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Fogaça VD, Souza DMD, Silva L, Guedes DMB, Domingues F, Trinquinato I, Rossato LM. Suicide attempts by adolescents assisted in an emergency department: a cross-sectional study. Rev Bras Enferm 2023; 76:e20220137. [PMID: 37042925 PMCID: PMC10084778 DOI: 10.1590/0034-7167-2022-0137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Accepted: 10/18/2022] [Indexed: 04/13/2023] Open
Abstract
OBJECTIVES to identify and characterize the care provided to adolescents admitted to an emergency department due to a suicide attempt. METHODS an observational, cross-sectional, descriptive study with a retrospective approach, carried out with medical records of adolescents aged 10 to 19 admitted for suicide attempts, between January 2015 and July 2020, in an emergency department. Data were subjected to descriptive and inferential analysis. RESULTS eighty-eight service occurrences were identified, mainly to females, exposed to multiple risk factors. Exogenous intoxication was the main method used, occurring at home and on weekdays. There were systemic repercussions, requiring multiple interventions and hospitalizations. Only 26% of cases were notified. CONCLUSIONS adolescents treated for suicide attempts were exposed to multiple risk factors, with intoxication as the main means used. There is concern about the underreporting of cases and the logic of clinical care and medicalization.
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Affiliation(s)
| | | | - Lucía Silva
- Universidade Federal de São Paulo. São Paulo, São Paulo, Brazil
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Fakhari A, Allahverdipour H, Esmaeili ED, Chattu VK, Salehiniya H, Azizi H. Early marriage, stressful life events and risk of suicide and suicide attempt: a case-control study in Iran. BMC Psychiatry 2022; 22:71. [PMID: 35090417 PMCID: PMC8796480 DOI: 10.1186/s12888-022-03700-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Accepted: 01/11/2022] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Early Marriage (EM) and associated Stressful Life Events (SLEs) and consequences such as psychological and physical well-being issues can lead to suicide and suicide attempts (SA). The study aimed to investigate the risk of suicide and SA among early married people who experienced SLEs. METHODS A case-control study was conducted based on the registry for suicide in Malekan county in Iran during 2016-18. Cases included 154 SAs and 32 suicides. Simultaneously, 201 outpatients from the emergency department were chosen as controls. Holms and Rahe life event questionnaire was used to assess SLEs. Sub-group analysis (Mantel-Haenszel) by sex and age groups and multiple logistic regression were used to calculate adjusted Odds Ratios (ORs) with 95% Confidence Intervals (CIs) for the association between EM and suicide risk after adjusting for the potential confounders. RESULTS The proportion (female vs male) of EM among suicides, controls, and SAs was 31.25% (18.7 vs 12.5%), 15.92% (11.9 vs 4.0%), and 13.0% (11.7 vs 1.3%), respectively. In subgroup analyses by sex, EM was associated with an increased risk of suicide in both females and males 2.64 and 2.36 times, respectively. Likewise, subgroup analysis by age groups revealed that EM increased suicide risk in subjects aged 10-15 years, while no association was found for age groups of 26-40 and > 40. After adjusting for the potential confounders, EM (OR: 3.01; 95% CI: 1.15 -7.29), financial problems (OR = 4.50; 95% CI: 1.83 -9.07), and family problems (OR = 2.60; 95% CI: 1.19-9.59), were associated with an increased risk of suicide. However, no association was found between EM, various types of SLEs, and the risk of SA. CONCLUSIONS We found EM and SLEs were correlated with suicide risk, while no evidence found that EM increased the risk of SA. Progress in reducing EM and addressing its serious consequences can occur by a stronger political commitment and by sharing the experiences and voices of the early married. Our study provided preliminary findings to guide future studies; however, methodological and longitudinal studies are needed to understand and address the effect of EM on suicidal behaviors.
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Affiliation(s)
- Ali Fakhari
- Research Center of Psychiatry and Behavioral Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hamid Allahverdipour
- Research Center of Psychiatry and Behavioral Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Health Education and Promotion, School of Public Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Vijay Kumar Chattu
- Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5G 2C4 Canada
- Department of Public Health, Saveetha Medical College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, 600077 India
- Department of Community Medicine, Faculty of Medicine, Datta Meghe Institute of Medical Sciences, Wardha, 442107 India
| | - Hamid Salehiniya
- Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Hosein Azizi
- Research Center of Psychiatry and Behavioral Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Virgolino A, Costa J, Santos O, Pereira ME, Antunes R, Ambrósio S, Heitor MJ, Vaz Carneiro A. Lost in transition: a systematic review of the association between unemployment and mental health. J Ment Health 2022; 31:432-444. [PMID: 34983292 DOI: 10.1080/09638237.2021.2022615] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND Unemployment can involve financial strain and major psychosocial challenges. Integration of the existing evidence is needed to better characterize the association between unemployment and mental health, independently of macroeconomic contexts. AIMS Main objectives of this study: (a) review, integrate, and summarize evidence about the association between unemployment and anxiety disorders, mood disorders, and suicidal behaviour, and (b) identify variables affecting this association. METHOD Systematic review of literature following PRISMA guidelines. PubMed, Web of Science, SciELO, RCAAP, and Cochrane Library databases were searched. Quantitative empirical studies on the association between unemployment and mental illness of community-based samples were included. The quality of the evidence provided in the studies was assessed following pre-defined methodological criteria. RESULTS Overall, 294 articles were considered eligible. In total, 55.7% of the studies were conducted in Europe; 91.4% supported a positive association between increased unemployment rates and anxiety, mood disorders, or suicidal behavior. Men and young adults were most severely affected by unemployment. Education and social support were found to buffer the negative outcomes of job loss. CONCLUSIONS Unemployment was inversely associated with mental health irrespectively of the economic context; unemployed individuals were more vulnerable to commit suicide and suffer from anxiety and mood disorders.
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Affiliation(s)
- Ana Virgolino
- Faculdade de Medicina, Instituto de Saúde Ambiental, Universidade de Lisboa, Lisbon, Portugal.,Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Joana Costa
- Faculdade de Medicina, Instituto de Saúde Ambiental, Universidade de Lisboa, Lisbon, Portugal
| | - Osvaldo Santos
- Faculdade de Medicina, Instituto de Saúde Ambiental, Universidade de Lisboa, Lisbon, Portugal.,Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.,Unbreakable Idea Research, Painho, Portugal
| | | | - Rita Antunes
- Faculdade de Medicina, Instituto de Saúde Ambiental, Universidade de Lisboa, Lisbon, Portugal
| | - Sara Ambrósio
- Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Maria João Heitor
- Faculdade de Medicina, Instituto de Saúde Ambiental, Universidade de Lisboa, Lisbon, Portugal.,Departamento de Psiquiatria e Saúde Mental, Hospital Beatriz Ângelo, Loures, Portugal
| | - António Vaz Carneiro
- Faculdade de Medicina, Instituto de Saúde Ambiental, Universidade de Lisboa, Lisbon, Portugal.,Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.,Institute for Evidence Based Healthcare, Lisbon, Portugal.,Cochrane Portugal, Lisbon, Portugal
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Barreto AAM, Souza LEPFD. Unemployment and suicide among the Brazilian population in the crisis of capitalism. CIENCIA & SAUDE COLETIVA 2021; 26:5869-5882. [PMID: 34909980 DOI: 10.1590/1413-812320212612.14672021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 07/21/2021] [Indexed: 01/09/2023] Open
Abstract
The current crisis of capitalism has multiple economic, financial, social, environmental, cultural and political facets. In Brazil, the severity of the crisis is no different, resulting from the exhaustion of the neo-developmentalist model and its inability to resist global crisis. This study compares suicide mortality rates (MR) among employed and unemployed persons in Brazil prior to and during the economic crisis using death records from the period 2011 to 2016. The findings show that in the period 2011 to 2016 the suicide MR fell from 2.66/100,000 to 2.46 among unemployed persons and increased from 5.52/100,000 to 6.89/100,000 in employed persons. Suicide is a complex, multi-causal phenomenon determined by a diverse range of social factors, including strategies that increase worker exploitation. Indeed, being employed can have a greater negative impact on the mental health of workers than being unemployed.
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Affiliation(s)
- Antonio Angelo Menezes Barreto
- Instituto de Saúde Coletiva, Universidade Federal da Bahia. R. Basílio da Gama s/n, Canela. 40110-040 Salvador BA Brasil.
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Avanci JQ, Pinto LW, Assis SGD. Notifications, hospitalizations and deaths from self-harm in children in Brazil's national health systems. CIENCIA & SAUDE COLETIVA 2021; 26:4895-4908. [PMID: 34787184 DOI: 10.1590/1413-812320212611.3.35202019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Accepted: 01/09/2020] [Indexed: 11/21/2022] Open
Abstract
There are virtually no statistics on childhood suicidal behavior globally. This setting can be partly explained by the social representation of joy in this early phase of life. This paper aims to analyze information on self-harm reports, hospitalizations, and deaths among children aged 5-9 years in Brazil to know its magnitude and distribution from 2006 to 2017, based on data from national health information systems. The results show 58 deaths of Brazilian children with intentional self-harm, primarily male, white, and nine years old. Hanging was the most commonly used mechanism for children to kill themselves. A total of 1,994 hospitalizations were recorded for suicide attempts in children in the period 2006-2017, with a predominance of males in all regions. Regarding notifications, most refer to children between 8 and 9 years of age, black and female, emphasizing self-poisoning. Evidence that any suicidal behavior in childhood is strongly associated with attempted or completed suicide in adolescence and adulthood is one of the main indications of the need to prevent this behavior in the first decade of life.
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Affiliation(s)
- Joviana Quintes Avanci
- Departamento de Estudos sobre Violência e Saúde Jorge Careli (Claves), Escola Nacional de Saúde Pública - Fundação Oswaldo Cruz. R. Leopoldo Bulhões 1480, Manguinhos. 21041-210 Rio de Janeiro RJ Brasil.
| | - Liana Wernersbach Pinto
- Departamento de Estudos sobre Violência e Saúde Jorge Careli (Claves), Escola Nacional de Saúde Pública - Fundação Oswaldo Cruz. R. Leopoldo Bulhões 1480, Manguinhos. 21041-210 Rio de Janeiro RJ Brasil.
| | - Simone Gonçalves de Assis
- Departamento de Estudos sobre Violência e Saúde Jorge Careli (Claves), Escola Nacional de Saúde Pública - Fundação Oswaldo Cruz. R. Leopoldo Bulhões 1480, Manguinhos. 21041-210 Rio de Janeiro RJ Brasil.
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Ferreira LM, Lima KPD, Morais ARD, Safadi T, Ferreira JL. Suicide cases in developed and emerging countries: an analysis using wavelets. JORNAL BRASILEIRO DE PSIQUIATRIA 2021. [DOI: 10.1590/0047-2085000000341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
ABSTRACT Objective The aim of this study was to use a wavelet technique to determine whether the number of suicides is similar between developed and emerging countries. Methods Annual data were obtained from World Health Organization (WHO) reports from 1986 to 2015. Discrete nondecimated wavelet transform was used for the analysis, and the Daubechies wavelet function was applied with five-level decomposition. Regarding clustering, energy (variance) was used to analyze the clusters and visualize the clustering process. We constructed a dendrogram using the Mahalanobis distance. The number of groups was set using a specific function in the R program. Results The cluster analysis verified the formation of four groups as follows: Japan, the United States and Brazil were distinct and isolated groups, and other countries (Austria, Belgium, Chile, Israel, Mexico, Italy and the Netherlands) constituted a single group. Conclusion The methods utilized in this paper enabled a detailed verification of countries with similar behaviors despite very distinct socioeconomic, geographic and climate characteristics.
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Jaen-Varas DC, Mari JJ, Asevedo E, Borschmann R, Diniz E, Ziebold C, Gadelha A. A 10-year ecological study of the methods of suicide used by Brazilian adolescents. CAD SAUDE PUBLICA 2020; 36:e00104619. [PMID: 32901704 DOI: 10.1590/0102-311x00104619] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2019] [Accepted: 02/07/2020] [Indexed: 11/21/2022] Open
Abstract
Suicide among adolescents has become a major public health problem worldwide. Our study sought to describe the most commonly used methods of suicide among adolescents aged 10 to 19 years in Brazil between 2006 and 2015. Complete data were obtained from the Brazilian Health Informatics Department (DATASUS) and coded into seven categories of suicide methods. The following statistical analyzes were performed: chi-square (χ2) tests to examine the association between the frequency of each suicide method and the year; odds ratios (OR) and 95% confidence intervals (95%CI) compared the relative chances of each suicide method occurring between boys and girls. In total, 8,026 suicides among Brazilian adolescents were registered over the analyzed period. The most commonly used method of suicide by both sexes was hanging (2015 = 70.3%), and the most significant increase was observed in girls (2015 = 65.82%). The proportional use of arms (2006 = 14.2%; 2015 = 9.1%) and poisoning (2006 = 13.3%; 2015 = 9.2%) decreased over the period. The increase in hanging is worrisome, mostly due to difficulties to impose access barriers and to its high lethality. In such context, a comprehensive understanding of suicide behaviors among adolescents in Brazil should be drawn to inform general prevention measures and, more specifically, the reasons for the increase in hanging need to be further investigated.
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Affiliation(s)
| | - Jair J Mari
- Universidade Federal de São Paulo, São Paulo, Brasil.,Instituto Nacional de Psiquiatria do Desenvolvimento para Crianças e Adolescentes, São Paulo, Brasil
| | - Elson Asevedo
- Universidade Federal de São Paulo, São Paulo, Brasil.,Global Mental Health Program, Columbia University, New York, U.S.A
| | - Rohan Borschmann
- Melbourne School of Psychological Sciences; University of Melbourne, Melbourne, Australia.,Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia
| | - Elton Diniz
- Universidade Federal de São Paulo, São Paulo, Brasil
| | - Carolina Ziebold
- Universidade Federal de São Paulo, São Paulo, Brasil.,Instituto Nacional de Psiquiatria do Desenvolvimento para Crianças e Adolescentes, São Paulo, Brasil
| | - Ary Gadelha
- Universidade Federal de São Paulo, São Paulo, Brasil.,Instituto Nacional de Psiquiatria do Desenvolvimento para Crianças e Adolescentes, São Paulo, Brasil
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Razzouk D, Cheli Caparroce D, Sousa A. Community-based mental health services in Brazil. CONSORTIUM PSYCHIATRICUM 2020; 1:60-70. [PMID: 38680388 PMCID: PMC11047271 DOI: 10.17650/2712-7672-2020-1-1-60-70] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 09/10/2020] [Indexed: 05/01/2024] Open
Abstract
Introduction The shift from the hospital-based model of care to community-based mental health services began three decades ago and is still an ongoing process in Brazil. Objectives To update data on the development of the community mental health services network in Brazil in relation to service availability and structure, manpower, pattern of service use, financing, epidemiological studies and the burden of mental disorders, research and national mental health policy. Methods Searches were constructed to collect data on indexed databases (Medline, Scielo), as well as governmental,NGOs and medical council sources, reports and the grey literature up until 30th March, 2019. Results Community mental health services are unevenly distributed in the country. Brazil leads the world in terms of the prevalence of anxiety disorders, ranking fifth for depression prevalence. Violence and suicide rates are two growing factors which exacerbate the prevalence of mental disorders prevalence. An increased reduction of the number of psychiatric beds in the country, in addition to the unbalanced growth of services in the community, has resulted in treatment gaps and the underutilization of services and barriers to treating people with the most severe psychosis. Investment in mental healthcare is still scarce. However, mental health funding is not addressed according to the population´s needs and scientific evidence, resulting in a waste of resources and inefficiency. Programmes and service interruptions are common according to each government mandate. Conclusion Successive changes in ideological perspectives have led to the introduction of policies which have caused fragmentation in the mental health system and services. A lack of evaluation and transparency of services and costs are the main barriers to integrating multiple services and planning long-term developmental phases.
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Affiliation(s)
- Denise Razzouk
- Centre of Mental Health Economics, Department of Psychiatry, Universidade Federal de Sao Paulo (Unifesp)
| | - Daniela Cheli Caparroce
- Centre of Mental Health Economics, Department of Psychiatry, Universidade Federal de Sao Paulo (Unifesp)
| | - Aglae Sousa
- Centre of Mental Health Economics, Department of Psychiatry, Universidade Federal de Sao Paulo (Unifesp)
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The Role and Comparison of Stressful Life Events in Suicide and Suicide Attempt: A Descriptive-Analytical Study. IRANIAN JOURNAL OF PSYCHIATRY AND BEHAVIORAL SCIENCES 2020. [DOI: 10.5812/ijpbs.96051] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: In recent years, suicide in Iran has become a growing concern. Although stressful life events (SLEs) are increasing as a global prevalence, suicide attempters (SAs) and the impact and association between suicide and SLEs are poorly understood. Objectives: This study aimed at examining the role and effect of SLEs in suicides and SAs. Methods: This descriptive-analytical study was performed during 2014 to 2016 based on 186 records (through random quota sampling) of suicidal behaviors (SBs), including 154 SAs and 32 suicide cases in Malekan County, East Azerbaijan, Iran. A valid semi-structured Life Event questionnaire (LEQ) with 43-items of common types of SLEs in the last year before SBs was used by trained interviewers through single sitting and face to face interviews. The point-biserial correlation and multiple logistic regression analysis were utilized to estimate the adjusted odds ratios and confidence intervals for suicide risk. Results: A significant correlation was found between SLEs scores and suicide (R = 0.739). Comparing SLEs types between the two groups of SAs and suicides, it was revealed that the highest odds ratios were related to financial problems (OR = 11.9; 95% CI = 4.00 - 35.85), early marriage (OR = 4.97; 95% CI = 1.68 - 14.65), exposure to new conditions (OR = 8.79; 95% CI = 1.3 - 59.22), and family conflicts (OR = 2.53; 95% CI = 1.23 - 6.53), respectively. Conclusions: SLEs are most strongly associated with committing suicide. Suicide determinants are different from SA. SLEs management by health systems is imperative to improve life skills in suicide prevention.
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Rufino NC, Mirkovic B, Consoli A, Pellerin H, Santos JPM, Fidalgo TM, Gerardin P, Silveira DX, Cohen D. Suicide Attempts Among French and Brazilian Adolescents Admitted to an Emergency Room. A Comparative Study of Risk and Protective Factors. Front Psychiatry 2020; 11:742. [PMID: 32848921 PMCID: PMC7424044 DOI: 10.3389/fpsyt.2020.00742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Accepted: 07/15/2020] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Suicide is the second most common cause of preventable mortality among Brazilian and French adolescents. The aim of the current study was to compare the main risk and protective factors associated with a suicide attempt (SA) and to highlight differences based on geographical characteristics. METHOD We compared a Brazilian sample (N = 45) of adolescents admitted to the emergency room of a public hospital in São Paulo for SA to a French sample (N = 320) of adolescents hospitalized for SA across 5 paediatric departments. Then, we ran several multivariate models to examine how each selected variable was related to geographic origin and to the other selected variables linked to geographic origin. RESULTS The two samples presented no significant differences regarding gender, age or schooling. Both samples had high rates of depressive disorders, anxiety disorders, substance use, disruptive disorders, borderline psychopathology, and lifetime SAs. However, the Brazilian sample presented significantly higher levels of psychopathology and had more insecure attachment relationships (fearful and detached), whereas the French sample had a more secure attachment style. Brazilian adolescents had more recourse to spiritual beliefs and spiritual support, whereas the French adolescents had higher scores on the Reasons for Living Inventory and used more help-seeking strategies from their social network, mainly close friends. Multivariate models showed that two productive coping strategies (seeking spiritual support and social action) and the dependence score were significantly associated with membership in the Brazilian cohort, whereas a secure attachment style and depression severity (evaluated by the Beck Depression Inventory) were significantly associated with membership in the French cohort. CONCLUSION Despite presenting similar psychopathologies, Brazilian adolescents presented a more insecure attachment style and used the religious kind of coping more commonly than their French counterparts. We hypothesize that religion may compensate for the social vulnerabilities present in a middle-income country such as Brazil. More transcultural studies may help to elucidate this phenomenon.
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Affiliation(s)
- Natalia C Rufino
- Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Bojan Mirkovic
- Service de Psychiatrie de l'Enfant et de l'Adolescent, CHU Charles Nicolle/CH Le Rouvray, Normandie Université, Rouen, France
| | - Angèle Consoli
- Département de Psychiatrie de l'Enfant et de l'Adolescent, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Paris, France.,GRC-15, Approche dimensionnelle des épisodes psychotiques de l'enfant et de l'adolescent, Faculté de Médecine, UPMC, Sorbonne Université, Paris, France
| | - Hugues Pellerin
- Département de Psychiatrie de l'Enfant et de l'Adolescent, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | - Juliana P M Santos
- Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Thiago M Fidalgo
- Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Priscille Gerardin
- Service de Psychiatrie de l'Enfant et de l'Adolescent, CHU Charles Nicolle/CH Le Rouvray, Normandie Université, Rouen, France
| | - Dartiu X Silveira
- Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil
| | - David Cohen
- Département de Psychiatrie de l'Enfant et de l'Adolescent, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Paris, France.,GRC-15, Approche dimensionnelle des épisodes psychotiques de l'enfant et de l'adolescent, Faculté de Médecine, UPMC, Sorbonne Université, Paris, France.,CNRS UMR 7222 "Institut des Systèmes Intelligents et Robotiques", Sorbonne Université, Paris, France
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Abstract
PURPOSE OF REVIEW The questions of urban living, mental health and well-being are complex issues correlated to many interacting factors. The purpose of this review is to provide data on mental health challenges of urban life and perspectives to address these challenges. RECENT FINDINGS Urbanization may cause mental health problems, such as psychotic experiences, depression and stress-related disorders, particularly in vulnerable individuals. Challenges of urban living are even greater in developing countries, because of other urgent problems these countries are facing. New findings identified distinct neural mechanisms for an established environmental risk factor, linking the urban environment to social stress processing. Nature-based solutions may be helpful in preventing mental disorders and in alleviating psychological symptoms. SUMMARY The data of impact of urban living on mental health are still controversial and mechanism of association is unclear. Urban living may be related to biological or social/environmental factors or both. Most probably, urbanicity has a synergistic effect with genetic vulnerability. Interdisciplinary and intersectoral actions are needed to meet urban living challenges, such as providing access to green space and mental health services, decrease of poverty, homelessness and emerging problems of immigration to cities.
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Jaen-Varas D, Mari JJ, Asevedo E, Borschmann R, Diniz E, Ziebold C, Gadelha A. The association between adolescent suicide rates and socioeconomic indicators in Brazil: a 10-year retrospective ecological study. REVISTA BRASILEIRA DE PSIQUIATRIA (SAO PAULO, BRAZIL : 1999) 2019; 41:389-395. [PMID: 30785539 PMCID: PMC6796813 DOI: 10.1590/1516-4446-2018-0223] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 10/17/2018] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To examine suicide rates among adolescents from six large cities in Brazil and to analyze the relationship between adolescent suicide rates and socioeconomic indicators between 2006 and 2015. METHODS Generalized estimating equation models were used to assess the impact of socioeconomic factors - including social inequality and unemployment rates - on adolescent suicide rates. RESULTS The rate of adolescent suicide increased by 24% over the course of the study period. Social inequality (assessed using the Gini index), was positively associated with overall adolescent suicide rates (β = 10.68; 95%CI = 2.32-19.05; p ≤ 0.012). After disaggregating the findings by age (10-14 and 15-19 years), social inequality was associated with suicide rate only for adolescents aged 15-19 years (β = 9.63; 95%CI = 2.31-16.96; p ≤ 0.005). Disaggregating these findings by sex, the association with economic variables became significant only among females. Males had a higher overall suicide rate than females, and the highest rate was observed in male adolescents aged 15-19 years. Higher levels of unemployment were associated with higher suicide rates. CONCLUSION Our findings suggest that socioeconomic indicators, particularly unemployment and social inequality, are relevant social determinants of suicide in adolescence.
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Affiliation(s)
- Denisse Jaen-Varas
- Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Jair J. Mari
- Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
- Instituto Nacional de Psiquiatria do Desenvolvimento para Crianças e Adolescentes (INPD), São Paulo, SP, Brazil
| | - Elson Asevedo
- Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
- Instituto Nacional de Psiquiatria do Desenvolvimento para Crianças e Adolescentes (INPD), São Paulo, SP, Brazil
- Global Mental Health Program, Columbia University, New York, NY, USA
| | - Rohan Borschmann
- Centre for Adolescent Health, Murdoch Children’s Research Institute, Melbourne, Australia
- Justice Health Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
- Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
- Department of Psychiatry, University of Melbourne, Melbourne, Australia
| | - Elton Diniz
- Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Carolina Ziebold
- Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
- Global Mental Health Program, Columbia University, New York, NY, USA
| | - Ary Gadelha
- Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
- Global Mental Health Program, Columbia University, New York, NY, USA
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