Suicide mortality in Rio Grande do Sul, Brazil: a cross-sectional analysis of cases, 2017-2018

Franck, Maria Cristina; Monteiro, Maristela Goldnadel; Limberger, Renata Pereira

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Epidemiologia e Serviços de Saúde

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ORIGINAL ARTICLE • Epidemiol. Serv. Saúde 29 (2) • 2020 • https://doi.org/10.5123/S1679-49742020000200014 copy

Suicide mortality in Rio Grande do Sul, Brazil: a cross-sectional analysis of cases, 2017-2018

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective:

to analyze the epidemiological and toxicological profile of suicide cases in Rio Grande do Sul, Brazil, in 2017 and 2018.

Methods:

this was a cross-sectional study with data from police incident reports and state General Forensic Institute records; multiple correspondence analyses were performed and logistic regression models were built.

Results:

there were 2,564 suicides (11.3/100,000 inhabitants/year), mostly involving males (79.4%), and the 50-54 years age group (10.3%); the main method was hanging (72.5%); positive results for ethanol were found in 29.1% of cases and for other psychotropic drugs in 36.1% of cases; young people were 4.5 times (95%CI 2.7;7.7) and 2.4 times (95%CI 1.5;3.6) more likely to be the victims when there were positive results for an illegal substance or parental absence, respectively.

Conclusion:

male and adult victims predominated, hanging was the most common means, and, in one third of the cases, psychotropic drugs were present.

Keywords:
Suicide; Cross-Sectional Studies; Demography; Public Health; Forensic Toxicology; Multivariate Analysis

Independent variable	Year						Dependent variables
	2017			2018			Youth (Model A)		Poison (Model B)		Toxicology (no information) (Model C)
	n	Rate	Sex Ratio	n	Sex Ratio	Sex Ratio	OR^a	n	OR^a	n	OR^a	n
Region							p=0.003		p<0.001		p<0.001
Alto-Jacuí^b	28	14.8	2.1	15	8.1	14.0	1.7 (0.7;4.6)	8	-	-	8.3 (3.5;22.8)	6
Campanha^b	21	9.3	4.3	22	9.9	4.5	3.0 (1.1;9.7)	5	2.0 (0.1;49.7)	1	0.8 (0.4;1.5)	27
Centra^b	86	12.6	3.5	88	13.1	3.6	1.8 (0.9;3.5)	31	4.2 (1.0;19.6)	4	reference	98
Centro Sul^c	36	13.7	8.0	35	13.3	1.5	1.1 (0.5;2.5)	18	3.7 (0.6;29.7)	2	14.1 (6.2;38.0)	6
Fronteira Noroeste^d	41	18.2	3.6	39	17.8	5.5	2.5 (1.1;5.8)*	11	-	-	-	-
Fronteira Oeste^b	60	11.1	9.0	60	11.5	5.7	2.3 (1.1;4.7)	18	-	-	2.6 (1.6;4.2)	40
Hortênsias^e	11	7.5	1.8	21	14.2	4.3	2.1 (0.7;6.9)	5	3.4 (0.3;78.8)	1	8.8 (3.2;30.6)	4
Litoral^e	35	9.4	7.8	44	11.4	7.8	2.0 (0.9;4.6)	13	-	-	19.0 (8.0;56.1)	5
Médio Alto Uruguai^d	28	15.9	2.1	36	21.2	2.6	1.5 (0.7;3.5)	13	11.7 (2;24.1)	1	15.1 (6.3;44.9)	5
Metropolitano Delta do Jacuí^e	217	8.6	4.0	188	7.4	2.5	1.3 (0.7;2.2)	96	17.4 (5.0;65.5)	6	17.0 (10.6;27.9)	29
Missões^d	34	14.5	2.8	36	15.9	2.6	1.9 (0.8;4.3)	12	4.5 (0.8;36.3)	2	21.4 (8.4;72.6)	4
Nordeste^f	36	17	5.0	31	14.7	5.2	reference	19	reference	8	2.7 (1.5;4.9)	22
Noroeste Colonial^d	37	11.6	6.4	42	13.4	3.2	2.7 (1.2;6.6)	10	17.0 (2.5;345)	1	5.5 (3.0;10.7)	15
Norte^d	34	15.3	4.7	29	13.3	13.5	2.7 (1.1;7.2)	8	3.7 (0.7;29.7)	2	1.7 (1.0;3.1)	27
Paranhana-Encosta Serra^e	14	6.2	13.0	22	9.5	4.5	1.6 (0.6;4.6)	7	-	-	44.3 (9.2;797)	1
Produção^d	72	13.9	5.5	70	13.5	3.4	1.8 (0.9;3.6)	25	22.4 (3.4;448)	1	5.8 (3.5;9.9)	26
Serra^f	97	10.1	4.1	80	8.1	2.8	1.6 (0.8;3.0)	35	2.1 (0.7;7.0)	13	16.6 (9.0;32.7)	13
Sul^c	111	12.5	3.4	114	12.9	3.8	2.1 (1.1;3.9)	36	12.9 (3.0;70.0)	3	3.1 (2.0;4.6)	67
Vale do Caí^f	22	12	4.5	28	14.9	6.0	9.5 (2.6;61.8)	2	-	-	20.1 (7.0;84.9)	3
Vale do Rio dos Sinos^e	113	8.2	3.5	128	9.2	4.3	1.7 (0.9;3.1)	46	62.8 (10;1249)	1	27.0 (14.3;55.8)	11
Vale do Rio Pardo^f	96	20.8	5.0	90	19.5	4.0	2.7 (1.3;5.3)	24	5.0 (1.3;21.1)	5	1.3 (0.9;2.0)	93
Vale do Taquari^f	55	14.8	4.0	62	16.5	3.4	3.8 (1.7;8.8)	11	1.8 (0.3;11.2)	3	1.0 (0.6;1.6)	66
Total	1.284	11.3	4.2	1.280	11.3	3.6	-	453	-	54	-	568

Municipalities	2017			2018
Municipalities	n	Sex Ratio	Sex Ratio	n	Sex Ratio	Sex Ratio
Eight highest numbers of suicide cases
Porto Alegre^a	120	8.1	3.6	110	Sex Ratio	Sex Ratio	7.4	2.1
Caxias do Sul^b	45	9.3	4.0	38	7.5	2.5
Pelotas^c	43	12.5	2.9	34	9,9	3.6
Santa Maria^d	34	12.2	4.7	26	9.3	2.3
Rio Grande^c	30	14.3	4.0	16	7.6	4.3
Canoas^a	28	8.1	2.1	36	10.4	2.0
Passo Fundo^e	23	11.6	6.7	30	14.9	3.3
Santa Cruz do Sul^b	23	18.0	6.7	21	16.2	3.2
Eight highest suicide rates (per 100,000 inhab.)
André da Rocha^b	2	153.1	*	1	75.5	*
Santa Tereza^b	-	-	-	2	115.3	1.0
Carlos Gomes^e	2	129.3	*	-	-	-
Floriano Peixoto^e	-	-	-	2	111.4	*
Esperança do Sul^e	2	62.4	*	3	101.0	2.0
São Domingos do Sul^e	1	32.5	*	3	97.9	*
Vale Verde^b	4	115.6	3.0	1	28.7	*
Almirante Tamandaré do Sul^e	2	96,2	*	-	-	-

Independent variables	Year					Dependent variables
	2017		2018		Total	Ethanol (Model D)		Psychotropics (Model E)		Youth (Model F)
	N	%	N	%	N	OR^a (95%CI^b)	N	OR^a (95%CI^b)	N	OR^a (95%CI^b)	N
Sex						p<0.001		p<0.001		p=0.446
Male	1,035	80.6	1,002	78.3	2.037	Reference	479	1.9 (1.4;2.4)	443	reference	368
Female	249	19.4	278	21.7	527	2.0 (1.5;2.8)	60	Reference	194	0.9 (0.6;1.2)	85
Age (in years)						p<0.001		p=0.010
Child (0-12)	3	0.2	3	0.2	6	-	-	-	-	-	-
Adolescent (13-18)	58	4.5	48	3.8	106	3.3 (1.8;6.7)	12	1.9 (1.2;3.4)	23	-	-
Adult (19-59)	878	68.4	836	65.3	1,714	Reference	437	Reference	471	-	-
Elderly (60 or more)	345	26.9	393	30.7	738	2.3 (1.7;3.1)	90	1.3 (1.0;1.6)	143	-	-
Parental absence						p=0.630		p=0.444		p<0.001
Absence	76	5.9	92	7.2	168	Reference	34	Reference	37	Reference	43
Presence	1,208	94.1	1,188	92.8	2,396	0.9 (0.5;1.4)	505	0.8 (0.5;1.3)	600	2.4 (1.5;3.6)	410
Cause of death						p=0.194		p<0.001		p=0.370
Hanging	941	73.3	916	71.6	1,857	Reference	406	5.7 (3.8;8.8)	403	Reference	331
Use of fire arm	189	14.7	168	13.1	357	0.8 (0.6;1.1)	80	7.6 (4.7;12.7)	59	1.0 (0.7;1.5)	55
Intoxication	78	6.1	108	8.5	186	1.0 (0.7;1.7)	31	reference	126	0.8 (0.5;1.3)	35
Jumping	37	2.9	22	1.7	59	2.1 (0.9;5.4)	8	3.9 (1.9;8.2)	20	0.6 (0.3;1.1)	15
Use of cold weapon	21	1.6	22	1.7	43	1.8 (0.7;5.5)	6	3.6 (1.6;8.4)	14	1.9 (0.6;8.2)	4
Other^c	18	1.4	43	3.4	61	1.1 (0.5;2.8)	8	4.6 (2.0;10.8)	15	0.7 (0.3;1.9)	13
Toxicology results^d
Ethanol								p=0.743		p=0.009
Positive	283	30.9	256	27.3	539	-	-	reference	166	1.5 (1.1;2.0)	100
Negative	632	69.1	682	72.7	1314	-	-	1.0 (0.7;1.2)	434	reference	258
No information	369	-	342	-	711	-	-	-	37	-	95
Ethanol + psychotropics	75	29.4^e	91	38.6^e	166	-	-	-	-	-	39
Ethanol + psychotropics	75	29.3^f	91	26.4^f	166	-	-	-	-	-	39
Psychotropics						p=0.009				p=0.135
Positive	268	31.2	369	40.7	637	1.8 (1.2;2.9)	166	-	-	reference	126
Negative	590	68.8	537	59.3	1127	reference	325	-	-	0.7 (0.4;1.1)	218
No information	426	-	374	-	800	-	48	-	-	-	109
Anxiolytics						p=0.817				p=0.012
Positive	108	40.3	145	39.3	253	reference	52	-	-	1.9 (1.2;3.3)	31
Negative	750	-	761	-	1511	1.0 (0.7;1.7)	439	-	-	reference	313
Antidepressants						p=0.501				p=0.637
Positive	63	23.5	126	34.1	189	1.2 (0.7;2.0)	29	-	-	1.1 (0.6;2.0)	27
Negative	795	-	780	-	1575	reference	463	-	-	reference	317
Illicit compounds						p<0.001				p<0.001
Positive	92	34.3	99	26.8	191	reference	98	-	-	reference	72
Negative	766	-	807	-	1573	3.7 (2.3;6.0)	393	-	-	4.5 (2.7;7.7)	272

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: Maria Cristina Franck - Rua Chile, No. 871/203, Jardim Botânico, Porto Alegre, RS, Brazil. Postcode: 90670-140. E-mail: mariacfranck@yahoo.com.br