Factores de riesgo sociodemográfico de ideación e intento suicida en adulto mayor. bogotá, colombia 2012-2013

Objetivo. Describir los factores de riesgo sociodemográfico de ideación e intento suicida en el adulto mayor en Bogotá, años 2012-2013. Método. Estudio observacional descriptivo transversal de datos comunes de la base oficial del sistema de vigilancia epidemiológica de la conducta suicida (Sisvecos) de la Secretaria Distrital de Salud de Bogotá, en 2012-2013. Se utilizó el cálculo porcentual, OR y Chi-cuadrado de Pearson para procesar los datos con un nivel de significancia de p < 0,05. Resultados. La mayoría de los casos se presentan entre 60 a 64 años (34,52%); sexo femenino (69,44%); aseguramiento en salud (49,60%) que pertenecían al régimen subsidiado, se afectan más los casados con (6,75%) para ideación y (4,76%) para intento suicida. Se evidenció la relación entre las variables: sexo (Chi-cuadrado = 6,87; p = 0,009); estrato bajo (Chi-cuadrado = 9,733; p = 0,002) y ocupación (Chi-cuadrado = 4,047; p = 0,044). Se encontró un riesgo 4,4 veces mayor de presentar intento e ideación suicida en personas que viven en estratos bajos que aquellos que viven en estratos altos (OR = 4,359, IC de 95% y 1,618 - 11,745); se encontraron OR protectores en ocupación por fuera de la casa (OR = 0,393, IC de 95% y 0,156 - 0,991) y ser de sexo masculino (OR de 0,469, IC de 95% y 0,246 - 0,831). Conclusiones. Se encontró significancia estadística para ideación e intento suicida en el adulto mayor en relación con estudio y sexo P = 0,009; estrato bajo P = 0,002 y ocupación P = 0,044. Existe 4,35 veces mayor riesgo de intento e ideación en estratos socioeconómicos bajos respecto a los altos. Las actividades fuera del hogar y vivir en pareja se identifican como factor protector.

Objective: To describe the sociodemographic risk factors of suicidal thinking and acting in elders in Bogotá, between 2012 and 2013. Method: Cross-sectional observational and descriptive study about common data in the official database of the epidemiologic assessment system of suicidal behavior (sisvecos in Spanish) from Bogota's Health Bureau, in 2012-2013. We used percentual estimations and Pearson's chi-squared test to process data with a significance level of p < 0,05. Results: Most cases occur in people of ages between 60 to 64 years old (34,52%); females (69,44%); health insurance subsidized by the government (69,44%). From the ones who were married, there were those with suicidal thoughts (6,75%) and those who had attempted suicide (4,76%). Relationship between factors was the following: sex (chi-squared=6,87; p = 0,009); low social class (chi-squared = 9,733; p = 0.002) and occupation (Chi-squared = 4,047; p = 0,044). We found a risk of suicidal thought and attempt 4.4 times higher in people who live in low-income neighborhoods than those who live in higher-income neighborhoods (OR = 4,359, 95% CI and 1,618 - 11,745). Finally, protective OR's were found to be either occupation outside home (OR = 0-393, 95% and 0,156 - 0,991 CI) and being of male sex (OR = 0,469, 95% and 0,246 - 0,831 CI). Conclusions: A statistical significance was found for suicidal thoughts and attempts in the elder in relation with education and sex P = 0,009; low income bajo P = 0,002 and occupation P = 0,044. There is a risk 4.35 times higher of attempt and thought in low-income neighborhoods against high-income neighborhoods. Any activities outside home and living with a partner were identified as protective factors.

Objetivo: descrever os fatores de risco sociodemográfico de ideação e tentativa de suicídio em idoso em Bogotá, em 2012 e 2013. Método: estudo observacional descritivo transversal de dados comuns da base oficial do sistema de vigilância epidemiológica do comportamento suicida (Sisvecos) da Secretaria Estadual de Saúde de Bogotá, em 2012 e 2013. Foi utilizado o cálculo porcentual, OR e Qui-Quadrado de Pearson para processar os dados com um nível de significância de p < 0,05. Resultados: a maioria dos casos se apresenta entre 60 e 64 anos (34,52%); sexo feminino (69,44%); asseguramento em saúde (49,60%), que pertenciam ao regime subsidiado; são mais afetados os casados com 6,75% para ideação e 4,76% para tentativa de suicídio. Tornou-se evidente a relação entre as variáveis: sexo (Qui-Quadrado = 6,87; p = 0,009); classe social baixa (Qui-Quadrado = 9,733; p = 0,002) e ocupação (Quo-Quadrado = 4,047; p = 0,044). Foi verificado um risco 4,4 vezes maior de apresentar ideação e tentativa de suicídio em pessoas que moram em lugares de classe baixa do que os que vivem em lugares de classe alta (OR = 4,359, IC de 95% e 1.618 - 11.745); foram constatados OR protetores em ocupação fora de casa (OR = 0,393, IC de 95% e 0,156 - 0,991) e ser de sexo masculino (OR de 0,469, IC de 95% e 0,246 - 0,831). Foi verificada significancia estatística para ideação e tentativa de suicidio em idoso em relação ao estudo e ao sexo (P = 0,009; classe baixa P = 0,002 e ocupação P = 0,044). Existem 4,35 vezes mais riscos de ideação e tentativa de suicidio em classes socioeconômicas baixas em comparação com as altas. As atividades fora de casa e morar com companheiro(a) são identificadas como fator protetor.

Perfil clínico y Psicosocial de los Adolescentes de 15 a 18 años Intentadores de Suicidio Hospitalizados en la Clínica Psiquiátrica de la Universidad de Chile (CPU) 2009-2011 / Clinical and Psychosocial Profile of 15 to 18-year-old Adolescents with Suicide Attempts Hospitalized in the Universidad de Chile Psychiatric Clinic (CPU) 2009-2011

El fenómeno suicida ha aumentado en la población general y esto cobra especial relevancia en los adolescentes de nuestro país. Si bien se conocen factores de riesgo asociados, existen aún escasos estudios locales respecto a las características de los adolescentes intentadores de suicidio en población consultante. Métodos: Se consideró población estudio a los adolescentes entre 15 y 18 años hospitalizados en la CPU entre 2009 y 2011, se dividieron intentadores (IS) y no intentadores de suicidio (NIS), registrando características clínicas y sociodemográficas, analizadas luego con el software STATA. Resultados: En el grupo de intentadores de suicidio el 68,13% presentaban historia de intento suicida previo, siendo más frecuente en mujeres. Otra característica distintiva de este grupo es la asociación a conducta suicida de familiar de primer grado y el antecedente de abuso sexual infantil. Palabras Clave: comportamiento suicida, intento suicida, adolescentes, perfil psicosocial, abuso sexual.

The suicidal phenomenon has increased in the general population and this is especially relevant in our country's adolescents. Although there are known risk factors for suicide, there are still few local studies regarding the characteristics of adolescents attempting suicide in our consulting population. Methods: The study population was considered to be 15 to 18-year-old adolescents hospitalized in the CPU between 2009 and 2011, they were divided into suicide attempters (SA) and non suicide attempters (NSA); clinical and sociodemographic characteristics were recorded and later analyzed with the software STATA. Results: In the group of suicide attempters 68.13% presented a history of previous suicide attempts, more frequently in women. Another distinctive feature of this group is the association of suicide attempts to suicidal behavior of a first-degree relative and a history of child sexual abuse.Key words: suicidal behaviour, suicidal attempt, adolescent, psychosocial profile, sexual abuse.

La conducta suicida y sus factores de riesgo en Holguín, Cuba / Suicidal behavior and risk factors in Holguín, Cuba

Introducción: la conducta suicida no solo se manifiesta a través del acto de quitarse la vida, sino mediante el intento suicida, el cual, por lo general, se presenta de 2 formas: 1) cuando el sujeto realiza un acto de auto-agresión, sin la intención de quitarse la vida, y 2) el fracaso del sujeto, en el intento consciente de quitarse la vida. Objetivo: caracterizar los factores de riesgos psico-socio-demográficos, en los pacientes con conducta suicida, atendidos en la consulta de cuerpo de guardia, en el Hospital Psiquiátrico de Holguín, en el período de septiembre a diciembre del 2015. Método: se realizó un estudio retrospectivo. El universo fueron los 163 pacientes, atendidos en la consulta de cuerpo de guardia, durante el período de estudio. La muestra fue de 42 pacientes con conductas suicidas. Las variables sociodemográficas estudiadas fueron: edad, sexo, raza, nivel de escolaridad, estado civil; y las psicosociales fueron: depresión, intentos suicidas previos, y aparición de sentimientos de culpa y desesperanza. Resultados: el sexo femenino predominó con un 52,3%; el grupo etario de 40 - 49 años en un 38%; la raza blanca en 88%; el nivel de escolaridad primario en el 52,3% de los casos; y el estado civil soltero en el 64,2% de la muestra. Los factores psicosociales de riesgo esenciales fueron: la depresión hasta un 73,8%, los intentos suicidas previos y la aparición de sentimientos de culpa y desesperanza hasta el 88% y 71,4% respectivamente. Conclusiones: por orden de significación, los principales factores de riesgo del intento suicida son: la depresión, los intentos suicidas previos, y los sentimientos de culpa y desesperanza; todos con mayor prevalencia en los pacientes del sexo femenino, entre 40 a 49 años de edad, solteras, de la raza blanca, y con un nivel de escolaridad primaria. Es por ello que, para tratar estos pacientes, es necesario conocer y aplicar adecuadamente las estrategias de intervención, en cada caso.

Introduction: suicidal behavior is not only about someone taking their own life, but also someone attempting suicide. Suicide attempts are classified in two ways: 1) self-injury without subsequent death, and 2) failed suicide attempts. Objective: to determine the sociodemographic and psychosocial risk factors for suicidal behavior, in patients assisted at the Psychiatric Hospital of Holguín emergency room, from September to December, 2015. Method: a retrospective descriptive study was carried out. Universe was formed by 163 patients, previously assisted at the hospital emergency room, and the sample was represented by 42 suicide attempts patients, either with suicidal thoughts or tendencies. Sociodemographic and psychosocial variables studied were: age, sex, race, marital status, scholarship level, previous suicidal attempts, depression, guilt and hopelessness. Results: females were ahead males, with 52.3%. The age group from 40 to 49 years old showed 38%, and white race group prevailed with 88%. Primary education level was over 52.3%, and singles had a remarkable 64.2%. Main psychosocial risk factors like: previous suicidal attempts, depression, guilt and hopelessness, were observed with 88%, 73.8% and 71.4%, each. Conclusions: main risk factors and suicidal attempts are related according to their significance levels, such as: previous suicidal attempts, depression, guilt, and hopelessness. They prevailed on single females, from 40 to 49 years old, white skin, and primary school level of education.

Gray Matter Volume Reductions Were Associated with TPH1 Polymorphisms in Depressive Disorder Patients with Suicidal Attempts

OBJECTIVE: Structural changes of brain areas have been reported in depressive disorder and suicidal behavior (SB), in which TPH1 also has been known as a promising candidate gene. We investigated gray matter volume (GMV) differences, TPH1 rs1800532 and rs1799913 polymorphisms previously found to be associated with depressive disorder and SB, and the relationship between the two markers. METHODS: Thirteen depressive disorder patients with suicidal attempts (SA) and twenty healthy controls were included. We examined GMV differences using a voxel-based morphometry and regions of interest analysis. Direct sequencing was used for genotyping. RESULTS: The patients showed significant GMV reduction in left cerebral region including middle frontal gyrus, inferior frontal gyrus, and anterior cingulate cortex; in right middle temporal gyrus; in left cerebellar tonsil; and in right cerebral region including precentral gyrus and postcentral gyrus (corrected p < 0.005). The right precentral and postcentral gyri GMV values of AA and CA genotypes patients were significantly decreased compared to those of CC genotype subjects (corrected p=0.040). CONCLUSION: These findings show the possibility that both GMV reductions and TPH1 rs1800532/rs1799913 A allele may be involved in the pathogenesis of depressive disorder patients with SA.

Caracterización de la Conducta suicida en Cuba, 2011-2014 / Characterization of suicidal behavoir in Cuba, 2011-2014

Introducción: La conducta suicida incluye el intento suicida y el suicidio consumado. En 2012, se registraron en el mundo 804 000 muertes por suicidio. En Cuba, el suicidio es la novena causa de muerte y la tercera en el grupo de 10-19 años. Objetivo: Caracterizar la Conducta Suicida en Cuba desde 2011-2014. Material y Métodos: El universo estuvo constituido por todos los registros de morbilidad por intento y los de mortalidad por suicidio de las bases de datos de la Dirección de Registros y Estadísticas del Ministerio de Salud Pública de Cuba, desde 2011 al 2014. Las variables fueron: sexo, edad para el intento y además color de la piel, ocupación y método empleado en el suicidio. Se calcularon las tasas acumuladas de morbilidad y mortalidad por grupos de edades por 100 000 habitantes, las tasas bruta, ajustada y específica por sexo, la razón de mortalidad hombre/mujer y la relación intento/suicidio. Se calculó el porcentaje de cambio relativo y los porcentajes según las variables. Resultados: Se reportaron 53 764 intentos suicidas, para una tasa acumulada de 126.2 por 100 000 habitantes. El sexo femenino aportó 37 617 (70 por ciento). La relación intento y suicidio fue de 9.1. Se reportaron 5 942 fallecidos por suicidio para una tasa acumulada de 14.8 por 100 000 habitantes. La ocupación que predominó fue en los jubilados (29.8 por ciento) y el método más empleado fue el ahorcamiento (76.4 por ciento). Conclusiones: El sexo femenino es el más afectado en el intento y en el suicidio, el masculino. La relación intento y suicidio disminuye a medida que se incrementa la la edad(AU)

Introduction: Suicidal behavior includes suicidal attempt and consummated suicide. 804 000 deaths by suicide were registered in the world in 2012. In Cuba, suicide is the ninth cause of death and the third one in the group of 10-19 years of age. Objective: To characterize suicidal behavior in Cuba from 2011 to 2014. Material and methods: The sampling universe was composed of all registries of mobidity by suicidal attempt and the registries of mortality by suicide, taken from the database of the Direction of Registry and Statistics of the Cuban Ministry of Public Health, from 2011 to 2014. The variables were: sex, age for the attempt, skin color, occupation, and the method used for suicide. The accumulated morbidity and mortality rates were calculated by groups of ages per 100 000 inhabitants, the crude-, adequate-, -and sex-specific rates, the man-woman cause of mortality, and the attempt-suicide relationship. The relative change (percentage) was calculated, as well as the percentages according to the variables. Results: 53 764 suicidal attempts were reported, for an accumulated rate of 126.2 per 100 000 inhabitants. The female sex was 37 617 (70 percent). The attempt-suicide relationship was 9.1. 5942 deaths by suicide were reported, for an accumulated rate of 14.8 per 100 000 inhabitants. The occupation that predominated was the retired one (29.8 percent), and the most used method was hanging (76.4 percent). Conclusions: The female sex is the most affected in the attempt, and the male sex is the most affected in the suicide. The attempt-suicide relationship decreases as age increases(AU)

Frecuencia de tendencias suicidas (suicidalidad) y factores asociados en mujeres durante el primer año posparto / Frequency of suicidality and associated factors in women during the first postpartum year

Objetivos: Estimar la frecuencia de tendencias suicidas (suicidalidad) y explorar su relación con diversas variables en mujeres atendidas en un hospital público peruano durante el primer año del periodo posparto. Material y Métodos: Se realizó un análisis secundario de datos de un trabajo de investigación realizado en el Hospital Cayetano Heredia (Lima, Perú) que incluía 321 mujeres durante el primer año posparto, con registros de variables sociodemográficas, ginecológicas, clínico-psiquiátricas y de suicidalidad definida como la presencia del síntoma 9 del criterio A de Episodio Depresivo Mayor evaluado mediante la Entrevista Clínica Estructurada para el DSM-IV (Structured Clinical Interview for DSM-IV Disorders, SCID). Resultados: Se encontró una frecuencia de 15,58 % (IC 95%: 11,79-20,01%) de suicidalidad en mujeres durante el primer año posparto. El análisis bivariado mostró relación significativa entre la presencia de suicidalidad y depresión mayor (OR = 14,52; p <0,001), trastorno obsesivo-compulsivo (OR = 3,96; p= 0,001), trastorno disfórico premenstrual (OR=3,25; p=0,002) y episodio maniaco o hipomaniaco previo (OR=2,12; p=0,025). Asimismo, el análisis multivariado encontró relación significativa con status de separada/divorciada (OR = 6,96; p = 0,027), abortos previos (OR = 2,92; p = 0,006), sueño menor de 6 horas (OR=5,34; p=0,003) y lactancia materna (OR=0,15; p=0,004). Conclusiones: Las tendencias suicidas en mujeres con menos de un año posparto fueron detectadas en 15,58% de la muestra y se relacionaron con una serie de variables de diversa índole, las cuales deben ser tenidas en cuenta para eventuales intervenciones preventivas y/o de atención clínica focalizada.

Objectives: To estimate the frequency of suicidality and to explore its relation with different variables in women seen in a Peruvian public hospital during their first year of their postpartum period. Material and Methods: A secondary data analysis of a research study carried out in the Hospital Cayetano Heredia (Lima, Peru) was conducted on 321 women seen during their first postpartum year, with focus on sociodemographic, psychiatric, gynecological and suicidality variables. Suicidality was defined as the presence of symptom 9 of criterion A of a Major Depressive Episode assessed through the Structured Clinical Interview for DSM-IV Disorders (SCID). Results: Suicidality was found in 15.58% (95% CI: 11.79-20.01%) of the sample. Bivariate analyses showed a significant relationship between suicidality and major depression (OR = 14.52, p <0.001), obsessive-compulsive disorder (OR = 3.96, p = 0.001), premenstrual dysphoric disorder (OR=3.25, p = 0.002) and previous manic or hypomanic episode (OR = 2.12, p = 0.025). In addition, multivariate analysis found a significant relationship with being separated / divorced (OR = 6.96, p = 0.027), previous abortions (OR = 2.92, p = 0.006), sleep of less than 6 hours (5.34, p = 0.003) and breastfeeding (OR = 0.15, p = 0.004). Conclusions: The suicidality in women with less than one year postpartum had a frequency of 15.58% and was related to a series of variables to be taken into account for eventual preventive and/or focused clinical interventions.

Principales factores de riesgo relacionados con el intento suicida en un grupo de adolescentes / Main risk factors related to suicidal attempt in a group of adolescents

Se realizó un estudio descriptivo longitudinal y retrospectivo de 87 adolescentes, quienes atentaron contra sus vidas, desde enero del 2012 hasta diciembre del 2014, pertenecientes al Policlínico Docente José Martí Pérez de Santiago de Cuba, a fin de determinar los principales factores de riesgo de intento suicida en este grupo poblacional. Predominaron las féminas (73,5 por ciento), el grupo etario de 15-19 años (60,9 por ciento), las familias disfuncionales (72,4 por ciento) y la ingestión de psicofármacos como el método empleado con mayor frecuencia (51,7 por ciento). Los principales factores predisponentes fueron: antecedentes familiares hereditarios (19,5 por ciento), violencia domiciliaria (18,3 por ciento), así como trastornos de conducta y depresiones (17,2 por ciento)

A longitudinal and retrospective descriptive study of 87 adolescents that attempted against their lives was carried out from January, 2012 to December, 2014. They belonged to José Martí Pérez Teaching Polyclinic in Santiago de Cuba, in order to determine the main risk factors of suicidal attempt in this population group. The female sex (73.5 percent), the 15-19 years age group (60.9 percent), the dysfunctional families (72.4 percent) prevailed and the psychotropic drug consumption was the method most frequently used (51.7 percent). The main predisposing factors were: hereditary family history (19.5 percent), domiciliary violence (18.3 percent), as well as behavioral dysfunctions and depressions (17.2 percent)

Intento e ideación suicida y su asociación con el abuso sexual en adolescentes escolarizados de Boyacá - Colombia / Suicidal ideation and attempt and their relation to sexual abuse in students of Boyacá - Colombia

Resumen El objetivo de este estudio empírico fue identificar la presencia del intento e ideación suicida, abuso sexual y la asociación entre estas variables en estudiantes de educación secundaria de tres ciudades del departamento de Boyacá. Se contó con 1292 participantes cuyas edades oscilaron entre 12 y 20 años. Los instrumentos utilizados fueron una Encuesta Sociodemográfica y el Inventario de Ideación Suicida Positiva y Negativa. Se hallaron diferencias estadísticamente significativas en las variables estudiadas. Se identifica que los jóvenes que han sido víctimas de abuso sexual por penetración, han tenido intento suicida (1.9%); además, el 48% de las victimas presentan ideación suicida.

Abstract The purpose of this descriptive study was to identify the presence of suicidal attempt and suicidal ideation, sexual abuse and the relationship among these variables, in high school students from three towns in Boyaca, Colombia. This study was conducted with 1,292 participants whose ages ranged between 12 and 20 years old. The instruments used were a sociodemographic survey and the Positive and Negative Suicide Ideation Inventory. Statistically significant differences in the variables studied were found. Among the most relevant findings of this research, it was found that young victims of sexual abuse with penetration have had suicidal attempts (1.9%); moreover, 48% of the victims have suicidal ideation.

Caracterización clínico epidemiológica de la conducta suicida en adolescentes en la provincia Holguín, 1996-2014 / Clinical Epidemiologic Characterization of the Suicidal Conduct in Adolescents from Holguin Province. 1996-2014

Introducción: la conducta suicida como fenómeno multifactorial y universal se manifiesta en todos los países, culturas y sociedades, y en función del contexto sociocultural, varía la actitud ante el fenómeno. A nivel mundial se observa un incremento paulatino de esta conducta en adolescentes y jóvenes, tendencia a la que Cuba está expuesta. Objetivo: caracterizar desde el punto de vista clínico epidemiológico la conducta suicida en adolescentes. Métodos: se realizó investigación transversal del comportamiento de la conducta suicida en adolescentes de 10 a 19 años de la provincia Holguín durante 1997-2014, se determinó la edad, sexo, medio suicida, factores de riesgo, tasas y tendencia; también se realizó una revisión bibliográfica del Anuarios Estadísticos Nacional, los datos del Centro Provincial de Higiene y Epidemiología y se tuvo en cuenta el Programa Nacional de Prevención de la Conducta Suicida. Resultados: el comportamiento del suicidio en adolescentes fue descendente desde tasa de 17,5 x 100 000 habitantes en 1990, hasta 2,4 en 2014, para ambos sexos. El intento suicida se mantuvo alto con predominio del sexo femenino. La ingestión de tabletas fue el método más usado. Los factores de riesgo encontrados fueron: edad de 13-15 y de 15-18 años, sexo femenino, presencia de estado depresivo y falta de un proyecto de vida creativo en familias disfuncionales con presencia de alcoholismo, trastornos psiquiátricos, violencia familiar e intento suicida. Conclusiones: la adolescencia media y tardía, constituyen factores de riesgo, agravados por trastornos depresivos, falta de un proyecto de vida creativo, en familias disfuncionales con trastornos o problemas relacionados con la salud mental.

Introduction: the suicidal conduct as a multifactorial and universal phenomenon occurs in all countries of the world, cultures and societies and according of the socio cultural context it varies the attitude towards the phenomenon. Worldwide, this teens´ conduct has increased gradually, trend in which Cuba is also exposed. Objective: the aim of this paper is to characterize the suicidal conduct in adolescents from a clinical epidemiologic point of view. Method: a cross-sectional research on the behavior of suicidal conduct in adolescents from 10 to 19 years old from Holguin Province from 1997 to 2014 was done defining age, sex, suicide environment, risk factors, rates and tendency. A bibliographic review was done considering National Program of prevention of The Suicidal Conduct and data of the Hygiene and Epidemiology Provincial Center. Results: the behavior of the suicide in teens was diminishing from rate from 17.5 per 100 000 inhabitants in 1990, to 2.4 in 2014, for both sexes. The suicidal attempt was high predominating female sex. The ingestion of pills was the most used method. Within the risk factors for the suicidal attempt were found: age between 13-15 and 15-18 years, female sex, and presence of depressing state and lack of a creative project of life in dysfunctional families with predominance of alcoholism, psychiatric disorders, familiar violence and suicidal attempt. Conclusion: the average adolescence and late adolescence constitute risk factors, aggravated by depressing upsets, lack of a creative project of life, in dysfunctional families with disorders or problems related with mental health.

The Relationships Among Highly Caffeinated Beverage Intake and Depressive Symptom, Suicide in Adolescents / 정신신체의학

OBJECTIVES: Despite the increased popularity of highly caffeinated beverages, there is little research examining psychiatric adverse effects. The purpose of this study was to investigate the relationships among pattern of highly caffeinated beverage intake and depressive symptom, suicidal ideation, suicidal plan, suicidal attempt in Korean adolescents. METHODS: The data was obtained from the 2014 Korean Youth's Risk Behavior Web-based Study by Korea Centers for Disease Control & Prevention. All participants conducted web-based questionnaire survey. Chisquare test and multiple logistic regression analysis were performed to determine the association among highly caffeinated beverage intake pattern, depressive symptom, suicidal ideation, suicidal plan and suicidal attempt adjusting for differences in age, gender, academic achievement, socioeconomic status. RESULTS: A total of 71,638 participants were enrolled in this study. Depressive symptom, suicidal ideation, suicidal plan and suicidal attempt were significantly more frequent in the group with presence of highly caffeinated beverage intake within 1 week than in non-drinker group(p<0.01). Highly caffeinated beverage intake was significantly associated with suicidal attempt(OR=1.99 ; 95% CI, 1.77–2.22). In addition, depressive symptom, suicidal ideation, suicidal plan and suicidal attempt were significantly more common in the group with heavydrinker who exceed recommended daily intake dose of caffeine than in the group with light-drinker(p<0.01). Heavy drinking of caffeinated beverage was significantly associated with suicidal attempt(OR=4.05 ; 95% CI, 3.02–5.43). CONCLUSIONS: We found that highly caffeinated beverage intake was related to more frequent depressive symptom, suicidal ideation, plan, attempt in adolescents. Also, caffeine intake which exceed recommended daily intake dose identified the predictor of suicidal attempt. Our result suggested that clinicians need to be aware of the possible psychiatric adverse effects of highly caffeinated beverage in vulnerable population including young adolescents.

Evaluation of a Functional Model of Acquired Capability for Suicide in a Nationwide Sample of Korean Adults

OBJECTIVE: We examined a functional model of acquired capability for suicide, which was elaborated from the “Interpersonal-Psychological Theory of Suicide”. METHODS: A total of 6,027 Korean community subjects were recruited from The Korean Epidemiologic Catchment Area study conducted in 2011. The subjects were assessed systematically using the Korean version of the Composite International Diagnostic Interview version 2.1, the Korean version of the Barratt Impulsiveness Scale, and the Korean version of the Mood Disorder Questionnaire. We used structural equation modeling to identify potential factors contributing to a suicide attempt. RESULTS: Most aspects of the model were supported by the data and “the short-term enhancer for the acquired capability for suicide” had direct effects on suicide attempts. However, the suicidal planning effects of “the short-term enhancer for the acquired capability for suicide” were eliminated by the rule of parsimony. CONCLUSION: The main finding was that “the short-term enhancer for the acquired capability for suicide” is relevant to suicide attempts when it's direct, indirect, and reciprocal effects are tested within a more complete system of relationships than found in existing studies. The implications of these findings are discussed with regard to future conceptual work and empirical research.

Comportamiento de algunos factores de riesgo del intento suicida en adolescentes / Behavior of some suicidal attempt risk factors in teenagers

Se realizó un estudio descriptivo, longitudinal, retrospectivo, en 71 adolescentes con intento suicida, pertenecientes al Policlínico Comunitario José Martí Pérez, de la provincia Santiago de Cuba, en el período comprendido de enero de 2012 a diciembre de 2013, con el fin de determinar el comportamiento de los factores de riesgo que estuvieron presentes en estos adolescentes. Se encontró un predominio del sexo femenino, con un 74,5 %, y del grupo de edad de 15 a 19 años, con un 63,4 %. El mayor número de estos adolescentes estudian (64,8 %) y tienen un 49,3 % de nivel de escolaridad preuniversitario, de ellos un 69,1 % pertenecía a familias disfuncionales. Los principales factores de riesgo encontrados fueron los antecedentes familiares hereditarios, con un 19,7 %, y la ruptura de relaciones amorosas, con un 16,9%, siendo la ingestión de psicofármacos el método empleado más frecuente (53,7 %).

We carried out a descriptive, longitudinal, retrospective study, in 71 teenagers who committed suicidal attempt, belonging to Community Policlinic José Martí Pérez, of Santiago de Cuba province, in the period from January 2012 to December 2013, with the aim of determining the behavior of the risk factors that were present in these teenagers. We found a predominance of the female genre, with 74,5 %, and the 15-19 years age group, with 63,4 %. The higher number of teenagers were students (64,8 %) and 49,3 % were senior high school students (pre-university scholarship); 69,1 % of them were members of dysfunctional families. The main risk factors we found were hereditary familiar antecedents, with 19,7 %, and love relations rupture, with 16,9 %, being psycho drugs ingestion the most frequently used method (53,7 %).

The Predictor of Suicidal Ideation and Attempt of Middle School Adolescents in an Urban Community / 신경정신의학

OBJECTIVES: This study was conducted in order to explore the prevalence of suicidal behavior and the risk or protecting factors. In addition, childhood trauma, school violence, and social support were hypothesized to have an association with suicidal behavior. METHODS: Data were collected by self-report questionnaire from 1219 students selected from middle schools in Guri-city, Korea. The students were asked to complete self-questionnaires and sociodemographic variables were collected for identification of factors associated with suicidal behavior. RESULTS: The prevalence of suicidal attempt was 1.1% (0.6%, 1.3%) from the total sample. Meaningful predictors of suicidal ideation were female, low socioeconomic status, low self-esteem, emotional abuse, neglect, delinquency, perpetration of school violence, family support, and friend support, in addition to the significant effect of depressive mood. In the case of suicidal attempt, female, low socioeconomic status, or delinquency showed a significant incremental effect, in addition to the explaining variance of depressive mood and suicidal ideation. CONCLUSION: Childhood experience should be dealt with, and school violence should be controlled in order to modulate mood disturbance and pessimistic ideation, which can block the channel to suicidal attempt. In addition, development of strategies for management of depression and delinquency is needed for prevention of suicidal attempt.

Factores relacionados con la carga de discapacidad en personas con intento de suicidio, atendidas en la red pública de servicios de salud de Santiago de Cali / Factors related to the disability burden in people with suicidal attempts attended in the public health care service network of Santiago de Cali

Introducción: Según la Organización Mundial de la Salud, las secuelas del intento de suicidio constituyen la sexta causa de mala salud y discapacidad en el mundo. Objetivo: Establecer los grados de discapacidad y sus factores relacionados, en términos de restricciones en la participación y limitaciones en la actividad, en personas con intento de suicidio entre septiembre del 2009 y junio del 2010, atendidas en la Red Pública de Servicios de Salud de Santiago de Cali. Método: Estudio observacional de corte transversal en 126 personas con intento de suicidio, con edades entre 15 y 65 años. Se empleó la versión en español de la Escala de Evaluación de Discapacidad de la Organización Mundial de la Salud. Resultados: Se calcularon 30 años de vida ajustados en función de la discapacidad (AVAD), se estimó una prevalencia del 95,3 % de discapacidad. El 4,6 % de la muestra no presenta discapacidad; el 41,27 %, discapacidad leve; el 38,1 %, discapacidad moderada, y el 15,87 %, discapacidad severa. Los factores relacionados con discapacidad fueron: edad, ocupación, presencia de enfermedad mental, presencia de síntomas depresivos actuales, métodos fatales, consumo de medicamentos psiquiátricos, limitaciones en la actividad, restricciones en la participación y no práctica religiosa. Conclusiones: La prevalencia de discapacidad en personas con intento de suicidio atendidas en la Red Pública de Servicios de Salud de Santiago de Cali fue del 95,3 %. Los resultados son acordes con el estudio de carga mundial de enfermedad que establece una alta carga para trastornos mentales asociados a intento de suicidio. La presencia de una deficiencia posterior al intento de suicidio incrementa la carga de discapacidad.

Introduction: According to the World Health Organization (WHO), the aftermaths of suicide attempts are the sixth leading cause of poor health and disability in the world. Object: Establish the level of disability and related factors in terms of restrictions regarding participation and activity limitations in cases of suicidal attempts attended by the Public Service Network Health of Santiago de Cali, from September 2009 to June 2010. Methodology: A cross-section, observational study was applied to 126 people between 15 and 65 who had attempted suicide and were treated at the Public Health Service in Santiago de Cali. A Spanish version of the Disability Assessment Scale of the World Health Organization Results: 30 disability-adjusted life years (DALYs) were calculated together with a disability prevalence of 95.3%. 4.6% of the sample did not show disability while 41.27% had mild disability, 38.1%, moderate disability, and 15.87%, severe disability. Factors related with disability were: Age, occupation, presence of mental illness, current depressive symptoms, lethal methods, use of psychiatric drugs, activity limitations, participation restrictions and lack of religious practice. Conclusions: The prevalence of disability in people who have committed suicidal attempts treated at the public health services in Santiago de Cali, was 95.3%. The results are consistent with the study of global burden of disease that establishes a high score for mental disorders in suicidal attempts. The presence of a deficiency after the suicide attempt increases the burden of disability.

The result of the assessing delusion symptoms in alcohol related psychosis / Монголын Анагаах Ухаан

Background. Acute alcohol delusions of persecution usually show up delusions of persecution, which is begun auditory hallucination, illusion, fair, anxiety in night time. The patient may conduct to attempt suicide or social harmful activities from the fair and the anxiety. Therefore, we studied types of delusion in alcohol related psychosis and risks of social harmful activities due to delusion. Aim. To identify types of delusion in alcohol related psychosis, risks of social harmful activities due to delusion.Materials and Methods. The study was conducted on the 110 cases of suicide (100 cases among males and 10 cases among females). In the study used special questionnaire with 45 chapters and 431 questions. The current mental condition was identified by the objective and subjective history of patients with Michigan scale questionnaire.Results. We were compared forms of alcohol related psychosis to delusion symptoms, there were occurred 29.6% of 64 patients with delusions of persecution during withdrawal state with delirium without convulsions (F10.40) and 34.4% of 64 patients with delusions of persecution during predominantly delusional psychotic disorder (F10.52). Those patients in 37 case (or 33.6%) were with suicidal thinking and 20 patients (or 18.2%) made suicidal attempts. 23.4% of 64 patients with delusions of persecution, 24.07% of 54 patients with hallucinatory delirium made suicidal attempts.Conclusions. Delusion symptoms in alcohol related psychosis are belonged to clinical form and were showed up many types.

Associations of Social Participation and Trust with Suicidal Ideation and Attempt in Communities with High Mortality / 農村醫學 地域保健

OBJECTIVES: This study was performed to identify the associations of social capital with suicidal thoughts and attempts in Korean communities with poor health. METHODS: We used the data from community health interviews conducted at 40 administrative sections (dong, eup, or myeon) with high mortality from August to October in 2010, 2011, and 2012 as part of the Health Plus Happiness Plus Projects in Gyeongsangnam-do Province. The 8,800 study subjects composed of 220 adults systematically sampled from each administrative section were asked if they had thought about suicide or had attempted suicide within 1 year. The social participation was measured with 'participation in formal and/or informal group' and trust using responses to three questions about trust of others. RESULTS: The prevalence of suicidal ideation and attempt within 1 year were 10.4% and 0.8%, respectively. The logistic regression analysis revealed that those who participated in only informal groups, or had highest trust level reported less suicidal ideation, or attempt after adjusting for socio-demographic factors (sex, age, marital status, occupation, and food affordability), self-rated health, and health behaviors (smoking, alcohol drinking, and exercise). CONCLUSIONS: This study suggested social capital such as social participation and trust was associated with less suicide ideation and attempt. More studies are warranted for the association of social capital with suicidal behavior.

Relationship Between Current Sleep Duration and Past Suicidal Ideation or Attempt Among Korean Adolescents / 예방의학회지

OBJECTIVES: To comprehensively examine the relationship between current sleep duration and past suicidal idea or attempt among Korean adolescents. METHODS: Data came from the 2009 Korea Youth Risk Behavior Web-based Survey with 75 066 participants (with the participation rate of 97.6%) in 800 middle and high schools. Binary logistic regression was conducted by gender and depressed mood to identify significant factors for suicidal ideation/attempt. The dependent variable was the log odds of suicidal ideation/attempt, while the independent/control variables were sleep duration and other demographic, socio-economic and health-related factors. RESULTS: A negative association between sleep duration and suicidal ideation or attempt was weaker for those with depressed mood than for those without such experience in Korea for Year 2009. The odds ratio of suicidal ideation/attempt regarding less than 4 hours of sleep compared to 6 to 7 hours of sleep, was smaller in a group with depressed mood than in a group without such experience, for example, 1.64 (95% confidence interval [CI], 1.29 to 2.08) vs. 2.06 (95% CI, 1.34 to 3.17) for men's suicidal ideation, 2.50 (95% CI, 1.69 to 3.69) vs. 3.89 (95% CI, 1.74 to 8.66) for men's suicidal attempt. A negative association between age (or self-rated health) and suicidal ideation/attempt was also weaker for those with depressed mood than for those without such experience in the nation for the year. CONCLUSIONS: There was a negative association between sleep duration and suicidal ideation/attempt in Korea for Year 2009 and this association was weaker for those with depressed mood than for those without such experience. Based on the findings of this study, adolescents' better mental health and longer, more comfortable sleep might help to prevent their suicidal ideation and attempt in Korea.

Caracterización de algunos factores socio-psicológicos en adolescentes con intento suicida en el municipio Morón / Characterization of sociopsychological factors in adolescents with suicidal attempt in Morón municipality

Se realizó un estudio observacional descriptivo en los adolescentes con intento suicida del municipio Morón, provincia Ciego de Ávila, en el período comprendido de enero 2009 hasta noviembre 2010, con el objetivo de caracterizar algunos factores socio-psicológicos en estos adolescentes asociados a dicho comportamiento. El universo estuvo formado por todos los adolescentes entre 11 y 18 años que realizaron intento suicida en dicho período. La muestra quedó constituida por 28 adolescentes a los que se le aplicó una encuesta para el control y la tipificación de la conducta suicida, la que ha sido validada en estudios realizados. Entre los resultados fundamentales predominaron las edades comprendidas entre 15 y 16 años y el sexo femenino; dentro de las manifestaciones del comportamiento suicida anterior estuvieron el intento suicida previo seguida de la ideación. En los factores de riesgo familiares se constató la existencia de dificultad en la comunicación con sus padres, divorcio y agresión física y verbal; en los escolares resultó ser el rechazo escolar, y en los personales la tristeza, aburrimiento y amistades que han intentado contra su vida. Todo lo anterior lleva a la conclusión de la necesidad de proponer un sistema de acciones para actuar sobre estos factores de riesgo.

An observational descriptive study was carried out on adolescents with suicidal attempt in Moron, Ciego de Avila province, from January 2009 to November 2010, with the aim of characterizing some sociopsychological factors in these adolescents asociated to this behavior. The universe was constituted by all adolescents between 11 and 18 years old with suicidal attempt in this period. The sample was composed of 28 adolescents to whom a survey was applied for the control and classification of suicidal conduct the one that has been validated in conducted studies. Between the fundamental results the ages between 15 and 16 years and feminine sex predominated; within the manifestations of previous suicide behavior were previous suicidal attempt followed by the ideation. In the risk familiar factors the existence of difficulty in the communication with their parents, divorce and physical and verbal aggression was stated; in the students it turned out to be the scholar rejection, and in the personal the sadness, boredom and friendships that have tried against their life. All the previous one takes to the conclusion of the necessity to propose an action system to act on these risk factors.

Experiencias sobre el impacto del Programa de Formación en Ética de la Investigación Biomédica y Psicosocial en el ámbito de la salud mental y la investigación conductual / Experiências sobre o impacto do Programa de Formação em Ética da Pesquisa Biomédica e Psicossocial no âmbito da saúde mental e pesquisa comportamental / Experiences about the impact of the Ethics of Biomedical and Psychosocial Research Training Program in mental health and behavioral research field

El propósito de este trabajo es presentar el impacto y la integración que los conocimientos adquiridos en el Programa Internacional de Formación en Ética de la Investigación Biomédica y Psicosocial de la Universidad de Chile han tenido en mi experiencia profesional, en el ámbito de la investigación psicosocial en un Instituto de Salud de México. Para este objetivo, expondré tres áreas en las cuales se ha podido evidenciar tal impacto: trabajo en los comités de ética, desarrollo de programas de académicos en bioética e investigación y publicación sobre ética y bioética. El motivo que me llevó a incursionar en el Programa fue que su enseñanza vincula la investigación psicosocial con la ética y la bioética, lo cual me permitió dirigir este tipo de reflexión hacia problemas como violencia, suicidio, adicciones, depresión y salud mental, y a nuevos campos como los estudios comunitarios, con poblaciones en riesgo o vulnerables, en los cuales las diversas implicaciones son difíciles de indagar.

The purpose of this article is to present the impact and the integration of knowledge acquired in the international ethics of biomedical and psychosocial research training program of the University of Chile has had in my professional experience in the field of psychosocial research at a Mental Health Institute in Mexico. With this purpose, I will develop three areas of clear impact: participation in scientific ethical review committees, development of academic programs in bioethics and research and publication on ethics and bioethics. My motivation to enter in the program was that this training links psychosocial research with ethics and bioethics, which allows me to apply this type of reflection to problems such as violence, suicide, addictions, depression and mental health, and new fields such as community studies with vulnerable or at risk populations, in which the diverse implications are difficult to inquire.

O propósito deste trabalho é apresentar o impacto e a integração que os conhecimentos adquiridos no Programa Internacional de Formação em Ética da Pesquisa Biomédica e Psicossocial da Universidade do Chile tiveram em minha experiência profissional no âmbito da pesquisa psicossocial no Instituto de Saúde do México. Para este objetivo, mostrarei três áreas nas quais foi possível evidenciar tal impacto: trabalho nos comitês de ética, desenvolvimento de programas acadêmicos em bioética e pesquisa e publicação sobre ética e bioética. O motivo que me levou a incursionar no Programa foi que o seu aprendizado vincula a pesquisa psicossocial com a ética e a bioética, o que me permitiu dirigir este tipo de reflexão para problemas como violência, suicídio, toxicofilias, depressão e saúde mental, e a novos campos como os estudos comunitários com populações em risco ou vulneráveis, nas quais as diversas implicações são difíceis de indagar.

Intoxicaciones exógenas en una unidad de cuidados intensivos pediátricos / Exogenous poisoning at a pediatric intensive care unit

Se realizó un estudio epidemiológico, descriptivo y transversal de 48 pacientes ingresados por intoxicaciones exógenas agudas en la Unidad de Cuidados Intensivos del Hospital Infantil Norte Docente "Juan de la Cruz Martínez Maceira" de Santiago de Cuba, desde enero del 2006 hasta diciembre del 2010, con vistas a caracterizarles según algunas variables clinicoepidemiológicas. En la serie, predominaron las edades de 10 a 14 años, el sexo femenino, el intento suicida como antecedente personal de mayor importancia, el estado grave de los pacientes al hospitalizar, la procedencia urbana, especialmente del municipio cabecera (Santiago de Cuba), y los medicamentos como el xenobiótico causal más frecuente, con prevalencia de la carbamazepina. Para evaluar la información se utilizó el cálculo porcentual y los resultados fueron expresados en porcentaje, los cuales mostraron la necesidad de continuar perfeccionando las estrategias de intervención, con la integración de los niveles primario y secundario de atención sanitaria.

An epidemiological descriptive and cross-sectional study was conducted in 48 patients admitted due to acute exogenous poisoning at the Intensive Care Unit of "Juan de la Cruz Martínez Maceira" Northern Teaching Children Hospital in Santiago de Cuba, from January 2006 to December 2010, with the purpose of characterizing them according to some clinical epidemiological variates. Ages between10 and 14 years, female sex, suicidal attempts as the most important past medical history predominated in the series, as well as the critical condition of patients to be hospitalized, urban origin, especially from Santiago de Cuba municipality and drugs as the most frequent causative xenobiotic with prevalence of carbamazepine. To evaluate the information the percentage calculation was used and the results were expressed as a percentage, which showed the need to continue to improve intervention strategies, with the integration of primary and secondary levels of care.