Suicidio y género en Antioquia (Colombia): estudio de autopsia psicológica

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 Behaviour and Cannabis and Tranquilizer use, Depression, Aggression and Other Borderline Personality Traits Among Students in Sincelejo, Colombia

OBJECTIVE

This objective of this study is to examine the association between suicidal behaviour and substance use, depression, aggressiveness and borderline personality traits among adolescents from Sincelejo, a rural city in the north of Colombia.

METHODS

This cross sectional study included 352 participants selected by purposive sampling, from a public and a private school located in Sincelejo, Sucre district, in the north of Colombia. Students ages ranged from 12 to 18 years old (mean, 15.09±1.82). The participants completed three screening tools: a socio-demographic questionnaire, a screening instrument to collect information related to the frequency of use of some substances, such as tobacco and cannabis, and a self-report inventory to assess various personality and psychopathology domains. A series of t-tests, ANOVA and linear regression analyses were conducted.

RESULTS

Physical aggression (t=7.74; p <0.01), cognitive depression (t=5.03; p <0.01), affective depression (t=8.24; p <0.01), affective instability (t=3.46; p <0.01), few social relationships (t=3.36; p <0.01), self-harm (t=3.45; p<.01), cannabis and tranquilizer use (t=2.83; p <0.05; and t=2.37; p <0.05) had a significant independent relationship with suicidal behaviour. Aggression (t=2.59; p <0.05), components of depression (t=9.03; p <0.01) and borderline personality traits (t=4.12; p <0.01) also predicted suicidal behaviour.

CONCLUSIONS

More longitudinal studies are needed in this area to identify the causal relations between the factors studied and the suicidal behaviour of young people in Sincelejo.

Association Between Suicidal Behaviour and Cannabis and Tranquilizer use, Depression, Aggression and Other Borderline Personality Traits Among Students in Sincelejo, Colombia

OBJECTIVE

This objective of this study is to examine the association between suicidal behaviour and substance use, depression, aggressiveness and borderline personality traits among adolescents from Sincelejo, a rural city in the north of Colombia.

METHODS

This cross sectional study included 352 participants selected by purposive sampling, from a public and a private school located in Sincelejo, Sucre district, in the north of Colombia. Students ages ranged from 12 to 18 years old (mean, 15.09±1.82). The participants completed three screening tools: a socio-demographic questionnaire, a screening instrument to collect information related to the frequency of use of some substances, such as tobacco and cannabis, and a self-report inventory to assess various personality and psychopathology domains. A series of t-tests, ANOVA and linear regression analyses were conducted.

RESULTS

Physical aggression (t=7.74; p <0.01), cognitive depression (t=5.03; p <0.01), affective depression (t=8.24; p <0.01), affective instability (t=3.46; p <0.01), few social relationships (t=3.36; p <0.01), self-harm (t=3.45; p<.01), cannabis and tranquilizer use (t=2.83; p <0.05; and t=2.37; p <0.05) had a significant independent relationship with suicidal behaviour. Aggression (t=2.59; p <0.05), components of depression (t=9.03; p <0.01) and borderline personality traits (t=4.12; p <0.01) also predicted suicidal behaviour.

CONCLUSIONS

More longitudinal studies are needed in this area to identify the causal relations between the factors studied and the suicidal behaviour of young people in Sincelejo.

Mortalidade por suicídio no Estado do Paraná segundo meios utilizados: uma análise epidemiológica

RESUMO Objetivo Analisar a distribuição epidemiológica da mortalidade por suicídio, segundo os meios utilizados no Estado do Paraná. Métodos Trata-se de um estudo descritivo sobre os dados de mortalidade por suicídio e meios utilizados nas Macrorregionais de Saúde de residência, constantes no Sistema de Informações sobre Mortalidade, de 1996 a 2000 e de 2009 a 2012 e analisados por meio de estatística descritiva e inferencial, teste de qui-quadrado/c2 e medida de associação/odds ratio. Resultados Houve aumento na variação percentual da taxa de mortalidade por suicídio pelo enforcamento na maioria das Macrorregionais de Saúde do Estado, para ambos os sexos. Entretanto, o suicídio por arma de fogo, autointoxicação por pesticidas e outros meios apresentou declínio no período de 1996 a 2000 para 2009 a 2012. O enforcamento esteve associado ao sexo masculino e à idade superior a 45 anos, no período de 1996 a 2000, e à escolaridade acima de 12 anos, não ter companheiro e óbito no domicílio, para o período de 2009 a 2012. Notou-se maior variação percentual na taxa de mortalidade por suicídio na Macrorregional Oeste. Conclusão O levantamento das características específicas dos meios utilizados para o suicídio no Estado é um componente necessário para a implementação de intervenções preventivas para sua redução.

[The Meaning That Families Place on the Suicide of Pregnant Mothers in Antioquia, 2010-2011]

OBJECTIVE

To identify the meaning that the families of two pregnant women from Antioquia placed on their suicide in 2010-2011.

METHODOLOGY

A qualitative research using the phenomenological and hermeneutical approach, specifically a case study analysis.

RESULTS

The category named "family task: weaving a history that helps them to understand" emerged in both families. Two trends were found in the family of Bella: "tragedy, tensions and scenarios" and "fluctuations: between fear-guilt and relief." The family of Consentida showed three trends: "trapped with no escape", "suicide and orphanhood: the understanding of Juanita" and "death is death."

CONCLUSIONS

For both families, the fact that the women were pregnant had an important effect on the event of voluntary death. The construction of meaning that took place in both families followed two paths: differentiation and death itself; both can be resilient ways of coping with such a tragedy.

[Suicide Risk Assessment in the Clinical Practice Guidelines for the Diagnosis and Management of Depression in Colombia]

INTRODUCTION

Suicide is the most serious complications of depression. It has high associated health costs and causes millions of deaths worldwide per year. Given its implications, it is important to know the factors that increase the risk of its occurrence and the most useful tools for addressing it.

OBJECTIVES

To identify the signs and symptoms that indicate an increased risk of suicide, and factors that increase the risk in patients diagnosed with depression. To establish the tools best fitted to identify suicide risk in people with depression.

METHOD

Clinical practice guidelines were developed, following those of the methodmethodological guidelines of the Ministry of Social Protection, to collect evidence and to adjust recommendations. Recommendations from the NICE90 and CANMAT guidelines were adopted and updated for questions found in these guidelines, while new recommendations were developed for questions not found in them.

RESULTS

Basic points and recommendations are presented from a chapter of the clinical practice guidelines on depressive episodes and recurrent depressive disorder related to suicide risk assessment. Their corresponding recommendation levels are included.

[Integral Care Guide for Early Detection and Diagnosis of Depressive Episodes and Recurrent Depressive Disorder in Adults. Integral Attention of Adults with a Diagnosis of Depressive Episodes and Recurrent Depressive Disorder: Part I: Risk Factors, Screening, Suicide Risk Diagnosis and Assessment in Patients with a Depression Diagnosis]

INTRODUCTION

Depression is an important cause of morbidity and disability in the world; however, it is under-diagnosed at all care levels.

OBJECTIVE

The purpose here is to present recommendations based on the evidence gathered to answer a series of clinical questions concerning risk factors, screening, suicide risk diagnosis and evaluation in patients undergoing a depressive episode and recurrent depressive disorder. Emphasis has been made upon the approach used at the primary care level so as to grant adult diagnosed patients the health care guidelines based on the best and more updated evidence available thus achieving minimum quality standards.

METHODOLOGY

A practical clinical guide was elaborated according to standards of the Methodological Guide of the Ministry of Social Protection. Recommendation from guides NICE90 and CANMAT were adopted and updated so as to answer the questions posed while de novo questions were developed.

RESULTS

Recommendations 1-22 corresponding to screening, suicide risk and depression diagnosis were presented. The corresponding degree of recommendation is included.