Padrões espaciais e caracterização epidemiológica dos suicídios na microrregião de Chapecó, Santa Catarina: estudo ecológico, 1996-2018 / Patrones espaciales y caracterización epidemiológica de los suicidios en la micro-región de Chapecó, Santa Catarina, Brasil: estudio ecológico, 1996-2018 / Spatial patterns and epidemiological characterization of suicides in the Chapecó micro-region, Santa Catarina, Brazil: an ecological study, 1996-2018

Objective: to identify spatial clusters of suicide and its epidemiological characteristics in the Chapecó (SC) micro-region from 1996 to 2018. Methods: this was an exploratory ecological study, using data from the Mortality Information System; specific suicide rates and relative risks (RR) were calculated with a 95% confidence interval (95%CI); the scan statistic was used for spatial analysis. Results: there were 1,034 suicides (13.7/100,000 inhabitants), with a male/female ratio of 3.79; the ≥ 60 age group was at higher risk for both sexes; a high risk cluster was found in the southwest region (RR = 1.57) and a low risk cluster in the southeast region, including Chapecó itself (RR = 0.68); risk of suicide among widowed (RR = 3.05; 95%CI 1.99;4.67), separated (RR = 2.48; 95%CI 1.44;4.27), and married (RR = 1.97; 95%CI 1.54;2.51) people was higher than among single people. The main methods were hanging (81.2%) and firearms (9.7%). Conclusion: there was a higher risk of suicide in the elderly, male and widowed people. Hanging was the most frequent method and risk clustering was found in the southwest.

Objetivo: identificar agregados espaciales de suicidio y el perfil epidemiológico en la microrregión de Chapecó (SC), 1996-2018. Métodos: estudio ecológico exploratorio, con datos del Sistema de Información de Mortalidad. Fueron calculadas tasas específicas de suicidio y riesgos relativos (RR) con intervalo de confianza 95% (IC95%). Para el análisis espacial se utilizó la estadística scan. Resultados: hubo 1.034 suicidios (13,7/100.000 habitantes), razón sexo masculino/femenino de 3,79. El grupo de ≥ 60 años presentó mayor riesgo para ambos sexos. Se observó un agregado de alto riesgo en la región suroeste (RR = 1,57) y un agregado de menor riesgo en el sureste (RR = 0,68). El riesgo de suicidio entre viudos (RR = 3.05; IC95% 1,99;4,67), separados (RR = 2.48; IC95% 1,44;4,27) y casados (RR = 1.97; IC95% 1,54;2,51) fueron mayores que entre solteros. El principal medio fue el ahorcamiento (81,2%), seguido de las armas de fuego (9,7%). Conclusión: hubo mayor riesgo de suicidio en ancianos, sexo masculino y viudos. Ahorcamiento fue el método más frecuente y se observó agrupación de riesgos hacia el Suroeste.

Objetivo: identificar conglomerados espaciais do suicídio e características epidemiológicas na microrregião de Chapecó, SC, Brasil, 1996-2018. Métodos: estudo ecológico exploratório, com dados do Sistema de Informações sobre Mortalidade; foram calculadas taxas específicas de suicídio, e riscos relativos (RR) com intervalo de confiança de 95% (IC95%); na análise espacial, utilizou-se estatística scan. Resultados: 1.034 suicídios (13,7/100 mil habitantes), a razão sexo masculino/feminino de 3,79; a idade ≥ 60 anos apresentou maior risco para ambos os sexos; observou-se um conglomerado de alto risco na região sudoeste (RR = 1,57) e um de menor risco a sudeste, incluindo Chapecó (RR = 0,68); risco de suicídio entre viúvos (RR = 3,05; IC95% 1,99;4,67), separados (RR = 2,48; IC95% 1,44;4,27) e casados (RR = 1,97; IC95% 1,54;2,51) maior que entre solteiros; principal método, enforcamento (81,2%), seguido por uso de arma de fogo (9,7%). Conclusão: maior risco de suicídio para idosos, sexo masculino e viúvos; enforcamento foi mais frequente; conglomerado de risco a sudoeste.

Suicide mortality among youth in southern Brazil: a spatiotemporal evaluation of socioeconomic vulnerability

Objective: To conduct a geospatial analysis of suicide deaths among young people in the state of Paraná, southern Brazil, and evaluate their association with socioeconomic and spatial determinants. Methods: Data were obtained from the Mortality Information System and the Brazilian Institute of Geography and Statistics. Data on suicide mortality rates (SMR) were extracted for three age groups (15-19, 20-24, and 25-29 years) from two 5-year periods (1998-2002 and 2008-2012). Geospatial data were analyzed through exploratory spatial data analysis. We applied Bayesian networks algorithms to explore the network structure of the socioeconomic predictors of SMR. Results: We observed spatial dependency in SMR in both periods, revealing geospatial clusters of high SMR. Our results show that socioeconomic deprivation at the municipality level was an important determinant of suicide in the youth population in Paraná, and significantly influenced the formation of high-risk SMR clusters. Conclusion: While youth suicide is multifactorial, there are predictable geospatial and sociodemographic factors associated with high SMR among municipalities in Paraná. Suicide among youth aged 15-29 occurs in geographic clusters which are associated with socioeconomic deprivation. Rural settings with poor infrastructure and development also correlate with increased SMR clusters.

Tendência de suicídio em adolescentes brasileiros entre 1997 e 2016 / Tendencia al suicidio en adolescentes brasileños entre 1997 y 2016 / Suicide trend among Brazilian adolescents between 1997 and 2016

Objetivo: Analisar a tendência da mortalidade por suicídio em adolescentes brasileiros no período de 1997 a 2016. Métodos: Estudo ecológico de séries temporais; empregou-se regressão de Prais-Winsten. Resultados: Foram registrados 14.852 óbitos por suicídio, com taxas de mortalidade por 100 mil habitantes de 1,95 em 1997, 2,65 em 2016, e média de 2,14 no período 1997-2016; predominaram óbitos no sexo masculino (67,59%), por lesões autoprovocadas intencionalmente (84,19%), ocorridos no domicílio (52,69%); a região Centro-Oeste apresentou a maior taxa no período (3,71/100 mil hab.), com destaque para Mato Grosso do Sul (8,3/100 mil hab.); observou-se tendência de aumento de 1,35% ao ano na mortalidade por suicídio na população geral de adolescentes (IC95% 0,56;2,15), 1,63% no sexo masculino (IC95% 0,56;2,29), 3,11% na região Norte (IC95% 2,25;3,98) e 4,19% no Nordeste (IC95% 2,58;5,84). Conclusão: A mortalidade por suicídio em adolescentes brasileiros mostrou tendência ascendente no período estudado.

Objetivo: analizar la tendencia al suicidio en adolescentes brasileños de 1997 a 2016. Método: estudio ecológico de series temporales; se utilizó la regresión de Prais-Winsten. Resultados: se registraron 14.852 suicidios, con tasas de mortalidad de 1,95 por 100.000 habitantes en 1997, 2,65 en 2016 y promedio de 2,14 en el período 1997-2016; las muertes predominaron en el sexo masculino (67,59%), por autolesión intencional (84,19%) y ocurridas en casa (52,69%); la región Centro-Oeste tuvo la tasa más alta en el período (3,71/100,000 habitantes), con énfasis en Mato Grosso do Sul (8,3/100,000 habitantes); hubo una tendencia de aumento del 1,35% al año de la mortalidad por suicidio en la población adolescente general (IC95% 0,56; 2,15), 1,63% en varones (IC95% 0,56; 2,29), 3,11% en la región Norte (IC95% 2,25; 3,98) y 4.19% en el Nordeste (IC95% 2,58; 5;84). Conclusión: la mortalidad por suicidio en adolescentes brasileños mostró una tendencia al alza en el período estudiado.

Objective: To analyze the suicide mortality trend among Brazilian adolescents from 1997 to 2016. Methods: This is an ecological time series study; Prais-Winsten regression was used. Results: 14,852 suicide deaths were recorded, with mortality rates per 100,000 inhabitants of 1.95 in 1997, 2.65 in 2016 and average of 2.14 for the period 1997-2016; deaths predominated in males (67.59%), as well as deaths due to intentional self-harm (84.19%) and suicides at home (52.69%); the Midwest region had the highest rate in the period (3.71/100,000 inhabitants), in particular the state of Mato Grosso do Sul (8.3/100,000 inhabitants); the suicide trend rose 1.35% per annum in the general adolescent population (95%CI 0.56;2.15), 1.63% in males (95%CI 0.56;2.29), 3.11% in the North (95%CI 2.25;3.98) and 4.19% in the Northeast (95%CI 2.58;5.84). Conclusion: Suicide mortality in Brazilian adolescents showed an upward trend in the period studied.

Prevalencia puntual de consumo de sustancias en individuos que cometen suicidio por asfixia secundario a ahorcamiento en Santiago, 2014-2015 / Point prevalence of consumption of substances in individuals who commit suicide for asphyxia by hanging in Santiago, 2014-2015

Introducción: El trastorno por consumo de sustancias se ha asociado a suicidio, el que constituye la segunda causa de muerte en individuos entre 15 y 29 años. Dentro de los mecanismos más comunes de suicidio, se encuentra la asfixia por ahorcamiento. Objetivo: Determinar la prevalencia puntual de consumo de sustancias en individuos que ingresaron al Servicio Médico Legal (SML) de Avenida La Paz #1.012, Independencia, Santiago de Chile por suicidio secundario a asfixia por ahorcamiento durante 2014-2015. Materiales y métodos: Estudio de corte transversal en individuos que ingresaron al SML entre los años 2014-2015, cuya causa de muerte correspondiera a suicidio por asfixia por ahorcamiento y que tuvieran registros de: sexo, edad, alcoholemia y examen toxicológico. Se utilizó una plantilla Excel® 2011, determinándose estadística descriptiva y análisis porcentual. Resultados: Durante los años 2014-2015, ingresaron 8.321 individuos al SML, de los cuales se seleccionaron aleatoriamente 1.218 individuos. De dicha muestra, un 11,58% correspondió a muertes secundarias a asfixia por ahorcamiento. De éstos un 74,47% eran varones. El rango etario más frecuente correspondió a los 40-49 años. Un 49,65 % tenía alcoholemia positiva en sangre y un 58,87 % examen toxicológico positivo, siendo lo más frecuente la asociación de dos o más sustancias al momento del suicidio (39,72 %). Discusión: Se observan resultados similares en relación a edad, sexo en comparación a estudios similares, no así cuando se comparan las sustancias consumidas, donde hubo mayor prevalencia de cocaína. La prevalencia de consumo de sustancias en casos de suicidios consumados es de un 58,86%.

Introduction: The disorder for consumption of substances has been associated to suicide, this constitute the second cause of death in individuals between 15 and 29 years old. Among the most common mechanisms of suicide we found asphyxia by hanging. Objective: Determine the point prevalence in the consume of substances of individuals that were admitted in the Medical Legal Service (MLS) of Avenida La Paz #1.012, Independencia, Santiago de Chile, for secondary suicide asphyxia by hanging during 2014-2015. Materials and methods: Cross-sectional study in individuals admitted in MLS between 2014-2015, whose cause of death corresponded to suicide due asphyxia by hanging wich had registers of: sex, age, blood alcohol test and toxicological exam. A 2011 Excel® template was used, determining descriptive statistics and percentage analysis. Results: During the years 2014-2015, 8.321 were admitted in MLS, of which 1.218 were randomly selected. Of this sample, 11.58 % corresponded to secondary death to asphyxia by hanging. Of these, 74.47 % were male. The most frequent age range corresponds to 40-49 years. 46.65 % hadethanol in blood and 58.87 % positive toxicological test, being the most frequent the association of two or more substances at the moment of the suicide (39.72 %). Discussion: Similar results are observed in relation to age, sex compared to similar studies, but not when comparing substances consumed, where there was a higher prevalence of cocaine. The prevalence of substances consumed in cases of completed suicides is 58.86%.