Determinações do suicídio de trabalhadore(a)s no agronegócio na região da Bacia do Rio Juruena, Mato Grosso / Determinations of worker's suicides in agribusiness from Juruena river basis region in the State of Mato Grosso

Esta pesquisa tem como objetivo analisar as determinações sociais dos suicídios de trabalhadores e trabalhadoras do agronegócio mato-grossense. Destaca-se o suicídio como sintoma da organização social em territórios dominados pela exploração humana e exposição ambiental do agronegócio a partir de autores como Marx e Breilh. Foi realizada uma pesquisa social quanti-qualitativa em três cidades da região noroeste, um dos pólos de produção de commodities do estado. Para a coleta dos dados foi desenvolvido um inquérito de morbidades autoreferidas, aplicado à 1.384 famílias de trabalhadores das três cidades, em seguida, foram feitas entrevistas para reconstituir o estado de saúde física/mental, as relações sociais, de trabalho e demais circunstâncias motivadoras do suicídio por meio de autópsia psicossocial. Foram identificados 16 casos de suicídio ocorridos entre 2000 e 2017, e a maioria envolveu trabalhadores agrícolas ligados às fazendas de produção de soja, milho e algodão. A análise das entrevistas demonstrou aspectos socioeconômicos, laborais, políticos, culturais e socioambientais como determinação desses casos. O estudo contribui para fazer avançar as estratégias de prevenção e de Vigilância em Saúde dos trabalhadores, que incidam nas fontes das exposições aos agrotóxicos e os vários aspectos identificados que compõem as determinações sociais dos casos de suicídio, ampliando a atenção aos múltiplos fatores destes eventos.

This research aims to analyze the social determination of suicides of male and female agribusiness in Mato Grosso. Based in authors such as Marx and Breilh, we understand the workers suicides as a symptom of social organization in territories dominated by human exploitation and environmental exposure of agribusiness. A quanti-qualitative social research was carried out in three cities of the northwestern region of the state of Mato Grosso. For data collection, a survey of self-reported morbidities was carried out, applied to 1,384 families of workers in three cities, then interviews were conducted to reconstruct the state of physical/mental health, social and work relationships and other motivating circumstances through psychosocial autopsy. Sixteen suicides cases were identified that occurred between 2000 and 2017, and the majority of cases involved agricultural workers linked to soybean, corn and cotton farms. The analysis of the interviews showed socioeconomic, labor, political, cultural and socio-environmental aspects as determinants of these cases. The paper contributes to advance prevention strategies and surveillance in workers' health, which focus on the sources of exposure to pesticides and the various aspects identified that make up the social determinations of suicide cases, expanding the attention to the multiple factors of these events.

Barreras para la atención de las conductas suicidas en Ciudad de México: experiencias del personal de salud en el primer nivel de atención / Barriers to Care of Suicidal Behavior in Mexico City: Health Personnel Experiences at the First Level of Care / Barreiras para a atenção das condutas suicidas na Cidade do México: experiências dos profissionais de saúde na atenção básica

Resumen Objetivo: Identificar las barreras que existen para la atención de las conductas suicidas, desde la perspectiva de las/los profesionales de la salud mental del primer nivel de atención de la Ciudad de México. Metodología: Estudio cualitativo exploratorio, basado en 35 entrevistas semiestructuradas, dirigidas a personal de salud de dos unidades de salud mental de referencia nacional. El análisis de la información se hizo mediante el Framework Analysis. Resultados: Las/los participantes consideraron que las conductas suicidas no han sido definidas como una prioridad dentro de los trastornos de salud mental. La ausencia de políticas públicas, la sobrecarga de trabajo, la falta de seguimiento a las/los pacientes, entre otras, fueron identificadas como barreras para una atención adecuada y oportuna. Conclusiones: Los programas de prevención de las conductas suicidas deben tomar en cuenta el contexto socioeconómico de la población y las características de los servicios de salud, así como las necesidades de las personas prestadoras de servicios de salud. Se requiere ampliar el entrenamiento profesional y mejorar el sistema de referencia y contrarreferencia entre los distintos niveles de atención.

Abstract Objective: To identify the existing barriers to the care of suicidal behavior from the perspective of mental health professionals at the first level of care in Mexico City. Methodology: Qualitative exploratory study based on 35 semi-structured interviews conducted on health personnel from two national reference mental health facilities. The data were analyzed with Framework Analysis. Results: The participants considered that suicidal behavior has not been prioritized among mental health disorders. The absence of public policies, work overload, lack of patient follow-up, among others, were identified as barriers to adequate and timely care. Conclusions: Suicidal behavior prevention programs should consider the socioeconomic context of the population, the characteristics of health services, and the needs of health care providers. Professional training should be enhanced, and the referral and counter-referral system across levels of care should be improved.

Resumo Objetivo: Identificar as barreiras existentes para a atenção das condutas suicidas, desde a perspectiva dos profissionais de saúde mental de atenção básica da Cidade do México. Metodologia: Estudo qualitativo exploratório, baseado em 35 entrevistas semiestruturadas, dirigidas a profissionais de saúde de duas unidades de saúde mental de referência nacional. A análise da informação foi feita através do Framework Analysis. Resultados: Os participantes consideraram que as condutas suicidas não têm sido definidas como uma prioridade dentro dos transtornos de saúde mental. A ausência de políticas públicas, a sobrecarga de trabalho, a falta de seguimento aos pacientes, entre outras, foram identificadas como barreiras para uma atenção adequada e oportuna. Conclusões: Os programas de prevenção das condutas suicidas devem considerar o contexto socioeconômico da população e as características dos serviços de saúde, além das necessidades dos profissionais de saúde. É necessário ampliar o treinamento profissional e melhorar o sistema de referência e contrarreferência entre os diferentes níveis de atenção.

Suicidal behaviors and sedentary lifestyles among adolescents: A cross-sectional epidemiological study in Latin American and Caribbean countries

OBJECTIVES: To verify the association between suicidal behaviors (ideation, planning, and attempts) and sedentary behaviors among adolescents from four Latin American and Caribbean countries. METHODS: A cross-sectional epidemiological study was conducted in four countries in Latin America and the Caribbean (Bahamas, Curação, El Salvador, and Guatemala). The sample comprised 6,813 adolescents aged 11-18 years, of which, 3,559 were females. The three suicidal behaviors considered were ideation, planning, and attempts. Sedentary behavior was regarded as the time that adolescents spent sitting, excluding time at school. Crude and adjusted logistic regression were used to estimate the odds ratio (OR) and 95% confidence interval (CI). RESULTS: Suicidal ideation was present in 10.7% of males and 22.7% of females. Suicidal planning was present in 8.6% of males and 16.3% of females. Suicidal attempt was present in 9.3% of males and 16.3% of females. Sedentary behavior was present in 39.6% of males and 45.7% of females. It was identified that male adolescents who reported spending ≥3 hours/day in sedentary behavior were more likely to have suicidal ideation (OR: 1.42; 95% CI: 1.13-1.80), whereas female adolescents who reported spending ≥3 hours/day in sedentary behavior were more likely to have suicidal ideation (OR: 1.55; 95% CI: 1.30-1.83), planning (OR: 1.54; 95% CI: 1.28-1.86), and attempts (OR: 1.31; 95% CI: 1.09-1.57). CONCLUSION: Adolescents of both sexes who reported spending ≥3 hours/day in sedentary behaviors were more likely to have some suicidal behaviors than those who spent less time in sedentary behaviors.

Urgencias subjetivas en la ciudad de Formosa / Subjective urgencies in the city of Formosa

La presente investigación tiene como fin conocer las urgencias subjetivas que se desarrollan con mayor recurrencia en la ciudad de Formosa. El estudio es explotarorio descriptivo con metodología de tipo cualitativa. Para responder al objetivo se realizaron entrevistas semi-estructuradas, a licenciadas/os en psicología. En suma, se lleva a cabo un análisis de los dichos en las entrevistas. Prestando importancia a la recurrencia de lo considerado urgencias subjetivas para los entrevistados, y a su grado de relevancia. Definido esto último según la experiencia y los lugares en donde trabajan o trabajaron

The purpose of this research is to know the subjective urgencies that develop with greater recurrence in the city of Formosa. The study is exploratory-descriptive with qualitative methodology. To answer the objective, semistructured interviews were conducted with psychology graduates. In sum, an analysis of the sayings is carried out in the interviews. Giving importance to the recurrence of what is considered subjective emergencies for the interviewees, and their degree of relevance. The latter is defined according to experience and the places where they work or worked.

A 2-Year Psychological Autopsy Study of Completed Suicides in the Athens Greater Area, Greece

OBJECTIVE: To study the characteristics of a sample of suicide victims from the Athens Greater Area using the psychological autopsy method for the first time in Greece. METHODS: We studied all recorded cases of completed suicide for the 2-year time period November 2007-October 2009 collecting data from the victims' forensic records as well as from the completion of a psychological autopsy questionnaire. RESULTS: 335 persons were recorded as suicide victims. We contacted relatives of 256 victims interviewing those of 248 of them (96.9%). The differences regarding sex, marital and employment status between our sample and the general population were statistically significant (p<0.001). The male/female ratio was 3:1. Comparatively more victims were divorced, separated or single and a greater proportion were pensioners or unemployed. 26.0% of the victims had history of prior attempts (64.4% once, 20.3% twice and 15.3% more times). 42.6% were taking psychiatric medication-significantly more women than men according to blood tests; 14.2% had been hospitalized in a psychiatric clinic the year prior to their death. 84.8% have deceased at the place of suicide and 15.2% died in the hospital; 80.3% died indoors and 19.7% outdoors. Men died primarily by hanging or shooting by a firearm while women preferred jumping from height instead (p<0.001). As many as 48.8% had expressed their intention to die to their relatives; 26.6% left a suicide note. CONCLUSION: Our study has shown that the psychological autopsy method is applicable and widely accepted yielding results comparable to the international literature. Specific parameters associated with suicide have been studied for the first time in Greece.

Health behaviours & problems among young people in India: Cause for concern & call for action.

the young people in the age group of 10-24 yr in India constitutes one of the precious resources of India characterized by growth and development and is a phase of vulnerability often influenced by several intrinsic and extrinsic factors that affect their health and safety. Nearly 10-30 per cent of young people suffer from health impacting behaviours and conditions that need urgent attention of policy makers and public health professionals. Nutritional disorders (both malnutrition and over-nutrition), tobacco use, harmful alcohol use, other substance use, high risk sexual behaviours, stress, common mental disorders, and injuries (road traffic injuries, suicides, violence of different types) specifically affect this population and have long lasting impact. Multiple behaviours and conditions often coexist in the same individual adding a cumulative risk for their poor health. Many of these being precursors and determinants of non communicable diseases (NCDs) including mental and neurological disorders and injuries place a heavy burden on Indian society in terms of mortality, morbidity, disability and socio-economic losses. Many health policies and programmes have focused on prioritized individual health problems and integrated (both vertical and horizontal) coordinated approaches are found lacking. Healthy life-style and health promotion policies and programmes that are central for health of youth, driven by robust population-based studies are required in India which will also address the growing tide of NCDs and injuries.

Fatores de risco relacionados com suicidios em Palmas (TO), Brasil, 2006-2009, investigados por meio de autopsia psicossocial / Risk factors associated with suicides in Palmas in the state of Tocantins, Brazil, between 2006 and 2009 investigated by psycho-social autopsy

Este artigo objetiva analisar e descrever os fatores de risco e seus determinantes, associados a 24 casos de suicídios ocorridos na cidade de Palmas (TO), no período de 2006 a 2009. Utilizou-se o método de autópsia psicológica e psicossocial, a qual, por meio de entrevistas com familiares, busca investigar os suicídios consumados, contextualizando características da vida do sujeito, e compreender os processos familiares e as circunstâncias afetivas, sociais, econômicas e culturais, fundamentando-se na reconstrução da história e da personalidade da pessoa. Os fatores socioeconômicos associados foram: ser do sexo masculino, solteiro, de cor parda, estar na faixa etária de 20 a 40 anos e com ensino fundamental. Os principais fatores de risco identificados foram: transtornos mentais, abuso de álcool e outras drogas, relacionamento familiar conturbado e histórico de tentativas anteriores. Buscamos contextualizar e refletir sobre alguns casos relatados pelos familiares e sobre a resposta das equipes de saúde às demandas das famílias. A necessidade de implantar programas de prevenção e de capacitar os profissionais da atenção básica foi verificada. .

The scope of this article is to analyze and describe the risk factors and determinants linked to 24 suicides in the city of Palmas in the state of Tocantins between 2006 and 2009. The psychological and psycho-social autopsy method was used in order to investigate the consummated suicides by interviewing family members. It contextualized the subjects' life characteristics to understand the family dynamics and the affective, social, economic and cultural background, based on the reconstruction of the history and personality of the individuals. The associated socio-economic factors were: being male, aged between 20 and 40, single, with mixed ethnicity and basic education. The major risk factors identified were: mental disorder, alcohol and other drug abuse, disturbed family relationship and a history of previous suicide attempts. An attempt was made to contextualize and reflect on some cases reported by family members, as well as on the response of the health care teams to the demands of the families. The need to implement prevention programs and to train the primary health care professionals was considered a priority. .

Suicídios de jovens Guarani/Kaiowá de Mato Grosso do Sul, Brasil / Suicides among young Guarani /Kaiowá in Mato Grosso do Sul, Brazil / Suicidios de j óvenes Guaraníes/Kaiowás de Mato Grosso do Sul, Brasil

O Estado de Mato Grosso do Sul possui a segunda maior nação indígena do Brasil, com 66.963 índios, de acordo com os últimos dados da Fundação Nacional de Saúde - FUNASA (2008), dos quais 40.245 são Guarani/Kaiowá. Ainda segundo a FUNASA, ocorreram 410 suicídios nessa nação de 2000 a agosto de 2008. As tentativas de suicídio não consumadas, porém, não foram registradas. A maioria dos suicidas são homens, 65% na faixa etária de 15 a 29 anos, e o método mais frequente é o enforcamento. Neste trabalho, apresentamos conclusões de estudos referentes às causas do problema, destacando-se a concepção de feitiço, com implicações nos conceitos de instinto de vida e de morte, inconsciente coletivo e sugestão; também o processo de confinamento compulsório ao qual o grupo vem sendo submetido, com superpopulação das aldeias, imposição de crenças, valores e lideranças estranhos a sua cultura são citados como fatores causais. Sugerimos, além da revisão urgente da política governamental em relação às terras indígenas, uma retomada da identidade étnica como forma de afirmação e a reorganização do grupo Guarani/Kaiowá....(AU)

According to the latest data from the Fundação Nacional de Saúde (National Health Foundation - FUNASA, 2008), the State of Mato Grosso do Sul shelters the second largest indigenous nation in Brazil, with 66.963 indians, among which 40.245 are Guarani/Kaiowá. Still according to FUNASA, 410 suicides were committed in this nation between 2000 and August 2008, a number that does not take failed suicide attempts into account. Most suicides were men and 65% were 15 to 29 years old. Their most common method is hanging. The present work presents the conclusions of studies related to the problem causes, emphasizes the conception of bewitchment, with implications on the concepts of life and death instincts, collective unconscious and suggestion. The compulsory confinement process to which this group has been submitted, which includes the overpopulation of their villages and the imposition of new beliefs, values and leaderships unfamiliar to their culture are mentioned as causal factors. Beyond the urgent revision of the government’s policy regarding indigenous land, we suggest the ransom of their ethnic identity as a way to affirm and reorganize the Guarani/Kaiowá group....(AU)

El Estado de Mato Grosso do Sul posee la segunda mayor nación indígena de Brasil, con 66.963 indios, según los últimos datos de la Fundación Nacional de Salud - FUNASA (2008), de los cuales 40.245 son Guaraníes/Kaiowás. Aún según FUNASA, han sucedido 410 suicidios en esa nación entre el año 2000 y agosto de 2008. Los intentos de suicidio no consumados, sin embargo, no se han registrado. La mayoría de las personas que intentan suicidio son hombres, un 65% en la franja de edad de 15 a 29 años, y el método más frecuente es el ahorcamiento. En este trabajo, presentamos conclusiones de estudios referentes a las causas del problema, destacándose la concepción de hechizo, con implicaciones en los conceptos de instinto de vida y de muerte, inconciente colectivo y sugerencia; también el proceso de confinamiento compulsorio al cual el grupo ha sido sometido, con sobrepoblación de las aldeas, imposición de creencias, valores y liderazgos extraños a su cultura son citados como factores causales. Sugerimos, más allá de la revisión urgente de la política gubernamental en relación a las tierras indígenas, una retomada de la identidad étnica como forma de afirmación y reorganización del grupo Guaraní/Kaiowá....(AU)

Síntomas psiquiátricos y rasgos de personalidad en dos grupos opuestos de la Facultad de Medicina de la UNAM / Psychiatric symptoms and personality traits in two opposite groups from the School of Medicine of the UNAM

Introduction Recent studies have shown an increase in psychiatric symptomatology in medical students and physicians during their professional practice. Some studies show that these professionals have a higher prevalence of psychiatric symptoms than the general population. This phenomenon is a consequence of the particular conditions of this professional activity, and, in the case of students, of high academic demands that lead to stressful situations that interfere with their academic performance and the development of clinical skills, which may have repercussions on their relationship with their patients. The predominant symptoms are anxiety, depression and stress, as well as substance use; there has also been an increase in the number of students with suicide attempts. Most of these problems occur during the first two years of the degree course as well as the internship year. Depression is masked by anger, by virtue of the fact that it is an internalized form of anger. It has also been documented that there is a significant link between certain personality traits and the presence or absence of mental symptoms, regardless of the situations to which people are exposed. The feature with the highest association with the presence of symptomatology is neuroticism, while the personality traits that are most conducive to the achievement of academic success and better adaptation and, therefore, a lower number of symptoms are empathy and kindness. The purpose of this study was to establish a diagnosis of the mental health and personality traits of medical students in the high performance groups and compare them with those of the groups of students that performed poorly during the first two years of the degree course. This transversal, exploratory study involved the participation of 370 students from the UNAM Medical School: 220 belonged to the high performance groups, called educational quality nuclei (NUCE), while 1 50 were repeat students. The variables considered were: age, sex, type of group (NUCE or repeat), academic year (first or second year of the degree), place of origin and type of high school from which they had graduated (public or private). Two instruments were used to measure personality traits and psychiatric symptomatology: the Big Five Personality Traits and the Symptom Check List-90. The results of the study show that in both groups (repeat students and NUCE) over 85% were from the Federal District. Repeat students were mainly women (85.3%) and students from public schools (93.6%). As for the high performance group (NUCE), 83.1 % were from private schools and just 1 6.9% from public schools. Repeat students showed personality traits that included neuroticism and very little openness compared with the high performance groups, which displayed traits of greater openness and less neuroticism, with p<0.01. In general, students from NUCE groups showed traits of greater extraversion, empathy and diligence compared with repeaters. Psychiatric symptomatology was more severe among the repeat group than the NUCE group (p<0.05). The psychiatric symptomatology displayed by both groups included: obsession-compulsion, depression and anxiety. In the comparisons, the two groups showed significant differences in total symptomatology. There were also differences in the following symptomatology, by order of importance: phobia, interpersonal sensitivity, somatization, anxiety, obsessive-compulsive disorder and psychoticism (p<0.05). Differences were found between academic years, with second-year students showing greater symptomatology; women displayed the greatest symptomatology. No differences were found for the interaction between sex and academic year. The analysis of structural models was used to determine the relationship between the variables being studied, with significant correlation coefficients with p<.05 being found between personality and sex, personality and type of high school, as well as type of group and suicidal ideation, academic year and psychiatric symptomatology, personality and suicidal ideation and personality and psychiatric symptomatology. The results of the study coincided with those in the literature, although there were some differences between the two groups of students. Repeat students displayed greater levels of psychiatric symptomatology compared with students in the high performance groups. This suggests that students who perform less well in their degree courses also report higher mean responses in psychiatric symptomatology, mainly on scales of somatization, anxiety, phobia and interpersonal sensitivity. As for type of personality, students in the high performance group reported higher average scores on the scales of extraversion, empathy and openness, with the exception of the neuroticism scale. This suggests that personality features may be predictors of better academic performance as well as greater intellectual skill. This finding is reinforced by the repeater group's results, since they report higher scores in the personality trait of neuroticism. The diligence scale was the same for both groups. The study corroborated the fact that second-year students display the greatest symptomatology, with women reporting higher averages in psychiatric symptomatology scores (mean = 7.3). Sex is associated with greater empathy and solidarity, with women achieving higher scores in both personality traits. Although the neuroticism trait is also associated with the female sex and suicidal ideation, scores for this trait were higher for men. This trait can be considered a predictor for both suicidal ideation and the presence of a higher number of psychiatric symptoms. Lastly, the symptomatology in which these students obtained the highest scores is related to the obsessive-compulsive disorder, a situation which we consider may be due to the type of screening test used. It is a fact that studying medicine involves continuously stressful conditions. For these students, however, seeking help to cope with the presence of psychiatric symptomatology is extremely complicated since they regard it as a form of weakness. This raises the need to develop large-scale programs to orient students in order to enable them to identify symptoms at an early stage, which in turn will permit timely treatment.

En estudios recientes se ha demostrado un incremento en la sintomatología psiquiátrica que presentan los estudiantes de medicina, así como los médicos durante su ejercicio profesional. En algunos estudios se señala que estos profesionistas tienen una prevalencia de síntomas psiquiátricos por arriba de los de la población general. Este fenómeno es una consecuencia de las condiciones propias de la actividad profesional y, en el caso de los alumnos, por situaciones que demandan una mayor exigencia académica, que conlleva a su vez situaciones estresantes que interfieren en su desempeño académico, así como en el desarrollo de habilidades clínicas que pueden repercutir en su relación con los pacientes. Los síntomas que predominan son la ansiedad, la depresión y el estrés, así como el consumo de sustancias; también se ha incrementado el número de estudiantes con intentos de suicidio. Se observa que la mayoría de estos problemas tipo se presentan en los dos primeros años de la carrera, así como en el año de internado. La depresión se encuentra enmascarada por enojo, en virtud de que ésta representa un enojo internalizado. Asimismo se ha documentado que existe una relación importante entre la presencia de ciertos rasgos de personalidad y la presencia o ausencia de síntomas mentales, independientemente de las situaciones a las que se expongan las personas. El rasgo que presenta una mayor asociación con la presencia de sintomatología es el neuroticismo, así como también los rasgos de personalidad que influyen con un mejor cumplimiento de logros académicos y una mejor adaptación. El objetivo de este trabajo fue establecer un diagnóstico de la salud mental y los rasgos de personalidad de los estudiantes de medicina que se encuentran en los grupos de alto rendimiento y compararlo con los grupos de alumnos que presentan bajo rendimiento académico durante los dos primeros años de la carrera. En este estudio exploratorio, de tipo transversal, participaron 370 estudiantes de la Facultad de Medicina de la UNAM: 220 correspondían a los grupos de alto rendimiento, llamados núcleos de calidad educativa (NUCE), y 150 eran alumnos repetidores. De entre los resultados que arrojó el estudio, se encontró que para ambos grupos (repetidores y NUCE) más de 85% provenía del Distrito Federal. En el grupo de repetidores predominaron las mujeres (85.3%) y los alumnos procedentes de escuelas públicas (93.6%). En relación con el grupo de alto rendimiento (NUCE), 83.1% procedía de escuelas privadas y sólo 16.9% de escuelas públicas. Los alumnos repetidores mostraron rasgos de personalidad de neuroticismo y de poca apertura en comparación con los grupos de alto rendimiento, quienes mostraron rasgos de mayor apertura y menor neuroticismo, con una p<0.01. En general, los alumnos de los grupos NUCE mostraron rasgos de mayor extroversión, mayor empatía y diligencia en comparación con los repetidores. La sintomatología psiquiátrica mostró mayor gravedad en el grupo repetidor con respecto al grupo NUCE (p<0.05). La sintomatología psiquiátrica que presentaron ambos grupos fue: obsesión-compulsión, depresión y ansiedad. Entre las comparaciones resultaron diferencias significativas en ambos grupos en el total de sintomatologías. También hubo diferencias en las siguientes sintomatologías por orden de importancia: fobia, sensibilidad interpersonal, somatización, ansiedad, trastorno obsesivo-compulsivo y psicoticismo (p<0.05). Los resultados del estudio presentan coincidencias con lo publicado por la bibliografía; sin embargo, hay diferencias entre ambos grupos de estudiantes. En los alumnos repetidores se observó mayor sintomatología psiquiátrica en comparación con los alumnos de los grupos de alto rendimiento. Por lo anterior, se concluye que los alumnos que presentan menores niveles de logro en la carrera también presentan medias de respuestas mayores en sintomatología psiquiátrica, principalmente en las escalas de somatización, ansiedad, fobia y sensibilidad interpersonal.

Álcool em vítimas de suicídio em São Paulo / Alcohol in suicide victims in Sao Paulo

CONTEXTO: A tendência a comportamentos violentos e impulsivos é aumentada após o consumo de álcool, sendo importante para a etiologia de mortes por causas externas. Nesse contexto, os suicídios aparecem como uma atitude impulsionada pelo consumo de álcool, ou como uma expressão da mesma patologia que leva ao abuso de substância. OBJETIVOS: Como carecemos de dados nacionais sobre suicídios sob a influência de álcool, o objetivo do presente estudo foi analisar a prevalência do consumo de álcool previamente ao suicídio. MÉTODOS: Leitura direta de 632 laudos necroscópicos de vítimas de suicídios necropsiadas no Instituto Médico-Legal do Estado de São Paulo no ano de 2005. RESULTADOS: Dos 632 casos analisados, 33,1 por cento apresentaram alcoolemia positiva, sendo essa prevalência maior para os homens (37,1 por cento) do que para as mulheres (20,1 por cento). Os enforcamentos apresentaram a maior prevalência de alcoolizados, com 38,9 por cento dos casos; as intoxicações apresentaram a maior média, com 1,78 g/L. CONCLUSÕES: Os resultados mostram que cerca de um terço dos suicídios na amostra foram cometidos subseqüentemente ao consumo de álcool, com diferenças entre os diversos métodos.

BACKGROUND: A tendency toward violent and impulsive behavior is enhanced following the consumption of alcohol and is important in determining the etiology of deaths by external causes. In this context suicide appears to result from an attitude brought about by alcohol consumption or an expression of that same pathology which leads to substance abuse. OBJECTIVES: Considering the inexistence nationwide of data on suicides occurring under the influence of alcohol, the aim of the present study was to analyze the prevalence of alcohol consumption prior to suicide. METHODS: Direct analysis of 632 medical examinerÆs reports on suicide victims autopsied at the ExaminerÆs Office (Instituto Médico-Legal) of the State of Sao Paulo, in the year 2005. RESULTS: Of the 632 cases reviewed, 33,1 percent presented a positive Blood Alcohol Concentration (BAC), with a higher occurrence in the case of men (37,1 percent) than that of women (20,1 percent). Hangings presented the highest prevalence of intoxicated victims, at a rate of 38,9 percent of the cases; intoxications presented the highest BAC mean, at 1,78 g/L. CONCLUSIONS: The results demonstrate that roughly speaking, about one third of the suicides in our sample carried out by differing methods were subsequent to alcohol consumption.

Incidência de suicídios e uso de agrotóxicos por trabalhadores rurais em Luz (MG), Brasil / Incidence of suicides and rural workers use of pesticides in Luz, Minas Gerais, Brazil

Este artigo apresenta um estudo sobre a incidência de suicídios em Luz (MG), verificando as eventuais relações com agrotóxicos. Para tanto, adotou-se estudo descritivo com 50 moradores de uma micro-região, entrevistados mediante questionário. Realizaram-se dosagens de acetilcolinesterase, gama-glutamiltransferase (GGT), transaminase glutâmico-oxalacética (TGO) e transaminase glutâmico-pirúvica (TGP) no soro e pesquisas nos prontuários hospitalares e no cartório do registro civil, estudando-se os casos de suicídios entre os anos de 2000 e 2004. A pesquisa nos prontuários e no cartório permitiu verificar a ocorrência de 8,1 atendimentos/mês de casos de intoxicação por agrotóxicos, sendo19 suicídios (22,6/100.000 hab./ano) no período. Desses, 18 eram trabalhadores rurais do sexo masculino. O mecanismo de suicídio foi, em 57,9% dos casos, envenenamento com agrotóxicos. Dos entrevistados, 98% relataram usar regularmente agrotóxicos, 72% não utilizaram nenhum equipamento de proteção, 56% nunca leram as bulas e 40% afirmaram ter tido intoxicação. Encontrou-se elevação da TGO e da TGP em 33,33% dos homens e da GGT em 21,42% das mulheres e 13,88% dos homens. Não foi detectada redução da atividade da acetilcolinesterase. Constatou-se que a incidência de suicídios foi mais que o dobro da maior média estadual brasileira e que o número de atendimentos de intoxicações foi alto se comparado aos do Sinitox.

The article presents the incidence of suicides and attended cases of poisoning in the micro-region of Luz, Minas Gerais, and their possible relationship with pesticides. A descriptive study was held involving 50 local residents, who were asked to answer a questionnaire. Acetylcholinesterase, gamma-glutamyltransferase (GGT), Serum glutamic oxaloacetic transaminase (SGOT), and Serum glutamic pyruvic transaminase (SGPT) were measured, and suicides between the years 2000 to 2004 were analyzed through hospital and civil registryrecords. The results pointed at 8.1 cases/month pesticide poisoning. During the period under study, 19 suicidal deaths occurred (22.6/100,000 inhab./year), 18 involving male rural workers, 57.9% of these caused by pesticide poisoning. From the interviewed residents, 98% reported they handled pesticides regularly, 72% had never used any protection equipment, 56% had never read any information sheets, and 40% had been poisoned by pesticides. Increase of SGOT and SGPT was observed in 33.33% of the male subjects, while GGT elevation was found in21.42% of the women and 13.88% of the men. Reduction of Acetylcholinesterase activity was not detected. Incidence of suicides was more than twice the highest state average in Brazil and, compared to Sinitox data, the number of pesticide poisoning cases was high.

Trends of suicides in north eastern rural Haryana: A retrospective study.

Suicide patterns and rates differ in various populations and cultures. It is known that in most countries that have been studied, more than 90 percent of those who commit suicide have a mental disorder. This behavior, although often triggered by external factors, occurs in vulnerable individuals who have a neurobiological and often familial predisposition. Suicides in rural India are attributed mostly to crushing financial pressures on farmers. Indebtedness, crop failure and the inability to pay back loans due to high rates of interest have led as many as 25,000 peasants in India to commit suicide since the 1990s, according to official figures. The present study was designed to investigate the different methods of self-destruction, age and gender susceptibility to suicide, the groups particularly affected and the underlying motivating factors for such an extreme step among rural North Eastern Haryana people. Various suggestions relating to decreasing the tensions of modern life, proper use and storage of agrochemicals and financial improvement of farmers have been put forward.