Perfil de métodos en intentos de suicidio: tendencias e implicancias para la prevención. Jujuy, noroeste de Argentina
DOI:
https://doi.org/10.22235/cp.v13i2.1872Palabras clave:
métodos, intento de suicidio, sexo, edad, prevenciónResumen
Se realizó la primera descripción del perfil de métodos en intentos suicidas en Jujuy (Argentina) y se discutieron sus implicancias para prevención. El estudio fue epidemiológico, transversal. Se incluyeron todos los intentos suicidas asistidos psicológicamente durante dos bienios en el Servicio de Guardia del principal hospital (n = 481). Usar un solo método fue prevalente (84%) en todas las franjas etarias y ambos sexos, pero combinar métodos caracterizó a masculinos (p< .05). Auto-envenenamiento con medicamentos (39.8%) y auto-lesión mediante cortes (27.3%) fueron los más frecuentes en ambos sexos. Métodos no violentos fueron prevalentes en ambos sexos, aunque masculinos tendieron a usar métodos más violentos y potencialmente más letales. Algunos métodos de los hallados podrían ser objeto de intervenciones preventivas que limiten su disponibilidad (e.g. medicamentos, especialmente psicofármacos, bebidas alcohólicas, lugares de salto, armas de fuego). En cambio, otros métodos (e.g. ahorcamiento, gases, productos de limpieza, etc.) parecen de difícil restricción.
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Agrawal, A., Tillman, R., Grucza, R. A., Nelson, E. C., McCutcheon, V. V., Few, L., … Bucholz, K. K. (2017). Reciprocal relationships between substance use and disorders and suicidal ideation and suicide attempts in the Collaborative Study of the Genetics of Alcoholism. Journal of Affective Disorders, 213, 96-104. doi: 10.1016/j.jad.2016.12.060
Ajdacic-Gross, V., Weiss, M. G., Ring, M., Hepp, U., Bopp, M., Gutzwiller, F., & Rossler W. (2008). Methods of suicide: International suicide patterns derived from the WHO mortality database. Bulletin of the World Health Organization, 86, 726-732.
Beautrais, A. L. (2000). Methods of youth suicide in New Zealand: Trends and implications for prevention. The Australian and New Zealand Journal of Psychiatry, 34(3), 413-419. doi: 10.1080/j.1440-1614.2000.00690.x
Beautrais, A. L. (2003). Suicide and serious suicide attempts in youth: A multiple-group comparison study. The American Journal of Psychiatry, 160(6), 1093-1099. doi: 10.1176/appi.ajp.160.6.1093
Beghi, M., Rosenbaum, J. F., Cerri, C., & Cornaggia, C. M. (2013). Risk factors for fatal and nonfatal repetition of suicide attempts: A literature review. Neuropsychiatric Disease and Treatment, 9, 1725-1736. doi: 10.2147/NDT.S40213
Bergen, H., Hawton, K., Waters, K., Ness, J., Cooper, J., Steeg, S., & Kapur, N. (2012). How do methods of non-fatal self-harm relate to eventual suicide? Journal of Affective Disorders, 136(3), 526-533. doi: 10.1016/j.jad.2011.10.036
Bhaskaran, J., Wang, Y., Roos, L., Sareen, J., Skakum, K., & Bolton, J. M. (2014). Method of suicide attempt and reaction to survival as predictors of repeat suicide attempts: A longitudinal analysis. The Journal of Clinical Psychiatry, 75(8), e802-e808. doi: 10.4088/JCP.13m08879
Birtwistle, J., Kelley, R., House, A., & Owens, D. (2017). Combination of self-harm methods and fatal and non-fatal repetition: A cohort study. Journal of Affective Disorders, 218, 188-194. doi: 10.1016/j.jad.2017.04.027
Bohnert, A. S., Roeder, K. M., & Ilgen, M. A. (2010). Unintentional overdose and suicide among substance users: A review of overlap and risk factors. Drug and Alcohol Dependence, 110(3), 183-192. doi: 10.1016/j.drugalcdep.2010.03.010
Bohnert, A. S., Roeder, K. M., & Ilgen, M. A. (2011). Suicide attempts and overdoses among adults entering addictions treatment: comparing correlates in a U.S. National study. Drug and Alcohol Dependence, 119(1-2), 106-112. doi: 10.1016/j.drugalcdep.2011.05.032
Borges, G., Bagge, C. L., Cherpitel, C. J., Conner, K. R., Orozco, R., & Rossow, I. (2017). A meta-analysis of acute use of alcohol and the risk of suicide attempt. Psychological Medicine, 47(5), 949-957. doi: 10.1017/S0033291716002841
Brent, D. A., Baugher, M., Bridge, J., Chen, T., & Chiappetta, L. (1999). Age- and sex-related risk factors for adolescent suicide. Journal of the American Academy of Child and Adolescent Psychiatry, 38(12), 1497-1505. doi: 10.1097/00004583-199912000-00010
Bridge, J. A., McBee-Strayer, S. M., Cannon, E. A., Sheftall, A. H., Reynolds, B., Campo, J. V., … Brent, D. A. (2012). Impaired decision making in adolescent suicide attempters. Journal of the American Academy of Child and Adolescent Psychiatry, 51(4), 394-403. doi: 10.1016/j.jaac.2012.01.002
Daigle, M. S. (2005). Suicide prevention through means restrictions: Assessing the risk of substitution: A critical review and synthesis. Accident; Analysis and Prevention, 37(4), 625-632. doi: 10.1016/j.aap.2005.03.004
Deisenhammer, E. A., Kuen, D., Ing, Ch.-M., Kemmler, G., Defrancesco, M., von Gleissenthall, G., & Weiss, E. M. (2016). Stability in the choice of method during the period preceding a suicide attempt and in attempt repeaters. The European Journal of Psychiatry, 30(3), 205-217.
Dirección General de Epidemiología Jujuy (2013). Boletín de vigilancia: enfermedades no transmisibles y factores de riesgo. Boletín N° 1: mortalidad. Jujuy: Ministerio de Salud.
Dombrovski, A. Y., Clark, L., Siegle, G. J., Butters, M. A., Ichikawa, N., Sahakian, B., & Szanto, K. (2010). Reward/punishment reversal learning in older suicide attempters. The American Journal of Psychiatry, 167(6), 699-707. doi: 10.1176/appi.ajp.2009.09030407
Grasso, L. (1999). Introducción a la estadística en ciencias sociales y del comportamiento. Córdoba: Universidad Nacional de Córdoba.
Hawton, K., Simkin, S., & Fagg, J. (1997). Deliberate self-harm in alcohol and drug misusers: Patient characteristics and patterns of clinical care. Drug and Alcohol Review, 16(2), 123-129. doi: 10.1080/09595239700186411
Huang, Y. C., Wu, Y. W., Chen, C. K., & Wang, L. J. (2014). Methods of suicide predict the risks and method-switching of subsequent suicide attempts: A community cohort study in Taiwan. Neuropsychiatric Disease and Treatment, 10, 711-718. doi: 10.2147%2FNDT.S61965
Jollant, F., Bellivier, F., Leboyer, M., Astruc, B., Torres, S., Verdier, R., … Courtet P. (2005). Impaired decision making in suicide attempters. The American Journal of Psychiatry, 162(2), 304-310. doi: 10.1176/appi.ajp.162.2.304
Law, C. K., Sveticic, J., & De Leo, D. (2014). Restricting access to a suicide hotspot does not shift the problem to another location. An experiment of two river bridges in Brisbane, Australia. Australian and New Zealand Journal of Public Health, 38(2), 134-138. doi: 10.1111/1753-6405.12157
Lilley, R., Owens, D., Horrocks, J., House, A., Noble, R., Bergen, H., … Kapur N. (2008). Hospital care and repetition following self-harm: Multicentre comparison of self-poisoning and self-injury. The British Journal of Psychiatry, 192(6), 440-445. doi: 10.1192/bjp.bp.107.043380
López Steinmetz, L. C. (2015). Marcadores temporales de riesgo supuesto en casos asistidos psicológicamente en un Servicio de Guardia: descripción de sus distribuciones y confrontación de la hipótesis de asociación entre temporalidad y conductas suicidas. Investigaciones en Psicología, 20(2), 79-93.
López Steinmetz, L. C. (2017a). Caracterización de riesgo diferencial-demográfico en urgencias psicológicas: intento de suicidio y otros motivos de consulta. Revista Argentina de Ciencias del Comportamiento, 9(1), 44-53.
López Steinmetz, L. C. (2017b). Factores psicopatológicos de riesgo en intentos de suicidio. Ciencias Psicológicas, 11(1), 89-100. doi: 10.22235/cp.v11i2.1350
López Steinmetz L. C. (n.d.). Coyunturas desencadenantes de urgencias suicidas: un enfoque psicoanalítico y epidemiológico (Tesis de Doctorado). Buenos Aires: Universidad de Buenos Aires, Facultad de Psicología.
Mateos Rodríguez, A. A., Huerta Arroyo, A., & Benito Vellisca, M. A. (2007). Características epidemiológicas del intento autolítico por fármacos. Emergencias, 19(5), 251-254.
Miller, M., Hempstead, K., Nguyen, T., Barber, C., Rosenberg-Wohl, S., & Azrael, D. (2013). Method choice in nonfatal self-harm as a predictor of subsequent episodes of self-harm and suicide: Implications for clinical practice. American Journal of Public Health, 103(6), e61-e68. doi: 10.2105/AJPH.2013.301326
Milner, A., Witt, K., Maheen, H., & LaMontagne, A. D. (2017). Access to means of suicide, occupation and the risk of suicide: A national study over 12 years of coronial data. BMC Psychiatry, 17(1), 125. doi: 10.1186/s12888-017-1288-0
Móscicki, E. K. (1994). Gender differences in completed and attempted suicides. Annals of Epidemiology, 4(2), 152-158. doi: 10.1016/1047-2797(94)90062-0
Norström, T., & Rossow, I. (2016). Alcohol consumption as a risk factor for suicidal behavior: A systematic review of associations at the individual and at the population level. Archives of Suicide Research, 20(4), 489-506. doi: 10.1080/13811118.2016.1158678
O’Carroll, P. W., Berman, A. L., Maris, R. W., Moscicki, E. K., Tanney, B. L., & Silverman, M- M. (1996). Beyond the Tower of Babel: A nomenclature for suicidology. Suicide & Life-Threatening Behavior, 26(3), 237-252.
Owens, D., Kelley, R., Munyombwe, T., Bergen, H., Hawton, K., Cooper, J., … Kapur, N. (2015). Switching methods of self-harm at repeat episodes: Findings from a multicentre cohort study. Journal of Affective Disorders, 180, 44-51. doi: 10.1016/j.jad.2015.03.051
Runeson, B., Tidemalm, D., Dahlin, M., Lichtenstein, P., & Långström, N. (2010). Method of attempted suicide as predictor of subsequent successful suicide: National long term cohort study. BMJ, 341, c3222. doi: 10.1136/bmj.c3222
Sarchiapone, M., Mandelli, L., Iosue, M., Andrisano, C., & Roy, A. (2011). Controlling access to suicide means. International Journal of Environmental Research and Public Health, 8(12), 4550-4562. doi: 10.3390/ijerph8124550
Skegg, K., & Herbison, P. (2009). Effect of restricting access to a suicide jumping site. Australian and New Zealand Journal of Psychiatry, 43(6), 498-502. doi: 10.1080/00048670902873698
Too, L. S., Spittal, M. J., Bugeja, L., McClure, L., & Milner, A. (2016). Individual and community factors for railway suicide: A matched case-control study in Victoria, Australia. Social Psychiatry and Psychiatric Epidemiology, 51(6), 849-856. doi: 10.1007/s00127-016-1212-9
Wilcox, H. C., Conner, K. R., & Caine, E. D. (2004). Association of alcohol and drug use disorders and completed suicide: An empirical review of cohort studies. Drug and Alcohol Dependence, 76, S11-S19. doi: 10.1016/j.drugalcdep.2004.08.003
World Health Organization (1994). Chapter XX. External causes of morbidity and mortality (V01-Y98). Intentional self harm (X60-X84). En: WHO, Pocket Guide to the ICD-10 Classification of Mental and Behavioral Disorders (pp. 68-70). Edinburgh: Churchill Livingstone.
Ajdacic-Gross, V., Weiss, M. G., Ring, M., Hepp, U., Bopp, M., Gutzwiller, F., & Rossler W. (2008). Methods of suicide: International suicide patterns derived from the WHO mortality database. Bulletin of the World Health Organization, 86, 726-732.
Beautrais, A. L. (2000). Methods of youth suicide in New Zealand: Trends and implications for prevention. The Australian and New Zealand Journal of Psychiatry, 34(3), 413-419. doi: 10.1080/j.1440-1614.2000.00690.x
Beautrais, A. L. (2003). Suicide and serious suicide attempts in youth: A multiple-group comparison study. The American Journal of Psychiatry, 160(6), 1093-1099. doi: 10.1176/appi.ajp.160.6.1093
Beghi, M., Rosenbaum, J. F., Cerri, C., & Cornaggia, C. M. (2013). Risk factors for fatal and nonfatal repetition of suicide attempts: A literature review. Neuropsychiatric Disease and Treatment, 9, 1725-1736. doi: 10.2147/NDT.S40213
Bergen, H., Hawton, K., Waters, K., Ness, J., Cooper, J., Steeg, S., & Kapur, N. (2012). How do methods of non-fatal self-harm relate to eventual suicide? Journal of Affective Disorders, 136(3), 526-533. doi: 10.1016/j.jad.2011.10.036
Bhaskaran, J., Wang, Y., Roos, L., Sareen, J., Skakum, K., & Bolton, J. M. (2014). Method of suicide attempt and reaction to survival as predictors of repeat suicide attempts: A longitudinal analysis. The Journal of Clinical Psychiatry, 75(8), e802-e808. doi: 10.4088/JCP.13m08879
Birtwistle, J., Kelley, R., House, A., & Owens, D. (2017). Combination of self-harm methods and fatal and non-fatal repetition: A cohort study. Journal of Affective Disorders, 218, 188-194. doi: 10.1016/j.jad.2017.04.027
Bohnert, A. S., Roeder, K. M., & Ilgen, M. A. (2010). Unintentional overdose and suicide among substance users: A review of overlap and risk factors. Drug and Alcohol Dependence, 110(3), 183-192. doi: 10.1016/j.drugalcdep.2010.03.010
Bohnert, A. S., Roeder, K. M., & Ilgen, M. A. (2011). Suicide attempts and overdoses among adults entering addictions treatment: comparing correlates in a U.S. National study. Drug and Alcohol Dependence, 119(1-2), 106-112. doi: 10.1016/j.drugalcdep.2011.05.032
Borges, G., Bagge, C. L., Cherpitel, C. J., Conner, K. R., Orozco, R., & Rossow, I. (2017). A meta-analysis of acute use of alcohol and the risk of suicide attempt. Psychological Medicine, 47(5), 949-957. doi: 10.1017/S0033291716002841
Brent, D. A., Baugher, M., Bridge, J., Chen, T., & Chiappetta, L. (1999). Age- and sex-related risk factors for adolescent suicide. Journal of the American Academy of Child and Adolescent Psychiatry, 38(12), 1497-1505. doi: 10.1097/00004583-199912000-00010
Bridge, J. A., McBee-Strayer, S. M., Cannon, E. A., Sheftall, A. H., Reynolds, B., Campo, J. V., … Brent, D. A. (2012). Impaired decision making in adolescent suicide attempters. Journal of the American Academy of Child and Adolescent Psychiatry, 51(4), 394-403. doi: 10.1016/j.jaac.2012.01.002
Daigle, M. S. (2005). Suicide prevention through means restrictions: Assessing the risk of substitution: A critical review and synthesis. Accident; Analysis and Prevention, 37(4), 625-632. doi: 10.1016/j.aap.2005.03.004
Deisenhammer, E. A., Kuen, D., Ing, Ch.-M., Kemmler, G., Defrancesco, M., von Gleissenthall, G., & Weiss, E. M. (2016). Stability in the choice of method during the period preceding a suicide attempt and in attempt repeaters. The European Journal of Psychiatry, 30(3), 205-217.
Dirección General de Epidemiología Jujuy (2013). Boletín de vigilancia: enfermedades no transmisibles y factores de riesgo. Boletín N° 1: mortalidad. Jujuy: Ministerio de Salud.
Dombrovski, A. Y., Clark, L., Siegle, G. J., Butters, M. A., Ichikawa, N., Sahakian, B., & Szanto, K. (2010). Reward/punishment reversal learning in older suicide attempters. The American Journal of Psychiatry, 167(6), 699-707. doi: 10.1176/appi.ajp.2009.09030407
Grasso, L. (1999). Introducción a la estadística en ciencias sociales y del comportamiento. Córdoba: Universidad Nacional de Córdoba.
Hawton, K., Simkin, S., & Fagg, J. (1997). Deliberate self-harm in alcohol and drug misusers: Patient characteristics and patterns of clinical care. Drug and Alcohol Review, 16(2), 123-129. doi: 10.1080/09595239700186411
Huang, Y. C., Wu, Y. W., Chen, C. K., & Wang, L. J. (2014). Methods of suicide predict the risks and method-switching of subsequent suicide attempts: A community cohort study in Taiwan. Neuropsychiatric Disease and Treatment, 10, 711-718. doi: 10.2147%2FNDT.S61965
Jollant, F., Bellivier, F., Leboyer, M., Astruc, B., Torres, S., Verdier, R., … Courtet P. (2005). Impaired decision making in suicide attempters. The American Journal of Psychiatry, 162(2), 304-310. doi: 10.1176/appi.ajp.162.2.304
Law, C. K., Sveticic, J., & De Leo, D. (2014). Restricting access to a suicide hotspot does not shift the problem to another location. An experiment of two river bridges in Brisbane, Australia. Australian and New Zealand Journal of Public Health, 38(2), 134-138. doi: 10.1111/1753-6405.12157
Lilley, R., Owens, D., Horrocks, J., House, A., Noble, R., Bergen, H., … Kapur N. (2008). Hospital care and repetition following self-harm: Multicentre comparison of self-poisoning and self-injury. The British Journal of Psychiatry, 192(6), 440-445. doi: 10.1192/bjp.bp.107.043380
López Steinmetz, L. C. (2015). Marcadores temporales de riesgo supuesto en casos asistidos psicológicamente en un Servicio de Guardia: descripción de sus distribuciones y confrontación de la hipótesis de asociación entre temporalidad y conductas suicidas. Investigaciones en Psicología, 20(2), 79-93.
López Steinmetz, L. C. (2017a). Caracterización de riesgo diferencial-demográfico en urgencias psicológicas: intento de suicidio y otros motivos de consulta. Revista Argentina de Ciencias del Comportamiento, 9(1), 44-53.
López Steinmetz, L. C. (2017b). Factores psicopatológicos de riesgo en intentos de suicidio. Ciencias Psicológicas, 11(1), 89-100. doi: 10.22235/cp.v11i2.1350
López Steinmetz L. C. (n.d.). Coyunturas desencadenantes de urgencias suicidas: un enfoque psicoanalítico y epidemiológico (Tesis de Doctorado). Buenos Aires: Universidad de Buenos Aires, Facultad de Psicología.
Mateos Rodríguez, A. A., Huerta Arroyo, A., & Benito Vellisca, M. A. (2007). Características epidemiológicas del intento autolítico por fármacos. Emergencias, 19(5), 251-254.
Miller, M., Hempstead, K., Nguyen, T., Barber, C., Rosenberg-Wohl, S., & Azrael, D. (2013). Method choice in nonfatal self-harm as a predictor of subsequent episodes of self-harm and suicide: Implications for clinical practice. American Journal of Public Health, 103(6), e61-e68. doi: 10.2105/AJPH.2013.301326
Milner, A., Witt, K., Maheen, H., & LaMontagne, A. D. (2017). Access to means of suicide, occupation and the risk of suicide: A national study over 12 years of coronial data. BMC Psychiatry, 17(1), 125. doi: 10.1186/s12888-017-1288-0
Móscicki, E. K. (1994). Gender differences in completed and attempted suicides. Annals of Epidemiology, 4(2), 152-158. doi: 10.1016/1047-2797(94)90062-0
Norström, T., & Rossow, I. (2016). Alcohol consumption as a risk factor for suicidal behavior: A systematic review of associations at the individual and at the population level. Archives of Suicide Research, 20(4), 489-506. doi: 10.1080/13811118.2016.1158678
O’Carroll, P. W., Berman, A. L., Maris, R. W., Moscicki, E. K., Tanney, B. L., & Silverman, M- M. (1996). Beyond the Tower of Babel: A nomenclature for suicidology. Suicide & Life-Threatening Behavior, 26(3), 237-252.
Owens, D., Kelley, R., Munyombwe, T., Bergen, H., Hawton, K., Cooper, J., … Kapur, N. (2015). Switching methods of self-harm at repeat episodes: Findings from a multicentre cohort study. Journal of Affective Disorders, 180, 44-51. doi: 10.1016/j.jad.2015.03.051
Runeson, B., Tidemalm, D., Dahlin, M., Lichtenstein, P., & Långström, N. (2010). Method of attempted suicide as predictor of subsequent successful suicide: National long term cohort study. BMJ, 341, c3222. doi: 10.1136/bmj.c3222
Sarchiapone, M., Mandelli, L., Iosue, M., Andrisano, C., & Roy, A. (2011). Controlling access to suicide means. International Journal of Environmental Research and Public Health, 8(12), 4550-4562. doi: 10.3390/ijerph8124550
Skegg, K., & Herbison, P. (2009). Effect of restricting access to a suicide jumping site. Australian and New Zealand Journal of Psychiatry, 43(6), 498-502. doi: 10.1080/00048670902873698
Too, L. S., Spittal, M. J., Bugeja, L., McClure, L., & Milner, A. (2016). Individual and community factors for railway suicide: A matched case-control study in Victoria, Australia. Social Psychiatry and Psychiatric Epidemiology, 51(6), 849-856. doi: 10.1007/s00127-016-1212-9
Wilcox, H. C., Conner, K. R., & Caine, E. D. (2004). Association of alcohol and drug use disorders and completed suicide: An empirical review of cohort studies. Drug and Alcohol Dependence, 76, S11-S19. doi: 10.1016/j.drugalcdep.2004.08.003
World Health Organization (1994). Chapter XX. External causes of morbidity and mortality (V01-Y98). Intentional self harm (X60-X84). En: WHO, Pocket Guide to the ICD-10 Classification of Mental and Behavioral Disorders (pp. 68-70). Edinburgh: Churchill Livingstone.
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2019-09-30
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López Steinmetz, L. C. (2019). Perfil de métodos en intentos de suicidio: tendencias e implicancias para la prevención. Jujuy, noroeste de Argentina. Ciencias Psicológicas, 13(2), 197–208. https://doi.org/10.22235/cp.v13i2.1872
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