Suicídio e tentativas de suicídio: características epidemiológicas no Município de Belo Horizonte Brasil, 1971-1981 / Suicide and attempt suicide: epidemiological characteristics in the city of Belo Horizonte, Brazil, from 1971 to 1981

Estudo retrospectivo descritivo dos suicídios e tentativas de suicídio no município de Belo Horizonte, no período 1971-81, baseado em dados oficiais. Analisa-se a evoluçäo de algumas características epidemiológicas ligadas a populaçäo e ao tempo

El suicidio en San Luis Potosí (1975-1984): un enfoque epidemiológico psicosocial / Suicide in San Luis Potosi (1975-1984) a psychosocial and epidemiologic approach

En este artículo se presenta un enfoque epidemiológico psicosocial para el estudio del fenómeno del suicidio. Existen otros modelos y otras teorías que no se han consolidado, por lo que la tendencia moderna es la de llevar a cabo estudios descriptivos de la frecuencia de la tendencia suicidógena. La necesidad de hacer una investigación empírica sobre el fenómeno del suicidio, en la cual se consideren la multitud de variables que inciden en este fenómeno, es de especial relevancia para países como México. El suicidio no sólo es una de las causas de muerte de mayor importancia, sino que este fenómeno está relacionado con la muerte violenta y los accidentes en general. Esto último es de importancia porque en México, al igual que en otros países, la determinación de si hubo o no suicidio depende en mucho del médico forense; sin embargo, los autores hicieron notar hacer tiempo que, a menudo, esta información no queda registrada y, en consecuencia, se carece del registro formal del fenómeno y mucho menos se tiene información complementaria de las causas adversas que pudieron llevar al suicidio. El hecho de que las estadísticas obtenidas en estas circunstancias no sen tan confiables como se quisiera, no es impedimento para ccomprender que el suicidio es un problema de salud y que requiere estudiarse más. El presente estudio enfoca el suicido bajo el concepto de que las características de los individuos y los factores sociales inciden en sus actos (Tendencia Suicidógena; fonseca, 1976). El objetivo es presentar, desde un punto de vista descriptivo (epidemiológico-psicoscial), los componentes de los intentos de suicidio y los suicidios consumados en el Estado de San Luis Potosí, México, entre 1975 y 1984. Se considera que el Estado de San Luis Potosí tiene una baja tasa de suicidios en comparación con otros estados del país. Se revisaron los periódicos del estado y se regitraron las características de cada individuo, incluyéndose: sexo edad, estado civil, ocupación, mensaje o recado póstumo (si lo hubo), y además, se recolectó información socio-ambiental: mes, día, hora, medio utilizando, causas probables del suicidio, variables de paternidad, lugar y localización geográfica en el Estado...

Homicide, suicide, motor vehicle crash, and fall mortality: United States' experience in comparative perspective.

US mortality data on motor vehicle crashes, falls, suicide, and homicide for 1980 are compared with corresponding data for France, Japan, West Germany, and the United Kingdom. Unadjusted and age-specific death rates are presented, together with age-adjusted rates of years of life lost (YLL). A large male excess in rates is typical outside the fall category. Motor vehicle crashes are the predominant cause of YLL, and the United States manifests the highest YLL rates for each sex. US fall death rates at the older ages are exceeded by those of France and West Germany. The elderly generally manifest the greatest risk of suicide; American females exhibit a unique rate decline after ages 45-54 years, however. Beyond early adulthood, US suicide rates are lower than those of France, Japan, and West Germany. US homicide rates dwarf those of the comparison countries with 16- to 29-fold differentials separating prime-risk American males aged 25-34 years from their foreign counterparts.

Fatal injuries in Oklahoma: descriptive epidemiology using Medical Examiner data.

To characterize mortality associated with injuries and other health problems in Oklahoma, we examined data from the Office of the Chief Medical Examiner of the State of Oklahoma for the years 1978 through 1984. Each year, approximately 1,500 and 800 deaths resulted from unintentional injury (UI) and intentional injury (ie, suicide and homicide), respectively. The medical examiner (ME) data differed substantially from the state's vital statistics (VS); over the seven years, the ME records showed 2,021 (16%) fewer UI deaths than did the VS, as well as 24 (1%) more cases of suicide and 499 (23%) more cases of homicide. Rates for UI and suicide were highest for young adults and for the elderly; in contrast, rates for homicide were highest for young adults, and then decreased with age. For each of the three categories of injury-related deaths, rates for male subjects were approximately three times those for female subjects; rates also varied by race-ethnic group. Deaths due to UI and homicide occurred more often in the summer and on weekends, though suicides did not vary by month and were slightly more common on weekdays. This study indicates that ME data represent an important source of epidemiologic information for the surveillance and study of injury-related mortality.

Network television news stories about suicide and short-term changes in total U.S. suicides.

A number of recent reports have documented a positive association between mass media news stories about suicide and subsequent short-term increases in total U.S. suicides. However, the estimated magnitude of this association varies considerably across these published reports and tends to be smaller in the more comprehensive studies. A detailed investigation of all network television suicide news stories broadcast between January 1, 1973, and December 31, 1984, was undertaken to resolve this inconsistency. The information about television coverage of suicides was more comprehensive than in previous studies. The analyses show that there was no reliable association between news stories and suicides among adults at any time over the 12 years investigated. A reliable association existed among teenagers between 1973 and 1980. This association reversed in 1981, however, and the relative risk of suicide associated with network news stories was consistently less than 1.0 through the end of the study period.

Coping with the suicidal elderly: a physician's guide.

Advancing age is associated with a markedly increased risk of suicide. In the United States, one fourth of all suicides are carried out by citizens age 60 or older. The majority of American elders who commit suicide use a firearm to do so. Most suicidal elders look to their primary care physician for help, although they may not directly express their plan. Therefore, physicians must be alert to clues. By far the principal risk factor for suicide is major depression. The risk is heightened by recent losses, alcohol or drug abuse, psychosis, cognitive decline, and chronic disease. Hopelessness, anhedonia, self-reproach, guilt, and a formed lethal plan are signs of a life-threatening suicidal crisis which requires urgent intervention. Physicians must act decisively in recognition of the fact that suicidality is a transient, treatable condition.

Suicides by prisoners.

In a consecutive series of 44 deaths of male prisoners in Brisbane Prison, a maximum-security prison, in the 15-year period 1973-1987, 20 deaths were a result of suicide. More than half the suicides occurred within the first two months in custody. Prisoners on remand were more prone to commit suicide than were sentenced prisoners. A history of psychiatric disorder was frequent, and more than one-third of the prisoners previously had received psychiatric inpatient treatment. In 40% of cases suicide had been attempted previously. Hanging was the usual method of suicide. The application of preventive measures in the presence of risk factors for suicide at the present level of knowledge are discussed.

Suicide of AIDS patients in Texas: a preliminary report.

The incidence of suicide in patients with the diagnosis of acquired immunodeficiency syndrome (AIDS) in the state of Texas during the period between January 1986 and August 1987 was determined. AIDS patients were found to have a rate of suicide higher than expected when compared to the general population. The results of this study document this trend which has important implications in the care of the growing number of patients with AIDS.

Prevalencia de bebedores consuetudinarios en México: un análisis ecológico / Prevalence of heavy drinkers in Mexico: an ecological analysis

El consumo de bebidas alcohólicas es un elemento importante en el perfil epidemiológico actual de México, como se puede comprobar por la tendencia al aumento en el consumo per cápita de ciertos tipos de bebidas (como cerveza y vino, por ejemplo), por ciertas patologías relacionadas con el consumo (como la cirrosis hepática), por problemas sociales generales (como las violencias), o por propias encuestas de prevalencia que se han realizado en el país desde la década de los 60's. Este consumo poblacional de bebidas alcohólicas ha generado preocupación ya que, según la llamada Teoría de la Distribución Simple (TDS), un aumento del consumo per cápita lleva un aumento de los bebedores fuertes y esto produce, a su vez, un aumento en las patologías relacionadas con el consumo de bebidas alcohólicas. Como una forma de someter parcialmente a prueba la TDS se utilizaron datos provenientes de encuestas realizadas en el país, en particular a las seis encuestas de la década de los 70's que se realizaron en diferentes ciudades capitales, con metodología y definiciones del consumo comparables. Así, se utilizaron los datos de prevalencia de bebedores consuetudinarios en las ciudades como variables independientes para varios problemas médicos y sociales, en un diseño ecológico multigrupal. Los resultados obtenidos, en general, no apoyaron la TDS para el caso de la mortalidad por cirrosis hepática, por suicidio y por accidentes de tránsito, y tampoco para los delitos del fuero federal con alcohol cuyos resultados van en contra a los postulados por la TDS. El análisis aportó resultados confirmatorios para algunos grupos en el caso de los delitos del fuero común y para la tasa de accidentes de tránsito. A comparación de otras variables independientes utilizadas (prevalencia de abstemios, tasa de expendios, porcentaje de analfabetos, desempleo y densidad poblacional), la prevalencia de bebedores consuetudinarios y la densidad poblacional son las que logran un mayor número de correlaciones estadísticamente significativas con los problemas investigados, aunque muchas van en sentido inverso a lo planteado en la teoría, en el caso de la primera de esas variables

Conducta suicida en niños y adolescentes / Suicide behavior in children and adolescents

Existe un amplio rango de conductas suicidas, que representan un continuo de una dimensión común, con algunas diferencias cualitativas: 1) Planificación o pensamientos suicidas con intención de morir; 2) Amenaza, expresión verbal de intención suicida; 3) Gesto, amenaza suicida con los medios disponibles para intentarlo. Por ej.: tener las pastillas en la mano sin tomarlas; 4) Intentos de suicidio, conducta autodestructiva con intención suicida; 5) Suicidio logrado, muerte por suicidio comprobado. En los intentos de suicidio predominan las mujeres y el uso de métodos pasivos, menos letales como la autointoxicación. En los suicidios logrados predominan los hombres de todas las edades, y el uso de métodos más activos de autoeliminación. Muchos autores piensan que se trata de poblaciones distintas con intenciones distintas, y que estas personas pretenden llamar la atención y pedir ayuda, y no autoeliminarse. Sin embargo, el riesgo de suicido logrado aumenta en los sujetos que han efectuado intentos previos, el riesgo es mayor en los primeros meses, continuando hasta los 2 años posteriores. Por este motivo, las investigaciones se han centrado en comprender toda la gama de conductas suicidas, identificar las intervenciones terapéuticas más eficientes para los intentos de suicidio, mejorar el seguimiento de estos casos, e identificar los factores de riesgo para el suicidio logrado, con fines de prevención

Suicide mortality in the Maryland state prison system, 1979 through 1987.

Prisoners are reported to have a higher suicide rate than the community. We studied suicides in the Maryland prison system to determine the level of risk and risk factors for inmate suicide. There were 37 male inmate suicide deaths between 1979 and 1987 (39.6 suicides per 100,000 male inmates), which is significantly higher than the age- and race-adjusted male suicide rate in the general population of Maryland (22.0 per 100,000). Risk of male inmate suicide was increased for the following characteristics: white race (relative risk [RR], 2.0; 95% confidence interval [CI], 1.1 to 3.9), age 25 to 34 years (RR, 1.8; 95% CI, 1.0 to 3.4), major crime committed against person (RR, 3.4; 95% CI, 1.7 to 6.7), life sentence (RR, 4.7; 95% CI, 2.2 to 10.0), and classification to the major maximum security institution in the prison system (RR, 5.1; 95% CI, 2.7 to 9.8). The methods of suicide chosen by inmates were hanging (86%), cutting wound (5%), antidepressant overdose (5%), and fall from height (3%). We conclude that inmate suicide represents a significant correctional health and public health problem. Specific implications for prevention of inmate suicide are examined.