ABSTRACT
Suicidal behaviour is a major public health problem that needs to be tackled by all health agents including mental health nurses. AIMS: The purpose of this study was to analyse the relationship between demographic and clinical characteristics and different kinds of suicidal behaviour with a nurse-led suicide prevention programme. METHODS: The design was a cross-sectional study, performed in the region of Osona (Catalonia) in the five-year period 2013-2017. Suicidal behaviour was classified as suicidal ideation, interrupted self-directed violence, suicide attempt or completed suicide. RESULTS: The sample included 753 patients (of whom 53 completed suicide) who experienced 931 suicidal behaviour episodes. Men represented only 38.4% of the sample but 81.1% of completed suicides. Mental disorders were associated with suicidal behaviour in 75.4% of the sample. Two thirds (66.4%) of the individuals (0.8% (n = 4) of whom completed suicide) were participants in a nurse-led suicidal behaviour case management programme. CONCLUSION: The main risk factors were being a woman for suicidal behaviour and being a man and being older for completed suicide. Mental disorders, widowhood and retirement were also associated with completed suicide. The completed suicide rate was lower among participants in the nurse-led programme.
Subject(s)
Community Health Nursing , Preventive Health Services , Suicide, Attempted , Community Health Nursing/statistics & numerical data , Cross-Sectional Studies , Demography , Female , Humans , Male , Mental Disorders/epidemiology , Nurses , Preventive Health Services/statistics & numerical data , Risk Factors , Suicidal Ideation , Suicide, Attempted/prevention & control , Suicide, Attempted/psychology , Suicide, Attempted/statistics & numerical dataABSTRACT
Introducción. El objetivo del presente estudio es describir el perfil de las muertes por suicidio en la comarca de Osona (Barcelona) durante el período 2013-2015 y analizar la aplicación de la técnica autopsia psicológica (AP). Material y métodos. El diseño es retrospectivo a partir del registro de suicidios (n=31). La muestra de la AP (n=14) estuvo formada por familiares y personas adultas próximas al fallecido, reclutadas a través del registro del Consorci Hospitalari de Vic. Se utilizó el método de la AP mediante la Semi-Structured Interview for Psychological Autopsy (SSIPA), una entrevista semiestructurada adaptada y validada al español (García-Caballero et al., 2010). Resultados. El perfil mayoritario de las muertes por suicidio corresponde a varones, casados, sin antecedentes psiquiátricos que utilizaron métodos como el ahorcamiento o el arrollamiento por tren. En la submuestra en que se realizó la AP se observa que los factores precipitantes o motivadores están relacionados con problemas a nivel social, familiar y de salud. La prevalencia de psicopatologías diagnosticadas no fue mayoritaria, pero se detectaron rasgos de personalidad vulnerables. En muchos casos hubo preparativos y verbalizaciones previas respecto a sus intenciones, por lo que se deduce que la decisión fue tomada de forma premeditada y no impulsiva. Conclusiones. La AP representa una herramienta eficaz para la obtención de datos relativos al suicidio que pueden ser relevantes y útiles en el diseño y la implementación de programas de prevención, ayudando a detectar la idiosincrasia particular de cada región y permitiendo una mayor adaptación e individualización de dichos programas (AU)
Introduction. The aim of the present study is to describe the pattern of suicide deaths in the region of Osona (Barcelona) during the period 2013-2015, and to analyse the use of the Psychological Autopsy (PA) method. Material and methods. It is a retrospective design using the suicide deaths register (n=31). The PA sample (n=14) was composed of adult relatives and close friends, recruited from the Consorci Hospitalari de Vic. The PA method was performed using the Semi-Structured Interview for Psychological Autopsy (SSIPA), adapted and validated to the Spanish language (García-Caballero et al., 2010). Results. The main profile was of a male, married, with no psychiatric history, and used methods like hanging or being running over by a train. In the sub-sample on which the PA was carried out, it was observed that the main precipitating or motivating factors were those related to social, family, and health problems. The prevalence of diagnosed psychopathologies was not a majority profile, but vulnerable personality traits were found. As most of the cases showed previous preparations and verbalisations regarding their intention, it can be concluded that the decision was not impulsive but deliberate. Conclusions. The PA method is an efficient tool to describe and obtain data about suicide that may be relevant and useful in the design and implementation of prevention programs. Moreover, it may help to perceive the individual characteristics of each region promoting a better adjustment and individualisation of these programs (AU)
Subject(s)
Humans , Male , Female , Middle Aged , Suicide/psychology , Autopsy/methods , Forensic Medicine/legislation & jurisprudence , Suicide/prevention & control , Cause of Death , Confidentiality/legislation & jurisprudence , Algorithms , Spain/epidemiology , Retrospective Studies , Cross-Sectional Studies/methods , Cross-Sectional Studies/statistics & numerical data , 28599ABSTRACT
Introducción. El presente trabajo resulta de la colaboración entre el Consorcio Hospitalario de Vic (CHV) y el Instituto de Medicina Legal de Catalunya (IMLC) a través de la Clínica Médico Forense (CMF) de Vic, para el análisis y valoración de las muertes por suicidio consumado. Material y métodos. Previamente, se establece un acuerdo o convenio que fija los términos de la colaboración entre las 2 instituciones. Se analizan todas las muertes por suicidio consumado desde 2006 en el partido judicial de Vic. Se estudian las variables: edad, sexo, país de origen, estado civil, constitución, medio utilizado, población, época del año, antecedentes patológicos, lugar de los hechos, intentos previos de suicidio y notas de despedida. Se calcula la tasa de incidencia y la distribución de los suicidios según las variables señaladas, y se ponen en práctica una serie de medidas encaminadas a disminuir la incidencia de suicidio. Resultados. El suicidio es más frecuente en varones que en mujeres. Predomina en edades medias y avanzadas de la vida. Los métodos violentos (ahorcadura, precipitación, arrollamiento por tren) son los más frecuentes. Un alto porcentaje de suicidas presenta antecedentes psiquiátricos. Discusión. La tasa de suicidios de Osona es superior a la de Catalunya. Desde el inicio del estudio, la tasa ha disminuido a excepción del último año. Un amplio porcentaje de suicidas con antecedentes psiquiátricos, no seguían el tratamiento. Se sugiere la necesidad de ampliar/modificar el número de variables estudiadas, abordar la autopsia psicológica, así como el beneficio de la participación y colaboración de todos los dispositivos del ámbito de la salud(AU)
Introduction. This work is a collaboration between the Hospital Consortium of Vic (CHV) and the Legal Medicine Institute of Catalonia (LMIC), through Forensic Clinical Services (FCS) of Vic, for the analysis and assessment of deaths by suicide. Material and methods. Prior to the study, we negotiated an agreement establishing the terms of the collaboration between both institutions. We analyzed all deaths by suicide in the judicial district of Vic since 2006. Variables studied were: age, sex, country of origin, marital status, physical constitution, used method, population, time of year, medical and psychiatric history, suicide scene, previous suicide attempts and suicide notes. We calculated the rate of incidence and distribution of suicides according to these variables, and put into practice actions to reduce suicide incidence. Results. Suicide is more common in men than women. It prevails both in middle age and old age of life. Violent methods (hanging, jumping from heights, train impact) are the most frequent. A high percentage of people who committed suicide had a psychiatric history. Discussion. Suicide rate in Osona is higher than in Catalonia. The rate has decreased from the baseline, except for the last year. A large percentage of suicidal patients with a psychiatric history were untreated. This suggests the need to develop programs to increase detection and treatment of people at risk, by means of raising awareness and training of groups in contact with them (gatekeepers). In the future, we will use psychological autopsy to study suicides in order to obtain complete and relevant information(AU)
