Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 9.181
Filtrar
1.
Rev. bras. cir. plást ; 34(4): 509-516, oct.-dec. 2019. ilus, tab
Artigo em Inglês, Português | LILACS | ID: biblio-1047916

RESUMO

Introdução: O suicídio é um sério problema de saúde pública. Estima-se que para cada óbito existam 10 tentativas. Dentre os meios utilizados, as queimaduras têm destaque devido à gravidade das lesões, a alta taxa de letalidade e os grandes prejuízos funcionais, estéticos e psicológicos. As mulheres, por constituírem a maioria dos pacientes com história de tentativa de suicídio e morte por queimaduras, representam um grupo vulnerável que merece recorte para aprofundamento do estudo. Métodos: Estudo retrospectivo, de caráter descritivo de série temporal. Foi desenvolvido na Unidade Tratamento de Queimados e no Instituto de Medicina Legal em Brasília (DF), entre os anos de 2010 e 2015. Resultados: Foram identificadas 42 mulheres com história de suicídio por queimaduras, tentado ou consumado. Houve 15 óbitos relacionados diretamente à lesão térmica. Houve um predomínio da faixa etária entre 30 e 44 anos, seguida por 15 a 29 anos. Em 64,3% dos casos o evento aconteceu no DF. Em relação aos agentes etiológicos, o mais comum foi o álcool (71,4%). A média de superfície corporal queimada foi de 34,38%, sendo que as pacientes que faleceram apresentaram áreas queimadas maiores (59,53%) do que as que sobreviveram (20,4%). Conclusão: Os dados obtidos no DF corroboram informações da literatura. Apesar do progresso envolvendo manejo e tratamento dos pacientes queimados, a prevenção continua sendo a melhor atitude.


Introduction: Suicide is a serious public health problem. For every death, there are an estimated 10 suicide attempts. Among the means of suicide, burns are prominent due to the lesion severity, the high mortality rate, and the severe functional, aesthetic, and psychological damage. Women comprise the majority of patients with a history of attempting suicide and death by burns and represent a vulnerable group that deserves attention. Methods: This retrospective descriptive time-series study was performed in the Burn Treatment Unit at the Institute of Legal Medicine in Brasília, Distrito Federal (DF) between 2010 and 2015. Results: A total of 42 women with a history of suicide by burns, attempted or consummated, were identified; 15 deaths were directly related to the thermal injury. Suicide by burns was the most predominant among patients aged 30 to 44 years was observed, followed by those aged 15 to 29 years. In 64.3% of cases, the event occurred in the Brasília, Distrito Federal (DF). Alcohol was the most common etiological agent (71.4%). The average burned body surface area was 34.38%, and the patients who died presented larger burned areas (59.53%) than that in those who survived (20.4%). Conclusion: The data obtained from the Brasília, Distrito Federal (DF) corroborate information from the literature. Despite progress involving the management and treatment of burn patients, prevention remains the best strategy.


Assuntos
Humanos , Feminino , Adolescente , Adulto , História do Século XXI , Suicídio , Tentativa de Suicídio , Unidades de Queimados , Queimaduras , Saúde Pública , Funções Essenciais da Saúde Pública , Suicídio/estatística & dados numéricos , Tentativa de Suicídio/psicologia , Tentativa de Suicídio/estatística & dados numéricos , Unidades de Queimados/normas , Unidades de Queimados/estatística & dados numéricos , Queimaduras/mortalidade , Queimaduras/psicologia , Queimaduras/terapia
2.
Psychiatr Hung ; 34(4): 359-368, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31767796

RESUMO

The risk of suicidal behaviour in mood disorders is an inherent severity of the depressive episode. Suicidal behaviour in patients with mood disorders is both state and severity dependent, which means that suicidality markedly decreases or vanishes after clinical recovery. However, since the majority of mood disorder patients never commit or attempt suicide, special clinical characteristics of the illness, as well as some personality, familial and psycho-social factors should also play a contributory role. This paper discusses the clinically explorable suicide risk factors in patients with major mood disorders, with particular regard to the underlying bipolarity. Successful acute and longterm pharmacotherapy - supplemented by psycho-social interventions - markedly reduces the risk of attempted and completed suicide, even in this high-risk population. Keywords: major depressive disorder; bipolar disorders.


Assuntos
Transtorno Bipolar/psicologia , Depressão/psicologia , Transtorno Depressivo Maior/psicologia , Suicídio/psicologia , Transtorno Bipolar/terapia , Depressão/terapia , Transtorno Depressivo Maior/terapia , Humanos , Fatores de Risco , Ideação Suicida , Tentativa de Suicídio/psicologia
3.
Lancet Psychiatry ; 6(12): 1031-1038, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31757590

RESUMO

BACKGROUND: Suicidal ideation due to abortion has been used to justify restrictive US abortion policies. Much research examining abortion and mental health has relied on self-report, has had low participation rates, and did not consider confounding factors. In the present study, we used data that do not rely on self-report and are not affected by low participation rates to examine the association between abortion and non-fatal suicide attempts, adjusting for confounding factors. METHODS: In this longitudinal cohort study of Danish population registries, we linked data on a cohort of women born in Denmark between Jan 1, 1980, and Dec 30, 1998, who did not die or emigrate from Denmark before their 18th birthday or before study entry. Follow-up started on the woman's 18th birthday or Jan 1, 2000, whichever came last. Follow-up ended at the date of first suicide attempt, date of emigration from Denmark, date of death, or Dec 31, 2016, whichever came first. Women were between the ages of 18 and 36 years during the study period. We used a survival analysis to examine the risk of first suicide attempts or self-harm associated with a first abortion compared with no abortion, in the complete study cohort. To examine incidence rate ratios (IRRs) associated with abortion, we used Poisson regression with the logarithm of woman-years at risk as an offset. We also examined whether the risk of suicide attempts changed before and after the abortion, adjusting for age, calendar year, socioeconomic status, and history of childbirth, mental health, parental mental health, and physical health. FINDINGS: Data on 523 280 women were included in this study. Of these, 48 990 (9·4%) women had a record of at least one first-trimester abortion, and 10 216 (2·0%) had a suicide attempt during the study period. Among 48 990 women who had an abortion, 1402 (2·9%) had a first suicide attempt after the first abortion. In our fully-adjusted model which adjusted for all covariates, the risk of first-time non-fatal suicide attempts was similar in the year before an abortion (IRR 2·46 [95% CI 2·22-2·72]) and the year after an abortion (IRR 2·54 [2·29-2·81], p=0·509) compared with women who had not had an abortion, and decreased with increasing time since the abortion (1-5 years IRR 1·90 [1·75-2·06]; ≥5 years IRR 1·73 [1·53-1·96]). INTERPRETATION: We found that women who had abortions had a higher risk of non-fatal suicide attempts compared with women who did not have an abortion. However, because the increased risk was the same both the year before and after the abortion, it is not attributable to the abortion. Thus, policies based on the notion that abortion increases women's risk of suicide attempts are misinformed. FUNDING: Society of Family Planning, American Foundation for Suicide Prevention, and The Lundbeck Foundation Initiative for Integrative Psychiatric Research.


Assuntos
Aborto Legal/estatística & dados numéricos , Tentativa de Suicídio/estatística & dados numéricos , Aborto Legal/psicologia , Adolescente , Adulto , Estudos de Coortes , Dinamarca/epidemiologia , Feminino , Humanos , Estudos Longitudinais , Transtornos Mentais/psicologia , Gravidez , Sistema de Registros , Fatores de Risco , Tentativa de Suicídio/psicologia , Adulto Jovem
5.
Actas esp. psiquiatr ; 47(5): 179-189, sept.-oct. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-185170

RESUMO

Introducción. El suicidio es un problema de salud importante en España. Examinamos la relación entre la reincidencia de los intentos y el nivel de letalidad alcanzado, y el perfil de los pacientes reincidentes que realizan intentos más letales. El objetivo es establecer los factores sociodemográficos y clínicos predictores de una mayor letalidad y reincidencia. Método. Todos los pacientes atendidos por intento suicida en un área sanitaria de 360.000 habitantes de 2009 a 2014 (N = 711) fueron valorados de forma sistemática. Comparamos las características clínicas y demográficas en función de la letalidad (leve versus moderada-severa) y la reincidencia (1-2 intentos versus > 2 intentos) usando análisis univariantes y modelos de regresión. Posteriormente, repe-timos los análisis tras distribuir la muestra en cuatro grupos en función de la presencia o ausencia de alta letalidad y/o reincidencia. Resultados. La reincidencia se asoció con la edad media (35-65 años), inactividad laboral, y los trastornos de personalidad o por uso de sustancias. La letalidad se asoció con el género masculino, edades extremas, método violento y los trastornos afectivos, pero no con la reincidencia. La coincidencia de múltiples intentos y letalidad severa en un mismo paciente parece relacionarse con el grupo de edad de 35-65 años, sexo masculino, uso de métodos violentos, trastornos mentales y la inactividad laboral. Conclusiones. Distintos factores demográficos y clínicos se asocian al riesgo de letalidad médica y de reincidencia. Nuestros resultados muestran que aquellos pacientes que repiten los intentos y realizan al menos un intento de alta letalidad, tienen mayor presencia de psicopatología, sobre todo trastornos afectivos


Introduction. Suicidal behaviour is a major health problem in Spain. The aim of this study is to examine the relationship between the recurrence of suicide attempts and the level of lethality reached, and the profile of repeaters who perform more lethal attempts. Method. All patients admitted for attempted suicide in a health area of 360,000 inhabitants from 2009 to 2014 (N = 711) were systematically assessed. We compared clinical and demographic characteristics of these patients in terms of lethality (low versus moderate-severe) and recidivism (1-2 attempts versus >2 attempts) using univariate analyses and regression models. Later, we repeated the analyses after distributing the sample into four groups depending on the presence or absence of high lethality and/or recidivism. Results. Recidivism was associated with the middle-age group (35-65 years), the lack of professional activity, and personality or substance use disorders. Lethality was associated with male gender, extreme age-groups, the use of a violent method, and affective disorders, but not with recidivism. Multiple suicide attempts and high lethality in a single patient was associated with 35-65 years age-group, male gender, violent methods, mental disorders, and inactivity. Conclusions. Different demographic and clinical factors indicate an increased risk of medical lethality and recurrence in suicidal patients. Our results show that at least some recidivist patients end up making more lethal and violent attempts with the passage of time, especially if they have psychiatric comorbidity


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Tentativa de Suicídio/psicologia , Transtorno da Personalidade Antissocial/mortalidade , Transtornos Relacionados ao Uso de Substâncias/mortalidade , Reincidência/psicologia , Modelos Lineares , Transtornos Relacionados ao Uso de Substâncias/psicologia , Transtornos do Humor/psicologia , Transtornos Mentais/mortalidade , Transtornos Mentais/psicologia
6.
Zh Nevrol Psikhiatr Im S S Korsakova ; 119(7. Vyp. 2): 20-24, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31532587

RESUMO

OBJECTIVE: To identify age-related psychopathological disorders and psychological characteristics of mental development and mental state of minors who committed suicide. MATERIAL AND METHODS: The study included a continuous sample of 285 reports of post-mortem psychological-psychiatric forensic assessment (CSPE) of juveniles, aged 11 to 17 years (average age 14.92±1.82), who committed suicide, in 7 federal districts of the Russian Federation. Within the total sample, two age groups were compared: adolescents from 11 to 14 years old (1) and 15-17 years old (2). Document analysis, clinical-psychopathological, clinical-psychological, qualitative and statistical methods were used. RESULTS AND CONCLUSION: Within the period from 11 to 17 years, the exponential growth of suicide rate is observed. An increase of family- and school-related psychological problems as well as difficulties in the relationship with the opposite sex are typical for the older group. Simultaneously, the effect of maladaptive individual features increases and psychopathological states and disorders, including, stress and adjustment disorders and depressive disorders, develop.


Assuntos
Transtorno Depressivo , Transtornos Mentais , Tentativa de Suicídio , Suicídio , Adolescente , Criança , Humanos , Federação Russa , Suicídio/psicologia , Tentativa de Suicídio/psicologia
7.
Medicine (Baltimore) ; 98(33): e16851, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31415415

RESUMO

BACKGROUND: Studies aimed at understanding the higher risk profiles for self-inflicted violence in individuals with BD become essential as a possible predictive risk measure for the presence of suicidal behavior, corroborating the expressive reduction of suicide deaths in young people who are in psychic suffering. METHODS: The protocol was constructed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA-P) and the research question was constructed using guidelines from the Population Intervention Comparator Outcome Setting (PICOS) strategy. A third reviewer will be contacted, and two studies will be included in the selection, analysis and inclusion phases of the articles, in case of divergence, a third reviewer will be contacted. (1) methodological design studies of cohorts, case-control and cross-sectional; (2) Diagnosis of Bipolar disorder according to Diagnostic and statistical Manual of mental disorders V; (3) Studies with adult population and (4) Studies that consider at least one type of self-inflicted violence as a variable. The articles considered eligible will be analyzed by New Castle - Ottawa quality assessment scale/cross section studies (NOS) to evaluate the quality of the studies. RESULTS: The identification of the characteristics of self-harm may subsidize professionals who work in the treatment of bipolar disorder with greater attention to these practices and monitoring of possible suicidal behaviors. CONCLUSION: This study may represent one of the initial measures of evaluation on these correlations, which will allow to protocol the guidelines in the field of practice and contribute to improvements in public health indexes.


Assuntos
Transtorno Bipolar/psicologia , Ideação Suicida , Tentativa de Suicídio/psicologia , Humanos , Medição de Risco , Revisão Sistemática como Assunto
8.
Nord J Psychiatry ; 73(7): 433-440, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31393750

RESUMO

Purpose: The aim of this study is to compare differences in metacognitive beliefs between patients with bipolar disorder type I (BPDI) with previous suicide attempts (BPDI+), those without suicide attempts (BPDI-), and a control group. It also discusses the relationship between metacognitive beliefs and suicidal behavioral parameters. Materials and methods: The study included 72 BPDI+ and 73 BPDI- euthymic patients and 86 healthy age- and gender-matched individuals. All participants completed a sociodemographic data form, the Beck Depression Inventory, Metacognition Questionnaire-30 (MCQ-30), Suicide Behaviors Questionnaire, and Structured Clinical Interview for DSM-IV Axis I. In addition, the Young Mania Rating Scale was used for the patient groups. Results: Both the BPDI+ and BPDI- patients had higher MCQ-30 scores than the control group (p < .01). Scores for the 'need to control thoughts' subscale were higher in the BPDI+ group than in the BPDI- group and were also higher in both the BPDI+ and BPDI- groups compared to the control group (p < .01). In addition, the 'cognitive self-consciousness' sub-scores of the BPDI- group were higher than those of the BPDI+ and the control group. Conclusion: The scores of 'cognitive self-consciousness' and 'need to control thoughts' vary across BPDI+ and BPDI- patients. It seems important to consider metacognitive beliefs regarding 'need to control thoughts' and 'cognitive self-consciousness' in terms of suicide prevention.


Assuntos
Transtorno Bipolar/diagnóstico , Transtorno Bipolar/psicologia , Metacognição/fisiologia , Tentativa de Suicídio/psicologia , Adolescente , Adulto , Transtorno Bipolar/epidemiologia , Estudos Transversais , Manual Diagnóstico e Estatístico de Transtornos Mentais , Emoções/fisiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Escalas de Graduação Psiquiátrica , Inquéritos e Questionários , Adulto Jovem
9.
Tijdschr Psychiatr ; 61(7): 464-476, 2019.
Artigo em Holandês | MEDLINE | ID: mdl-31372968

RESUMO

BACKGROUND: Although hanging is a frequently used suicide method, little is known about the prognosis of patients that survived hanging (near-hanging).
AIM: To describe a case report and present a literature-review on the functional neurologic outcome after near-hanging (with separate analyses for the presence of cardiac arrest and use of neuro-protection), and possible residual neuropsychological symptoms.
RESULTS: Only 12,4% (bi 4,6-29,4) of patients after near-hanging with cardiac arrest had a good functional outcome, compared to 90,6% (bi 85,7-94,0) of those without cardiac arrest. Neuroprotection through targeted temperature management has no significant influence on the outcome, neither in the presence nor absence of cardiac arrest. Near-hanging victims with a good functional outcome have, at most, mild residual neuropsychological symptoms. These can manifest throughout all cognitive domains, although learning and memory are most frequently and severely affected. DISCUSSION A significant subgroup of patients after near-hanging without cardiac arrest recovers towards a good level of functioning. A range of residual neuropsychological symptoms remain apparent, which are challenges for diagnostics and suicide prevention.


Assuntos
Hipotermia Induzida/métodos , Hipóxia-Isquemia Encefálica/etiologia , Hipóxia-Isquemia Encefálica/fisiopatologia , Tentativa de Suicídio , Asfixia , Serviço Hospitalar de Emergência , Parada Cardíaca , Humanos , Prognóstico , Tentativa de Suicídio/psicologia
10.
Psychiatriki ; 30(2): 120-128, 2019.
Artigo em Grego Moderno | MEDLINE | ID: mdl-31425140

RESUMO

Despite the large progress during the last decades in the medical treatment of HIV/AIDS infection, people living with HIV nevertheless face multiple adversities at various levels of their lives. Mental disorders, in particular, are the most common comorbidities in HIV infection with negative consequences in adherence to antiretroviral medication, disease progress and overall quality of life. HIVrelated stigma, still quite intense in Greece, is one of the most debilitating factors concerning people's living with HIV mental health. The present study looked at the clinical presentation at intake and treatment requests of 191 (83% males) people living with HIV who addressed the psychological support service of the non-governmental organization 'Centre for Life' during the years 2016- 18. Data were collected through a semi-structured clinical interview and administration of adapted questionnaires (PHQ-9, BAI, CAGE), which resulted in 7 dichotomous variables related to clinical presentation and 13 dichotomous variables related to treatment requests at intake. To analyze data, we constructed frequency tables and performed chi-square tests. In the whole sample, 42.2% presented anxiety disorders, 40.3% depression, 28.8% occasional substance use, 17.5% problematic use of alcohol and 13.6% intravenous drug use. Moreover, 14% reported at least one suicide attempt in the past and 9.2% current suicidal ideation. Apart from more frequent intravenous drug use among heterosexual males and more frequent occasional/recreational drug use among men who have sex with men, no other differences related to gender, age group, sexual orientation or ethnicity were observed in the initial clinical presentation. Similarly, the most frequent treatment requests were homogenously distributed in our sample, such as depressive symptoms (58.6%), difficulties in romantic relationships (48.7%), accepting being HIV positive (42.9%), anxiety symptoms (42.4%) and issues of negative self-esteem (40.8%). The presence of clinically significant depression was found to be related to a wider range of treatment requests compared to other mental health problems. A large group of requests focused on interpersonal relationships difficulties (e.g. disclosure anxiety, social isolation, disturbed relationships with familiar persons). This indicates an important area of psychological intervention. HIV infection may affect many levels of an individual's life, including their mental health. Respectively, HIV treatment needs to adopt a more holistic approach.


Assuntos
Síndrome de Imunodeficiência Adquirida/psicologia , Síndrome de Imunodeficiência Adquirida/terapia , Infecções por HIV/psicologia , Infecções por HIV/terapia , Psicoterapia/estatística & dados numéricos , Síndrome de Imunodeficiência Adquirida/epidemiologia , Adulto , Idoso , Aconselhamento/estatística & dados numéricos , Feminino , Grécia/epidemiologia , Infecções por HIV/epidemiologia , Humanos , Masculino , Transtornos Mentais/etiologia , Transtornos Mentais/psicologia , Transtornos Mentais/reabilitação , Saúde Mental , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde , Autoimagem , Minorias Sexuais e de Gênero , Abuso de Substâncias por Via Intravenosa/epidemiologia , Abuso de Substâncias por Via Intravenosa/reabilitação , Tentativa de Suicídio/psicologia , Tentativa de Suicídio/estatística & dados numéricos , Inquéritos e Questionários
11.
Artigo em Inglês | MEDLINE | ID: mdl-31443208

RESUMO

This study examines the potential of delayed monthly bill payments as a predictor of suicidal behavior in South Korea with the highest suicide rate among developed countries. Using the Korea Welfare Panel Study, multivariable logistic regressions examined the association between suicide ideation/attempts and the frequency of late payments on utility bills or National Health Insurance premium during last three years. Confounding factors such as past depression and suicide ideation/attempts history were adjusted for. Among 10,988 individuals, 2.7% reported suicide ideation and 0.11% attempted suicide in the past year, while 7.1% reported they paid late once or more during the last three years. Adults with two or more delayed payment had 2.32 times increased odds of suicidal ideation and 10.99 times increased odds of suicide attempts, compared to having no late payments. Adjusting for other socio-economic characteristics rarely changed the relationship between late payments and suicide ideation/attempts (for suicidal ideation, OR = 2.11; for suicide attempts: OR = 7.44), suggesting the independent effect of late payments on suicide behavior. With these findings, it can be suggested that late payment is an important factor, preemptively signaling suicide behavior with serious consequences in health and life.


Assuntos
Transtorno Depressivo/epidemiologia , Economia , Ideação Suicida , Tentativa de Suicídio/psicologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , República da Coreia/epidemiologia , Fatores de Risco , Adulto Jovem
12.
Nord J Psychiatry ; 73(8): 490-496, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31464549

RESUMO

Purpose: The aim of this study was to determine the relationship between childhood trauma and aggression-suicidal behavior in patients with bipolar disorder. Material and Methods: A total of 112 outpatients diagnosed with bipolar disorder in remission in the province of Siirt on the east coast of Turkey were included in this study carried out between January and June 2018. Personal Information Form, Childhood Trauma Questionnaire (CTQ), Buss-Perry Aggression Scale (BPAS) and Suicide Probability Scale (SPS) were used for data acquisition. Results: It was determined that patients with bipolar disorder have 89.3% of physical neglect, 74.1% of emotional neglect, 75.9% of physical abuse, 79.5% of emotional abuse and 40.2% of sexual abuse. The mean score of CTQ was 66.8 ± 19.2, the total score of BPAS was 94.6 ± 28.8 and the total score of SPS was 85.3 ± 17.9. A statistically significant and positive correlation was determined between CTQ, BPAS and SPS (p < 0.05). There was a weak and positive relationship between BPAS, CTQ (r = 0.325**; p < 0.05) and subscales of CTQ which are emotional abuse (r = 0.350**; p < 0.05), physical abuse (r = 0.354**; p < 0.01), physical neglect (r = 0.313**; p < 0.01) and emotional neglect (r = 0.316**; p < 0.01). A statistically significant difference was observed between the regular use of drugs, violence against others and total score of CTQ, BPAS and SPS (p < 0.05). Conclusion: It is suggested that patients diagnosed with bipolar disorder should be evaluated with regards to childhood trauma history by taking into consideration sociodemographic characteristics and psychiatric support in order to prevent their aggression and suicide attempts.


Assuntos
Agressão/psicologia , Transtorno Bipolar/epidemiologia , Transtorno Bipolar/psicologia , Maus-Tratos Infantis/psicologia , Ideação Suicida , Tentativa de Suicídio/psicologia , Adulto , Idoso , Transtorno Bipolar/diagnóstico , Estudos de Casos e Controles , Criança , Maus-Tratos Infantis/tendências , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Tentativa de Suicídio/tendências , Inquéritos e Questionários , Turquia/epidemiologia , Adulto Jovem
13.
Actas esp. psiquiatr ; 47(4): 127-136, jul.-ago. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-185163

RESUMO

Introducción. Existe una fuerte asociación entre quienes repiten un intento de suicidio (IS) y quienes lo consuman. Por ello el seguimiento de la intervención de estos pacientes es fundamental. En este estudio: se establece el perfil sociodemográfico y clínico de personas atendidas en urgencias psiquiátricas por un IS, en función del sexo; se determina la prevalencia de reintentos en un periodo de seis meses; se compara el perfil de los pacientes que repiten o no el IS; y se evalúan variables predictoras de la repetición. Metodología. Se entrevistó a 207 pacientes (122 mujeres y 85 hombres) que acudieron a urgencias psiquiátricas por un IS (enero-octubre de 2015), y se revisó su historia clínica a los 6 meses. Resultados. Las mujeres presentaron una menor letalidad en la conducta suicida. Un 14% de la muestra (n=29) repitió un IS en los 6 meses siguientes y 2 personas fallecieron por suicidio; 3 fallecieron por otras causas. Los pacientes ingresados en la Unidad de Hospitalización Psiquiátrica presentaron más reintentos (X2=4,1; g.l.=1; p=0,043). En el análisis multivariable, de todas las variables analizadas, la única asociada a la repetición del intento fue encontrarse en tratamiento en salud mental al incluirse en el estudio (OR=3,504; p=,009; I.C.95%=1,361-9,018). En el periodo de seguimiento se incrementó un 21,7% los pacientes tratados en salud mental. Conclusiones. El riesgo de repetición tras ser tratado en urgencias psiquiátricas por IS es crítico los meses posteriores, siendo necesario mejorar los programas de prevención e intervención destinados a mejorar estas cifras


Introduction. There is a strong association between those who re-attempt a suicide attempt and those who complete it. Therefore, follow-up on the interventions car-ried out for suicidal patients is essential. This study investigated the sociodemographic and clinical profiles of individuals admitted as psychiatric emergencies after a suicide attempt according to sex, determined the prevalence of re-attempts in a period of six months, compared the profiles of patients who engaged in repeated suicide attempts to those who did not, and evaluated predictive variables for repeated suicide attempts. Methodology. A total of 207 patients (122 women and 85 men) who went to the psychiatric emergency room for a suicide attempt (January-October 2015) were interviewed, and their clinical histories were reviewed at 6 months. Results. Lethal suicidal behaviour was lower in women. Fourteen percent of the sample (n=29) repeated a suicide attempt in the following 6 months, and 2 people died by suicide; 3 died from other causes. The patients admitted to the Psychiatric Hospitalization Unit presented with more re-attempts (X2=4.1; d.f.=1; p=0.043). In the multivariate analysis, of all the variables analysed, the only one associated with repeated suicide attempts was having been in mental health treatment upon inclusion into the study (OR=3.504, p=0.009, CI95%: 1.361-9.018). In the follow-up period, the percentage of patients who engaged in mental health treatment increased 21.7%.Conclusions. The risk of recurrence after being treated for a suicide attempt psychiatric emergency is high in the months following an attempt, and it is necessary to improve prevention and intervention programmes aimed at improving these figures


Assuntos
Humanos , Masculino , Feminino , Tentativa de Suicídio/psicologia , Seguimentos , Recidiva , Intervenção na Crise/métodos , Serviços de Emergência Psiquiátrica/métodos , Saúde Mental , Estudos Longitudinais
14.
Psicothema (Oviedo) ; 31(3): 246-254, ago. 2019. graf, tab
Artigo em Inglês | IBECS | ID: ibc-185350

RESUMO

Background: Previous literature suggests that low self-esteem is a risk factor for suicide attempts, but no meta-analyses have been conducted to assess this association in adolescents/young adults. The present study examined the relationship between low self-esteem and suicide attempts in young people (12-26 years old). Method: Meta-analyses were performed using random-effects models (ES) and odds ratio (OR). Heterogeneity and sensitivity analyses were performed. Results: From 26,883 initial titles, 22 studies met the inclusion criteria, of which 9 studies had data that could be included in the meta-analysis. The meta-analysis showed that youths with lower self-esteem were more likely to have future suicide attempts, with an effect size (self-esteem as continuous variable) of d = .58 (95% CI = .44 - .73) and, for low self-esteem (categorical variable) an OR = 1.99 (95% CI = 1.39-2.86; p < .001). Conclusion: A low level of self-esteem is a risk factor for suicide attempts in adolescents/young adults


Antecedentes: según la literatura, la baja autoestima es un factor de riesgo para los intentos de suicidio, pero no se han realizado metaanálisis para evaluar esta asociación entre los adolescentes/jóvenes. El presente estudio examinó la relación entre la baja autoestima y los intentos de suicidio entre los jóvenes (12-26 años de edad). Método: los metaanálisis se realizaron mediante modelos de efectos aleatorios, con tamaños del efecto (TE) y odds-ratio (OR). Se realizaron análisis de heterogeneidad y sensibilidad. Resultados: de 2.883 trabajos iniciales, 22 estudios cumplieron con los criterios de inclusión, de los cuales 9 estudios tenían datos que podían incluirse en el meta-análisis. El meta-análisis mostró que los jóvenes con menor autoestima eran más propensos a tener intentos futuros de suicidio, con un tamaño del efecto (autoestima como variable continua) de TE = 0,58 (IC del 95%: 0,44 a 0,73) y para la autoestima baja (variable categórica), un OR = 1,99 (IC del 95%: 1,39 a 2,86; p<0,001). Conclusión: el bajo nivel de autoestima es un factor de riesgo para los intentos de suicidio en adolescentes/jóvenes. Se necesitan programas eficaces para aumentar los niveles de autoestima y prevenir futuros comportamientos suicidas


Assuntos
Humanos , Criança , Adolescente , Adulto Jovem , Adulto , Autoimagem , Tentativa de Suicídio/psicologia , Tentativa de Suicídio/estatística & dados numéricos , Estudos Longitudinais , Razão de Chances , Fatores de Risco , Sensibilidade e Especificidade
15.
J Youth Adolesc ; 48(9): 1818-1834, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31346925

RESUMO

Suicidal ideation is considered to be the first step on the pathway to suicide. Despite the fact that suicidal ideation is surprisingly prevalent among preadolescent children in China and elsewhere, and despite its possible increase during the transition into adolescence, its developmental patterns and predictors during this period are unclear, thus precluding a meaningful understanding of its determinants and possible trajectories. Thus, this study aimed to identify suicidal ideation trajectories and multisystemic predictors covering the transition from middle childhood to early adolescence. A total of 715 Chinese elementary school students (Mage = 8.95, SD = 0.71; 54.5% was male) participated in assessments at six time points, using six-month assessment intervals. Growth mixture modeling analyses extracted three distinct trajectories of suicidal ideation: "low-stable" (86.4%), "moderate-increasing" (7.1%) and "high-start" (6.5%). Multivariate logistic regression analyses revealed that social anxiety and academic anxiety served as risk factors for the adverse developmental trajectories of suicidal ideation; whereas self-esteem, life satisfaction, and academic achievement served as protective factors for the positive developmental trajectory of suicidal ideation. The identification of three subgroups with unique predictors highlights the importance of individual difference considerations in understanding the progression of suicidal ideation in childhood and adolescence and the need for specific programs tailored to the unique characteristics of the relevant trajectories. Furthermore, given that suicidal ideation may start in a proportion of middle childhood youths and continue into adolescence, the middle childhood period should provide an important window of opportunity for large-scale screening and prevention of the escalation of suicidality in adolescence.


Assuntos
Comportamento do Adolescente/psicologia , Comportamento Infantil/psicologia , Autoimagem , Ideação Suicida , Adolescente , Criança , China , Feminino , Humanos , Controle Interno-Externo , Masculino , Fatores de Proteção , Fatores de Risco , Identificação Social , Tentativa de Suicídio/psicologia
16.
Medicina (Kaunas) ; 55(7)2019 Jul 19.
Artigo em Inglês | MEDLINE | ID: mdl-31331102

RESUMO

Background and Objectives: Suicide is the leading cause of death in patients with Bipolar Disorder (BD). In particular, the high mortality rate is due to violent suicide attempts. Several risk factors associated with suicide attempts in patients with BD have been identified. Affective temperaments are associated with suicidal risk, but their predictive role is still understudied. The aim of this study is to assess the relationship between affective temperaments and personal history of violent suicide attempts. Materials and Methods: 74 patients with Bipolar Disorder type I (BD-I) or II (BD-II) were included. All patients filled in the short version of Munster Temperament Evaluation of the Memphis, Pisa, Paris and San Diego (short TEMPS-M) and the Temperament and Character Inventory, revised version (TCI-R). The sample was divided into two groups on the basis of a positive history for suicidal attempts and the suicidal group was further divided into two subgroups according to violent suicide attempts. Results: Violent suicide attempts were positively associated with the cyclothymic temperament and inversely to the hyperthymic one. BD-I patients and patients with a clinical history of rapid cycling were significantly more represented in the group of patients with a history of violent suicide attempts. Conclusions: Our study highlights that several clinical and temperamental characteristics are associated with violent suicide attempts, suggesting the importance of affective temperaments in the clinical management of patients with BPI.


Assuntos
Transtorno Bipolar/complicações , Tentativa de Suicídio/psicologia , Temperamento , Adulto , Agressão/psicologia , Transtorno Bipolar/psicologia , Feminino , Humanos , Itália , Masculino , Pessoa de Meia-Idade , Psicometria/instrumentação , Psicometria/métodos , Tentativa de Suicídio/prevenção & controle
17.
Psicothema ; 31(3): 246-254, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31292038

RESUMO

BACKGROUND: Previous literature suggests that low self-esteem is a risk factor for suicide attempts, but no meta-analyses have been conducted to assess this association in adolescents/young adults. The present study examined the relationship between low self-esteem and suicide attempts in young people (12-26 years old). METHOD: Meta-analyses were performed using random-effects models (ES) and odds ratio (OR). Heterogeneity and sensitivity analyses were performed. RESULTS: From 26,883 initial titles, 22 studies met the inclusion criteria, of which 9 studies had data that could be included in the meta-analysis. The meta-analysis showed that youths with lower self-esteem were more likely to have future suicide attempts, with an effect size (self-esteem as continuous variable) of d = .58 (95% CI = .44 - .73) and, for low self-esteem (categorical variable) an OR = 1.99 (95% CI = 1.39-2.86; p < .001). CONCLUSION: A low level of self-esteem is a risk factor for suicide attempts in adolescents/young adults.


Assuntos
Autoimagem , Tentativa de Suicídio/psicologia , Adolescente , Adulto , Criança , Humanos , Estudos Longitudinais , Razão de Chances , Fatores de Risco , Sensibilidade e Especificidade , Tentativa de Suicídio/estatística & dados numéricos , Adulto Jovem
18.
Pan Afr Med J ; 32: 204, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31312316

RESUMO

Background: Suicidal behaviors are increasing in Tunisia at younger and younger ages. This study aims to describe the sociodemographic and clinical profile of suicide attempts in children and adolescents. Methods: We conducted a cross-sectional and descriptive study, including 50 suicidal individuals, recruited in the Child Psychiatry Department at the Razi Hospital in Manouba and in two Departments in Tunisia (Intensive Care and Reanimation Department and Department of Pediatrics) between July 2012 and June 2013. We identified the socio-demographic and clinical factors, the histories of abuse, subjects' education, the characteristics of the attempted suicides (TS), suicidal ideation assessed by the Suicidal Intent Scale and psychopathological disorders diagnosed using the Mini-International Neuropsychiatric Interview. Results: The sex-ratio was 0.56, the average age was 12.4 years ranging from 7 to 16 years. School failure or dropout were found in 86% of suicidal individuals. In 38% of cases suicidal behavior was recurrent; the subjects had a history of self-mutilation to the same extent. A context of abuse was reported in 46% of cases. Drug ingestion was the most common means of suicide, psychotropic drugs were the most common substances used. There was a significant gender difference in the use of the means of suicide: the boys mainly used physical means (P=0.04) while the girls poisoning (P=0.001). Suicidal intent was high in 44% of cases. A major depressive episode and adjustment disorder were the most common disorders found (58% and 24% of cases respectively). Conclusion: Depressive disorders and abuse are risk factors of TS in children and adolescents, these factors should be considered when implementing suicide prevention strategies for this population.


Assuntos
Maus-Tratos Infantis/estatística & dados numéricos , Transtornos Mentais/epidemiologia , Ideação Suicida , Tentativa de Suicídio/estatística & dados numéricos , Transtornos de Adaptação/epidemiologia , Adolescente , Criança , Estudos Transversais , Transtorno Depressivo Maior/epidemiologia , Feminino , Humanos , Masculino , Escalas de Graduação Psiquiátrica , Psicotrópicos/administração & dosagem , Recidiva , Fatores de Risco , Comportamento Autodestrutivo/epidemiologia , Fatores Sexuais , Tentativa de Suicídio/psicologia , Tunísia/epidemiologia
19.
Trends Psychiatry Psychother ; 41(2): 191-200, 2019 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-31291413

RESUMO

INTRODUCTION: The objective of this study was to identify whether mixed states in bipolar disorder (BD) are associated with more frequent suicidal behavior when compared to manic/hypomanic and depressive episodes. METHOD: We performed a systematic search of the scientific literature on the subject using the PubMed, ISI Web Of Science, PsycINFO and SciELO databases. The terms chosen for the search were (bipolar) AND (suicid*) AND (mixed). We selected original studies comparing suicidal behavior of patients in mixed states and suicidal behavior of patients in other BD phases. RESULTS: Sixteen papers fit the selection criteria. Twelve of the original 16 studies compared suicidal behavior in mixed states and pure mania, and the majority of these studies (n = 11) revealed that suicidal behavior was more frequent among individuals in mixed states. Five of the papers compared suicidal behavior between depressive and mixed phases of BD. One of these five papers reported more severe suicidal behavior in patients in mixed states and another described more frequent suicidal behavior in patients with pure depression. There were no significant statistical differences between groups in the remaining three of these five studies. CONCLUSION: During acute BD episodes, suicidal behavior is more strongly associated with mixed states than with pure mania or hypomania. However, it was not possible to demonstrate that the association between suicidal behavior and mixed states is stronger than the association between suicidal behavior and depressive phases. The results hereby presented are worth considering in clinical practice to better evaluate suicide risk and to prevent suicide.


Assuntos
Transtorno Bipolar/psicologia , Ideação Suicida , Tentativa de Suicídio/psicologia , Humanos
20.
Clín. salud ; 30(2): 109-113, jul. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-183924

RESUMO

Este trabajo compara personas fallecidas por suicidio con personas que realizaron algún intento (leves o graves), identificando factores asociados a cada grupo. En el estudio se utilizan dos muestras en las que se recogieron variables sociodemográficas y clínicas de las personas fallecidas por suicidio en Navarra (2010-2013, n = 180) y de personas atendidas en urgencias de psiquiatría por un intento de suicidio (enero-octubre 2015, n = 207). Los resultados indican que un método de suicidio no violento, no estar jubilado y la ausencia de intentos de suicidio previos se asocian a quienes realizan intentos leves. Ser hombre, la ausencia de atenciones previas en urgencias de psiquiatría y el haber nacido en España se asocian a los fallecidos por suicidio. Se concluye que las diferencias encontradas entre los fallecidos y los intentos de suicidio subrayan la necesidad de abordajes diferenciados en la prevención de la repetición de la conducta suicida


This paper compares people who committed suicide with people who made some (mild or severe) attempt, identifying factors associated with each group. This study uses two samples in which sociodemographic and clinical variables of people dying by suicide in Navarre (2010-2013, n = 180) and people attending psychiatry emergencies for an attempted suicide (January-October 2015, n = 207) were collected. The results show that a non-violent method of suicide, not being retired, and the absence of previous suicide attempts are associated with those who perform mild attempts. Being a male, the absence of previous attendances in psychiatry emergencies and being born in Spain are associated with those who have committed suicide. It is concluded that the differences between the deceased and suicide attempts underline the need for differentiated approaches in preventing the recurrence of suicidal behavior


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Tentativa de Suicídio/estatística & dados numéricos , Tentativa de Suicídio/psicologia , Transtornos Mentais/psicologia , Suicídio/estatística & dados numéricos , Fatores Socioeconômicos , Espanha/epidemiologia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA