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Ghadipasha M, Talaie R, Mahmoodi Z, Karimi SE, Forouzesh M, Morsalpour M, Mahdavi SA, Mousavi SS, Ashrafiesfahani S, Kordrostami R, Dadashzadehasl N. Spatial, geographic, and demographic factors associated with adolescent and youth suicide: a systematic review study. Front Psychiatry 2024; 15:1261621. [PMID: 38404471 PMCID: PMC10893588 DOI: 10.3389/fpsyt.2024.1261621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 01/26/2024] [Indexed: 02/27/2024] Open
Abstract
Background Suicide is a public health issue and a main cause of mortality among adolescents and the youth worldwide, particularly in developing countries. Objectives The present research is a systematic review aiming to investigate the spatial, geographical, and demographic factors related to suicide among adolescents and the youth. Methods In this systematic review, two researchers examined PsycINFO, Web of Science, Scopus, and PubMed databases on December 7th, 2022 with no time limits from the beginning of publication until 2022 to identify the primary studies on spatial and geographic analysis on adolescent and youth suicides. Once duplicate studies were identified and removed, the titles and abstracts of studies were examined and irrelevant studies were also removed. Finally, 22 studies were reviewed based on the inclusion criteria. Results Our findings show that suicide rates are generally higher among men, residents of rural and less densely populated regions, coastal and mountainous regions, natives, 15-29 age group, less privileged populations with social fragmentation, unemployed, divorced or lonely people, those who live in single parent families, people with mental health issues, and those with low levels of education. Conclusions Stronger evidence supports the effects of geographic and demographic variables on youth and adolescent suicide rates as compared with spatial variables. These findings suggest that policy makers take spatial and demographic factors into consideration when health systems allocate resources for suicide prevention, and that national policymakers integrate demographic and geographic variables into health service programs. Systematic Review Registration https://www.crd.york.ac.uk/prospero/, identifier CRD42023430994.
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Affiliation(s)
- Masoud Ghadipasha
- Legal Medicine Research Center, Legal Medicine Organization, Tehran, Iran
| | - Ramin Talaie
- Department of Gastroenterology and Hepatology, School of Medicine, Shahid Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zohreh Mahmoodi
- Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Salah Eddin Karimi
- Social Determinants of Health Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mehdi Forouzesh
- Legal Medicine Research Center, Legal Medicine Organization, Tehran, Iran
| | - Masoud Morsalpour
- Department of Criminal Law and Criminology, Islamic Azad University, Tehran, Iran
| | | | | | | | - Roya Kordrostami
- Legal Medicine Research Center, Legal Medicine Organization, Tehran, Iran
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Paiva de Araujo JA, Fialho É, Oliveira Alves FJ, Cardoso AM, Yamall Orellana JD, Naslund JA, Barreto ML, Patel V, Machado DB. Suicide among Indigenous peoples in Brazil from 2000 to 2020: a descriptive study. LANCET REGIONAL HEALTH. AMERICAS 2023; 26:100591. [PMID: 37732137 PMCID: PMC10507632 DOI: 10.1016/j.lana.2023.100591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 07/28/2023] [Accepted: 08/29/2023] [Indexed: 09/22/2023]
Abstract
Background Previous studies in Australia, Canada, and Brazil, found that suicide among ethnic minority groups is higher than in the general population. Indigenous peoples in Brazil have been reported to have a high suicide rate, with reports of suicide clusters occurring in several communities. The objective of this study was to report trends in countrywide suicide rates among Indigenous peoples in Brazil between 2000 and 2020, and to compare these with the non-Indigenous population. Methods This ecological study used Indigenous suicide data collected from all regions of Brazil during a 21-year period, between 2000 and 2020. We used suicide estimates from the Mortality Information System (SIM), available at the Brazilian Health Ministry website (DATASUS). Suicide mortality rates by state and region were calculated using the estimated Indigenous population from the 2010 census, and estimated population proportions for the other years. We performed a trend analysis and compared trends in suicide between the Indigenous and non-Indigenous population during the period studied. Findings Suicide rates among Indigenous Brazilians have reached more than two and a half times the levels for the overall Brazilian population in 2020 (17.57 suicide deaths versus 6.35 suicide deaths per 100,000 inhabitants, respectively). The Central-West region of Brazil had the highest suicide rates among Indigenous Brazilians over the study period, reaching 58.8 deaths/100,000 inhabitants in 2008. The younger age group (10-24 years old) had the highest suicide rates for all the years studied. Time-series analyses showed a trend of statistically significant increases in suicide rates in Brazil for both the Indigenous and non-Indigenous population during the study period. The North region, and specifically Amazonas state, has shown a decisive increase in suicide rates among the Indigenous populations. The suicide rate for Indigenous people in Brazil, excluding cases in Amazonas and Mato Grosso do Sul states, were similar to those for the entire Brazilian population, showing that the Indigenous peoples who are the most vulnerable to suicide reside in these locations. Interpretation While there were statistically significant increases in suicide rates for all Brazilians over the study period, they remained alarmingly high among Indigenous people, compared to their non-Indigenous counterparts. The high suicide rates among Indigenous people, and younger individuals in particular (aged between 10 and 24), reinforces the need for specific prevention strategies for these populations. Further studies should be concentrated on determining risk factors in distinct ethnic groups, specifically within regions experiencing an elevated risk, such as the states of Amazonas and Mato Grosso do Sul. Funding Research reported in this publication was supported by the National Institute of Mental Health of the National Institutes of Health under award number R01MH128911-01. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
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Affiliation(s)
| | - Érika Fialho
- Center of Data and Knowledge Integration for Health (CIDACS), Fiocruz, R. Mundo, 121. Salvador, Bahia, Brazil
| | - Flávia Jôse Oliveira Alves
- Center of Data and Knowledge Integration for Health (CIDACS), Fiocruz, R. Mundo, 121. Salvador, Bahia, Brazil
| | - Andrey Moreira Cardoso
- National School of Public Health, Oswaldo Cruz Foundation (ENSP/FIOCRUZ), Rua Leopoldo Bulhões, 1480, Rio de Janeiro, Brazil
| | - Jesem Douglas Yamall Orellana
- Leônidas and Maria Deane Institute (ILMD), Oswaldo Cruz Foundation (FIOCRUZ), Rua Teresina, 476, Adrianópolis, Manaus, Amazonas, Brazil
| | - John A. Naslund
- Department of Global Health and Social Medicine, Harvard Medical School, 641 Huntington Avenue, Boston, MA, United States of America
| | - Mauricio L. Barreto
- Center of Data and Knowledge Integration for Health (CIDACS), Fiocruz, R. Mundo, 121. Salvador, Bahia, Brazil
| | - Vikram Patel
- Department of Global Health and Social Medicine, Harvard Medical School, 641 Huntington Avenue, Boston, MA, United States of America
| | - Daiane Borges Machado
- Center of Data and Knowledge Integration for Health (CIDACS), Fiocruz, R. Mundo, 121. Salvador, Bahia, Brazil
- Department of Global Health and Social Medicine, Harvard Medical School, 641 Huntington Avenue, Boston, MA, United States of America
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Troya M, Spittal MJ, Pendrous R, Crowley G, Gorton HC, Russell K, Byrne S, Musgrove R, Hannah-Swain S, Kapur N, Knipe D. Suicide rates amongst individuals from ethnic minority backgrounds: A systematic review and meta-analysis. EClinicalMedicine 2022; 47:101399. [PMID: 35518122 PMCID: PMC9065636 DOI: 10.1016/j.eclinm.2022.101399] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 03/29/2022] [Accepted: 03/31/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Existing evidence suggests that some individuals from ethnic minority backgrounds are at increased risk of suicide compared to their majority ethnic counterparts, whereas others are at decreased risk. We aimed to estimate the absolute and relative risk of suicide in individuals from ethnic minority backgrounds globally. METHODS Databases (Medline, Embase, and PsycInfo) were searched for epidemiological studies between 01/01/2000 and 3/07/2020, which provided data on absolute and relative rates of suicide amongst ethnic minority groups. Studies reporting on clinical or specific populations were excluded. Pairs of reviewers independently screened titles, abstracts, and full texts. We used random effects meta-analysis to estimate overall, sex, location, migrant status, and ancestral origin, stratified pooled estimates for absolute and rate ratios. PROSPERO registration: CRD42020197940. FINDINGS A total of 128 studies were included with 6,026,103 suicide deaths in individuals from an ethnic minority background across 31 countries. Using data from 42 moderate-high quality studies, we estimated a pooled suicide rate of 12·1 per 100,000 (95% CIs 8·4-17·6) in people from ethnic minority backgrounds with a broad range of estimates (1·2-139·7 per 100,000). There was weak statistical evidence from 51 moderate-high quality studies that individuals from ethnic minority groups were more likely to die by suicide (RR 1·3 95% CIs 0·9-1·7) with again a broad range amongst studies (RR 0·2-18·5). In our sub-group analysis we only found evidence of elevated risk for indigenous populations (RR: 2·8 95% CIs 1·9-4·0; pooled rate: 23·2 per 100,000 95% CIs 14·7-36·6). There was very substantial heterogeneity (I2 > 98%) between studies for all pooled estimates. INTERPRETATION The homogeneous grouping of individuals from ethnic minority backgrounds is inappropriate. To support suicide prevention in marginalised groups, further exploration of important contextual differences in risk is required. It is possible that some ethnic minority groups (for example those from indigenous backgrounds) have higher rates of suicide than majority populations. FUNDING No specific funding was provided to conduct this research. DK is funded by Wellcome Trust and Elizabeth Blackwell Institute Bristol. Matthew Spittal is a recipient of an Australian Research Council Future Fellowship (project number FT180100075) funded by the Australian Government. Rebecca Musgrove is funded by the NIHR Greater Manchester Patient Safety Translational Research Centre (PSTRC-2016-003).
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Affiliation(s)
- M.Isabela Troya
- School of Public Health, College of Medicine and Health, University College Cork, 4.07 Western Gateway Building, Cork, Ireland
- National Suicide Research Foundation, University College Cork, 4.28 Western Gateway Building, Cork, Ireland
| | - Matthew J. Spittal
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | | | - Grace Crowley
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Hayley C Gorton
- Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Huddersfield, UK
| | - Kirsten Russell
- School of Psychological Sciences and Health, Graham Hills Building, 40 George Street, Glasgow, UK
| | - Sadhbh Byrne
- Trinity Centre for Global Health, Trinity College Dublin, Dublin, Ireland
| | - Rebecca Musgrove
- Centre for Mental Health and Safety, National Institute for Health Research Greater Manchester Patient Safety Translational Research Centre, Manchester Academic Health Sciences Centre, University of Manchester, and Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | | | - Navneet Kapur
- Division of Psychology and Mental Health, Centre for Mental Health and Safety, The University of Manchester, Manchester, UK
| | - Duleeka Knipe
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Corresponding author.
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Pires AM, Reis JGM, Garcia FM, Veloso GA, Melo APS, Naghavi M, Passos VMDA. Suicide mortality among older adults in Brazil between 2000 and 2019 - estimates from the Global Burden of Disease Study 2019. Rev Soc Bras Med Trop 2022; 55:e0322. [PMID: 35107540 PMCID: PMC9009432 DOI: 10.1590/0037-8682-0322-2021] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 09/29/2021] [Indexed: 01/08/2023] Open
Abstract
INTRODUCTION Older adults present a higher risk of suicide, and Brazil is experiencing a fast population aging. To understand the impact of demographic transition, we compared Brazilian suicide mortality rates (MR) among adults (50+ years) with global rates, those from one high-income country, and those from one middle-income country. Looking for regional disparities, the MR was analyzed among older adults (60+ years) by Brazilian states. METHODS This was an ecological study based on estimates from the Global Burden of Disease Study, from 2000 to 2019. Age-standardized MR and age-specific MR per 100,000 inhabitants were described, with 95% uncertainty intervals (UI). RESULTS During the period, the annual estimates and the declining trend in mortality were higher in the world than in the studied countries. In 2019, global age-standardized MR was 9.39 (95% UI 8.48-10.29), compared to 5.68 (95% UI 5.40-6.19), 6.01 (95% UI 5.10-7.04), and 6.63 (95% UI 6.43-6.95) in Brazil, Mexico, and England, respectively. In Brazil, despite a significant decline in national rates, stability was observed in 15 states. An increase in aging was only found for men, who presented 3-4 times higher MR than women. The states' rates presented large differences: in 2019, the rates among men aged 60-64 years varied from 7.24 (95% UI 5.31; 9.85) to 26.32 (95% UI 20.21; 34.50). CONCLUSIONS The smaller decline in suicide mortality among older Brazilian adults, the increasing risk with aging, and the higher mortality among men indicate the need for specific prevention policies. The variation within states suggests differences in the data quality or in socio-cultural and historical aspects, which requires further investigation.
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Affiliation(s)
- Ademar Moreira Pires
- Faculdade de Ciências Médicas de Minas Gerais, Programa de Pós-Graduação em Ciências da Saúde, Belo Horizonte, MG, Brasil
| | - Júlia Gondim Maia Reis
- Faculdade Ciências Médicas de Minas Gerais, Faculdade de Medicina, Belo Horizonte, MG, Brasil
| | - Flávia Megda Garcia
- Faculdade Ciências Médicas de Minas Gerais, Faculdade de Medicina, Belo Horizonte, MG, Brasil
| | - Guilherme Augusto Veloso
- Universidade Federal de Minas Gerais, Instituto de Ciências Exatas, Programa de Pós-Graduação em Estatística, Belo Horizonte, MG, Brasil
| | - Ana Paula Souto Melo
- Universidade Federal de São João del-Rei, Faculdade de Medicina, Divinópolis, MG, Brasil
| | - Mohsen Naghavi
- Washington University, Institute of Health Metrics and Evaluation, Seattle, USA
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Leveau CM, Guevel C, Alazraqui M. [Intra-urban differentials of suicide: the role of social fragmentation in Argentina]. CIENCIA & SAUDE COLETIVA 2021; 26:2345-2354. [PMID: 34231744 DOI: 10.1590/1413-81232021266.22892019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Accepted: 08/28/2019] [Indexed: 11/21/2022] Open
Abstract
El suicidio constituye una de las principales causas de muerte por lesiones en Argentina y existen pocos estudios que analicen las variaciones geográficas intra-urbanas en países en desarrollo. El objetivo de este estudio fue analizar la relación entre el suicidio y el nivel socioeconómico y la fragmentación social en áreas pequeñas de la Ciudad Autónoma de Buenos Aires (CABA) durante el período 2011-2015. Se realizó un estudio ecológico utilizando datos sobre registros de suicidio en población residente de la CABA disponibles en el Ministerio de Seguridad de la Nación. Se llevó a cabo una regresión múltiple espacial para poner a prueba la relación entre el suicidio e indicadores de nivel socioeconómico y de fragmentación social por área. El riesgo de suicidio estuvo asociado positivamente a mayores índices de fragmentación social, mientras no mostró relación con el índice de pobreza. Los resultados de este estudio apoyan la hipótesis de fragmentación social como un factor asociado positivamente al aumento del suicidio a nivel intra-urbano en ciudades de países en desarrollo.
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Affiliation(s)
- Carlos Marcelo Leveau
- Instituto de Producción, Economía y Trabajo, Consejo Nacional de Investigaciones Científicas y Técnicas, Universidad Nacional de Lanús. 29 de Septiembre 3901, Remedios de Escalada. B1824PJU Provincia de Buenos Aires Argentina.
| | - Carlos Guevel
- Instituto de Producción, Economía y Trabajo, Consejo Nacional de Investigaciones Científicas y Técnicas, Universidad Nacional de Lanús. 29 de Septiembre 3901, Remedios de Escalada. B1824PJU Provincia de Buenos Aires Argentina.
| | - Marcio Alazraqui
- Instituto de Producción, Economía y Trabajo, Consejo Nacional de Investigaciones Científicas y Técnicas, Universidad Nacional de Lanús. 29 de Septiembre 3901, Remedios de Escalada. B1824PJU Provincia de Buenos Aires Argentina.
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Braga CMR, Nogueira LMV, Trindade LDNM, Rodrigues ILA, André SR, Silva IFSD, Paiva BL. Suicide in indigenous and non-indigenous population: a contribution to health management. Rev Bras Enferm 2021; 73:e20200186. [PMID: 33470381 DOI: 10.1590/0034-7167-2020-0186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 09/09/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To analyze the sociodemographic and epidemiological profile of suicide in the indigenous and non-indigenous population and the spatiality of the event. METHOD Epidemiological, descriptive research, carried out with data from the Mortality Information System. Suicide mortality rates were calculated for the 144 municipalities in Pará and linked to the geographic location values of the municipalities; subsequently, thematic maps were built using the QGIS 3.10.3 software. The association between variables was measured by the G test. RESULTS 1,387 suicide records were studied, and the mortality rate among indigenous people was low in comparison to non-indigenous people, reaching 0.1/100 thousand inhabitants and 17.5/100 thousand inhabitants, respectively. CONCLUSION Suicide is heterogeneously distributed in the territory, with greater vulnerability of the indigenous people, which demands different policies considering their cultural diversity.
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Affiliation(s)
| | | | | | | | - Suzana Rosa André
- Universidade Federal do Rio de Janeiro. Rio de Janeiro, Rio de Janeiro, Brazil
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Moreno Velásquez I, Castelpietra G, Higuera G, Castro F, Gómez B, Motta J, Goti R. Suicide trends and self-harm in Panama: results from the National Mortality Registry and hospital-based data. Soc Psychiatry Psychiatr Epidemiol 2020; 55:1513-1524. [PMID: 32556380 DOI: 10.1007/s00127-020-01895-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 06/09/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE We aimed to (1) to investigate mortality trends due to suicide in Panama at the national and regional levels from 2001 to 2016, (2) to describe the sociodemographic and clinical characteristics of admitted patients with non-fatal self-harm from 2009 to 2017 in a regional hospital, and (3) to examine the association between mental health diagnoses and intentional self-harm, lethality, self-harm repetition and all-cause mortality within this population. METHODS Using the national mortality registry, annual percentage changes (APC) with 95% confidence intervals (CI) were estimated to evaluate suicide trends over time. Self-harm cases were assessed by trained psychiatrists at a referral hospital through interviews. Logistic regression models were used to estimate the association between mental diagnosis with intent-to-die and lethality, expressed as odds ratios (OR) and 95% CI. Cox proportional hazards models were used to calculate hazard ratios (HR) with 95% CI for self-harm repetition and all-cause mortality. RESULTS The trend of suicide in women declined, with an APC of - 4.8, 95% CI - 7.8, - 1.7, while the trend began to decline from 2006 in men; APC - 6.9, 95% CI - 8.9, - 4.9. Self-harm repetition over 12 months was 1.8%. Having a mental health diagnosis was associated with intentional self-harm (OR 1.5; 95% CI 1.0-2.4) and self-harm repetition (HR 2.7, 95% CI 1.3-5.8). Medication overdose was the preferred method for self-harm, while intentional self-harm by hanging was the preferred method for suicide. CONCLUSIONS Strategies for prevention and early intervention after self-harm deserve attention. Our findings highlight the importance of data to inform action.
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Affiliation(s)
| | - Giulio Castelpietra
- Primary Care Services Area, Central Health Directorate, Venezia Giulia, Region Friuli, Trieste, Italy
| | - Gladys Higuera
- Gorgas Memorial Institute for Health Studies, Panama City, Panama
| | - Franz Castro
- Gorgas Memorial Institute for Health Studies, Panama City, Panama
| | - Beatriz Gómez
- Gorgas Memorial Institute for Health Studies, Panama City, Panama
| | - Jorge Motta
- Gorgas Memorial Institute for Health Studies, Panama City, Panama
| | - Ricardo Goti
- Department of Mental Health, Ministry of Health, Panama City, Panama.,Centro de Salud de Curundú, Ministry of Health, Panama City, Panama
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de Souza RSB, de Oliveira JC, Alvares-Teodoro J, Teodoro MLM. [Suicide and indigenous populations in Brazil: systematic reviewEl suicidio y los pueblos indígenas brasileños: revisión sistemática]. Rev Panam Salud Publica 2020; 44:e58. [PMID: 32612644 PMCID: PMC7323757 DOI: 10.26633/rpsp.2020.58] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 02/28/2020] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVE To describe the frequency, characteristics, and factors contributing to suicide in indigenous populations in Brazil. METHOD A systematic review of the literature was performed in PubMed, SciELO, PsycINFO, and LILACS. All population-based studies focusing on suicide among indigenous populations in Brazil were included. RESULTS The search identified 111 articles, of which nine met the inclusion criteria. Three of these studies were performed in the Midwest and four in the North of Brazil, while two covered all Brazilian regions. The ethnic groups investigated were specified in three studies (Terena, Kadiweu, Guato, Ofaie-Xavante, Guarani, Guarani-Kaiowá, and Guarani-Nandeva). Suicide rates were highest among males, single individuals, those with 4 to 11 years of schooling, and those aged 15 to 24 years. Suicides occurred most often in the home and on weekends, mostly by hanging. The main risk factors for suicide identified in the articles were poverty, historical and cultural factors, poor wellbeing indicators, family disintegration, social vulnerability, and lack of life or future perspective. CONCLUSIONS All the studies indicated the need to engage communities in developing strategies, considering their cosmovision and the social, historic, and cultural view of each ethnic group to minimize risk factors and reduce suicide rates.
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Affiliation(s)
- Ronaldo Santhiago Bonfim de Souza
- Universidade Federal de Minas Gerais (UFMG)Programa de Pós-Graduação em Psicologia: Cognição e Comportamento (CogCom)Belo HorizonteMGBrasilUniversidade Federal de Minas Gerais (UFMG), Programa de Pós-Graduação em Psicologia: Cognição e Comportamento (CogCom), Belo Horizonte (MG), Brasil.
| | - Júlia Costa de Oliveira
- Universidade Federal de Minas Gerais (UFMG)Programa de Pós-Graduação em PsicologiaBelo HorizonteMGBrasilUniversidade Federal de Minas Gerais (UFMG), Programa de Pós-Graduação em Psicologia, Belo Horizonte (MG), Brasil.
| | - Juliana Alvares-Teodoro
- Universidade Federal de Minas Gerais (UFMG)Programa de Pós-Graduação em Medicamentos e Assistência FarmacêuticaBelo HorizonteMGBrasilUniversidade Federal de Minas Gerais (UFMG), Programa de Pós-Graduação em Medicamentos e Assistência Farmacêutica, Belo Horizonte (MG), Brasil.
| | - Maycoln Leôni Martins Teodoro
- Universidade Federal de Minas Gerais (UFMG)Programa de Pós-Graduação em Psicologia: Cognição e Comportamento (CogCom)Belo HorizonteMGBrasilUniversidade Federal de Minas Gerais (UFMG), Programa de Pós-Graduação em Psicologia: Cognição e Comportamento (CogCom), Belo Horizonte (MG), Brasil.
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Yamaoka K, Suzuki M, Inoue M, Ishikawa H, Tango T. Spatial clustering of suicide mortality and associated community characteristics in Kanagawa prefecture, Japan, 2011-2017. BMC Psychiatry 2020; 20:74. [PMID: 32070316 PMCID: PMC7029524 DOI: 10.1186/s12888-020-2479-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 01/31/2020] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Suicide mortality is high in Japan and early interventional strategies to solve that problem are needed. An accurate evaluation of the regional status of current suicide mortality would be useful for community interventions. A few studies in Kanagawa prefecture, located next to Tokyo and with the second largest population in Japan, have identified spatial clusters of suicide mortality at regional levels. This study examined spatial clustering and clustering over time of such events using spatial data from regional statistics on suicide deaths. METHODS Data were obtained from regional statistics (58 regions in Kanagawa prefecture) of the National Vital Statistics of Japan from 2011 to 2017. The standardized mortality ratio (SMR) and Empirical Bayes estimator for the SMR (EBSMR) were used as measures. Spatial clusters were examined by Kulldorff's circular spatial scan statistic, Tango-Takahashi's flexible spatial scan statistic and Tango's test. Linear regression and conditional autoregressive (CAR) models were used not only to adjust for covariates but also to estimate regional effects. The analyses were conducted for each year, inclusive. RESULTS Among male suicide deaths, being unemployed (50%) was most frequently related to suicide while among female health problem (50%) were frequent. Spatial clusters with significance detected by FlexScan, SatScan and Tango's test were few and varied somewhat according to the method used. Spatial clusters were detected in some regions including Kawasaki ward after adjustment by covariates. By the linear regression models, selected variables with significance were different between the sexes. For males, unemployment, family size, and proportion of higher education were detected for several of the years studied while for females, family size and divorce rate were detected over this period. These variables were also observed by the CAR model with 5 covariates. Regional effects were much clearer by considering the spatial parameter for both males and females and especially, Kawasaki ward was detected as a high risk region in many years. CONCLUSION The present results detected some spatial clustering of suicide deaths within certain regions. Factors related to suicide deaths were also indicated. These results would provide important information in policy making for suicide prevention.
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Affiliation(s)
- Kazue Yamaoka
- Teikyo University Graduate School of Public Health, 2-11-1, Kaga, Itabashi-ku, Tokyo, 173-8605, Japan.
| | - Masako Suzuki
- grid.264706.10000 0000 9239 9995Teikyo University Graduate School of Public Health, 2-11-1, Kaga, Itabashi-ku, Tokyo, 173-8605 Japan
| | - Mariko Inoue
- grid.264706.10000 0000 9239 9995Teikyo University Graduate School of Public Health, 2-11-1, Kaga, Itabashi-ku, Tokyo, 173-8605 Japan
| | - Hirono Ishikawa
- grid.264706.10000 0000 9239 9995Teikyo University Graduate School of Public Health, 2-11-1, Kaga, Itabashi-ku, Tokyo, 173-8605 Japan
| | - Toshiro Tango
- grid.264706.10000 0000 9239 9995Teikyo University Graduate School of Public Health, 2-11-1, Kaga, Itabashi-ku, Tokyo, 173-8605 Japan ,Center for Medical Statistics, Tokyo, Japan
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Beringuel BM, Costa HVVD, Silva APDSC, Bonfim CVD. Mortality by suicide in the State of Pernambuco, Brazil (1996-2015). Rev Bras Enferm 2020; 73 Suppl 1:e20180270. [DOI: 10.1590/0034-7167-2018-0270] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 03/02/2019] [Indexed: 12/26/2022] Open
Abstract
ABSTRACT Objective: To describe the epidemiological characteristics of suicide mortality in the state of Pernambuco, from 1996 to 2015. Method: Study with data from the Sistema de Informações sobre Mortalidade. The simple linear regression model was used to verify the trend in the period analyzed. Results: There were 6,229 suicides, of which 3,390 (54.4%) occurred in the second decade of study. The mortality rate was 4.7 per 100,000 inhabitants. The temporal trend presented a decrease of 23.5% (p=0.031). For the male sex and the age range between 20 and 39 years, there was a decline in self-inflicted death of 23.8% (p=0.018) and 26.1% (p=0.046), respectively. Conclusion: The temporal analysis revealed a reduction in suicide mortality coefficients. This observation may contribute to better targeting of health interventions, optimizing resources and efforts, especially in suicide prevention.
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Souza MLPD. [Mortality from suicide in indigenous children in Brazil]. CAD SAUDE PUBLICA 2019; 35Suppl 3:e00019219. [PMID: 31433029 DOI: 10.1590/0102-311x00019219] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 04/17/2019] [Indexed: 11/22/2022] Open
Abstract
This study aimed to describe the characteristics, distribution, and mortality rates from suicide in indigenous children in Brazil compared to non-indigenous children. This descriptive study covered the years from 2010 to 2014, using national databases. The study collected deaths in individuals 10 to 14 years of age whose underlying cause was "inentional self-inflicted injury". Hanging was the most frequently used means in both indigenous and non-indigenous children, although it was more frequent in the former. Among indigenous children, suicides in hospitals or other healthcare establishments were less common than in non-indigenous. Approximately three-fourths of suicides in indigenous children occurred in just 17 municipalities. The mortality rate from suicide among indigenous children was 11.0/100,000 (8.4-14.3), or 18.5 times higher (10.9-31.6) than in non-indigenous, which was 0.6/100,000 (0.5-0.6), with no differences between boys and girls. This study showed for the first time on a national scale the specific characteristics of suicide in indigenous children, with high rates, and also identified priority areas for interventions.
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Yamall Orellana JD, de Souza CC, Ponte de Souza ML. Hidden Suicides of the Indigenous People of the Brazilian Amazon: Gender, Alcohol and Familial Clustering. REVISTA COLOMBIANA DE PSIQUIATRIA (ENGLISH ED.) 2019; 48:133-139. [PMID: 31426915 DOI: 10.1016/j.rcp.2017.12.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Revised: 10/26/2017] [Accepted: 12/05/2017] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To evaluate the coverage, characteristics and the risk of suicide in the indigenous people of Tabatinga in the Brazilian Amazon. METHODS An active surveillance strategy for suicide cases was used: records of the Ministry of Health, the Municipal Health Secretariat, the Special Indigenous Health District of the Upper River Solimões (Distrito Sanitario Especial Indígena Alto Río Solimões), the Military Hospital of Tabatinga, the National Indian Foundation (Fundación Nacional del Indio) and the civil registry offices were examined from 2007 to 2011 for individuals over 9 years of age. Adjusted rates were estimated using the direct method and according to age. A descriptive analysis was performed and the hypothesis tests were considered significant if p-values were <0.05. RESULTS The coverage of indigenous suicide was 82.8%, since 11 (17.2%) were classified as hidden suicides. For men between 15 and 29 years of age, and for women aged from 12 to 20 years, the probability of suicide was around 70.0%. In 17.2% of the sample there was a record of alcohol consumption before death and relationship between victims. The corrected adjusted mortality rate was 111.7/100,000 (95% CI, 84.6-148.6). CONCLUSIONS The risk of suicide in the indigenous people of the Tabatinga is very high. Coping strategies should consider the complex relationship between suicide and alcohol consumption, gender differences and the existence of vulnerable groups, such as young people, especially those with close relatives who have committed suicide.
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Wanzinack C, Signorelli MC, Shimakura S, Pereira PPG, Polidoro M, Oliveira LBD, Reis C. Indigenous homicide in Brazil: geospatial mapping and secondary data analysis (2010 to 2014). CIENCIA & SAUDE COLETIVA 2019; 24:2637-2648. [DOI: 10.1590/1413-81232018247.23442017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Accepted: 10/01/2017] [Indexed: 11/22/2022] Open
Abstract
Abstract This study aimed to describe a panorama of Indigenous homicide in Brazil, analysing the main characteristics and territorial distribution between 2010 and 2014. Demographic study of Indigenous population data obtained from the Brazilian Institute of Geography and Statistics and Indigenous homicide data (2010-2014) from the Ministry of Health. Data were analysed using descriptive statistics, victims’ characteristics, type of homicides and geographical distribution, which were then plotted on maps using ArcGIS. Findings revealed: 1) a national estimated average of Indigenous homicide rate of 22.5 per 100,000 Indigenous inhabitants per year; 2) a map showing where homicides were registered and the mean homicide rates for Brazilian regions and states, with highest rates in Roraima and Mato Grosso do Sul; 3) the main homicide method were sharp or penetrating objects; 4) Indigenous male homicide rate was 2.4 times higher than female, but Indigenous female rate was more than double that of non-Indigenous; 5) high homicide rates of Indigenous children (under 1-year-old) in areas of the states of Roraima and Amazonas. We advise careful consideration of Indigenous cultural beliefs to avoid errors of judgement, reflecting how Indigenous populations are at risk of homicide in some areas.
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Affiliation(s)
| | | | | | | | - Mauricio Polidoro
- Instituto Federal de Educação, Ciência e Tecnologia do Rio Grande do Sul, Brasil
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Malacarne J, Kolte IV, Freitas LP, Orellana JDY, Souza MLPD, Souza-Santos R, Basta PC. Factors associated with TB in an indigenous population in Brazil: the effect of a cash transfer program. Rev Inst Med Trop Sao Paulo 2018; 60:e63. [PMID: 30379230 PMCID: PMC6201742 DOI: 10.1590/s1678-9946201860063] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Accepted: 09/24/2018] [Indexed: 11/21/2022] Open
Abstract
The Mato Grosso do Sul State (MS) has the second-largest indigenous population
and the highest incidence rates of TB among indigenous people in Brazil.
However, little is known about the risk factors associated with active TB in
indigenous people in the region, especially regarding socioeconomic factors. The
aim of this study is to assess the effect of the Family Allowance Program (BFP)
and of other predictors of active TB in a high-risk indigenous population in
Brazil. We conducted a case-control study with incident TB cases matched by age
and by village of residence (1:2 proportion) between March 2011 and December
2012. We used a conditional logistic regression for data analysis. A total of
153 cases and 306 controls were enrolled. The final model included the following
risk factors: alcohol consumption (low-risk use OR=2.2; 95% CI 1.1-4.3; risky
use OR=2.4; 95% CI 1.0-6.0; dependent/ damaging use OR=9.1; 95% CI 2.9-29.1);
recent contact with a TB patient (OR=2.0; 95% CI 1.2-3.5); and male sex (OR=1.9;
95% CI 1.1-3.2). BFP participation (OR=0.5; 95% CI 0.3-0.6) and BCG vaccination
(OR=0.5; 95% CI 0.3-0.9) were found to be protective factors against TB.
Although the BFP was not designed to target TB-affected households specifically,
our findings reveal the importance of the BFP in preventing one of the most
important infectious diseases among adults in indigenous villages in Brazil.
This result is in line with the End-TB strategy, which identifies social
protection, poverty alleviation and targeting other determinants of TB as key
actions.
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Affiliation(s)
- Jocieli Malacarne
- Fundação Oswaldo Cruz, Escola Nacional de Saúde Pública Sergio Arouca, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Ida Viktoria Kolte
- Fundação Oswaldo Cruz, Escola Nacional de Saúde Pública Sergio Arouca, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Lais Picinini Freitas
- Fundação Oswaldo Cruz, Escola Nacional de Saúde Pública Sergio Arouca, Rio de Janeiro, Rio de Janeiro, Brazil
| | | | | | - Reinaldo Souza-Santos
- Fundação Oswaldo Cruz, Escola Nacional de Saúde Pública Sergio Arouca, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Paulo Cesar Basta
- Fundação Oswaldo Cruz, Escola Nacional de Saúde Pública Sergio Arouca, Rio de Janeiro, Rio de Janeiro, Brazil
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Pollock NJ, Naicker K, Loro A, Mulay S, Colman I. Global incidence of suicide among Indigenous peoples: a systematic review. BMC Med 2018; 16:145. [PMID: 30122155 PMCID: PMC6100719 DOI: 10.1186/s12916-018-1115-6] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 07/02/2018] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Suicide is the second leading cause of death among adolescents worldwide, and is a major driver of health inequity among Indigenous people in high-income countries. However, little is known about the burden of suicide among Indigenous populations in low- and middle-income nations, and no synthesis of the global data is currently available. Our objective was to examine the global incidence of suicide among Indigenous peoples and assess disparities through comparisons with non-Indigenous populations. METHODS We conducted a systematic review of suicide rates among Indigenous peoples worldwide and assessed disparities between Indigenous and non-Indigenous populations. We performed text word and Medical Subject Headings searches in PubMed, MEDLINE, Embase, Cumulative Index of Nursing and Allied Health (CINAHL), PsycINFO, Latin American and Caribbean Health Sciences Literature (LILACS), and Scientific Electronic Library Online (SciELO) for observational studies in any language, indexed from database inception until June 1, 2017. Eligible studies examined crude or standardized suicide rates in Indigenous populations at national, regional, or local levels, and examined rate ratios for comparisons to non-Indigenous populations. RESULTS The search identified 13,736 papers and we included 99. Eligible studies examined suicide rates among Indigenous peoples in 30 countries and territories, though the majority focused on populations in high-income nations. Results showed that suicide rates are elevated in many Indigenous populations worldwide, though rate variation is common, and suicide incidence ranges from 0 to 187.5 suicide deaths per 100,000 population. We found evidence of suicide rate parity between Indigenous and non-Indigenous populations in some contexts, while elsewhere rates were more than 20 times higher among Indigenous peoples. CONCLUSIONS This review showed that suicide rates in Indigenous populations vary globally, and that suicide rate disparities between Indigenous and non-Indigenous populations are substantial in some settings but not universal. Including Indigenous identifiers and disaggregating national suicide mortality data by geography and ethnicity will improve the quality and relevance of evidence that informs community, clinical, and public health practice in Indigenous suicide prevention.
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Affiliation(s)
- Nathaniel J Pollock
- Division of Community Health and Humanities, Faculty of Medicine, Memorial University, Prince Philip Drive, St. John's, Newfoundland and Labrador, A1B 3V6, Canada. .,Labrador Institute of Memorial University, P.O. Box 490, Stn. B, 219 Hamilton River Road, Happy Valley-Goose Bay, ,Newfoundland and Labrador, A0P 1E0, Canada.
| | - Kiyuri Naicker
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, 600 Peter Morand Cr, Room 308C, Ottawa, ON, K1G 5Z3, Canada
| | - Alex Loro
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, 600 Peter Morand Cr, Room 308C, Ottawa, ON, K1G 5Z3, Canada
| | - Shree Mulay
- Division of Community Health and Humanities, Faculty of Medicine, Memorial University, Prince Philip Drive, St. John's, Newfoundland and Labrador, A1B 3V6, Canada
| | - Ian Colman
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, 600 Peter Morand Cr, Room 308C, Ottawa, ON, K1G 5Z3, Canada
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Suicidal thoughts and attempts in First Nations communities: links to parental Indian residential school attendance across development. J Dev Orig Health Dis 2018; 10:123-131. [PMID: 29923477 DOI: 10.1017/s2040174418000405] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The Indian residential school (IRS) system in Canada ran for over a century until the last school closed in 1996. Conditions in the IRSs resulted in generations of Indigenous children being exposed to chronic childhood adversity. The current investigation used data from the 2008-2010 First Nations Regional Health Survey to explore whether parental IRS attendance was associated with suicidal thoughts and attempts in childhood, adolescence and in adulthood among a representative sample of First Nations peoples living on-reserve across Canada. Analyses of the adult sample in Study 1 (unweighted n=7716; weighted n=186,830) revealed that having a parent who attended IRS was linked with increased risk for suicidal thoughts and attempts in adolescence and adulthood. Although females were negatively affected by having a parent who attended IRS, the link with suicidal ideation in adulthood was greater for males. Analyses of the youth sample in Study 2 (unweighted n=2883; weighted n=30,190) confirmed that parental IRS attendance was associated with an increased risk for suicidal ideation and attempts. In contrast to the adult sample, parental IRS attendance had a significantly greater relation with suicidal ideation among female youth. A significant interaction also emerged between parental IRS attendance and age in the youth sample, with the influence of parental attendance being particularly strong among youth ages 12-14, compared with those 15-17 years. These results underscore the need for culturally relevant early interventions for the large proportions of Indigenous children and youth intergenerationally affected by IRSs and other collective traumas.
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Lazzarini TA, Gonçalves CCM, Benites WM, Silva LFD, Tsuha DH, Ko AI, Rohrbaugh R, Andrews JR, Croda J. Suicide in Brazilian indigenous communities: clustering of cases in children and adolescents by household. Rev Saude Publica 2018; 52:56. [PMID: 29791676 PMCID: PMC5958965 DOI: 10.11606/s1518-8787.2018052000541] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Accepted: 12/20/2017] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To estimate age and sex-specific suicide rates, compare suicide rates between indigenous communities, and quantify the frequency of intrafamilial suicide clustering. METHODS We performed a retrospective cohort study involving 14,666 indigenous individuals in reservations in Dourados, state of Mato Grosso do Sul, Brazil, from 2003 through 2013 using national and local census. RESULTS The overall suicide rate was 73.4 per 100,000 person-years. Adolescent males aged 15-19 and girls aged 10-14 had the highest rates for each sex at 289.3 (95%CI 187.5-391.2) and 85.3 (95%CI 34.9-135.7), respectively. Comparing the largest reservations, Bororo had a higher suicide rate than Jaguapiru (RR = 4.83, 95%CI 2.85-8.16) and had significantly lower socioeconomic indicators including income and access to electricity. Nine of 19 suicides among children under 15 occurred in household clusters. Compared with adult suicides, a greater proportion of child (OR = 5.12, 95%CI 1.89-13.86, p = 0.001) and adolescent (OR = 3.48, 95%CI 1.29-9.44, p = 0.017) suicides occurred within household clusters. CONCLUSIONS High rates of suicide occur among children and adolescents in these indigenous reservations, particularly in poor communities. Nearly half of child suicides occur within household clusters. These findings underscore the need for broad public health interventions and focused mental health interventions in households following a suicide.
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Affiliation(s)
| | | | | | | | - Daniel Henrique Tsuha
- Faculdade de Computação, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brasil
| | | | - Robert Rohrbaugh
- School of Medicine, Yale University, New Haven, Connecticut, USA
| | - Jason Randolph Andrews
- Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Julio Croda
- Faculdade de Medicina, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brasil
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