Proximal characteristics of suicide attempts: a study in a public hospital in Spain.

INTRODUCTION: Different parameters of suicide attempts treated since the implementation of the Attention to Suicide Risk Program (ARSUIC) in 2012 at the Hospital Ramón y Cajal in Madrid Region are described in this paper. METHOD: The sample was composed of 107 patients and the information was collected through a questionnaire created ad hoc with the following variables: type of suicidal ideation; drug use immediately prior to the attempt; method (in case of drug overdosing: drug/s used); location; accessibility to rescue; planning; intentionality; criticism; and brakes. RESULTS: Descriptive statistics were obtained and a comparison by gender was made through the χ2 and contingency coefficients tests. The data from the retrospective longitudinal study showed that the most common profile was of patients with unstructured ideas of death and no previous drug use who took an unplanned drug overdose in the family home, with the intention of self-harm or avoidance of discomfort, especially with benzodiazepines. Patients tend to ask for help afterwards and criticise the attempt, but potential restraints are often not recorded in the clinical report. Regarding the dissimilarities based on gender, statistically significant differences were found in prior alcohol consumption, in favour of men and in the overdose method, specifically with benzodiazepines, in favour of women. CONCLUSIONS: Knowing the types of attempts at self-harm is essential for improving prevention, understanding and patient management.

Association between suicidal behavior and symptoms of other mental health problems in Mexican adolescents.

BACKGROUND: Suicidal behavior in adolescents is a growing public health problem. Knowing its risk factors is key for reducing it. OBJECTIVE: To identify the relationship between two suicidal behaviors (ideation and attempt) and eight mental health problems (MHPs) in Mexican adolescents. MATERIAL AND METHODS: Through an online survey of adolescent students from 20 states, the following information was screened: symptomatology of six MHPs (affective problems/depression, behavioral problems, somatic problems, inattention and hyperactivity problems, oppositional defiant problems and anxiety problems) and suicidal behavior (suicidal ideation and suicide attempts). MHP and suicidal behavior frequencies and percentages were analyzed, and associations were sought using binary logistic regression. RESULTS: Six-thousand seven hundred sixty-six adolescents completed the survey, out of whom 61.02% were females, with ages ranging between 11 and 19 years (16.38 ± 1.33); 10% reported suicidal behavior, and between 3 and 5%, MHPs. The predictors (χ2(8) = 387.13, p < 0.001) of suicidal behavior were affective problems/depression, behavioral problems, somatic problems, oppositional defiant problems and anxiety problems. CONCLUSION: Five mental health problems increased the risk of reporting suicidal behaviors.

ANTECEDENTES: Las conductas suicidas en adolescentes son un problema de salud pública que va en aumento. Conocer sus factores de riesgo es clave para reducirlas. OBJETIVO: Identificar la relación entre dos conductas suicidas (ideación e intento) y ocho problemas de salud mental (PSM) en adolescentes mexicanos. MATERIAL Y MÉTODOS: Mediante una encuesta en línea a adolescentes escolarizados de 20 estados, se tamizó la siguiente información: sintomatología de seis PSM (problemas afectivos/depresión, problemas conductuales, problemas somáticos, problemas de inatención e hiperactividad, problemas oposicionistas desafianes y problemas de ansiedad) y conducta suicida (ideación e intentos de suicidio). Se analizaron frecuencias y porcentajes y se indagó asociación mediante regresión logística binaria. RESULTADOS: Completaron la encuesta 6766 adolescentes entre 11 y 19 años (16.38 ± 1.33), 61.02 % del sexo femenino. El 10 % reportó conducta suicida y entre 3 y 5 %, PSM. Los factores predictivos (χ2(8) = 387.13, p < 0.001) de la conducta suicida fueron problemas afectivos/depresión, problemas conductuales, problemas somáticos, problemas oposicionistas desafiantes y problemas de ansiedad. CONCLUSIÓN: Cinco problemas de salud mental incrementaron el riesgo de reportar conductas suicidas.

Programa de prevención del riesgo de suicidio «RENACE» / [“RENACE” suicide risk prevention program]

A pesar de que en España el suicidio supone la primera causa de muerte externa, no existe a nivel nacional un plan de prevención o intervención protocolizado. Este estudio tiene como objetivo final el diseño, la implementación y la evaluación de un nuevo programa de prevención del riesgo de suicidio en el Complejo Hospitalario Universitario de Albacete, llamado «RENACE». Para ello, se describe el perfil sociodemográfico y clínico de los pacientes con ideación y con conducta suicida. Se obtuvieron los siguientes resultados: la mayoría de pacientes fueron mujeres (59%) y el grupo etario más prevalente fue el de 31 a 65 años. Entre la población infantojuvenil, predominó el rango de edad de 14 a 17 años. En cuanto al perfil clínico, el diagnóstico principal fue trastornos relacionados con traumas y factores de estrés, seguido de trastornos depresivos. (AU)

Despite the fact that suicide is the leading cause of external death in Spain, there is no protocolized prevention or intervention plan at national level. The final aim of this study is the design, implementation and evaluation of a new suicide risk prevention program at the Albacete University Hospital Complex, called "RENACE". For this purpose, the sociodemographic and clinical profile of patients with suicidal ideation and behavior was described. The following results were obtained: the majority of patients were women (59%) and the most prevalent age group was 31 to 65 years old. Among the juvenile population, the predominant age range was 14 to 17 years. Regarding the clinical profile, the main diagnosis was trauma-related disorders and stress factors, followed by depressive disorders. (AU)

Asociación entre conducta suicida y síntomas de otros problemas de salud mental en adolescentes mexicanos / Association between suicidal behavior and symptoms of other mental health problems in Mexican adolescents

Resumen Antecedentes: Las conductas suicidas en adolescentes son un problema de salud pública que va en aumento. Conocer sus factores de riesgo es clave para reducirlas. Objetivo: Identificar la relación entre dos conductas suicidas (ideación e intento) y ocho problemas de salud mental (PSM) en adolescentes mexicanos. Material y métodos: Mediante una encuesta en línea a adolescentes escolarizados de 20 estados, se tamizó la siguiente información: sintomatología de seis PSM (problemas afectivos/depresión, problemas conductuales, problemas somáticos, problemas de inatención e hiperactividad, problemas oposicionistas desafianes y problemas de ansiedad) y conducta suicida (ideación e intentos de suicidio). Se analizaron frecuencias y porcentajes y se indagó asociación mediante regresión logística binaria. Resultados: Completaron la encuesta 6766 adolescentes entre 11 y 19 años (16.38 ± 1.33), 61.02 % del sexo femenino. El 10 % reportó conducta suicida y entre 3 y 5 %, PSM. Los factores predictivos (χ2(8) =387.13, p < 0.001) de la conducta suicida fueron problemas afectivos/depresión, problemas conductuales, problemas somáticos, problemas oposicionistas desafiantes y problemas de ansiedad. Conclusión: Cinco problemas de salud mental incrementaron el riesgo de reportar conductas suicidas.

Abstract Background: Suicidal behavior in adolescents is a growing public health problem. Knowing its risk factors is key for reducing it. Objective: To identify the relationship between two suicidal behaviors (ideation and attempt) and eight mental health problems (MHPs) in Mexican adolescents. Material and methods: Through an online survey of adolescent students from 20 states, the following information was screened: symptomatology of six MHPs (affective problems/depression, behavioral problems, somatic problems, inattention and hyperactivity problems, oppositional defiant problems and anxiety problems) and suicidal behavior (suicidal ideation and suicide attempts). MHP and suicidal behavior frequencies and percentages were analyzed, and associations were sought using binary logistic regression. Results: Six-thousand seven hundred sixty-six adolescents completed the survey, out of whom 61.02% were females, with ages ranging between 11 and 19 years (16.38 ± 1.33); 10% reported suicidal behavior, and between 3 and 5%, MHPs. The predictors (χ2(8) = 387.13, p < 0.001) of suicidal behavior were affective problems/depression, behavioral problems, somatic problems, oppositional defiant problems and anxiety problems. Conclusions: Five mental health problems increased the risk of reporting suicidal behaviors.

Beethoven y su sobrino: El peligro que es el otro

1). La vida de Ludwig van Beethoven experimentó un cambio existencial al morir su hermano y dejar a su hijo Karl en tutoría compartida con su madre Johanna. 2). Casi sin haber tenido relación con su sobrino, se desencadena una necesidad emocional intensa e inesperada de convertirse en su único tutor, objetivo que consigue derrotando legalmente a su madre. 3). La relación Beethoven-Karl se desarrolla plagada de disputas, vigilancia, exigencias, control, como si el compositor viviera por vez primera lo que siempre se había negado, llegar a ser padre. 4). El intento de suicidio del sobrino le señala a Beethoven que convertirse en padre significa permitir que el hijo llegue a ser diferente a las arrogantes y desmesuradas ambiciones y expectativas personales, pero esta señal extrema fue insuficiente para hacerle entender que el otro siempre es un peligro porque muestra una verdad oculta intolerable y dolorosa del propio sí-mismo.

Ludwig van Beethoven's life underwent an existential change when his brother died and left his son Karl in shared tutorship with his mother Johanna. 2. Almost without having had any relationship with his nephew, an intense and unexpected emotional need to become his sole guardian is triggered, an objective that he achieves by legally defeating his mother. 3. The Beethoven-Karl relationship develops plagued by disputes, surveillance, demands, control, as if the composer were experiencing for the first time what he had always denied himself, becoming a father.4. The nephew's suicide attempt points out to Beethoven that becoming a father means allowing the son to become different from the arrogant and inordinate personal ambitions and expectations, but this extreme signal was insufficient to make him understand that the other is always a danger because it shows a hidden and painful truth of one´s own self.

Tentativa de suicídio em mulheres privadas de liberdade em unidade prisional / Suicide attempts amomg women deprived of their freedom in a prison unit / Intento de suicidio en mujeres privadas de la libertad en una unidad penitenciaria

RESUMO Objetivo: descrever as ocorrências e os fatores associados à tentativa de suicídio em mulheres privadas de liberdade em uma unidade prisional. Método: estudo transversal, em unidade prisional do Paraná - Brasil, com 30 mulheres, com dados coletados em 2022, através dos instrumentos Columbia-Suicide Severity Rating Scale e outro elaborado pelas autoras e analisados descritivamente e inferencialmente. Resultados: durante a vida, 16 (53,3%) mulheres apresentaram comportamentos suicidas; 14 (46,7%) fizeram tentativas efetivas de suicídio; 14 (46,7%) tiveram danos físicos; e 10 (33,3%) atos preparatórios. A tentativa efetiva de suicídio teve associação com pensamentos suicidas antes da prisão (p <0,01) e pensamentos durante a prisão (p< 0,02). Conclusão: histórico anterior de ideação influenciaram na tentativa de suicídio. Assim, importa avaliar comportamentos suicidas na admissão e permanência de mulheres privadas de liberdade. Este estudo contribui para diminuir a lacuna na produção científica brasileira dessa temática com essa população.

ABSTRACT Objective: to describe the occurrences and factors associated with attempted suicide among women deprived of their freedom in a prison unit. Method: a cross-sectional study conducted at a detention facility in Paraná - Brazil, with 30 women, with data collected in 2022 using the Columbia-Suicide Severity Rating Scale instrument and another one prepared by the authors and analyzed descriptively and inferentially. Results: during their lifetime, 16 (53.3%) women presented suicidal behavior; 14 (46.7%) made actual suicide attempts; 14 (46.7%) had physical damage; and 10 (33.3%) preparatory acts. An actual suicide attempt was associated with suicidal thoughts before arrest (p<0.01) and with thoughts during arrest (p<0.02). Conclusion: previous history of ideation influenced the suicide attempt. Therefore, it is important to evaluate suicidal behavior in the admission and permanence of women deprived of their freedom. This study contributes to reducing the gap in the Brazilian scientific production on this topic with this population segment.

RESUMEN Objetivo: describir los sucesos y factores asociados al intento de suicidio en mujeres privadas de la libertad en una unidad penitenciaria. Método: estudio transversal, en una unidad penitenciaria de Paraná, Brasil, con 30 mujeres, con datos recolectados en 2022, mediante dos instrumentos, el Columbia-Suicide Severity Rating Scale y otro elaborado por las autoras, y analizados de forma descriptiva e inferencial. Resultados: a lo largo de su vida, 16 (53,3%) mujeres presentaron conductas suicidas; 14 (46,7%) intentaron suicidarse realmente; 14 (46,7%) sufrieron daños físicos; y 10 (33,3%) realizaron actos preparatorios. El intento de suicidio se asoció con pensamientos suicidas antes de ir a prisión (p <0,01) y con pensamientos durante la permanencia en prisión (p<0,02). Conclusión: el antecedente previo de ideación influyó en el intento de suicidio. Por lo tanto, es importante evaluar la conducta suicida al ingreso y durante la permanencia de mujeres privadas de la libertad. Este estudio contribuye a reducir las lagunas de la producción científica brasileña sobre este tema con esta población.

Avaliação funcional em famílias de pessoas com comportamento suicida: aplicação do modelo calgary / Functional assessment in families of people with suicidal behavior: application of the calgary model / Evaluación funcional de familias de personas con conducta suicida: aplicación del modelo de calgary

RESUMO: Objetivo: desvelar as ações que mantém a funcionalidade da família de pessoas com comportamento suicida. Método: trata-se de estudo qualitativo, descritivo-exploratório, baseado no referencial teórico e metodológico do Modelo Calgary de avaliação familiar. Participaram do encontro online, no ano de 2022, para construção do genograma familiar 11 usuários do Núcleo de Estudo e Prevenção do Suicídio, localizado em Salvador, Bahia, Brasil. Da segunda etapa, a entrevista contou com nove famílias de usuários. Resultados: emergiram as categorias: vigilância por familiares; uso de tecnologias pelo familiar para contato diário; manejo da crise suicida por familiares e atenção dos familiares às necessidades básicas, todas as categorias relacionadas a pessoa com comportamento suicida. Conclusão: percebe-se caminhos para implementação de políticas de saúde e manuais que orientem família e amigos no manejo da crise suicida, evitando assim consequências não desejáveis, como a tentativa de suicídio e o ato concretizado.

Objective: unveil the actions that maintain the functionality of the family of people with suicidal behavior. Method: this is a qualitative, descriptive-exploratory study, based on the theoretical and methodological framework of the Calgary Family Assessment Model. 11 users of the Suicide Study and Prevention Center, located in Salvador, Bahia, Brazil, participated in the online meeting in 2022 to construct the family genogram. In the second stage, the interview included nine user families. Results: the following categories emerged: surveillance by family members; family member's use of technology for daily contact; management of the suicidal crisis by family members and family attention to basic needs, all categories related to a person with suicidal behavior. Conclusion: there are ways to implement health policies and manuals that guide family and friends in managing the suicidal crisis, thus avoiding undesirable consequences, such as the suicide attempt and the completed act.

RESUMEN: Objetivo: revelar las acciones que mantienen la funcionalidad de la familia de personas con conducta suicida. Método: se trata de un estudio cualitativo, descriptivo-exploratorio, basado en el marco teórico y metodológico del Modelo de Evaluación Familiar de Calgary. Once usuarios del Centro de Estudio y Prevención del Suicidio, ubicado en Salvador, Bahía, Brasil, participaron del encuentro online en 2022 para elaborar el genograma familiar. En la segunda etapa, la entrevista incluyó a nueve familias de usuarios. Resultados: surgieron las categorías: control por parte de los familiares; uso de la tecnología por parte de los familiares para mantener contacto diario; manejo de la crisis suicida por parte de los familiares y atención de los familiares a las necesidades básicas, todas las categorías se relacionan con la persona con conducta suicida. Conclusión: existen formas de implementar políticas y manuales de salud que orienten a los familiares y amigos para manejar la crisis suicida, y evitar consecuencias no deseadas, como el intento de suicidio y el acto consumado.

Vidas activas y cascos rotos: mapeo sistemático de la asociación entre suicidio y deporte / Vidas ativas e capacetes quebrados: mapeamento sistemático da associação entre suicídio e esporte / Active lives and broken helmets: systematic mapping of the association between suicide and sport

Resumen La cuestión del comportamiento suicida ha ganado relevancia en la actualidad debido a los efectos que tiene sobre los individuos y la sociedad. Aunque este tema ha sido ampliamente estudiado, la relación entre suicidio y deporte ha sido poco explorada en el contexto latinoamericano. Así, se ha hecho evidente que la mayor parte de la producción académica sobre la temática está dispersa en revistas norteamericanas y europeas. En este contexto, el objetivo de este artículo es analizar la asociación entre el comportamiento suicida y el deporte en la producción académica internacional entre 2000 y 2021. Para alcanzar estos objetivos, se realizó un mapeo de la literatura. Se evidenció la importancia del deporte en la prevención del comportamiento suicida y la necesidad de investigar variables contextuales en los procesos que contribuyen a la prevención o desarrollo de la ideación o intento suicida.

Resumo A questão do comportamento suicida ganhou relevância nos dias de hoje devido aos efeitos que tem sobre os indivíduos e a sociedade. Embora este tema tenha sido amplamente estudado, a relação entre suicídio e esporte tem sido pouco explorada no contexto latino-americano. Assim, tornou-se evidente que a maior parte da produção acadêmica sobre o assunto está dispersa em revistas norte-americanas e europeias. Nesse contexto, o objetivo deste artigo é analisar a associação entre o comportamento suicida e o esporte na produção acadêmica internacional entre 2000 e 2021. Para alcançar estes objetivos, foi realizado um mapeamento da literatura. Foi evidenciada a importância do esporte na prevenção do comportamento suicida e a necessidade de investigar variáveis contextuais nos processos que contribuem para a prevenção ou desenvolvimento da ideação ou tentativa suicida.

Abstract The issue of suicidal behavior has become especially relevant in recent years because of its effects on individuals and society. Although this topic has been studied extensively in North America and Europe, the relationship between suicide and sport is comparatively under-researched in the Latin-American context. This paper aims to contribute to this literature by supplementing existing research with an analysis of the association between suicidal behavior and sports in a more inclusive international context. This paper surveys academic productions between 2000 and 2021 using a systematic Mapping method to highlight the imbalance in research production on a global scale. The paper demonstrates the importance of participation in sports activity in the prevention of suicidal behavior, in addition to the importance of investigating mediational variables that contribute to the processes of prevention and development of both suicidal ideation and attempt.

Modelos teóricos do suicídio: uma revisão narrativa / Modelos teóricos del suicidio: una revisión narrativa / Theoretical models of suicide: a narrative review

RESUMO O suicídio é considerado um grave problema de saúde pública mundial. Compreender a sua manifestação é necessário para traçar futuras intervenções. O objetivo desta revisão narrativa da literatura foi apresentar alguns dos modelos teóricos mais recentes e citados sobre o suicídio: Modelo Cognitivo do Atos Suicidas, teoria Interpessoal do Suicídio, Modelo Motivacional-volitivo Integrado de Suicídio e teoria das Três Etapas. Além disso, foram analisadas as variáveis explicativas que os modelos têm em comum e as evidências empíricas que os sustentam. Os modelos indicam relações entre aspectos individuais e contextuais, e se complementam para compreensão do suicídio. De forma geral, aspectos associados à ideação suicida são mais bem estabelecidos na literatura. No entanto, a diferenciação e a transição da ideação suicida para a tentativa de suicídio precisam ser melhor esclarecidas para ajudar a identificar pessoas em risco de vida e formular ações efetivas de prevenção e tratamento. Apesar de ser uma premissa de modelos explicativos, observou-se a ausência de pesquisas longitudinais que auxiliam na predição do suicídio. As variáveis explicativas, sustentadas por evidências empíricas, podem contribuir para qualificar políticas públicas em saúde para enfrentamento do fenômeno.

RESUMEN. El suicidio se considera un grave problema de salud pública en todo el mundo. Es necesario comprender su manifestación para delinear futuras intervenciones. El objetivo de esta revisión narrativa de la literatura fue presentar algunos de los modelos teóricos más recientes mencionados en la literatura sobre el suicidio: Modelo Cognitivo de Actos Suicidas, Teoría Interpersonal del Suicidio, Modelo Integrado Motivacional-Volativo del Suicidio y Teoría de Tres Pasos. Asimismo, analizar qué variables explicativas tienen en común, así como la evidencia empírica que las sustenta. Los modelos indican relaciones entre aspectos individuales y contextuales, y se complementan para entender el suicidio. En general, los aspectos asociados a la ideación suicida se encontraron mejor establecidos en la literatura. Sin embargo, es necesario aclarar mejor la diferenciación y la transición de la ideación suicida al intento de suicidio para ayudar a identificar a las personas en riesgo de vida y formular acciones de prevención y tratamiento eficaces. A pesar de ser una premisa de los modelos explicativos, faltaron investigaciones longitudinales que ayuden a predecir el suicidio. Las variables explicativas, sustentadas en evidencia empírica, pueden contribuir a calificar las políticas de salud pública para enfrentar el fenómeno.

ABSTRACT. Suicide is a serious public health problem worldwide. Understanding its manifestation is important to outline future interventions. This narrative review of the literature aimed to discuss some of the most recent and prominently referenced theoretical models in the literature about suicide: Cognitive Model of Suicidal Acts, Interpersonal Theory of Suicide, Integrated Motivational-Volitional Model of Suicidal Behavior, and Three-Step Theory. Also, we analyzed the explanatory variables the models have in common and the empirical evidence that supports them. The models indicate relationships between individual and contextual aspects and complement each other to understand suicide. While the literature extensively elucidates factors associated with suicidal ideation, the differentiation and transition from ideation to suicide attempts demand further elucidation to help identify people at risk of death and develop effective prevention and treatment actions. Despite being a premise of explanatory models, there was a lack of longitudinal studies that help predict suicide. The explanatory variables, supported by empirical evidence, can contribute to qualifying public health policies to combat the phenomenon.

[Suicidal attempt in a school-aged patient and related factors: a case report]. / Intento de suicidio en paciente escolar y factores relacionados: reporte de caso.

Background: Suicide is a public health problem, which has increased in recent years, becoming a serious cause of mortality, mostly in low- and middle-income countries. Suicidal behavior is infrequent before adolescent years, various related factors have been described. The purpose of this work is to describe the case of a patient in school age who attempted suicide and the identified factors that might have contributed. Clinical case: Nine-year-old male attempted suicide by hanging in the bathroom, endangering his life. He received emergency attention and hospitalized in intensive care. During his hospitalization, the mental health service approached him. Amongst the factors previously associated with suicidal intent during school age and identifiable in the patient are family disintegration, symptoms of major depression episodes, reading-related learning difficulties and attention deficit hyperactivity disorder. The patient received treatment and follow up consultation, without showing any suicidal behavior up to this date. The patient is currently 13 years old. Conclusions: It must be recognized that children of school age can present suicidal behavior. It is important to acknowledge the factors associated with this kind of behavior, to reduce risks and provide an opportune attention and handling.

Introducción: el suicidio es un problema de salud pública que se ha incrementado en los últimos años, convirtiéndose en una grave causa de mortalidad principalmente en países de ingresos bajos y medios. Las conductas suicidas son poco frecuentes antes de la adolescencia, por lo que se han descrito diversos factores relacionados. El propósito de este trabajo es describir el caso de un paciente en edad escolar que intentó suicidarse y las causas identificadas que pudieron influir. Caso clínico: paciente masculino de nueve años puso su vida en riesgo al intentar suicidarse por ahorcamiento en el cuarto de baño. Recibió atención de urgencia y estuvo en la terapia intensiva. Durante su hospitalización fue abordado por el servicio de salud mental. Entre los factores que han sido previamente asociados al intento suicida en la edad escolar que pudieron identificarse en el paciente se encuentran: desintegración familiar, síntomas de episodio depresivo grave, dificultad en el aprendizaje para la lectura y un trastorno por déficit de atención con hiperactividad. El paciente recibió tratamiento y seguimiento, hasta el día de hoy no ha vuelto a presentar comportamientos suicidas. Actualmente tiene trece años. Conclusiones: se debe reconocer que los niños en edad escolar pueden presentar comportamientos suicidas, y es importante conocer los factores asociados a este tipo de conductas. Esto, con la finalidad de poder reducir el riesgo, así como otorgar atención y manejo de forma oportuna.

Intentos de suicidio en personas mayores en servicios de Urgencias psiquiátricas hospitalarias / Elderly people’s suicide attempts in psychiatric emergency departments

Fundamentos: En las personas mayores hay una alta prevalencia de trastorno mental, baja demanda asistencial y mayor riesgo de conducta suicida. La atención en Urgencias psiquiátricas puede ser la puerta de acceso a los servicios de salud. Por lo tanto, este trabajo tuvo como objetivos: 1) comparar el perfil de las personas de sesenta y cinco o más años atendidas por intento de suicidio (IS) y las atendidas por otros problemas de salud mental en Urgencias psiquiátricas hospitalarias; y 2) establecer la especificidad de la Escala de Cribado Columbia (C-SSRS) en la exploración del riesgo de suicidio. Métodos: Se realizó un análisis secundario de un estudio observacional descriptivo, multicéntrico, en el que se compararon todas las personas atendidas por IS (n=21) y un grupo control (n=27) atendido por otro motivo, entre enero y octubre de 2015. Se realizan análisis no paramétricos en variables sociodemográficas, clínicas, acontecimientos vitales estresantes vividos y C-SSRS. Resultados: 1) Entre quienes acuden por IS el 52,4% eran hombres mientras que los que acudían por otro motivo eran el 18,5%. 2) El 38,1% de quienes acudieron por IS se encontraban en seguimiento en salud mental frente al 66,7% de los atendidos por otros motivos. 3) El cribado mediante C-SSRS discriminó entre las atenciones por IS y otro motivo.Conclusiones: El IS en los hombres mayores puede ser la oportunidad para iniciar la atención y continuidad de cuidados en los servicios de salud mental. Se recomienda el uso de la escala C-SSRS en Urgencias psiquiátricas hospitalarias.(AU)

Background: Elderly people have a high prevalence of mental disorder, low demand for care and increased risk of suicidal behaviour. Psychiatric emergency care may be the gateway to health services. Therefore, the aims of this study were: 1) to compare the profile of people aged sixty-five years and older seen for suicide attempts (SA) and those seen for other mental health problems in hospital psychiatric emergency departments; and 2) to establish the specificity of theColumbia Screening Scale (C-SSRS) in the exploration of suicide risk. Methods: We carried out a secondary analysis of a descriptive, multicentre, observational, descriptive study comparing all persons seen for SA (n=21) and a control group (n=27) seen for another reason, between January and October 2015. Non-parametric analyses were performed on sociodemographic and clinical variables, stressful life events experienced and C-SSRS. Results: 1) Among those attending for SA, 52.4% were men while those attending for another reason accounted for 18.5%. 2) 38.1% of those attending for SA were in mental health follow-up compared to 66.7% of those attending for other reasons. 3) C-SSRS screening discriminated between those seen for SA and those seen for other reasons. Conclusions: SA in older men may be the opportunity to initiate care and continuity of care in mental health services. The use of the C-SSRS scale in hospital psychiatric emergency departments is recommended.(AU)

Risk factors associated with suicide attempt as predictors of suicide, Colombia, 2016-2017.

BACKGROUND: Suicidal behaviour is the cause of half of all violent deaths. It is considered to be a public health problem with one million victims a year. Suicide attempt is the most important risk factor. In Colombia, in 2017 the suicide attempt rate was 51.8/100,000 inhabitants, and the fatality rate reached 10.0/100,000. The objective is to identify suicide attempt factors associated with death and determine survival after the attempt for 2 years. MATERIAL AND METHODS: Retrospective cohort study and survival analysis. A total of 42,594 records of the suicide attempt surveillance system databases and 325 records of death by suicide in 2016 and 2017 were analysed. The risk factors were examined and a χ2-test and multivariate analysis and logistic regression were performed. Cumulative survival probability was calculated using the Kaplan-Meier method. A Cox regression model was applied to determine the proportional relationship of the suicide attempt variables that are related to suicide. RESULTS: Men die by suicide 4.5 times more often than women. One in four suicide victims had made at least one prior suicide attempt. The attempt factors related with death by suicide were: male gender (HR = 2.99; 95% CI, 2.27-3.92), adulthood (over 29 years, HR = 2.38; 95% CI, 1.90-2.99), living in a rural area (HR = 2.56; 95% CI, 2.04-3.20), chronic disease history (HR = 2.43; 95% CI, 1.66-3.57) and depression disorder (HR = 1.94; 95% CI, 1.55-2.41). Some 50% of suicide deaths occur up to 560 days after the suicide attempt. CONCLUSIONS: The risk of suicide is highest in male patients, with a history of depression, chronic illness and exposure to heavy workloads.

Factores De Riesgo Relacionados Con Intento de Suicidio Como Predictores De suicidio, Colombia 2016-2017✩

Introducción: La conducta suicida es la causa de la mitad de las muertes violentas. Se considera un problema de salud pública con un millón de víctimas al año. El intento de suicidio es el factor de riesgo más importante. En Colombia, en 2017 la tasa de intento de suicidio fue de 51,8/100.000 hab. y la letalidad alcanzó 10,0/100.000. El objetivo es identificar factores del intento suicida asociados con la muerte y determinar la supervivencia después del intento durante 2 años. Material y métodos: Estudio de cohorte retrospectiva y análisis de supervivencia. Se cruzaron 42.594 registros del sistema de vigilancia de intento de suicidio con 325 muertes por suicidio del registro único de defunciones de 2016 y 2017. Se examinaron factores de riesgo, y se realizó la prueba de la x2, análisis multivariado y regresión logística. Se calculó la probabilidad de supervivencia acumulada con el método de Kaplan-Meier. Se aplicó un modelo de regresión de Cox para determinar la relación proporcional de las variables del intento suicida que se relacionan con suicidio. Resultados: Por cada muerte de mujer por suicidio, mueren 4,5 varones por esta causa; 1 de cada 4 personas fallecidas reportó al menos un intento previo. Los factores del intento relacionados con la muerte por suicidio fueron: ser varón (HR = 2,99; IC95%, 2,27-3,92), la edad adulta (> 29 años, HR = 2,38; IC95%, 1,90-2,99), vivir en área rural (HR = 2,56; IC95%, 2,04-3,20) y padecer enfermedad crónica (HR = 2,43; IC95%, 1,66-3,57) o trastorno depresivo (HR = 1,94; IC95%, 1,55-2,41). El 50% de las muertes por suicidio ocurren hasta en los 560 días posteriores al intento. Conclusiones: Se evidencia mayor riesgo de suicidio en pacientes varones, con historia de expresión, antecedentes de enfermedades crónicas y exposición a carga laboral.

Background: Suicidal behaviour is the cause of half of all violent deaths. It is considered to be a public health problem with one million victims a year. Suicide attempt is the most important risk factor. In Colombia, in 2017 the suicide attempt rate was 51.8/100,000 inhabitants, and he fatality rate reached 10.0/100,000. The objective is to identify suicide attempt factors associated with death and determine survival after the attempt for 2 years. Material and methods: Retrospective cohort study and survival analysis. A total of 42,594 records of the suicide attempt surveillance system databases and 325 records of death by suicide in 2016 and 2017 were analysed. The risk factors were examined and a X2-test and multivariate analysis and logistic regression were performed. Cumulative survival probability was calculated using the Kaplan-Meier method. A Cox regression model was applied to determine the proportional relationship of the suicide attempt variables that are related to suicide. Results: Men die by suicide 4.5 times more often than women. One in four suicide victims had made at least one prior suicide attempt. The attempt factors related with death by suicide were: male gender (HR = 2.99; 95% CI, 2.27-3.92), adulthood (over 29 years, HR = 2.38; 95% CI, 1.90-2.99), living in a rural area (HR = 2.56; 95% CI, 2.04-3.20), chronic disease history (HR = 2.43; 95% CI, 1.66-3.57) and depression disorder (HR = 1.94; 95% CI, 1.55-2.41). Some 50% of suicide deaths occur up to 560 days after the suicide attempt. Conclusions: The risk of suicide is highest in male patients, with a history of depression, chronic illness and exposure to heavy workloads.

Caracterización sociodemográfica y epidemiológica de niños y adolescentes con intento de suicidio en el municipio de Santiago de Cuba / Sociodemographic and epidemiologic characterization of children and adolescents with suicide attempt in Santiago de Cuba municipality i: en

Introducción: El intento de suicidio en las poblaciones infantojuveniles resulta un problema de salud grave en Cuba y el mundo. Objetivo: Caracterizar sociodemográfica y epidemiológicamente a pacientes en edades entre 6 y 18 años con intento de suicidio. Métodos: Se realizó un estudio observacional, descriptivo y transversal de 145 niños y adolescentes, ingresados en el Hospital Docente Infantil Sur Dr. Antonio María Béguez César de Santiago de Cuba por intento de suicidio, durante el 2018. Las historias clínicas individuales de cada paciente constituyeron la fuente de información y se seleccionaron variables demográficas y epidemiológicas. Resultados: Las féminas mostraron el mayor riesgo de intento de suicidio (27,9 por cada 10 000); asimismo, predominaron el grupo de edades de 15 a 18 años (64,8 %) y la ingestión de psicofármacos (84,1 %) como método para tratar de quitarse la vida, por ser fácilmente accesible. Los conflictos familiares (60,6 %) y la falta de apoyo familiar (46,2 %) se destacaron entre los principales factores asociados al comportamiento suicida. Conclusiones: Los niños y adolescentes de esta serie procedían de familias con conflictos y violencia doméstica, lo cual, junto a la falta de apoyo familiar, identificada en su medio, pudiera haber influido en la tentativa de suicidio.

Introduction: The suicide attempt in children and young populations is a serious health problem in Cuba and the world. Objective: To characterize sociodemographic and epidemiologically the patients aged 6 and 18 with suicide attempt. Methods: An observational, descriptive and cross-sectional study of 145 children and adolescents was carried out, who were admitted to Dr. Antonio María Beguez César Southern Children Teaching Hospital in Santiago de Cuba due to suicide attempt, during 2018. Each patient's individual medical records constituted the source of information and demographic and epidemiologic variables were selected. Results: The females showed the highest risk of suicide attempt (27.9 for each 10 000); likewise, the 15 to 18 age group (64.8%) and the psychoactive drug ingestion (84.1%) as a method to try to kill oneself, because it was easily accessible, prevailed. Family conflicts (60.6%) and the lack of family support (46.2%) were notable among the main factors associated with suicidal behavior. Conclusions: Children and adolescents in this series came from families with conflicts and domestic violence, which, along with the lack of the family support, identified in their environment, could have influenced the suicide attempt.

Factors associated with suicidal intent in economically active patients diagnosed with major depression.

INTRODUCTION: Every 40s, one person in the world commits suicide. As such, suicide is considered a public health problem, and prior suicide attempt is one of the risk factors associated with completed suicide. Despite the strategies implemented and the studies carried out, in Colombia suicide figures are on the rise, more markedly in the economically active population. OBJECTIVE: To identify the sociodemographic, family, personal, economic and religious factors associated with suicide attempt in patients of productive age (18-62 years old) in a mental health institution in Bogota, Colombia. METHODS: An analytical prevalence study was conducted at the Nuestra Señora de la Paz mental health clinic in Bogota. To explore the relationship between the factors described and suicide attempt, a review of 350 medical records of the selected population was carried out. RESULTS: In total, 37.7% of the sample presented a suicide attempt. Associations were found between the suicide attempt and higher education than primary school (PR=0.47 [0.23-0.97]), no economic income (PR=1.72 [1.13-2.61]), no partner (PR=2.10 [1.33-3.32]), alcohol consumption (P=.045), hallucinogen use (PR=2.39 [0.97-3.43]) and the presence of personality disorder (PR=1.93 [1.11-3.34]). CONCLUSIONS: The results of the study are similar to those previously described in other studies around the world. There is a need to recognise and address various factors associated with suicide attempt in depressed patients in order to implement promotion and prevention actions, early identification and specific interventions that have an impact on the numbers of completed suicide in the country.

Factores asociados con intento suicida en pacientes económicamente activos con diagnóstico de depresión mayor

Introducción: En el mundo, cada 40 segundos una persona se quita la vida; el suicidio se considera un problema de salud pública, y el intento de suicidio previo es uno de los factores de riesgo relacionados con suicidio consumado. A pesar de las estrategias implementadas y los estudios realizados, en Colombia las cifras de suicidio van en ascenso, de manera más marcada en la población económicamente activa. Objetivo: Identificar los factores sociodemográficos, familiares, personales, económicos y religiosos asociados con el intento suicida en pacientes con trastorno depresivo en edad productiva (18-62 arios), en una institución de salud mental en Bogotá, Colombia. Métodos: Se realizó un estudio de prevalencia analítica en la Clínica de Nuestra Señora de la Paz, de Bogotá; para explorar la relación entre los factores descritos y el intento suicida, se realizó una revisión de 350 historias clínicas de la población seleccionada. Resultados: El 37,7% de la muestra presentó intento de suicidio. Se encontraron asociaciones entre el intento de suicidio y la formación superior a primaria (RP = 0,47 [0,23-0,97]), no recibir ingresos (RP = 1,72 [1,13-2,61]), no tener pareja (RP = 2,10 [1,33-3,32]), el consumo de alcohol (p = 0,045), el consumo de alucinógenos (RP = 2,39 [0,97-3,43]) y la presencia de trastorno de personalidad (RP = 1,93 [1,11-3,34]). Conclusiones: Los resultados del estudio son similares a los descritos previamente en el mundo. Es necesario reconocer y abordar diversos factores asociados con el intento de suicidio en pacientes depresivos para desplegar acciones de promoción y prevención, identificación temprana e intervenciones específicas que impacten en las cifras de suicidio consumado en el país.

Introduction: Every 40 seconds, one person in the world commits suicide. As such, suicide is considered a public health problem, and prior suicide attempt is one of the risk factors associated with completed suicide. Despite the strategies implemented and the studies carried out, in Colombia suicide figures are on the rise, more markedly in the economically active population. Objective: To identify the sociodemographic, family, personal, economic and religious factors associated with suicide attempt in patients of productive age (18-62 years old) in a mental health institution in Bogota, Colombia. Methods: An analytical prevalence study was conducted at the Nuestra Señora de la Paz mental health clinic in Bogota. To explore the relationship between the factors described and suicide attempt, a review of 350 medical records of the selected population was carried out. Results: In total, 37.7% of the sample presented a suicide attempt. Associations were found between the suicide attempt and higher education than primary school (PR = 0.47 [0.23-0.97]), no economic income (PR = 1.72 [1.13-2.61]), no partner (PR = 2.10 [1.33-3.32]), alcohol consumption (p = 0.045), hallucinogen use (PR = 2.39 [0.97-3.43]) and the presence of personality disorder (PR= 1.93 [1.11-3.34]). Conclusions: The results of the study are similar to those previously described in other studies around the world. There is a need to recognize and address various factors associated with suicide attempt in depressed patients in order to implement promotion and prevention actions, early identification and specific interventions that have an impact on the numbers of completed suicide in the country.

Valoración de algunos indicadores del programa de atención a la conducta suicida en adolescentes / Evaluation of Some Indicators of the Program of Attention to Suicidal Behavior in Adolescents

Introducción: El suicidio está entre las tres primeras causas de muerte en el grupo de adolescentes y adultos jóvenes, su incidencia no ha descendido en el presente siglo. Objetivo: Valorar algunos indicadores relevantes del programa de atención a la conducta suicida en adolescentes. Métodos: Investigación en sistema y servicios de salud con diseño de estudio observacional descriptivo en tres áreas de salud del municipio Cienfuegos: áreas V, VII y VIII, de enero a septiembre del 2019. El universo fue de 46 profesionales de los Equipos de Salud Mental y Equipo Básicos de Salud. Se utilizaron como instrumentos dos encuestas, diseñadas y validadas por criterio de experto. Fueron seleccionados 6 indicadores en las dimensiones estructura y proceso y 4 en resultado. Se utilizó una media ponderada para procesar los datos. Resultados: Los indicadores valorados de regular fueron: en la estructura: capacitación de los recursos humanos y capacidad técnica del personal; en el proceso: confección de las historias clínicas, diseminación del programa en las unidades de salud y su verificación y las modalidades terapéuticas; y en resultado: la participación del equipo de salud mental en las investigaciones relacionadas con la conducta suicida. Conclusiones: Existe un grupo de deficiencias que conlleva a que el cumplimiento del programa de atención a la conducta suicida en adolescentes sea valorado como regular, en las tres áreas de salud del municipio Cienfuegos estudiadas(AU)

Introduction: Suicide is among the first three causes of death in the group of adolescents and young adults; its incidence has not decreased in the present century. Objective: To assess some relevant indicators of the adolescent suicidal behavior care program. Methods: Research in health system and services with descriptive observational study design in health areas V, VII and VIII of Cienfuegos municipality from January to September 2019. The universe was 46 professionals of the Mental Health Teams and Basic Health Team. Two surveys were used as instruments, designed and validated by expert criteria. Six indicators were selected in the structure and process dimensions and four in outcome. A weighted average was used to process the data. Results: The indicators rated as fair were: in the structure: training of human resources and technical aptitude of personnel; in the process: preparation of clinical histories, dissemination of the program in health units and its verification and therapeutic modalities; and in the outcome: participation of the mental health team in research related to suicidal behavior. Conclusions: There is a group of deficiencies that leads to the fact that compliance with the program of attention to suicidal behavior in adolescents is valued as regular in the three health areas of the Cienfuegos municipality studied(AU)

Caracterización clínico-epidemiológica de pacientes pediátricos con intento suicida en el Hospital Pediátrico Provincial de Holguín

Fundamento los intentos de suicidio en edades pediátricas son un problema actual con tendencia creciente a nivel mundial. Este grupo es muy vulnerable a la acción de factores internos y externos que alteran su integridad. En Cuba, a pesar de los logros obtenidos en ese sentido, también se considera como un problema de salud mental. Objetivo caracterizar desde el punto de vista clínico y epidemiológico a pacientes pediátricos con intento suicida. Métodos se realizó un estudio descriptivo, retrospectivo y de corte transversal, en el Hospital Pediátrico Provincial Octavio Concepción y de la Pedraja, de la provincia de Holguín, en el periodo enero/2020-diciembre/2021. Se trabajó con la totalidad del universo, conformado por 397 pacientes atendidos en la institución hospitalaria por intento suicida en el periodo de estudio. Las variables estudiadas fueron: edad, sexo, procedencia y método utilizado. Se empleó la estadística descriptiva. Resultados predominaron los pacientes con edades entre 16 y 18 años (48,4 %), del sexo femenino (74,6 %) y de procedencia urbana (70,3 %). El 92,2 % utilizó como método de suicidio la ingestión de psicofármacos. Conclusiones las variables estudiadas se comportan de forma similar a lo descrito en otras poblaciones y contextos, en los cuales también predominaron las adolescentes de procedencia urbana que ingirieron psicofármacos.

Background suicide attempts in pediatric ages are a current problem with a growing trend worldwide. This group is very vulnerable to the action of internal and external factors that alter their integrity. In Cuba, despite the achievements in this regard, it is also considered a mental health problem. Objective to characterize, from the clinical and epidemiological point of view, pediatric patients with suicide attempts. Methods a descriptive, retrospective and cross-sectional study was carried out at the Octavio Concepción y de la Pedraja Provincial Pediatric Hospital, in the Holguín province, from January/2020 to December/2021. The entire universe was analyzed made up of 397 patients, treated at the hospital for suicide attempts during the studied period. The variables were: age, sex, origin and method used. Descriptive statistics were used. Results patients aged between 16 and 18 years old (48.4%), female (74.6%) and urban origin (70.3%) predominated. 92.2% used the ingestion of psychotropic drugs as a method of suicide. Conclusions the studied variables behave in a similar way to that described in other populations and contexts, in which adolescents from urban origin who ingested psychoactive drugs also predominated.

Abordaje enfermero del intento autolítico en adolescentes en el servicio de urgencias / Approach by nurses for attempted suicide in adolescents at the Emergency Unit

Objetivo: analizar el papel de los profesionales enfermeros de urgencias en los cuidados psicosociales del adolescente con intento autolítico.Método: se llevó a cabo una revisión narrativa en las bases de datos Pubmed, Cinahl, Cochrane y Scopus, haciendo uso de lenguaje libre y controlado, y estableciendo filtros de fecha de publicación (últimos 10 años) e idioma (inglés y español).Resultados: se recuperaron 253 artículos, y finalmente se eligieron 14 que respondían a los criterios de inclusión/exclusión. Del análisis de estos 14 artículos se conformaron cuatro categorías: intervenciones de los profesionales enfermeros de Urgencias, estrategias de afrontamiento para progenitores, prevención de recaídas y, por último, importancia de la formación en salud mental de los profesionales enfermeros de Urgencias.Conclusiones: el intento autolítico sigue siendo un tema estigmatizado y poco visibilizado. Existe una falta de recursos para ofertar una atención de calidad en salud mental. Los profesionales enfermeros juegan un papel importante en el afrontamiento de los progenitores, quienes necesitan apoyo para garantizar la seguridad de sus hijos e hijas. Hay que mejorar la formación pregrado en salud mental dado el limitado acceso existente hoy en día a la formación especialista vía residencia en salud mental.(AU)

Objectives: to analyse the role of professional Emergency Nurses regarding psychosocial care for adolescents with attempted suicide.Method: a narrative review was conducted in the Pubmed, Cinahl, Cochrane and Scopus databases, using free and controlled language, and establishing filters for publication data (last 10 years) and language (English and Spanish).Results: in total, 253 articles were retrieved, and 14 were finally chosen which met the inclusion and exclusion criteria. Four categories were formed from the analysis of these 14 articles: interventions by Emergency nursing professionals, coping strategies for parents, prevention of relapses and, finally, the importance of training on mental health for Emergency nursing professionals.Conclusions: attempted suicide is still a stigmatized subject with poor visibility. There is lack of resources to offer quality care in mental health. Nursing professionals play a major role regarding the coping process of parents, who need support to guarantee the safety of their children. Undergraduate training on mental health must be improved, due to the limited current access to specialized training through mental health residency.(AU)

Conducta suicida y autolesiva en adolescentes, un problema sin resolver. Una revisión comprensiva / Suicidal and self-injurious behaviour among adolescents, an unresolved problem. A comprehensive review

En los últimos años se ha observado un aumento de la prevalencia de la conducta suicida y de los suicidios consumados en la población infantojuvenil. Entendiendo la adolescencia como una ventana sensible en la que implementaractuaciones de promoción de bienestar emocional, consideramos pertinente el análisis de la conducta suicida en estapoblación. A tal efecto este trabajo realiza una revisión comprensiva sobre el tema de interés, estructurando el trabajoen los siguientes epígrafes: conceptualización del fenómeno,factores de riesgo, modelos explicativos, instrumentos deevaluación, intervenciones psicoterapéuticas eficaces y planes actuales de prevención. Se concluye que aún habiendodiseñado múltiples estrategias de intervención, el aumentode prevalencia del suicidio justifica el diseño de nuevos programas con contenidos apropiados, concretos y factibles. (AU)

In recent years, an increase in the prevalence of suicidal behaviour and completed suicides among children andyoung people have been observed. Considering adolescenceas a sensitive point where actions to promote emotional wellbeing can be implemented, we consider relevant the analysis of suicidal behaviour in this population. For this purpose,this paper carries out a comprehensive review of the topic ofinterest, structuring the work under the following headings:phenomenon conceptualization, risk factors, explanatorymodels, assessment instruments, effective psychotherapeutic interventions and current prevention plans. The conclusion isthat while multiple intervention strategies have been developed, the increase in the prevalence of suicide justifies theimplementation of new programs with appropriate, concreteand feasible content. (AU)