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1.
BMJ ; 373: n973, 2021 05 05.
Artículo en Inglés | MEDLINE | ID: mdl-33952509

RESUMEN

OBJECTIVE: To analyse the association between survival from critical illness and suicide or self-harm after hospital discharge. DESIGN: Population based cohort study using linked and validated provincial databases. SETTING: Ontario, Canada between January 2009 and December 2017 (inclusive). PARTICIPANTS: Consecutive adult intensive care unit (ICU) survivors (≥18 years) were included. Linked administrative databases were used to compare ICU hospital survivors with hospital survivors who never required ICU admission (non-ICU hospital survivors). Patients were categorised based on their index hospital admission (ICU or non-ICU) during the study period. MAIN OUTCOME MEASURES: The primary outcome was the composite of death by suicide (as noted in provincial death records) and deliberate self-harm events after discharge. Each outcome was also assessed independently. Incidence of suicide was evaluated while accounting for competing risk of death from other causes. Analyses were conducted by using overlap propensity score weighted, cause specific Cox proportional hazard models. RESULTS: 423 060 consecutive ICU survivors (mean age 61.7 years, 39% women) were identified. During the study period, the crude incidence (per 100 000 person years) of suicide, self-harm, and the composite of suicide or self-harm among ICU survivors was 41.4, 327.9, and 361.0, respectively, compared with 16.8, 177.3, and 191.6 in non-ICU hospital survivors. Analysis using weighted models showed that ICU survivors (v non-ICU hospital survivors) had a higher risk of suicide (adjusted hazards ratio 1.22, 95% confidence interval 1.11 to 1.33) and self-harm (1.15, 1.12 to 1.19). Among ICU survivors, several factors were associated with suicide or self-harm: previous depression or anxiety (5.69, 5.38 to 6.02), previous post-traumatic stress disorder (1.87, 1.64 to 2.13), invasive mechanical ventilation (1.45, 1.38 to 1.54), and renal replacement therapy (1.35, 1.17 to 1.56). CONCLUSIONS: Survivors of critical illness have increased risk of suicide and self-harm, and these outcomes were associated with pre-existing psychiatric illness and receipt of invasive life support. Knowledge of these prognostic factors might allow for earlier intervention to potentially reduce this important public health problem.


Asunto(s)
Enfermedad Crítica/psicología , Conducta Autodestructiva/etiología , Sobrevivientes/psicología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Estudios de Casos y Controles , Cuidados Críticos , Enfermedad Crítica/terapia , Femenino , Estudios de Seguimiento , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Ontario/epidemiología , Modelos de Riesgos Proporcionales , Estudios Retrospectivos , Factores de Riesgo , Conducta Autodestructiva/diagnóstico , Conducta Autodestructiva/epidemiología , Conducta Autodestructiva/psicología , Suicidio/psicología , Suicidio/estadística & datos numéricos , Adulto Joven
2.
Prof Case Manag ; 26(4): 175-176, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34021099

RESUMEN

Although accurate secondary statistics may never be known, the COVID-19 pandemic has certainly been a major contributor to several health care issues: social isolation/loneliness, behavioral sequelae (anxiety, drug overdoses, and suicide), delays in treating preventive care that lead to late-stage diagnoses, and even a resurgence of drug-resistant infections.


Asunto(s)
Ansiedad/psicología , Sobredosis de Droga/psicología , Soledad/psicología , Salud Mental/estadística & datos numéricos , Pandemias/estadística & datos numéricos , Aislamiento Social/psicología , Suicidio/psicología , Adulto , Anciano , Anciano de 80 o más Años , Ansiedad/epidemiología , Sobredosis de Droga/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estados Unidos/epidemiología
4.
Rev Infirm ; 70(270): 22-23, 2021 Apr.
Artículo en Francés | MEDLINE | ID: mdl-33832724

RESUMEN

In the vast majority of cases, people who commit suicide do so alone. Exceptionally, suicides can be carried out by mutual agreement between two or more people. These are called suicide pacts. The motivations and operating methods of these rare acts are multiple.


Asunto(s)
Relaciones Interpersonales , Suicidio , Humanos , Motivación , Suicidio/psicología
5.
Lancet ; 397(10285): 1658-1667, 2021 05 01.
Artículo en Inglés | MEDLINE | ID: mdl-33915094

RESUMEN

Miscarriage is generally defined as the loss of a pregnancy before viability. An estimated 23 million miscarriages occur every year worldwide, translating to 44 pregnancy losses each minute. The pooled risk of miscarriage is 15·3% (95% CI 12·5-18·7%) of all recognised pregnancies. The population prevalence of women who have had one miscarriage is 10·8% (10·3-11·4%), two miscarriages is 1·9% (1·8-2·1%), and three or more miscarriages is 0·7% (0·5-0·8%). Risk factors for miscarriage include very young or older female age (younger than 20 years and older than 35 years), older male age (older than 40 years), very low or very high body-mass index, Black ethnicity, previous miscarriages, smoking, alcohol, stress, working night shifts, air pollution, and exposure to pesticides. The consequences of miscarriage are both physical, such as bleeding or infection, and psychological. Psychological consequences include increases in the risk of anxiety, depression, post-traumatic stress disorder, and suicide. Miscarriage, and especially recurrent miscarriage, is also a sentinel risk marker for obstetric complications, including preterm birth, fetal growth restriction, placental abruption, and stillbirth in future pregnancies, and a predictor of longer-term health problems, such as cardiovascular disease and venous thromboembolism. The costs of miscarriage affect individuals, health-care systems, and society. The short-term national economic cost of miscarriage is estimated to be £471 million per year in the UK. As recurrent miscarriage is a sentinel marker for various obstetric risks in future pregnancies, women should receive care in preconception and obstetric clinics specialising in patients at high risk. As psychological morbidity is common after pregnancy loss, effective screening instruments and treatment options for mental health consequences of miscarriage need to be available. We recommend that miscarriage data are gathered and reported to facilitate comparison of rates among countries, to accelerate research, and to improve patient care and policy development.


Asunto(s)
Aborto Espontáneo/epidemiología , Ansiedad/psicología , Depresión/psicología , Trastornos por Estrés Postraumático/psicología , Aborto Habitual/economía , Aborto Habitual/epidemiología , Aborto Habitual/fisiopatología , Aborto Habitual/psicología , Aborto Espontáneo/economía , Aborto Espontáneo/fisiopatología , Aborto Espontáneo/psicología , Endometritis/epidemiología , Femenino , Retardo del Crecimiento Fetal/epidemiología , Humanos , Nacimiento Prematuro/epidemiología , Prevalencia , Factores de Riesgo , Mortinato/epidemiología , Suicidio/psicología , Hemorragia Uterina/epidemiología
6.
Psychosom Med ; 83(4): 309-321, 2021 05 01.
Artículo en Inglés | MEDLINE | ID: mdl-33790201

RESUMEN

OBJECTIVE: This review highlights the scope and significance of the coronavirus disease 2019 (COVID-19) pandemic with a focus on biobehavioral aspects and critical avenues for research. METHODS: A narrative review of the published research literature was undertaken, highlighting major empirical findings emerging during the first and second waves of the COVID-19 pandemic. RESULTS: Interactions among biological, behavioral, and societal processes were prominent across all regions of the globe during the first year of the COVID-19 emergency. Affective, cognitive, behavioral, socioeconomic, and technological factors all played a significant role in the spread of infection, response precautions, and outcomes of mitigation efforts. Affective symptoms, suicidality, and cognitive dysfunction have been widely described consequences of the infection, the economic fallout, and the necessary public health mitigation measures themselves. The impact of COVID-19 may be especially serious for those living with severe mental illness and/or chronic medical diseases, given the confluence of several adverse factors in a manner that appears to have syndemic potential. CONCLUSIONS: The COVID-19 pandemic has made clear that biological and behavioral factors interact with societal processes in the infectious disease context. Empirical research examining mechanistic pathways from infection and recovery to immunological, behavioral, and emotional outcomes is critical. Examination of how emotional and behavioral factors relate to the pandemic-both as causes and as effects-can provide valuable insights that can improve management of the current pandemic and future pandemics to come.


Asunto(s)
/psicología , /prevención & control , Miedo , Humanos , Estilo de Vida , Salud Mental/estadística & datos numéricos , Pandemias , Racismo/psicología , Determinantes Sociales de la Salud , Suicidio/psicología
8.
Eur Psychiatry ; 64(1): e18, 2021 02 03.
Artículo en Inglés | MEDLINE | ID: mdl-33686933

RESUMEN

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic is a major threat to the public. However, the comprehensive profile of suicidal ideation among the general population has not been systematically investigated in a large sample in the age of COVID-19. METHODS: A national online cross-sectional survey was conducted between February 28, 2020 and March 11, 2020 in a representative sample of Chinese adults aged 18 years and older. Suicidal ideation was assessed using item 9 of the Patient Health Questionnaire-9. The prevalence of suicidal ideation and its risk factors was evaluated. RESULTS: A total of 56,679 participants (27,149 males and 29,530 females) were included. The overall prevalence of suicidal ideation was 16.4%, including 10.9% seldom, 4.1% often, and 1.4% always suicidal ideation. The prevalence of suicidal ideation was higher in males (19.1%) and individuals aged 18-24 years (24.7%) than in females (14.0%) and those aged 45 years and older (11.9%). Suicidal ideation was more prevalent in individuals with suspected or confirmed infection (63.0%), frontline workers (19.2%), and people with pre-existing mental disorders (41.6%). Experience of quarantine, unemployed, and increased psychological stress during the pandemic were associated with an increased risk of suicidal ideation and its severity. However, paying more attention to and gaining a better understanding of COVID-19-related knowledge, especially information about psychological interventions, could reduce the risk. CONCLUSIONS: The estimated prevalence of suicidal ideation among the general population in China during COVID-19 was significant. The findings will be important for improving suicide prevention strategies during COVID-19.


Asunto(s)
/epidemiología , Pandemias , Ideación Suicida , Adolescente , Adulto , China/epidemiología , Estudios Transversales , Femenino , Humanos , Masculino , Prevalencia , Cuarentena/psicología , Cuarentena/estadística & datos numéricos , Factores de Riesgo , Estrés Psicológico/epidemiología , Suicidio/prevención & control , Suicidio/psicología , Suicidio/estadística & datos numéricos , Desempleo/psicología , Desempleo/estadística & datos numéricos , Adulto Joven
9.
East Asian Arch Psychiatry ; 31(1): 3-8, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33753570

RESUMEN

OBJECTIVES: To compare older adults with late-life depression (LLD) and healthy controls in terms of suicidal ideation during the COVID-19 pandemic, and to determine predictors of suicidal ideation. METHODS: Between March and April 2020, old adults diagnosed with major depressive disorder (single or recurrent episode) as defined by the DSM-5 were recruited from psychiatric clinics or inpatient wards, whereas 31 healthy older adults without a history of depression or other psychiatric illnesses were recruited from voluntary organisations or elderly community centres. Their depressive symptoms, perceived severity of the pandemic, perceived time spent on receiving related information, perceived health, levels of loneliness, perceived coping efficacy, suicidal ideation, and the level of symptomatic responses to a specific traumatic stressor in the past week were assessed. RESULTS: In total, 21 men and 43 women aged 61 to 89 years were interviewed through telephone by trained research assistants. Of them, 33 were older adults with LLD (cases) and 31 were healthy older adults (controls). Older people with LLD had a higher level of suicidal ideation than healthy controls, after controlling for the level of depression and medical comorbidity (F (1, 59) = 5.72, p = 0.020). Regression analyses showed that coping efficacy and loneliness accounted for a significant portion of the variance in suicidal ideation, and loneliness significantly predicted the level of stress. Mediation analyses reveal an indirect effect between group and suicidal ideation through coping efficacy (Z = 2.43, p = 0.015). CONCLUSIONS: Older people with LLD are at increased suicidal risk and require timely mental health support. Coping efficacy and loneliness are important predictors for suicidal ideation and stress.


Asunto(s)
Trastorno Depresivo Mayor , Trastornos Mentales , Enfermedades no Transmisibles , Ideación Suicida , Suicidio , Adaptación Psicológica , Anciano , /prevención & control , Estudios de Casos y Controles , Depresión/diagnóstico , Depresión/etiología , Trastorno Depresivo Mayor/diagnóstico , Trastorno Depresivo Mayor/epidemiología , Trastorno Depresivo Mayor/psicología , Manual Diagnóstico y Estadístico de los Trastornos Mentales , Femenino , Hong Kong/epidemiología , Humanos , Soledad/psicología , Masculino , Trastornos Mentales/diagnóstico , Trastornos Mentales/epidemiología , Trastornos Mentales/psicología , Enfermedades no Transmisibles/epidemiología , Enfermedades no Transmisibles/psicología , Sistemas de Apoyo Psicosocial , Estrés Psicológico/diagnóstico , Estrés Psicológico/etiología , Suicidio/prevención & control , Suicidio/psicología
10.
Mo Med ; 118(1): 7-12, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33551470

RESUMEN

Medical students, residents, and practicing physicians experience high burnout, depression, and suicide rates, and the COVID-19 pandemic has exacerbated stress for many.1-6 While laudable, current well-being efforts appear insufficient to meet the challenges that so many are facing. This essay explores approaches that individuals and organizations can take to promote mental health and well-being from medical school to practice.


Asunto(s)
/psicología , Salud Mental/normas , Médicos/psicología , Estudiantes de Medicina/psicología , Adaptación Psicológica/fisiología , Agotamiento Profesional/epidemiología , Agotamiento Profesional/terapia , /epidemiología , Terapia Cognitivo-Conductual/métodos , Depresión/epidemiología , Depresión/terapia , Humanos , Sistema Límbico/fisiopatología , Salud Mental/estadística & datos numéricos , Atención Plena/métodos , Facultades de Medicina/organización & administración , Facultades de Medicina/normas , Estrés Psicológico/complicaciones , Estrés Psicológico/epidemiología , Estrés Psicológico/psicología , Suicidio/prevención & control , Suicidio/psicología , Suicidio/estadística & datos numéricos
11.
Acad Med ; 96(5): 624-628, 2021 05 01.
Artículo en Inglés | MEDLINE | ID: mdl-33570850

RESUMEN

In this commentary, the authors offer a call to action in the long-standing fight to prevent clinicians from dying by suicide. In April 2020, the nation was shocked by the suicide of New York City emergency physician Dr. Lorna Breen, who died while recovering from COVID-19. She joins an unknown number of clinicians who have taken their lives over the past year. The authors introduce Dr. Breen, a highly talented physician working on the frontlines of the COVID-19 pandemic, and examine how pervasive distress and suicide are in clinicians. Then, they explain the lived experience movement and highlight how clinicians speaking openly about their mental illness and treatment are making it easier for their colleagues to seek lifesaving help, despite the stigma still surrounding mental illness and treatment in medicine. The authors sort through the science of clinician distress; critique how the COVID-19 pandemic is affecting the lives of clinicians; and describe existing national initiatives to address clinician stress, burnout, and suicide. Finally, they recommend evidence-based actions to prevent clinician suicide that multiple stakeholder groups can take, including regulatory agencies, licensing boards, and hospital privileging boards; specialty boards, professional associations, and continuing education organizations; medical educators; and individual clinicians. Suicide is a complex but generally preventable cause of death. Those in medicine must forge ahead with collective momentum. Dr. Breen, so many other clinicians, and those they have left behind deserve nothing less.


Asunto(s)
/epidemiología , Pandemias , Médicos/psicología , Suicidio/prevención & control , Agotamiento Profesional , Depresión , Femenino , Humanos , Ciudad de Nueva York , Estrés Laboral , Factores de Riesgo , Estigma Social , Suicidio/psicología
12.
Psychiatry Res ; 298: 113799, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33611165

RESUMEN

BACKGROUND: Suicide reports during the COVID pandemic is an increasing cause for concern. However, there is a limited understanding of suicide among individuals with positive/suspected COVID diagnosis specifically. Hence, this study, using online newspaper reports, aimed to determine factors influencing suicide among individuals withCOVID-19 infection status. METHODOLOGY: Information regarding positive/suspected COVID related suicide was obtained from online newspapers published in 4 languages between 30th Jan 2020 to 16th August 2020 using google news aggregator. Of 235 online identified, 93 were eligible for analysis after the exclusion and analysed using descriptive statistics. RESULTS: Median Age of COVID related suicide victims was 45 years (range 15 - 80) wherein 61.3% belonged to 30-59 year age group, and 75.3% were males. 50% of suicides occurred within the first week of COVID diagnosis confirmation, and 50% suicides occurred at COVID centres. Hanging (53.8%) was the commonest method of suicide, followed by jumping (12.9%). CONCLUSION: Higher risk for suicide was observed among male gender and those with positive/suspected COVID infection within the first week, while receiving treatment in COVID care centres. Hanging and jumping were the two commonest methods. The above highlight an urgent need to integrate suicide preventive strategies into standard care protocols of COVID-19 positive and suspected cases.


Asunto(s)
/psicología , Suicidio/psicología , Suicidio/estadística & datos numéricos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , India , Internet/estadística & datos numéricos , Masculino , Medios de Comunicación de Masas/estadística & datos numéricos , Persona de Mediana Edad , Adulto Joven
14.
J Gen Psychol ; 148(3): 305-326, 2021 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-33480333

RESUMEN

Psychologist Eric Miller of Kent State University has termed COVID-19 "the Loss and Trauma Event of Our Time." In this paper, I would like to problematize the public health response to the virus outbreak in light of two consequential and preventable traumas that shadow the COVID-19 calamity: femicide and suicide. As public health reaction to the pandemic is seen to negatively increase rates of domestic violence and suicidality this research accessed rapidly available data using Google Date Range analysis by utilizing queries from pre- and post-pandemic comprising the months of March-August in the years 2019 and 2020. The aim of this rapid-response research is to glimpse the possible presence of psychological stress in online searches that relate to debilitation in the four foundational strata of Maslow's Hierarchy of Human needs (basic and psychological needs). To search basic needs related to COVID-19 the following categories were utilized in online search phrases in Google (US): precarity and insecurity. To search basic and psychological needs related to suicide the following categories were utilized in online search phrases in Google (US): despondency and helplessness. Finally, to search basic and psychological needs related to femicide the following categories were utilized in online search phrases in Google (US): indicative male violence and intentional male violence. Results show an overwhelming upsurge from all six categories from 31% to 106%.


Asunto(s)
/psicología , Homicidio/psicología , Suicidio/psicología , Violencia Doméstica/psicología , Femenino , Desamparo Adquirido , Humanos , Relaciones Interpersonales , Masculino , Investigación , Factores de Riesgo , Aislamiento Social , Estrés Psicológico/complicaciones
17.
J Psychosom Res ; 141: 110347, 2021 02.
Artículo en Inglés | MEDLINE | ID: mdl-33453551

RESUMEN

OBJECTIVE: Evidence of increased suicidal risk in association with psoriasis is growing, but findings concerning atopic dermatitis are inconsistent. METHODS: We systematically reviewed reports of suicidal ideation, attempts, or suicides among subjects diagnosed with psoriasis or atopic dermatitis compared to healthy controls or persons with other illnesses. Reported rates of suicidal ideation and behavior were compared among the groups, using meta-analyses to compare suicidal rates with dermatologic patients versus controls, as well as between dermatological diagnoses. RESULTS: Mean rates of suicidal ideation with psoriasis were 1.60-fold (13.9%/8.67%) above controls, and with atopic dermatitis, 1.84-fold higher (16.8%/9.12%); meta-analyses found similar differences: psoriasis (OR = 1.97 [CI: 1.26-3.08]; p = 0.003) and atopic dermatitis (OR = 2.62 [1.32-5.19]; p = 0.006). For suicidal acts, with psoriasis, mean rates versus controls were 2.51-fold higher (3.34%/1.33%), and 2.81-fold higher (5.03%/1.79%) with atopic dermatitis; meta-analyses found significantly more suicidal acts with psoriasis (OR = 1.42 [1.05-1.92]; p = 0.02) and a similar tendency with atopic dermatitis (OR = 1.53 [0.96-2.45]; p = 0.08). CONCLUSIONS: The study findings support emerging evidence of increased risk of suicidal ideation and behavior with psoriasis and extend it to increased risk of suicidal ideation and a trend toward increased suicidal acts with atopic dermatitis.


Asunto(s)
Dermatitis Atópica/psicología , Psoriasis/psicología , Suicidio/psicología , Femenino , Humanos , Masculino
18.
Rev Bras Enferm ; 73(suppl 1): e20200186, 2021.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-33470381

RESUMEN

OBJECTIVE: To analyze the sociodemographic and epidemiological profile of suicide in the indigenous and non-indigenous population and the spatiality of the event. METHOD: Epidemiological, descriptive research, carried out with data from the Mortality Information System. Suicide mortality rates were calculated for the 144 municipalities in Pará and linked to the geographic location values of the municipalities; subsequently, thematic maps were built using the QGIS 3.10.3 software. The association between variables was measured by the G test. RESULTS: 1,387 suicide records were studied, and the mortality rate among indigenous people was low in comparison to non-indigenous people, reaching 0.1/100 thousand inhabitants and 17.5/100 thousand inhabitants, respectively. CONCLUSION: Suicide is heterogeneously distributed in the territory, with greater vulnerability of the indigenous people, which demands different policies considering their cultural diversity.


Asunto(s)
Disparidades en el Estado de Salud , Suicidio/estadística & datos numéricos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Ciudades , Femenino , Humanos , Pueblos Indígenas , Lactante , Recién Nacido , Sistemas de Información , Masculino , Persona de Mediana Edad , Análisis Espacial , Suicidio/etnología , Suicidio/psicología , Adulto Joven
20.
PLoS One ; 16(1): e0245268, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33481862

RESUMEN

BACKGROUND: LGBTQ+ youth have higher rates of self-harm and suicide than cisgender, heterosexual peers. Less is known about prevalence of risks within these populations. OBJECTIVES: The first systematic review and meta-analysis to investigate the prevalence of risks among young people throughout the LGBTQ+ umbrella with experiences across the dimension of self-harm, suicidal ideation and suicide behaviour; and how they may differ between LGBTQ+ umbrella groups. DATA SOURCES: MEDLINE, Scopus, EMBASE, PsycINFO, and Web of Science searches were run to identify quantitative research papers (database inception to 31st January, 2020). STUDY ELIGIBILITY CRITERIA: Articles included were empirical quantitative studies, which examined risks associated with self-harm, suicidal ideation or suicidal behaviour in LGBTQ+ young people (12-25 years). SYNTHESIS METHODS: 2457 articles were identified for screening which was completed by two independent reviewers. 104 studies met inclusion criteria of which 40 had data which could be meta-analysed in a meaningful way. This analysis represents victimisation and mental health difficulties as risks among LGBTQ+ youth with self-harm and suicide experiences. Random-effects modelling was used for the main analyses with planned subgroup analyses. RESULTS: Victimisation and mental health were key risk factors across the dimension self-harm and suicide identified through all analyses. A pooled prevalence of 0.36 was indicated for victimisation and 0.39 for mental health difficulties within LGBTQ+ young people with experiences of self-harm or suicide. Odds ratios were calculated which demonstrated particularly high levels of victimisation (3.74) and mental health difficulties (2.67) when compared to cisgender, heterosexual counterparts who also had these experiences. CONCLUSIONS: Victimisation and mental health difficulties are highly prevalent among LGBTQ+ youth with experiences of self-harm and suicide. Due to inconsistency of reporting, further risk synthesis is limited. Given the global inclusion of studies, these results can be considered across countries and inform policy and suicide prevention initiatives. PROSPERO REGISTRATION NUMBER: CRD42019130037.


Asunto(s)
Víctimas de Crimen/estadística & datos numéricos , Salud Mental , Minorías Sexuales y de Género/psicología , Humanos , Oportunidad Relativa , Riesgo , Conducta Autodestructiva/psicología , Ideación Suicida , Suicidio/psicología
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