Characterization of suicide attempts and self-harm by adolescents and adults notified in Santa Catarina, Brazil, 2014-2018

Pinheiro, Thayse de Paula; Warmling, Deise; Coelho, Elza Berger Salema

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Epidemiologia e Serviços de Saúde

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Original Article • Epidemiol. Serv. Saúde 30 (4) • 2021 • https://doi.org/10.1590/S1679-49742021000400026 copy

Characterization of suicide attempts and self-harm by adolescents and adults notified in Santa Catarina, Brazil, 2014-2018^* * Article derived from the Academic Master’s Degree dissertation entitled ‘Suicide attempts and self-harm by adolescents and adults notified in Santa Catarina - Brazil’, defended by Thayse de Paula Pinheiro at the Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal de Santa Catarina, in December 2020.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective

To characterize adolescent and adult suicide attempts and self-harm reported in Santa Catarina, Brazil, from 2014 to 2018.

Methods

This was a cross-sectional descriptive study with data from the Notifiable Health Conditions Information System. The sociodemographic, clinical and type of self-inflicted violence characteristics among adolescents and adults were compared.

Results

Among the 8,859 notifications analyzed, suicide attempts predominated in relation to self-mutilation; self-inflected violence was more frequent in females, those of white skin color and with mental disorders; it occurred more at home, in both age groups. Among adolescents, repeated self-mutilation (83.3%) stood out, while among adults, repeated suicide attempts (50.6%) and suspected alcohol use (18.3%) at the time of violence stood out.

Conclusion

We identified high prevalence of attempted suicide among adolescents and adults; the characteristics of violence were similar between the age groups analyzed.

Keywords:
Attempted Suicide; Self-mutilation; Self-injury; Self-aggression; Adolescents; Adults; Violence; Cross-sectional Studies

Adolescent and adult characteristics	Total	Adolescents		Adults		p-value^c
Adolescent and adult characteristics	n (%)	n (%)	95%CI^b	n (%)	95%CI^b	p-value^c
Sex						<0.001
Female	5,860 (69.2)	1,312 (73.4)	71.2;75.3	4.548 (68.1)	66.9;69.2
Male	2,604 (30.8)	476 (26.6)	24.6;28.7	2.128 (31.9)	30.7;33.0
Race/skin color						0.343
White	7,291 (89.2)	1,565 (90.0)	88.4;91.3	5.726 (89.0)	88.2;89.7
Black/brown	840 (10.3)	164 (9.4)	8.1;10.8	676 (10.5)	9.7;11.2
Yellow/Indigenous	39 (0.5)	10 (0.6)	0.3;0.10	29 (0.5)	0.3;0.6
Type of disability or disorder						0.005
Mental disorders^d	3,152 (98.3)	510 (96.8)	94.8;97.9	2,642 (98.5)	98.0;98.9
General disabilities^e	56 (1.7)	17 (3.2)	2.0;5.1	39 (1.5)	1.0;1.9
Marital status						<0.001
Single	3,537 (49.9)	1,350 (92.4)	90.9;93.6	2,187 (38.8)	37.5;40.1
Married/consensual union	2,905 (41.0)	104 (7.1)	5.9;8.5	2,801 (49.8)	48.4;51.0
Separated	564 (7.9)	6 (0.4)	0.1;0.9	558 (9.9)	9.1;10.7
Widowed	85 (1.2)	1 (0.1)	0.0;0.4	84 (1.5)	1.2;1.8
Schooling						<0.001
No schooling	23 (0.4)	1 (0.1)	0.0;0.5	22 (0.5)	0.3;0.6
Incomplete elementary education	1,921 (31.5)	505 (38.2)	35.3;40.8	1,416 (29.6)	28.3;30.9
Complete elementary education	1,731 (28.4)	564 (42.6)	39.9;45.3	1,168 (24.5)	23.2;25.6
Complete high school education	2,058 (33.7)	248 (18.8)	16.7;20.9	1,810 (37.9)	36.5;39.2
Complete higher education	365 (6.0)	5 (0.3)	0.1;0.9	360 (7.5)	6.8;8.3

Characteristics of the suicide attempt	Total	Adolescents		Adults		p-value^c
Characteristics of the suicide attempt	n (%)	n (%)	95%CI^b	n (%)	95%CI^b	p-value^c
Happened previously						<0.001
Yes	3,401 (49.5)	702 (45.8)	43.2;48.2	2,699 (50.6)	49.2;51.9
No	3,466 (50.5)	832 (54.2)	51.7;56.7	2,634 (49.4)	48.0;50.7
Means of aggression^d
Poisoning	5,431 (64.2)	1,141 (64.0)	61.7;66.2	4,290 (64.4)	63.2;65.5	0.746
Hanging	572 (6.8)	86 (4.8)	3.9;5.9	486 (7.3)	6.7;7.9	<0.001
Sharp object	887 (10.5)	286 (16.0)	14.3;17.8	601 (9.0)	8.3;9.7	<0.001
Blunt object	38 (0.4)	11 (0.6)	0.3;1.1	27 (0.4)	0.2;0.5)	0.238
Firearm	30 (0.4)	4 (0.2)	0.0;0.5	26 (0.3)	0.3;0.5	0.256
Place of occurrence						<0,001
Home	7,689 (92.4)	1,619 (91.9)	90.6;93.1	6,070 (92.4)	91.7;92.9
School	32 (0.3)	29 (1.6)	1.1;2.3	3 (0.0)	0.0;0.1
Collective housing	52 (0.6)	22 (1.2)	0.8;1.8	30 (0.5)	0.3;0.6
Public thoroughfare	274 (3.3)	39 (2.2)	1.6;3.0	235 (3.6)	3.1;4.0
Commerce	52 (0.6)	10 (0.5)	0.3;1.0	42 (0.6)	0.4;0.8
Other	232 (2.8)	41 (2.3)	1.7;3.1	191 (2.9)	2.5;3.3
Suspected use of alcohol						<0,001
Yes	1,130 (16.2)	135 (8.8)	7.4;10.3	995 (18.3)	17.3;19.3
No	5,836 (83.8)	1,396 (91.2)	89.6;92.5	4,440 (81.7)	80.6;82.6

Adolescent and adult characteristics	Total	Adolescents		Adults		p-value^c
Adolescent and adult characteristics	n (%)	n (%)	95%CI^b	n (%)	95%CI^b	p-value^c
Sex						0.105
Female	146 (76.4)	109 (79.6)	71.8;85.5	37 (68.5)	54.5;79.7
Male	45 (23.6)	28 (20.4)	14.4;28.1	17 (31.5)	20.2;45.4
Race/skin color						0.031
White	143 (81.8)	105 (85.4)	77.8;90.6	38 (73.1)	59.0;83.6
Black/brown	30 (17.1)	18 (14.6)	9.3;22.1	12 (23.1)	13.3;36.8
Yellow/Indigenous	2 (1.1)	-	-	2 (3.8)	0.9;14.7
Type of disability or disorder						0.168
Mental disorders^d	95 (99.0)	63 (100.0)	-	32 (97.0)	80.2;99.6
General disabilities^e	1 (1.0)	-	-	1 (3.0)	0.3;19.7
Marital status						<0.001
Single	138 (83.6)	112 (98.2)	93.1;99.5	26 (51.0)	37.0;64.7
Married/consensual union	23(14.0)	2 (1.8)	1.2;6.8	21 (41.1)	28.2;55.4
Separated	3 (1.8)	-	-	3 (5.9)	1.8;17.2
Widowed	1 (0.6)	-	-	1 (2.0)	0.2;13.4
Schooling						<0.001
No schooling	-	-	-	-	-
Incomplete elementary education	72 (46.5)	64 (55.6)	46.3;64.5	8 (20.0)	10.0;35.9
Complete elementary education	56 (36.1)	47 (40.9)	32.1;50.2	9 (22.5)	11.7;38.6
Complete high school education	25 (16.1)	4 (3.5)	1.2;9.0	21 (52.5)	36.6;67.8
Complete higher education	2 (1.3)	-	-	2 (5.0)	1.1;18.8

Self-mutilation characteristics	Total	Adolescents		Adults		p-value^c
Self-mutilation characteristics	n (%)	n (%)	95%CI^b	n (%)	95%CI^b	p-value^c
Happened previously						0.047
Yes	126 (73.3)	105 (83.3)	75.6;88.9	32 (69.6)	54.3;81.4
No	46 (26.7)	21 (16.6)	11.0;24.3	14 (30.4)	18.5;45.6
Means of aggression^d
Sharp object	166 (86.4)	127 (92.7)	86.8;96.0	39 (72.2)	58.4;82.7	<0.001
Blunt object	6 (4.4)	6 (4.3)	1.9;9.4	-	-	0.118
Place of occurrence						0.082
Home	174 (92.1)	125 (91.9)	85.8;95.4	49 (92.4)	81.0;97.2
School	5 (2.6)	5 (3.7)	1.5;8.6	-	-
Collective housing	6 (3.2)	5 (3.7)	1.5;8.6	1 (1.9)	0.2;12.9
Other	4 (2.1)	1 (0.7)	0.1;5.0	3 (5.7)	1.7;16.6
Suspected use of alcohol						0.031
Yes	20 (10.4)	10 (9.5)	5.1;16.9	10 (22.7)	12.3;37.9
No	129 (67.1)	95 (90.5)	83.0;94.8	34 (77.3)	62.0;87.6

Secretaria de Vigilância em Saúde e Ambiente - Ministério da Saúde do Brasil SRTVN Quadra 701, Via W5 Norte, Lote D, Edifício P0700, CEP: 70719-040, +55 61 3315-3464, Fax: +55 61 3315-3464 - Brasília - DF - Brazil
E-mail: ress.svs@gmail.com

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[1] Correspondence:
Thayse de Paula Pinheiro - Secretaria Municipal de Saúde, Av. Acioni Souza Filho, No. 403, 3º andar, Praia Comprida, São José, SC, Brasil. CEP: 88111-330. E-mail: thaysepinheiro@gmail.com