Biting myself so I don't bite the dust: prevalence and predictors of deliberate self-harm and suicide ideation in Azorean youths

Objective: To characterize non-suicidal self-injury (NSSI) behaviors, methods, and functions as well as suicide ideation in the adolescent population of a Portuguese community in São Miguel Island, Azores. Increasing rates of NSSI behaviors among adolescents have been observed globally, while suicidal behavior has been pointed as a major cause of death during adolescence. Methods: A sample of 1,763 adolescents, aged 14 to 22, was randomly drawn from public and private schools and administered a set of self-report questionnaires. Descriptive and regression analyses were used to look for specific relationships and predictors of NSSI and suicide ideation in this isolated community. Results: Approximately 30% of youths reported at least one NSSI behavior, a rate that is twice as high as most studies carried out in mainland Portugal and in other European countries. Biting oneself was the most frequent form of NSSI, and NSSI behaviors served predominantly automatic reinforcement purposes (i.e., regulation of disruptive emotional states). NSSI and suicide ideation encompassed different distal and proximal risk factors. Conclusions: Exploring and characterizing these phenomena is necessary to provide a better understanding, enhance current conceptualizations, and guide the development of more effective prevention and intervention strategies in youths.

Cancer in the Azores: initial results from a recently established population-based cancer registry / Câncer nos Açores: primeiros resultados de um registro oncológico de base populacional recentemente criado

INTRODUCTION: The Azores archipelago has long been the Portuguese region that presents the highest mortality rates for certain cancers. Lack of incidence data has prevented the evaluation of the actual burden of this disease in the Azorean population. METHODS: Malignant tumours (ICD-O 5th Digit /3) initially diagnosed between the January 1st 2000 and December 31st 2002 were retrieved from the database of the recently established population-based cancer registry. Crude, age-specific and age-standardized rates were calculated and confidence intervals were estimated using Poisson approximation. Relative risks of developing cancer in the Azores when compared to mainland Portugal have been represented by standardized ratios. Quality indicators, including Mortality:Incidence (M:I) ratios, were also assessed. RESULTS: Overall, the data shows a high incidence rate for some malignant diseases, specifically in men. Compared to those living in mainland Portugal, both Azorean men (RR 1.412; 99% CI 1.407-1.416) and women (1.127; 1.125-1.129) presented a significantly higher risk of developing cancer, all sites combined. When compared with other cancer registries, a less favourable cancer survival pattern is reported in the Azores, as emphasized by higher M:I ratios for several cancer sites. CONCLUSIONS: A preliminary analysis of the results suggests the presence of some major risk factors in the Azorean population, namely tobacco smoking in men. Higher M:I ratios would also point to survival disparities between the Azores archipelago and the continent, which should be further studied.

INTRODUÇÃO: O arquipélago dos Açores é a região Portuguesa a apresentar as mais elevadas taxas de mortalidade por câncer desde há alguns anos. A ausência de dados de incidência tem constituído um obstáculo ao conhecimento da distribuição da doença oncológica na população açoriana. METODOLOGIA: Todos os tumores malignos (5º dígito da ICD-O: /3) diagnosticados pela primeira vez entre 1 de Janeiro de 2000 e 31 de Dezembro de 2002 foram retirados da base de dados do Registo Oncológico Regional dos Açores. Foram calculadas as taxas brutas, específicas por idade e padronizadas, e estimados os respectivos intervalos de confiança, bem como os riscos relativos de desenvolver câncer nos Açores, em relação a Portugal continental. Finalmente, foram estabelecidos alguns indicadores de qualidade do Registo, como a razão mortalidade:incidência. RESULTADOS: Em termos globais, os resultados demonstram que alguns cânceres, sobretudo nos homens, apresentam taxas de incidência relativamente elevadas. Considerando todas as localizações, quer os homens (RR 1.412; 99% IC 1.407-1.416) quer as mulheres açorianas (1.127; 1.125-1.129) apresentaram um risco significativamente maior de desenvolver câncer, quando comparados com Portugal continental. No que respeita à razão mortalidade:incidência, os resultados poderão eventualmente apontar para padrões de sobrevivência mais desfavoráveis nos Açores relativamente a outras regiões europeias, incluindo o continente. CONCLUSÃO: Uma análise preliminar dos resultados aponta para a existência de fatores de risco, como o consumo de tabaco, a contribuir para a elevada incidência de câncer do pulmão nos homens açorianos. Eventuais disparidades na sobrevivência por câncer entre os Açores e o continente deverão também ser futuramente estudadas.