Suicides among adults in Paraguay: An 18-year national exploratory study (2004-2022).

BACKGROUND: The number of suicides has been increasing worldwide, year after year, becoming the fourth leading cause of death among young people between 15 and 29 years of age. AIM: In this study, we explored the frequency and characteristics of suicides among the adult general population in Paraguay between 2004 and 2022, considering that suicide attempts and suicidal risk/ideation are frequent and relevant issues in the consultation activity, even if epidemiological evidence on the national rates of suicide is scarce. METHODS: In this observational, descriptive, and exploratory study, official records of all deaths by suicide were reviewed and information analyzed. In addition, an attempt was made to predict the number of suicides in the next 5 years according to a mathematical modeling. RESULTS: In the 18-year period, 5,527 suicides of adults were recorded. Patients' mean age was 36.8 ± 17 years old. A 76.77% of them were males, 77.44% were from an urban area and 25.98% from the Greater Asunción and Central Department of Paraguay. The most frequently used method of suicide was intentional self-inflicted injury by hanging, strangulation, or suffocation (all 67.6%). The expected number of national suicides in the following years from 2023 to 2027 will range between 462 and 530. Limitations include the lack of information regarding diagnoses and personal history in the suicide reports as well as the possibility of underreporting of national suicide cases. CONCLUSION: Our results represent the first large national epidemiological report of suicides in Paraguay and may be of interest for mental health professionals and health authorities in order to reduce the suicide mortality rate within the country.

Psychodermatology of skin picking (excoriation disorder): A comprehensive review.

Excoriation disorder (ED) is a primary psychiatric disorder characterized by recurrent skin picking, which may lead to self-induced cutaneous lesions and significant distress or functional impairment. The affected patient is aware of his/her self-destructive behavior but feels unable to give up this habit, despite having made repeated attempts to decrease or stop it. ED is a relatively frequent disorder, of notable heterogeneity and phenomenological complexity, accompanied by significant emotional and physical consequences. Therefore, further research is necessary to enhance the knowledge on its clinical manifestations, epidemiology, and comorbidities. This article presents an update regarding the etiopathogenesis, clinical aspects, and treatment options of ED to provide an up-to-date review for psychiatrists, dermatologists, and general practitioners.