psiquiátrico en un periodo de 10 meses no consecutivos. MATERIAL Y MÉTODOS: Estudio retrospectivo, descriptivo y correlacional. Se recabaron 439 expedientes, de los cuales las mujeres representaron 62.9 % (n = 276), los hombres 36.7 % (n = 161) y las personas transgénero 0.5 % (n = 2); el rango de edad varió de 17 a 74 años. RESULTADOS: La mayor incidencia de casos se observó entre los 18 y 25 años, el diagnóstico más frecuente fue el trastorno depresivo y 45.5 % (n = 200) de los casos presentó una tentativa suicida. El principal método para cometer un acto suicida fue el envenenamiento por diversos medicamentos seguido por las lesiones autoinflingidas con objeto punzocortante. Se encontró correlación positiva entre intento suicida y autolesiones (c² = 1.965, p < 0.05). CONCLUSIONES: Los hallazgos resaltan la importancia de la identificación temprana de los factores de riesgo que pueden contribuir al incremento del comportamiento suicida.
Assuntos
Transtornos Mentais , Tentativa de Suicídio , Masculino , Humanos , Feminino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Tentativa de Suicídio/psicologia , Ideação Suicida , Estudos Retrospectivos , México/epidemiologia , Transtornos Mentais/epidemiologia , Fatores de RiscoRESUMO
Resumen Antecedentes: Uno de los grupos poblacionales en mayor riesgo de suicidio lo constituyen las personas que asisten a instituciones de salud mental. Objetivo: Conocer las características demográficas y clínicas de las personas ingresadas por ideación e intento suicida al área de observación de un hospital psiquiátrico en un periodo de 10 meses no consecutivos. Material y métodos: Estudio retrospectivo, descriptivo y correlacional. Se recabaron 439 expedientes, de los cuales las mujeres representaron 62.9 % (n = 276), los hombres 36.7 % (n = 161) y las personas transgénero 0.5 % (n = 2); el rango de edad varió de 17 a 74 años. Resultados: La mayor incidencia de casos se observó entre los 18 y 25 años, el diagnóstico más frecuente fue el trastorno depresivo y 45.5 % (n = 200) de los casos presentó una tentativa suicida. El principal método para cometer un acto suicida fue el envenenamiento por diversos medicamentos seguido por las lesiones autoinflingidas con objeto punzocortante. Se encontró correlación positiva entre intento suicida y autolesiones (χ2 = 1.965, p < 0.05). Conclusiones: Los hallazgos resaltan la importancia de la identificación temprana de los factores de riesgo que pueden contribuir al incremento del comportamiento suicida.
Abstract Background: One of the population groups at higher risk of suicide is that of people who attend mental health institutions. Objective: To know the demographic and clinical characteristics of people admitted for suicidal ideation and suicide attempt to the observation area of a psychiatric hospital in a period of 10 non-consecutive months. Material and methods: Retrospective, descriptive, correlational study. A total of 439 medical records were collected, out of which 62.9% (n = 276) corresponded to women, 36.7% (n = 161) to men and 0.5% (n = 2) to transgender people; age ranged from 17 to 74 years. Results: The highest incidence of cases was observed between 18 and 25 years of age; the most frequent diagnosis was depressive disorder, and 45.5% (n = 200) of the cases had a suicide attempt. The main method for committing a suicidal act was poisoning by taking various medications, followed by self-inflicted injuries with sharp objects. A positive correlation was found between suicide attempt and self-harm (χ2 = 1.965, p < 0.05). Conclusions: The findings highlight the importance of early identification of risk factors that may contribute to an increase in suicidal behaviors.
RESUMO
RESUMEN INTRODUCCIÓN: El suicidio constituye una de las principales causas de muerte consideradas como violentas y evitables. El objetivo fue estimar la incidencia y modalidad de suicidios en la serie histórica 2009-2020, considerando este último año como contexto pandémico por COVID-19. MÉTODOS: Se realizó un estudio transversal, observacional y retrospectivo de línea histórica. Los datos fueron obtenidos de la Dirección de Estadística e Información en Salud del Ministerio de Salud de la Provincia de Buenos Aires. Se clasificaron según tres modalidades de suicidio: intervención de un agente invasivo, un agente externo o sin agente. Para evaluar la posible variación de la densidad poblacional sobre las tasas de incidencia, se distribuyeron las defunciones sobre la base del tamaño poblacional de residencia. Finalmente, se obtuvieron dos índices: escore p y estimación de mortalidad observada (MO). RESULTADOS: Entre 2009 y 2020 se produjeron 13 221 muertes por lesiones autoinfligidas, con un promedio de 1110 suicidios al año. Al comparar 2020 (916 suicidios) con el quinquenio inmediato anterior (2015-2019, con una media de 1139 suicidios ±26 en su error estándar), el escore p mostró una reducción del 23,1% (275 muertes menos de lo esperado) y la MO, un descenso de 19,6% (223 muertes por debajo del intervalo superior esperado). DISCUSIÓN: En 2020 se redujo la incidencia absoluta y relativa de suicidios, aunque se mantuvo la diferencia según modalidad y género observada en la línea histórica.
ABSTRACT INTRODUCTION: Suicide is one of the main causes of death classified as violent and preventable. The objective was to estimate the incidence and mode of suicide in the 2009-2020 historical series, considering year 2020 as COVID-19 pandemic context. METHODS: A cross-sectional, retrospective, observational, historical timeline study was conducted. Data were obtained from the Department of Health Statistics and Information of the Ministry of Health of the Province of Buenos Aires. They were classified according to three modes of suicide: intervention of an invasive agent, an external agent or no agent. In order to evaluate the possible variation of population density on suicide incidence rates, deaths were distributed based on the population size of residence. Finally, two indices were obtained: the p-score and the estimate of observed mortality (OM). RESULTS: During 2009-2020 there were 13221 deaths due to self-inflicted injuries, with an average of 1110 suicides per year. When comparing the year 2020 (916 suicides) with the previous five-year period (2015-2019, with a mean of 1139 suicides ±26 in its standard error), the p-score showed a reduction of 23.1% (275 deaths less than expected) and OM, a decrease of 19.6% (223 deaths below the expected upper interval). DISCUSSION: During 2020 there was a reduction in the absolute and relative incidence of suicides, while maintaining the difference according to mode and gender observed through the historical timeline.
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Suicidal behavior is a serious health issue that affects the adolescent population and that may be prevented through evidence-based approaches. There are many risk factors involved in suicidal behavior, but there are few studies encompassing the complex relationships between them. This study tested the similarity between two latent class models from two different epidemiological samples of middle-school students and evaluated if the multinomial regression model replicated the associations between the classes and the psychosocial variables. Data of 4013 adolescents from the Mexican states of Campeche and Querétaro were included in LCA to characterize suicide behavior and associated factors. The most likely latent class membership was used as the outcome in multinomial regression models. The model with data from Querétaro was consistent with the previous LC model from Campeche. The four latent classes were nearly identical for both populations and can be defined as follows: 1) "No Problems," included 73% of the adolescents; 2) "Drug Use Only," comprised 7% of the adolescents; 3) "Suicidal Behavior, No Depression," captured 8% of the adolescents (25% reported binge drinking in the past month, 50% self-inflicted injuries, and 43% low-lethality suicide attempt); 4) "Depression and Suicidal Behavior," comprised 12% of the sample (66% met criteria for Major Depressive Episode, 28% reported binge drinking in the past month, and 11% had a high-lethality suicide attempt). The congruence between the models and the consistency with identified factors highlight the need for appropriate and effective prevention strategies to minimize risk factors and reinforce protective factors in the adolescent population.
Assuntos
Comportamento do Adolescente , Consumo Excessivo de Bebidas Alcoólicas , Transtorno Depressivo Maior , Adolescente , Comportamento do Adolescente/psicologia , Humanos , Análise de Classes Latentes , Fatores de Risco , Estudos de Amostragem , Ideação SuicidaRESUMO
Suicide is an important public health problem that requires a preventive approach. The present study aimed at assessing suicidal behaviors and their relations with other psychosocial factors in Campeche, Mexico, in order to inform the design of potential preventive interventions. A multistage probability sample of 2386 students representative of all middle schools of the state of Campeche, Mexico, took a standardized, paper-and-pencil survey covering selected psychosocial constructs including suicide behavior, depression, drug use, familial relationships, locus of control, impulsivity, and self-esteem, among others. Latent classes were identified and multinomial logistic regression was used to analyze associations between class membership and psychosocial covariates. An estimated 8% of the middle school population in Campeche had three or more psychosocial problems in the past month including drug use, major depression episode symptoms, as well as suicidal problems like attempts and self-inflicted injuries. Four latent classes were identified, one with lowest risk and three with varying characteristics in terms of binge alcohol and other drug use, depression, and suicide behaviors. Associations between psychosocial covariates and latent class were observed, as predicted based on a multi-dimensional theoretical framework. Heterogeneity across "High-Risk" groups and their potential determinants highlight the need for differentiated, specialized efforts ranging from universal to indicated interventions. Given the high level of risk factors in this population, universal preventive interventions should aim at building resiliency among youth by helping them develop an array of coping resources, as well as by creating a more nurturing psychosocial environment.
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Comportamento do Adolescente/psicologia , Depressão/psicologia , Prevenção do Suicídio , Suicídio/psicologia , Adolescente , Feminino , Humanos , Masculino , México , Modelos Estatísticos , Autoimagem , Transtornos Relacionados ao Uso de Substâncias , Inquéritos e QuestionáriosRESUMO
BACKGROUND: Patients burned intentionally experience extensive injuries with high rates of morbidity and mortality. Nonetheless, there is no consensus if these patients have worse outcomes than unintentional burns considering injury severity and other preexistent comorbidities. METHODS: We conducted a ten-year retrospective review on all patients treated at the Burn Unit of Hospital de Pronto Socorro, Porto Alegre, Brazil, between 2003 and 2012. The aim was to compare survival of self-inflicted burns and burns from assaults with unintentional injuries using a Multivariable Cox Regression Analysis. RESULTS: 1734 patients were included in the study, 87.7% non-intentional, 6.6% self-inflicted and 5.8% from aggression. Intentional injuries resulted in more severe injuries and were associated with psychiatric disorders and drug abuse. After controlling for injury severity, previous clinical comorbidities and previous psychiatric disorders, only self-inflicted burns correlated significantly with a higher risk of death (HR=1.59, CI 95% 1.05-2.41, p=0.03). CONCLUSIONS: Self-inflicted injuries were independently associated with a higher risk of death. Burns from aggression were not associated with higher mortality in this model. Prevention of these injuries must be priority and treating the main associated factors such as drug abuse and psychiatric disorders may lower its occurrence.