Navegando por Palavras-chave "Suicide"

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    Análise das tentativas de suicídio atendidas em emergência pública do município de São Paulo
    (Universidade Federal de São Paulo (UNIFESP), 2014-01-23) Araujo, Thalita Silva Gomes de [UNIFESP]; Marcolan, João Fernando [UNIFESP]; http://lattes.cnpq.br/5449589014899461; http://lattes.cnpq.br/6217484417037796; Universidade Federal de São Paulo (UNIFESP)
    Objetivo: analisar as tentativas de suicídio atendidas em pronto-socorro geral, por meio da definição do perfil epidemiológico dos indivíduos, fatores de risco e predisponentes. Métodos: Estudo transversal, aplicação de questionário semi estruturado por meio de entrevista. População de pacientes atendidos por tentativa de suicídio. Uso de testes qui-quadrado e testes da razão de verossimilhanças. Resultados: 93 participantes; 2:1 a proporção do sexo feminino em relação ao masculino, predomínio de solteiros, jovens, baixa escolaridade, altos índices de desemprego e baixa amplitude de rede social. Ocorrência de subnotificação do diagnóstico para tentativa de suicídio e hegemonia de diagnósticos clínicos, a mascarar magnitude do problema. Altos índices de diagnóstico prévio para depressão, transtorno mental na família, tentativa de suicídio prévia e presença de conflitos nas relações interpessoais. A maioria tinha atendimento profissional prévio, em geral uso de medicamentos. O principal método foi a ingesta medicamentosa, indicativo de melhor controle na prescrição. A maioria tinha planos de novamente tentar se matar. Conclusões: Se faz necessário diminuir o estigma social do sofrimento psíquico, implantar sistema de vigilância ao suicídio e qualificação profissional para adequar a assistência ao indivíduo com comportamento suicida.
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    Aproximações e distanciamentos ao suicídio: analisadores de um serviço de atenção psicossocial
    (Univ Sao Paulo, Fac Saude Publica, 2018) Cescon, Luciana Franca; Capozzolo, Angela Aparecida [UNIFESP]; Lima, Laura Camara [UNIFESP]
    This article is the product of a research-intervention of cartographic perspective, whose objective was to investigate attention to suicide in a psychosocial care service in a municipality of Sao Paulo. The methodological trajectory was dynamically built, in which the final stages were projected based on the analysis of data produced in the initial stages. The instruments used initially were: study of medical records, analysis of care attendance flows, field journals, and semi-structured interviews. The analyses revealed a work process centered on the offer of psychiatric consultations and the medication of suffering, in which the care to suicide was little problematized. In a second moment, conversation groups were held with the workers to share the data and the analysis produced, and to discuss issues emerging from them. The interventions encouraged professionals to rethink their work process. The team resumed the spaces of permanent education, with the objective of analyzing the psychosocial care offerings they produced. From these meetings, they rethought an offer of care that valued listening and welcoming not only in the care to suicide but also to mental suffering. The research also generated a blog about suicide awareness.
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    Associações entre sexo/gênero e suicídio/tentativa de suicídio: revisão integrativa
    (Universidade Federal de São Paulo, 2021-02-18) Oliveira, Ingrid Rodrigues [UNIFESP]; Nakamura, Eunice [UNIFESP]; http://lattes.cnpq.br/5029273945514325; http://lattes.cnpq.br/3655091915263937; Universidade Federal de São Paulo (UNIFESP)
    O suicídio é a segunda maior causa mundial de morte de indivíduos entre 15 a 29 anos. No Brasil é a quarta maior causa de morte entre jovens, no país em média 11.000 pessoas tiram a própria vida por ano e observa-se que mesmo que os homens morram mais por suicídio (79% das mortes), a maior parte das tentativas de suicídio é entre as mulheres (69% das tentativas). Este trabalho teve como objetivo fazer uma revisão integrativa para analisar de que forma os termos sexo e gênero estão associados ao suicídio na literatura nacional. Esta revisão integrativa foi dividida em seis etapas: elaboração da pergunta norteadora, busca ou amostragem na literatura, coleta de dados, análise crítica dos estudos incluídos, discussão dos resultados e apresentação da revisão. Os resultados demonstraram grande número de publicações epidemiológicas, com uso recorrente da variável sexo, trazendo dados que evidenciaram o paradoxo de gênero a nível nacional, estadual e municipal. Apesar da importância desses dados epidemiológicos, as publicações faltam em compreender aspectos específicos relacionados ao suicídio entre diferentes gêneros, podendo se tornar veículos de naturalização de comportamentos. Os estudos trouxeram explicações conflitantes sobre fatores de risco relacionados ao comportamento suicida entre mulheres. Conclui-se que são necessários mais estudos qualitativos compreensivos para entender o sofrimento mental de gênero, levando-se em conta outros aspectos sociodemográficos que atravessam a experiência dos sujeitos, com especial atenção para como esses sofrimentos ocorrem entre as mulheres. A análise de como a imposição de papeis de gênero afeta a saúde mental das pessoas pode ser uma contribuição maior para as pesquisas do que tentar encontrar comportamentos característicos dos gêneros
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    O comportamento suicida em Assis/SP: análise epidemiológica e qualitativa
    (Universidade Federal de São Paulo (UNIFESP), 2020-12-18) Silva, Daniel Augusto da [UNIFESP]; Marcolan, Joao Fernando [UNIFESP]; Universidade Federal de São Paulo
    Introduction: It is estimated that one person every 38 seconds dies by suicide worldwide. Objective: To analyze the epidemiological profile of suicidal behavior in the city of Assis / SP. Methods: Exploratory-descriptive, quantitative and qualitative research, statistical analysis for quantitative data and theoretical framework for content analysis for qualitative data. Data collection carried out between December 2017 and November 2019, with 113 participants who attempted suicide and who were attending the Emergency Care Unit in Assis / SP. An interview was conducted using a semi-structured questionnaire prepared by the authors, recorded on audio, and application of the Beck Depression Inventory. Variables analyzed were sex, age, marital status, sexual orientation, color / race, having children, education level, previous diagnosis for depression / other mental disorder Project approved by the Research Ethics Committee of the Federal University of São Paulo. Results: Among the 113 (100.0%) participants, 86 (76.1%) were female; age varied between 14 and 65 years, with an average of 32.4 years; Most self-declared to be heterosexual, white, single and married / in a stable relationship, without children, with complete high school education, with a previous diagnosis of mental disorder mostly mood disorder, not using drugs. Traumatic events were associated with suicidal behavior by 100 (88.5%) participants, plus incidents of unemployment and financial problems, physical violence and bullying. Most denied a history of suicidal behavior in family members and close people. Place of occurrence of attempted suicide was personal residence for 87 (77.0%) participants; 24 (21.2%) participants affirmed suicide planning, 80 (70.8%) had a personal history of previous suicide attempt, exogenous self-poisoning was the method most used in suicide attempts (73.3%); most decided to attempt suicide due to depressive symptoms and problems in affective relationships, did not give warnings or information about what they would do; half of the participants had no future plan for attempting suicide. Protection factors related to the family model and social / cultural factors. According to the Beck Depression Inventory, 91 (80,5%) presented depressive symptoms, of which 59 (62.1%) participants had no previous diagnosis of depression, 7 (11.9%) were scored for dysphoria and 48 (81.4%) for depression; of the 36 (37.9%) who stated previous diagnosis for depression, 1 (2.8%) was scored for mild depression, 7 (19.4%) for moderate depression and 28 (77.8%) for severe depression. Conclusion: Sociodemographic characteristics related to suicidal behavior in Assis / SP correspond to the national and global reality, with most suicide attempts made by women, at a young age. Qualitative analysis leads to the conclusion that there is an association between family relationships, a history of traumatic experiences and suicidal behavior. Depressive symptoms and problems in affective relationships were the biggest reasons for men and women to attempt suicide.
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    Comportamento suicida por contágio
    (Universidade Federal de São Paulo (UNIFESP), 2021) Souza, Sibele Dos Santos [UNIFESP]; Marcolan, Joao Fernando [UNIFESP]; Universidade Federal de São Paulo
    Introduction: There are controversial scientific data regarding contagious effect on suicidal behavior. Apparently, youth are more susceptible to contagious suicidal behavior. Objective: Analyze the presence of contagious suicidal behavior among federal university students. Methodology: Exploratory descriptive research, qualitative, use of semi-structured survey applied through digital means to college students of the Instituto Federal de Educação de Cubatão/SP; analysis by referential theory of the content analyses. Results: 34 survey responses analyzed; 23 respondents reported some sort of influence with exposure to a suicidal act and some identified themselves with the person who committed suicide, experienced feelings such as, sadness or despair, reported aversion to decision making, feelings of empathy, three considered suicide and wished to do something similar. The majority had relatives with mental health issues; one third had relatives with suicidal thoughts, and in some cases even the survey participant had this behavior. Most of the participants had suicidal thoughts, 7 put themselves in a life-threatening situation, 12 mutilated themselves, 5 planned suicide and 1 attempted suicide. Vulnerable individuals were found to be of higher risk, contagion being real and spread over school and social media. The suicide attempts and suicides were witnessed in person and through the media, videos, and social media. The reactions of those who witnessed the suicidal scene varied between discomfort and sadness, chills, traumatize, frighten, questioning about the theme, motive for the decision and the possibility to prevent it. The reports of identification showed feeling something similar or understanding the suicidal feelings, considering the possibility of suicide, alleviate sad thoughts and to put an end to their own pain. There were manifestations of aversion to the act and disregard to the suicidal individual, get used to living with the thoughts they felt after witnessing and confronting the suicide. The help needed after witnessing the suicidal act included specialty treatment, affection, and positive thoughts, some learned to live with the feelings, others affirmed little impact or resignation of the facts. There were considerations regarding human fragility, facing and sharing of difficult situations, reframing of life and death and about suicidal prevention. Considerations: The data does not allow to affirm by contagion, but by the influence of suicidal behavior some university students were exposed to disclose suicidal attempt and suicide. We highlight the need for additional studies about this topic to justify the plans of public policies and guidelines to prevent suicidal behavior, specifically in interventions regarding the communication and disclosure of suicidal behavior on social media platforms, the need for specific interventions by the government and a better qualification of mental health professionals, especially those of nursing practice, to provide treatment.
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    Consumo de cocaína no Brasil e sua associação com violência Interpessoal e comportamento suicida - II Levantamento Nacional de Álcool e Drogas/
    (Universidade Federal de São Paulo (UNIFESP), 2018-04-25) Abdalla, Renata Rigacci [UNIFESP]; Madruga, Clarice Sandi [UNIFESP]; http://lattes.cnpq.br/0659290459957967; http://lattes.cnpq.br/4831200193760907; Universidade Federal de São Paulo (UNIFESP)
    Introduction: This thesis analyzes the descriptive and analytical data of cocaine use in Brazil and also its associations with two forms of violence: one directed to others, denominated here as interpersonal violence, including both the victimization and perpetration behaviors (excluding domestic violence) and one self-directed, named as suicidal behavior, considering the personal history of suicidal ideation and suicide attempts. These data are based on the II Brazilian National Alcohol and Drugs Survey (BNADS). Objectives: This is the result of three studies with data from the Second National Survey of Alcohol and Drugs (BNADS II) that aims to: Study 1: estimate prevalence of cocaine and crack use (in life and in the last year) between Brazilian adults and adolescents and to analyze possible associations with risk and protection factors. Study 2: Investigate an association between cocaine use and urban violence, having alcohol consumption and the presence of depressive symptoms as mediators. Study 3: Investigate an association between substance use (alcohol, cannabis and cocaine) and suicide ideation and attempt. Method: A cross-sectional household survey based on data from the second national survey of alcohol and drugs covering information on the consumption of all psychotropic substances as well as sales, dependence, violent behaviors and suicidal behavior. The three studies used different cutouts from the original sample of 4507 participants. Multivariate analyzes used different regression model models and chemical odds ratios (ORs) adjusted for associations in the 3 studies. Model of causal pathways for the mediator no study 2. Results: Study 1: In the last year, consumption of all as cocaine forms 2.2% in the total population, excluding the elderly group. The prevalence rate of use in life and in the last year of cocaine aspirate was of 3,9% and 1,7%, respectively. The consumption of cocaine smoked in Brazil was estimated at 1.5% for experimentation and 0.8% in the last year. The dependence on cocaine was identified in 41.4% among the users of the previous year. Study 2: About 9.3% of the Brazilian population has already been the victim of at least one form of urban violence. This proportion increases to 19.7% among cocaine users and to 18.1% among alcohol use disorders (AUD). The perpetration of violence was reported in 6.1% of the sample. The use of cocaine and AUD increased by almost four times as a chance of being an aggressor. Being religious and married were protective factors both in relation to victimization and perpetration. Causal paths analysis was assessed considering cocaine use as a predictor of urban violence (victimization or perpetration) and alcohol consumption and depressive symptoms as mediators of this relation and all the paths were valid. Study 3: Suicide Ideation (SI) and Suicide Attempts (SA) were reported by 9.9% and 5.4% of the sample, respectively. This prevalence was 20.8% and 12.4% among problematic alcohol users, 31.5% and 16.5% among cannabis users and 40.0% and 20.8% among cocaine users. After adjusting for demographic characteristics, religion, tobacco use, family history of suicide and depressive disorder, both SI and SA were positively associated with alcohol, cannabis and cocaine misuse. Conclusion: Brazil has relevant rates of cocaine use, including the smoked form. Although men have a higher frequency of use, women are more vulnerable to the worst effects of cocaine, as well as younger population with precarious schooling. Although it does not establish causality, the association between substance use and violence, whether interpersonal or self-directed, is well proved. Depression is a frequently observed variable in all cases, assuming that the association between substance use, violent behavior and depression is a reciprocal and multidirectional relationship.
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    Cuidado, frágil: aproximações e distanciamentos de trabalhadores de um CAPS na atenção ao suicídio
    (Universidade Federal de São Paulo (UNIFESP), 2015-11-30) Cescon, Luciana França [UNIFESP]; Capozzolo, Angela Aparecida [UNIFESP]; Henz, Alexandre de Oliveira [UNIFESP]; http://lattes.cnpq.br/8635317893278680; http://lattes.cnpq.br/7660336218859464; http://lattes.cnpq.br/9939369074412215; Universidade Federal de São Paulo (UNIFESP)
    This work aimed to study suicide care in a Psychosocial Care Center from Santos/SP, proposing interventions that may qualify attention to these cases. It is an intervention research with cartographic approach, in which several instruments have been used to produce data. It is intended to initially understand the organizational work process to meet this request and, for that, screening appointment records from May 2012 to December 2013 were collected, study of medical records from people with suicidal ideation and/or suicide attempt, examination of user?s appointment flow and a survey of materials about suicide. They were also carried out semi-structured interviews with health workers involved in these cases to understand their views on the subject. These materials, as well as the implication of the researcher who was part of this unit staff, were analyzed in individual and collective orientation spaces. It was found that care offers were focused on mental distress medicalization and the service organization was predominantly focused on providing medical appointments. First analyzes create questions that allowed the construction of a material that also represents a research product, called as affection box (with books, articles, movies, music and poetry) that brings different perceptions about suicide and was used on the conversation circles. It can be consulted and/or used by professionals, students and others who are interested in the subject ? available in attachment and blog. On the next phase of this research, four conversation circles were made with the team, in which the materials and systematic issues were presented and provoked new conversations that allowed to question the prevailing views on the subject and rethink work process in the unit, not only in terms of suicide care, but also for other mental suffering issues. Another important aspect is workers suffering and the medicalization of this suffering. Later, unit's psychiatrists were also interviewed, considering the importance of medical appointment and drug prescription in this service organization to meet these and other requests. This step brought new data what contributed to the expansion of this discussion. Interventions produced by this investigation appeared since the early stages and they are expressed in the leadership of these workers, who have reunited to create spaces for meeting and continuing education in order to analyze their work processes and the produced care. In this way, it aims to contribute to reflection and attention proposals for this important public health problem.
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    Efeito de indicadores econômicos e de notícias veiculadas na mídia sobre o suicídio
    (Universidade Federal de São Paulo (UNIFESP), 2020-12-10) Asevedo, Elson de Miranda [UNIFESP]; Mari, Jair de Jesus [UNIFESP]; http://lattes.cnpq.br/5783141369706484; http://lattes.cnpq.br/2221727998024072; Universidade Federal de São Paulo
    Fatores de risco ambientais potencialmente modificáveis, como os relacionados ao ambiente econômico e à exposição a notícias veiculadas na mídia, têm sido associados a aumento da mortalidade por suicídio. No Brasil, eventos significativos dos últimos anos permitem investigar a associação destes fatores com comportamentos relacionados ao suicídio: no ambiente econômico, a crise iniciada em 2013; nas informações da mídia a notícia sobre o jogo Baleia Azul, que estimularia pessoas a realizarem suicídio, e a campanha Setembro Amarelo, de conscientização e orientação responsável sobre comportamento suicida. Objetivo: Verificar o efeito, sobre o suicídio, dos fatores ambientais populacionais desemprego, renda per capita e exposição a notícias relacionadas a suicídio no Brasil. Método: Esta tese é composta por dois estudos ecológicos analíticos de série temporal. No primeiro estudo, o efeito de indicadores econômicos sobre as taxas de suicídio foi estimado através do Produto Interno Bruto per capita, taxa de desemprego e taxas de suicídio do Brasil, em seis grandes capitais do país, no período de janeiro de 2006 a dezembro de 2015. Os dados foram coletados nas bases do Departamento Tecnologia de Informação do Sistema Único de Saúde e do Instituto Brasileiro de Geografia e Estatística e analisados segundo modelos de equação de estimativa generalizada. O segundo estudo investigou o efeito de duas notícias veiculadas pela mídia brasileira em 2017 sobre busca de informações sobre suicídio na internet. Foram utilizadas informações da ferramenta Google Trends, uma ferramenta gratuita que mede o índice "interesse de pesquisa na Internet" (ISI), uma pontuação normalizada da probabilidade de pesquisa de um termo. O ISI diário de termos relacionados ao jogo Baleia Azul, em abril, e à campanha Setembro Amarelo, em setembro de 2017, foi correlacionado com o ISI de suicídio nos mesmos períodos. Foi utilizada a análise de correlação cruzada. Resultados: O efeito dos indicadores econômicos foi heterogêneo entre os centros, mas, de maneira geral, a variação nas taxas de suicídio foi inversamente relacionada ao desemprego e não apresentou relação significativa com o PIB. Com a divulgação de notícias sobre o jogo Baleia Azul, houve aumento da atividade na internet associada a suicídio, com pico ocorrendo sem defasagem de tempo. A campanha do Setembro Amarelo também aumentou a atividade na internet de buscas sobre suicídio, xi incluindo termos de busca por ajuda, entretanto o tamanho foi menor do que a calculada para o jogo Baleia Azul. Conclusão: Os resultados obtidos sugerem que a maior parte da variação nas taxas de suicídio de grandes centros urbanos brasileiros entre 2006 e 2015 não era explicada por indicadores econômicos gerais. Por outro lado, tanto uma notícia sensacionalista sobre suicídio quanto uma campanha de conscientização sobre suicídio se correlacionaram positivamente com probabilidade de buscas por termos relacionados a suicídio na internet.
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    Factores de riesgo asociados a mortalidad por suicidio en adultos de América Latina: una revisión sistemática de estudios observacionales
    (Universidade Federal de São Paulo (UNIFESP), 2016-08-31) Hernandez, Tamara Francisca Otzen [UNIFESP]; Melnik, Tamara [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Objective: To determine the factors associated with suicide mortality in men and women over 18 years from countries of Latin America. Method: Systematic review of observational studies conducted according to checklist of MOOSE "Guidelines for Meta- Analyses and Systematic Reviews of Observational Studies". An electronic search was performed with the following databases: BVS, EBSCOhost, EMBASE, LILACS, PubMed, ProQuest, PsycNET, ScienceDirect, SciELO, Scopus and WoS. We included 57 ecological population studies, one qualitative study and 3 case-control studies. The latest update of the search was on January 5, 2016. Results: We included 61 studies with 1.415.479 participant. Multiple factors associated with suicide mortality in Latin America were found, which are distinctive of reality in other countries, so distinguishing between countries, age ranges and years considered in the research included. Which are grouped into demographic factors, socioeconomic status, social difficulties and morbid history. Were also found a series of inferential data in the studies. Discussion: The available evidence in Latin America, is reduced to 5 countries only (Brazil, Chile, Colombia, Mexico and Uruguay) and is full of biases that hinder the extrapolation of the results, although it realizes that there are marked differences with Europe, Asia and the United States that is where as many publications are concentrated, therefore this research is expected to be a reference for intervention on the subject. Conclusions: In this RS a number of factors associated with mortality by suicide in adults in Latin America were found, which are distinctive among countries, age groups and years of study. Grouping them into demographic, psychiatric and other factors. Thus complying with the objectives and hypotheses of the study.
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    Impactos do suicídio testemunhado no centro da metrópole de São Paulo: uma etnografia no hotspot Viaduto do Chá
    (Universidade Federal de São Paulo (UNIFESP), 2019-06-17) Cornejo, Elis Regina Souza Peito Urtubia [UNIFESP]; Marquetti, Fernanda Cristina [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Suicide is a multidetermined phenomenon that has distinct socially constructed meanings. historically. These conceptions, in turn, institute the way society deals with the suicide. It is a taboo theme and a kind of death that subverts the ways of dying in the West, a fact that increases sociocultural prejudice around the theme and makes it difficult to express from the grief and grief of the people who were impacted by a suicide: the survivors. Addressing the suicide that occurs on public roads, this research aimed to know what are the experiences of survivors witnessing suicide around the Tea Viaduct hotspot, place that is often used for suicide attempts in the center of the metropolis of São Paulo. Understanding the viaduct as a place of sociability, the use of ethnography in the city was the method chosen to unveil the symbolic processes of these survivors facing the act. As research instruments were used the participant observation, the field diary, the open interview with witnesses and photography as an audiovisual resource. The analysis was guided the contributions of Interpretive Anthropology in the dialogue with Suicidology authors to grasp the meanings, understandings and impacts of suicide in narratives and memories of those passers by. From the narratives of the survivors belonging to that place, four categories of analysis were built in order to list their different experiences in witnessing suicide: manifestation of interdiction, understanding of the suicide phenomenon, reactions to hotspot testimony and insights. The results show that the experience of the testimony of suicide on public roads explains the significance of this exposure in life of the surviving witnesses, especially when lived in the metropolis. Despite the similarities found in the experiences of survivors bereaved by suicide in general, the testimony of a suicide on public roads reserves its uniqueness, especially as regards the extent of the impacts and their collective meanings.
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    O lugar do suicídio na sociedade: trajetórias de vidas anônimas
    (Universidade Federal de São Paulo (UNIFESP), 2019-06-28) Jabur, Sergio Marques [UNIFESP]; Marquetti, Fernanda Cristina [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    The present research deals with suicide as a social phenomenon as opposed to the hegemony of medical discourse. The semantic dispute over the suicide discourse has been going on since the nineteenth century. The aim of the present study is to analyze the trajectories of individuals who sought or thought about their own death, and their experiences with the phenomenon of suicide. The bibliographic review led us to adopt the concept of liquid modernity of the sociologist Zygmunt Bauman as a basis for the understanding of suicide as a social phenomenon. Our starting hypothesis was to reflect whether there would be an interference of liquid times in people's daily life to the point of influencing the thought of death. The current time, described as liquid, was strongly influenced by the failure of the illuminist modernity project, by individualism, by the dissolution of utopias, and also by the strong impact of industrial and technological revolutions. The process of globalization, at the end of the last century, culminated in the fragmentation of institutions, the melting of social structures, and also the disengagement of individuals - living their identity crises. The research is qualitative in which the design is formed by interviews with people older than eighteen years. We use the instruments of the timeline to trace the trajectory and memories of the subjects as well as to work with their narratives whose analyzes occurred at the interface between liquid modernity and its displacements. The main finding of the research was the refugee status of the subjects; the semantics of the word, here discussed, is related to the state of drift, invisibility and nonbelonging. The person who thinks about suicide has no place in society and lives a constant crisis of identity. The unfoldings of the research, in terms of preventive action, indicate the need to invest in social relations, represented by micropolitics as opposed to oppressive macropolitics; and therefore a reconstruction of social structures.
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    Mental health and psychiatric care in Bolivia: what do we know?
    (Biomed Central Ltd, 2014-05-15) Jaen-Varas, Denisse [UNIFESP]; Ribeiro, Wagner Silva [UNIFESP]; Whitfield, Jessie; Mari, Jair de Jesus [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); St Louis Univ
    Background: Recently Bolivia has implemented a universal health system, but their mental health policy is still emerging.Objectives: To investigate the current state of the mental health care system in Bolivia and discuss challenges for structuring a coordinated network of services that can effectively meet the needs of the Bolivian population.Methods: This review was conducted by searching for scholarly articles through the databases Lilacs, Medline OPS, HISA and IBECS REPIDISCA via the search portal in the Virtual Health Library - NLM (www.bireme.br).Results: Bolivia has a National Mental Health Plan that is intended to guide mental health promotion, prevention, treatment and rehabilitation of mental illness, but the resources for this area of health are limited. There are 1.06 psychiatrists and 0.46 psychologists per 100, 000 inhabitants. Information on psychiatric morbidity in Bolivia and the impact of mental disorders on the global burden of disease is scarce. Admission statistics reported by psychiatric hospitals in the country show that the main cause of hospitalization is substance abuse (30%). Alcohol consumption is responsible for 90% of these admissions, in addition to being a major cause of deaths in traffic and one of the main risk factors for domestic violence. Almost one in two women in Bolivia (47%) experienced some form of violence from their partner in the last year. Nineteen percent of women living with a partner reported being physically abused, while 7% were sexually abused by their partners. Isolated studies report that suicide rates are disproportionately high in Bolivia.Conclusions: Although there is a shortage of epidemiological data in Bolivia, it is clear the impact of alcohol addiction in psychiatric admissions, domestic violence and traffic accidents. Violence against women and suicides are important issues to be tackled. Among the proposed strategies to afford human resources for mental health in Bolivia, task shifting, the delegation of tasks to non-specialists should be extensively adopted in the country to improve mental health care.
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    The mental health of graduate students at the Federal University of São Paulo: a preliminary report
    (Associação Brasileira de Divulgação Científica, 2004-10-01) Nogueira-Martins, Luiz Antonio [UNIFESP]; Fagnani Neto, Rafael [UNIFESP]; Macedo, Paulo Costa Mosca [UNIFESP]; Citero, Vanessa de Albuquerque [UNIFESP]; Mari, Jair de Jesus [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    We present data regarding the care provided to graduate level health professionals at the mental health center of the Federal University of São Paulo. From September 1996 to September 2003, 146 graduate students (99 in the Master's degree program and 47 in the Doctoral program) were attended. This population was predominantly female (68.5%), with a mean (± SD) age of 28.6 ± 4.42 years, not married (71.9%). Most of the subjects were professionals who had not graduated from the Federal University (78.1%). The students who sought help for psychological and/or psychiatric problems were classified into two categories: situational-adaptive crises and psychopathological crises. The main diagnoses were depression and anxiety disorders (44%) causing 4.5% of the subjects to be temporarily suspended from their graduate studies; 19.2% reported that they had used psychotropic drugs within the previous month, and 47.9% referred to sleep disturbances. Suicidal tendencies were mentioned by 18% of those interviewed. Students with emotional disturbances and academic dysfunctions should be recognized at an early stage, and it is fundamental for them to have access to mental health programs that provide formal, structured and confidential care. Thus, it is important that professors and advisors in graduate programs build a warm and affective learning environment. If we consider the expressive growth in Brazilian scientific production resulting from the implementation of an extensive national system of graduate education, it is important to focus efforts on enhancing and upgrading the mental health care system.
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    Nem doente, nem vítima: o atendimento às lesões autoprovocadas nas emergências
    (ABRASCO - Associação Brasileira de Saúde Coletiva, 2009-12-01) Machin, Rosana [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    This paper shows concepts and practices of health professionals regarding cases of self-injury. It is problematized the existent gap between professionals training based in the biomedical model and practices, in which are presented dimension not considered for biomedicine. The empiric reference is a public emergency hospital in the city of São Paulo. The qualitative nature study was developed by observing attendances, consults to medical records and interviews with health professionals. The underlying question is related to intelligibility model of the illness, based in the body as a privileged locus of care, and illness as accidental event. Contradictively, self-injury situations (suicide attempts, drug and alcohol abuse) are analyzed as intentionally events, consequence of a choice, implicating no identification of their authors as patients or victims of care.
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    Peripheral chemokine levels in women with recurrent major depression with suicidal ideation
    (Associação Brasileira de Psiquiatria - ABP, 2012-03-01) Grassi-Oliveira, Rodrigo; Brietzke, Elisa [UNIFESP]; Teixeira, Antonio Lúcio [UNIFESP]; Pezzi, Júlio Carlos; Zanini, Márcio [UNIFESP]; Lopes, Rodrigo Pestana; Bauer, Moisés Evandro; Pontifícia Universidade Católica Post-Graduate Program in Psychology Developmental Cognitive Neuroscience Research Group; Universidade Federal de São Paulo (UNIFESP); Universidade Federal Minas Gerais School of Medicine Department of Internal Medicine; Universidade Federal de Ciências da Saúde de Porto Alegre Post-Graduate Program in Health Sciences; Pontifícia Universidade Católica Institute of Biomedical Research and Faculty of Biosciences
    OBJECTIVE: To compare serum levels of MCP-1/CCL2, RANTES/CCL5, and Eotaxin/CCL11 between female patients with recurrent major depressive disorder (MDD) and healthy controls, verifying if there is a difference in the levels of these mediators between those with or without current suicidal ideation. METHODS: Thirty female outpatients with recurrent MDD were divided in two groups accordingly the presence or absence of suicidal ideation. These groups were compared with 16 healthy controls. Serum levels of MCP-1/CCL2, RANTES/CCL5, and Eotaxin/CCL11 were determined. Depression severity was evaluated by Beck Depression Inventory (BDI). Suicidal ideation was assessed by SCID-I and BDI. RESULTS: Patients with recurrent MDD and healthy controls did not differ in age, socioeconomic status, and education. All patients reported high scores of BDI (mean, SD, n; 29.75, 10.55, 28). Multivariable analysis of covariance adjusted for age and BMI showed that MDD patients with suicidal ideation presented lower levels of MCP-1/ CCL2 and RANTES/CCL5 (p < 0.001) and higher levels of Eotaxin/CCL11 (p = 0.04) compared to healthy controls. These differences remained significant after adjusting for depression severity. CONCLUSION: The findings of this study indicated that the presence of recurrent MDD with suicidal ideation is associated with differences in inflammatory chemokines when compared to those without suicidal ideation.
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    Potential role of sleep in bipolar disorder
    (Elsevier B.V., 2013-01-01) Tufik, Sergio B.; Bennedsen, Laura; Andersen, Monica L. [UNIFESP]; Tufik, Sergio [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP); Univ Maryland
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    Risco de suicídio e sintomas depressivos entre estudantes universitários antes e durante o isolamento social pela COVID-19
    (Universidade Federal de São Paulo, 2021-10-27) Moraes, Sabrina Marques [UNIFESP]; Tucci, Adriana Marcassa [UNIFESP]; Vedana, Kelly Graziani Giacchero; http://lattes.cnpq.br/2869735400377436; http://lattes.cnpq.br/6278405456405903; http://lattes.cnpq.br/8265313133764130; Universidade Federal de São Paulo (UNIFESP)
    Introdução: A graduação pode representar um período desafiador para os estudantes. As mudanças e incertezas causadas pela COVID-19 podem aumentar a suscetibilidade desse grupo para problemas de saúde mental e sofrimento psíquico, como depressão e risco de suicídio. Objetivo: Avaliamos a prevalência e os fatores de riscos e de proteção associados à gravidade do risco de suicídio e os sintomas depressivos entre estudantes universitários antes e durante a fase inicial do isolamento social provocado pela COVID-19. O período de coleta presencial ocorreu no início de março de 2020 e, online, de junho a 24 julho de 2020. Método: Estudo quantitativo, longitudinal e prospectivo, desenvolvido com 102 estudantes universitários do Instituto Saúde e Sociedade do Campus Baixada Santista, da Universidade Federal de São Paulo. Os dados foram coletados em duas etapas (antes do isolamento social e durante a fase inicial do isolamento social). Os seguintes instrumentos foram autoaplicados: questionário sociodemográfico e econômico, Módulo-C da Minientrevista Neuropsiquiátrica Internacional (MINI); Escala de Depressão, Ansiedade e Estresse (EDAE-21); e Questionário de Trauma na Infância (QUESI). Para análise dos desfechos investigados, foi utilizado o modelo de regressão multivariada Generalized Additive Models for Location, Scale and Shape (GAMLSS). Resultados: Predominaram na amostra os graduandos do sexo feminino (71,6%), com menos de 25 anos de idade (85,3%), da cor branca (67,6%), solteiros (96,1%), sem filhos (98%), e com religião (56,9%). Foram detectadas diferenças significativas nos sintomas de depressão e no risco de suicídio nos períodos antes e durante a pandemia. Os fatores de risco tanto para depressão quanto para risco de suicídio foram: se sentir frequentemente solitário; ter ingressado na universidade pelo sistema de cota; ter iniciado tratamento psicológico ou psiquiátrico durante a pandemia; e ter referido história de abuso emocional na infância e / ou na adolescência. Apenas para depressão: estudar em período integral; ter se autodeclarado da cor branca; ter iniciado tratamento de saúde durante o isolamento social; a fase inicial da pandemia. Apenas para risco de suicídio: ter renda familiar de até três salários mínimos durante o isolamento social; ter referido história de negligência física na infância e / ou na adolescência. Os fatores de proteção para depressão foram: possuir religião; ter pessoas a mais residindo no domicílio durante o isolamento social; mais idade; enquanto que para risco de suicídio foi apenas a fase inicial da pandemia. Conclusão: Os resultados apontam fatores relevantes associados a risco para suicídio e depressão entre universitários.
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    Suicidality in temporal lobe epilepsy: Measuring the weight of impulsivity and depression
    (Elsevier B.V., 2011-12-01) Oliveira, Guilherme Nogueira M. de; Kummer, Arthur; Salgado, Joao Vinicius; Araujo Filho, Gerardo Maria de [UNIFESP]; David, Anthony S.; Teixeira, Antonio Lucio; Hosp Felicio Rocho; Universidade Federal de Minas Gerais (UFMG); Universidade Federal de São Paulo (UNIFESP); Kings Coll London
    Objective: the aim of the work described here was to measure the role of psychopathological features, specifically impulsivity and depression, in suicidality in patients with temporal lobe epilepsy (TLE).Methods: Neuropsychiatric evaluation of 66 outpatients with TLE was performed with the following instruments: a structured clinical interview (Mini International Neuropsychiatric Interview Plus), the Barratt Impulsiveness Scale, the Hamilton Anxiety Scale, the Beck Depression Inventory, and the Brief Psychiatric Rating Scale.Results: A current Axis I psychiatric diagnosis, mainly mood and anxiety disorders, was assigned to 37 subjects (56.1%) Presence of suicide risk was identified in 19 patients (28.8%), and 14(21.2%) had attempted suicide. Frequency of seizures (P = 0.012), current major depression (P = 0.001), and motor impulsivity (P = 0.005) were associated with suicide risk on univariate analysis. Logistic regression stressed the main relevance of major depression (OR = 12.82, 95% CI = 2.58-63.76, P = 0.002) and motor impulsivity (OR = 1.21, 95% CI = 1.06-1.38, P = 0.005) to suicide risk.Conclusion: Depression has a major influence on suicidality in epilepsy. Motor impulsivity is also relevant and may be an important component of depression in TLE associated with suicide risk. (C) 2011 Elsevier Inc. All rights reserved.
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    O Suicídio E As Dores De Amélia: A Condição De Gênero Da Mulher No Desejo Da Morte De Si
    (Universidade Federal de São Paulo (UNIFESP), 2017-06-02) Costa, Renata Alves Da [UNIFESP]; Marquetti, Fernanda Cristina [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    The consequences of rigidities in the make and female conceptions of social roles can cause suffering. In the most extreme cases, put an end in the living can be searched as a way out. This research aimed to understand the perspective of women with an attempt and / or desire to suicide, regarding this phenomenon and its relation with issues related to gender. The work was done based on the sociology's areas, anthropology and psychology, seeking studies related to gender and suicide. The two participants live in Baixada Santista (São Paulo coast), and were invited through the researcher's network of contacts. The method of life history was used through the narration of their experiences, these women brought important information about the environment in which they live, revealing aspects of the culture in which they are inserted. Participants believe that they have experienced gender-related situations that have caused great suffering, but while one of them said she did not even remember the suicide attempt, the other woman made contradictory statements about it. The reports also reinforce the importance of analyzing suicide from a perspective that is not restricted to mental illness, but which considers the different aspects that make up the subjects' lives.
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    Suicídio entre adolescentes de 10 a 19 anos, métodos utilizados e sua relação entre os indicadores socioeconômicos no Brasil: um estudo ecológico e retrospectivo.
    (Universidade Federal de São Paulo (UNIFESP), 2019-08-09) Jaen Varas, Denisse Claudia [UNIFESP]; Araripe Neto, Ary Gadelha De Alencar [UNIFESP]; http://lattes.cnpq.br/2456474709926289; http://lattes.cnpq.br/2456474709926289; Universidade Federal de São Paulo (UNIFESP)
    Introduction:In Brazil, suicide ranks among the leading causes of death in young people, ranking fourth for 15- to 29-year-olds, there are striking gender differences in suicide rates. Suicide is the third leading cause of death among males (9.0 per 100,000 people each year) and the eighth leading cause among females (2.4 per 100,000 people each year). Main objective:Suicide rates among Brazilian adolescents have increased in recent years. Obtaining a better understanding of the methods adolescents use for suicide, and whether these methods have changed in recent years, may inform future preventive measures. Specific objectives: Study 1: To examine suicide rates among adolescents from six large cities in Brazil and to analyze the relationship between adolescent suicide rates and socioeconomic indicators between 2006 and 2015. Study 2: The aim of this study was to describe the most commonly used methods of suicide among adolescents aged 10 to 19 years in Brazil between 1 January 2006 and 31 December 2015. Methods: This study employed a retrospective ecological design, for the period of 1 January 2006 to 31 December 2015. To be included in this study, data relating to the suicide methods used by adolescents in Brazil were collected according the chronological limits of adolescence. of 10- 19 years and by sex (male and female). Suicide methods were obtained from the Information Technology Department of the Public Health Care System (DATASUS) of the Brazilian Ministry of Health Study 1: Generalized estimating equation models were used to assess the impact of socioeconomic factors – including social inequality and unemployment rates – on adolescent suicide rates. Study 2: In Brazil, suicide methods are registered using the International Classification of Disease 10th version (ICD-10) codes X60–X84, which indicate the main methods of suicide, and Y10–Y19, which indicate poisoning and exposure to substances with undetermined intent. Suicide methods were obtained from the DATASUS of the Brazilian Ministry of Health. xiv Results: Study 1: The rate of adolescent suicide increased by 24% over the course of the study period. Social inequality (assessed using the Gini index), was positively associated with overall adolescent suicide rates (β = 10.68; 95% CI = 2.32-19.05; p ≤ 0.012). After disaggregating the findings by age (10-14 and 15-19 years), social inequality was associated with suicide rate only for adolescents aged 15-19 years (β = 9.63; 95% CI = 2.31-16.96; p ≤ 0.005). Disaggregating these findings by sex, the association with economic variables became significant only among females. Males had a higher overall suicide rate than females, and the highest rate was observed in male adolescents aged 15-19 years. Higher levels of unemployment were associated with higher suicide rates. Study 2: 8026 suicides among Brazilian adolescents aged between 10–19 years were registered over the analyzed period. The most commonly used method of suicide by both sexes was hanging (2006= 54.9%; 2015= 70.3%). A relative increase was observed in males (2006= 62.9%; 2015= 72.3%), whereas a steeper increase was observed in females (2006= 39.27%; 2015= 65.82%). The proportional use of firearms (2006= 14.2%; 2015= 9.1%) and poisoning (2006= 13.3%; 2015= 9.2%) decreased over the period (-5.1% and -1.6% respectively). Conclusion: Study 1: Our findings suggest that socioeconomic indicators, particularly unemployment and social inequality, are relevant social determinants of suicide in adolescence. Study 2: The increase in hanging is worrisome, mostly regarding difficulties to impose access barriers and its high lethality. In such context, a comprehensive understanding of suicide behaviors among adolescents in Brazil should be drawn to inform general prevention measures and, more specifically, the reasons for the increase in hanging needs to be further investigated.