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Alves Luis M, Jiménez Monroy NA, Graziela de Godoi L, Costa Leite FM. Self-inflicted injuries among adolescents: Prevalence and associated factors, Espírito Santo, Brazil. AQUICHAN 2021. [DOI: 10.5294/aqui.2021.21.3.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective: To identify the prevalence of notified self-inflicted injuries among adolescents in Espírito Santo and to analyze the associated factors.
Materials and methods: A cross-sectional and analytical study, with the notified data of self-inflicted violence among adolescents in Espírito Santo registered in the Notifiable Diseases Information System from 2011 to 2018. The bivariate analyses considered the Chi-square (χ²) and Fisher’s Exact tests. The multivariate analysis considered the log-binomial model, and the adjustment results were presented as prevalence ratio.
Results: The prevalence of notified self-inflicted injuries was 33 % and, of this total, 79.8 % occurred among female adolescents. Prevalence was higher among adolescents aged from 13 to 17 years old (female gender) and from 18 to 19 years old (male gender), as well as among those with some disability or disorder. Higher prevalence values were found in the residence and in collective housing, as well as among those who did not consume alcohol at the event in question. In the female gender, there was also an association with the urban area (p < 0.05).
Conclusions: High prevalence of notified self-inflicted injuries is perceived among adolescents in Espírito Santo, as well as of the factors associated to this phenomenon. The importance of adopting promotion, prevention and recovery measures for the problem is verified.
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Shi P, Yang A, Zhao Q, Chen Z, Ren X, Dai Q. A Hypothesis of Gender Differences in Self-Reporting Symptom of Depression: Implications to Solve Under-Diagnosis and Under-Treatment of Depression in Males. Front Psychiatry 2021; 12:589687. [PMID: 34759845 PMCID: PMC8572815 DOI: 10.3389/fpsyt.2021.589687] [Citation(s) in RCA: 60] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 09/23/2021] [Indexed: 11/13/2022] Open
Abstract
The phenomenon of female preponderance in depression has been well-reported, which has been challenged by higher rates of suicide and addictive behaviors in males, and a longer life-span in females. We thus propose an alternative hypothesis "Gender differences in self-reporting symptom of depression," suggesting mild-moderate depression tends to be reported more often by females, and severe depression and suicide tend to be reported more often by males. Potential mechanisms that account for this difference may include three aspects: covariation between estrogen levels and the incidence peak of female depression, gender differences in coping style (e.g., comparative emotional inexpressiveness and non-help-seeking in males), and gender differences in symptom phenotypes (e.g., atypical symptoms in male depression). Our newly presented hypothesis implied the overlooked under-diagnosis and under-treatment of depression in males. For effective diagnoses and timely treatment of male depression, it is critical to incorporate symptoms of depression in males into the relevant diagnostic criteria, encourage males to express negative emotions, and increase awareness of suicidal behavior in males.
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Affiliation(s)
- Peixia Shi
- Department of Nursing Psychology, Army Medical University, Chongqing, China
| | - Aigang Yang
- Department of Nursing Psychology, Army Medical University, Chongqing, China
| | - Qing Zhao
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences (CAS), Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Zhaohua Chen
- Department of Nursing Psychology, Army Medical University, Chongqing, China
| | - Xiaomei Ren
- Department of Nursing Psychology, Army Medical University, Chongqing, China
| | - Qin Dai
- Department of Nursing Psychology, Army Medical University, Chongqing, China
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Oliveira JWTD, Magalhães APND, Barros AC, Monteiro EKR, Souza CDFD, Alves VDM. Características das tentativas de suicídio atendidas pelo serviço de emergência pré-hospitalar: um estudo epidemiológico de corte transversal. JORNAL BRASILEIRO DE PSIQUIATRIA 2020. [DOI: 10.1590/0047-2085000000289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
RESUMO Objetivo: Descrever o perfil das vítimas de tentativas de suicídio atendidas pelo Corpo de Bombeiros de um município do semiárido brasileiro. Métodos: Estudo transversal contendo dados do atendimento a vítimas de tentativas de suicídio, realizado pelos bombeiros militares do estado de Alagoas, no período de 1º de janeiro de 2000 a 31 de dezembro de 2017. Foram selecionadas as variáveis: sexo, idade, desfecho, intoxicação, uso de álcool, transtorno mental, estação do ano, dia da semana, horário, natureza da ocorrência e tempo de resposta, de transporte e total. Foram utilizados os testes qui-quadrado, exato de Fisher e Kruskal-Wallis. Resultados: Foram atendidas 144 vítimas de tentativas de suicídio. A frequência de atendimentos entre homens (n = 73; 50,7%) e mulheres (n = 71; 49,3%) foi semelhante. As mulheres apresentaram idade mais jovem (p < 0,001) e utilizaram o método da intoxicação (p < 0,001) duas vezes mais que os homens. A presença de transtorno mental (p = 0,04) foi mais comum entre os homens e o tempo consumido durante o atendimento pré-hospitalar foi maior entre eles, indicando que, possivelmente, as tentativas de suicídio cometidas por homens demandam maiores cuidados durante a assistência realizada pelos bombeiros. Conclusões: O perfil das vítimas de tentativas de suicídio apresentou frequência semelhante entre homens e mulheres, sendo as mulheres mais jovens. Nas mulheres, observou-se predomínio de intoxicações. Em homens, os transtornos mentais foram mais prevalentes. Além disso, fazem-se necessários o reconhecimento precoce dos casos de tentativas de suicídio, as principais formas de atuação e o preenchimento adequado das fichas de atendimento pré-hospitalar.
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Affiliation(s)
| | | | - Alice Correia Barros
- Universidade Estadual de Ciências da Saúde de Alagoas, Brasil; Universidade Federal de Alagoas, Brasil
| | - Elaine Kristhine Rocha Monteiro
- Corpo de Bombeiros Militar de Alagoas, Brasil; Universidade Federal de Alagoas, Brasil; Fundação de Ensino Superior de Olinda, Brasil
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Vilaça L, Volpe FM, Ladeira RM. ACCIDENTAL POISONING IN CHILDREN AND ADOLESCENTS ADMITTED TO A REFERRAL TOXICOLOGY DEPARTMENT OF A BRAZILIAN EMERGENCY HOSPITAL. ACTA ACUST UNITED AC 2019; 38:e2018096. [PMID: 31778403 PMCID: PMC6909246 DOI: 10.1590/1984-0462/2020/38/2018096] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 08/30/2018] [Indexed: 12/05/2022]
Abstract
Objective: To describe the profile of children and adolescents admitted for exogenous unintentional poisoning in the emergency room and analyze factors associated with subsequent in-hospital admissions. Methods: This is a cross-sectional study based on hospital records of all subjects up to 19 years-old admitted in 2013 at a specialized toxicology service on a major public emergency hospital due to unintentional intoxication (as reported). Accidents with poisonous animals and insects were excluded. Percentages and frequencies were calculated for the qualitative variables, and measures of central tendency and dispersion for the continuous quantitative variables. Multivariate analysis was performed using binary logistic regression to identify variables associated with subsequent in-hospital admissions. Results: In 2013, 353 cases were reported. Poisonings were more frequent in children 0-4 years-old (72.5%) and in boys (55%). The vast majority was of dwellers of the Metropolitan Region of Belo Horizonte (83%), and 90% of the accidental poisonings occurred at home. 82.7% of the poisonings occurred by oral ingestion, especially of medicinal (36.5%) and cleaning products (29.4% of all poisonings). Only 12.2% of the cases resulted in hospitalization, and only one resulted in death. Residing outside Belo Horizonte (OR=5.20 [95%CI 2.37-11.44]) and poisoning by two or more products (OR=4.29 [95%CI 1.33-13.82]) were considered risk factors for hospitalization. Conclusions: Accidental poisonings occurred most frequently by ingestion of household medications and cleaning products, especially among children under 4 years-old. Preventive strategies should be primarily directed for this prevalent profile.
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Affiliation(s)
- Luciana Vilaça
- Fundação Hospitalar do Estado de Minas Gerais, Belo Horizonte, MG, Brazil
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El Majzoub I, El Khuri C, Hajjar K, Bou Chebl R, Talih F, Makki M, Mailhac A, Abou Dagher G. Characteristics of patients presenting post-suicide attempt to an Academic Medical Center Emergency Department in Lebanon. Ann Gen Psychiatry 2018; 17:21. [PMID: 29849740 PMCID: PMC5970493 DOI: 10.1186/s12991-018-0191-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 05/16/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Emergency Department (ED) visits for suicide attempts have been described worldwide; however, the populations studied were predominantly Western European, North American, or East Asian. This study aims to describe the epidemiology of ED patients presenting post-suicide attempt to an academic medical center in Lebanon and to report on factors that affect ED disposition. METHODS A retrospective cohort study was conducted between 2009 and 2015. Patients of any age group were included if they had presented to the ED after a suicide attempt. Patients with unintentional self-harm were excluded. Descriptive analysis was performed on the demographics and characteristics of suicide attempts of the study population. A bivariate analysis to compare the two groups (hospitalized or discharged) was conducted using Student's t test and Pearson Chi-square where appropriate. A multivariate analysis was then conducted to determine the predictors of hospital admission. RESULTS One hundred and eight patients were included in the final analysis. Most patients were females (71.4%) and between 22 and 49 years of age. A considerable number of patients were unemployed (43%), unmarried (61.1%), and living with family (86.9%). Most suicide attempts were performed at home (93.5%) and on a weekday (71.3%). The most common mechanisms of injury were overdose with prescription medications (61.3%), overdose with over-the-counter drugs (27.9%), and self-inflicted lacerations (10.1%). The classes of medication most commonly abused were benzodiazepines (39.3%) followed by acetaminophen (27.3%). A large portion of our patients were admitted (70.3%), with the majority going to the psychiatric ward (71.1%). Of note, a quarter (27.5%) of our patients left the ED against medical advice, with 23.5% of admitted patients leaving the hospital before completion of treatment. The main predictors of admission were found to be overdose on prescription medications OR 9.25 (2.12-40.42 CI95%). CONCLUSIONS The characteristics of our suicide attempters mirror those of international and regional suicide attempters. Further work is required to quantify the effect of voluntary refusal of hospital treatment, the repercussions of family, and financial barriers to healthcare and suicide as a whole in our society.
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Affiliation(s)
- Imad El Majzoub
- 1Department of Emergency Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Christopher El Khuri
- 1Department of Emergency Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Karim Hajjar
- 1Department of Emergency Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Ralphe Bou Chebl
- 1Department of Emergency Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Farid Talih
- 2Department of Psychiatry, American University of Beirut Medical Center, Beirut, Lebanon
| | - Maha Makki
- 1Department of Emergency Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Aurelie Mailhac
- 3Clinical Research Institute, American University of Beirut Medical Center, Beirut, Lebanon
| | - Gilbert Abou Dagher
- 1Department of Emergency Medicine, American University of Beirut Medical Center, Beirut, Lebanon
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Sousa GSD, Santos MSPD, Silva ATPD, Perrelli JGA, Sougey EB. Revisão de literatura sobre suicídio na infância. CIENCIA & SAUDE COLETIVA 2017; 22:3099-3110. [DOI: 10.1590/1413-81232017229.14582017] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Accepted: 04/18/2017] [Indexed: 11/22/2022] Open
Abstract
Resumo Objetivou-se analisar a literatura específica sobre os fatores associados ao comportamento suicida em crianças com até 14 anos. Trata-se, portanto, de uma revisão integrativa sobre este tema. Os dados foram coletados nas bases de dados PubMed e Psycinfo, a partir dos seguintes descritores: “risk of suicide”; “children”; “suicide”; “childhood”. O tempo de publicação foi limitado ao período de 1980 a 2016. Um total de 29 artigos preencheu os critérios de elegibilidade e, portanto, foram selecionados e analisados. Os resultados indicaram haver associação do suicídio com fatores neurobiológicos, escolares, sociais e mentais, dentre eles destaca-se o papel da impulsividade. Além disso, evidenciou-se que a maioria dos fatores de vulnerabilidade ao comportamento suicida podem ser prevenidos desde que sejam identificados e a criança receba tratamento psicológico e médico. Conclui-se que conflitos familiares, problemas na escola, bullying, impulsividade e depressão estão associados ao suicídio na infância. Adicionalmente, a escassez de pesquisas no âmbito nacional acerca da temática do suicídio pode contribuir para a invisibilidade desse tema na instauração de programas de promoção e tratamento de saúde.
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de Medeiros Alves V, E Silva ACP, de Souza EVM, de Lima Francisco LCF, de Moura EL, de-Melo-Neto VL, Nardi AE. Suicide attempt in mental disorders (MeDi): Association with 5-HTT, IL-10 and TNF-alpha polymorphisms. J Psychiatr Res 2017; 91:36-46. [PMID: 28314127 DOI: 10.1016/j.jpsychires.2017.02.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2016] [Revised: 02/08/2017] [Accepted: 02/23/2017] [Indexed: 01/05/2023]
Abstract
BACKGROUND Mental disorders (MeDi) and suicide attempts (SA) are influenced by environmental and genetic factors. Genetic polymorphism studies have identified some candidate genes for suicidal behaviour in people with MeDi. OBJECTIVE To evaluate MeDi and SA in relation to the presence of rs2020933 (5-HTT), rs1800871 (IL-10) and rs1800629 (TNF-α) polymorphisms. METHODS A questionnaire for identification and general data, a brief quality of life assessment (WHOQOL-brief), the scale of suicide ideation by Beck and the MINI International Neuropsychiatric Interview were used in this study. DNA was obtained using buccal mucosa swab samples, and genotyping was performed using real-time polymerase chain reaction. A total of 306 patients were assessed with MeDi; 161 patients had MeDi and a history of SA, and 145 patients had MeDi and no history of SA. The study had 175 subjects in the control group. RESULTS The TNF-α rs1800629 -308A/G genotype was significantly associated with function as a protection factor in the control group compared with MeDi without SA. The TNF-α rs1800629 -308G allele appeared as risk factor for MeDi compared to the control group, for female gender. Additionally, the -308A/G + A/A genotype appeared as protection factor for the control group compared to the group with MeDi. For TNF-α, the -308G allele appeared as risk factor for the number of SA (1 time) compared to the control group. CONCLUSION The IL-10 (rs1800871) and 5-HTT (rs2020933) SNPs were considered to have inadequate statistical power. The rs1800629 (TNF-α) polymorphism may be associated with MeDi without SA, MeDi in females and the number of SA (1 time) in the studied group.
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Affiliation(s)
- Verônica de Medeiros Alves
- Doctor in Mental Health at Institute of Psychiatry, Federal University of Rio de Janeiro, Federal University of Alagoas, Arapiraca, Alagoas, Brazil.
| | - Aline Cristine Pereira E Silva
- Master in Health Sciences at Institute of Biological Sciences of Federal University of Alagoas, Arapiraca, Alagoas, Brazil
| | - Elaine Virgínia Martins de Souza
- PhD in Biotechnology in Health, Renorbio, Post- Graduate Program in Health Sciences, Federal University of Alagoas, Arapiraca, Alagoas, Brazil
| | | | - Edilson Leite de Moura
- Student of Biological Sciences, Federal University of Alagoas, Arapiraca, Alagoas, Brazil
| | - Valfrido Leão de-Melo-Neto
- Doctor in Psychiatry at Institute of Psychiatry, Federal University of Rio de Janeiro, Federal University of Alagoas, Maceió, Alagoas, Brazil
| | - Antonio E Nardi
- Postdoc in the Laboratory of Physiology of Respiration at Institute of Biophysics Carlos Chagas Filho, Panic & Respiration Laboratory, Institute of Psychiatry, Federal University of Rio de Janeiro, National Institute for Translational Medicine (INCT-TM), Rio de Janeiro, Brazil
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