Temporal trend of mortality by suicide among adults in Brazil: 2000 to 2015

A retrospective study of temporal trends in suicide mortality rates in adults aged 20 to 64 years, by macroregion and gender, from 2000 to 2015. Data from the Brazilian Mortality Database (SIM) and from the Brazilian Institute of Geography and Statistics (IBGE) were used. The mortality rate trends analysis was performed using simple linear regression, with Stata 14 software.

Results

There was an upward trend in mortality due to intentionally inflicted self-harm in the Brazilian adult population in the North, Northeast, and Southeast regions for both genders (p<0.001), with predominance in the male population in these three regions and throughout the country (p<0.001). A downward trend was observed in the South and Midwest (p=0.003 and p=0.040).

Conclusion

Mortality due to intentionally inflicted self-harm has increased in Brazil, but has undergone important variations in different parts of the country. Even a regional analysis is insufficient to achieve a thorough evaluation of these contrasts because of the country’s continental proportions and data collection biases. Further studies focused on this topic are required.

Epidemiology; suicide; community mental health; adult; regression analysis

Year of death	Male	Female	Total
2000	4,434	1,024	5,458
2001	4,993	1,155	6,148
2002	4,935	1,287	6,222
2003	5,118	1,215	6,333
2004	5,161	1,298	6,459
2005	5,521	1,400	6,921
2006	5,641	1,408	7,049
2007	5,710	1,496	7,206
2008	6,094	1,528	7,622
2009	6,215	1,511	7,726
2010	6,041	1,656	7,697
2011	6,369	1,654	8,023
2012	6,543	1,797	8,340
2013	6,798	1,752	8,550
2014	6,873	1,745	8,618
2015	7,071	1,879	8,950
Total	93,517	23,805	117,322

Region	2000	2001	2002	2003	2004	2005	2006	2007	2008	2009	2010	2011	2012	2013	2014	2015
North
Male	6.79	7.76	6.28	7.27	7.44	7.64	7.54	8.19	9.88	8.61	8.64	9.65	10.15	10.31	8.70	11.46
Female	1.98	2.09	2.29	1.83	1.85	1.93	2.03	2.04	1.76	1.90	2.35	2.45	1.84	2.17	2.11	2.46
Both	4.46	5.01	4.34	4.62	4.72	4.85	4.84	5.19	5.90	5.32	5.55	6.11	6.07	6.30	5.46	7.02
Northeast
Male	5.91	7.74	7.50	7.94	8.00	8.88	9.33	9.90	9.73	9.39	8.95	9.90	9.59	10.28	9.69	10.05
Female	1.42	1.69	2.22	2.05	1.89	2.27	1.97	2.31	2.38	2.19	2.29	2.14	2.37	2.22	2.23	2.35
Both	3.62	4.65	4.81	4.94	4.88	5.51	5.57	6.03	5.98	5.71	5.55	5.93	5.89	6.15	5.87	6.10
Southeast
Male	8.28	9.15	8.95	9.09	8.80	9.18	9.36	8.86	9.47	9.85	10.02	10.29	10.20	10.20	11.02	10.63
Female	1.85	2.18	2.23	2.13	2.18	2.38	2.51	2.46	2.45	2.55	2.71	2.75	2.93	2.79	2.77	2.90
Both	5.01	5.61	5.54	5.56	5.44	5.72	5.88	5.61	5.90	6.15	6.31	6.47	6.51	6.44	6.85	6.72
South
Male	18.80	19.44	18.11	17.83	17.95	18.70	17.48	17.31	17.53	18.38	15.96	15.45	16.41	16.65	16.16	16.87
Female	3.95	3.84	3.82	3.71	4.13	4.00	3.95	4.19	4.30	3.78	4.05	4.22	4.66	4.33	4.08	4.64
Both	11.29	11.56	10.89	10.70	10.97	11.27	10.65	10.69	10.85	11.01	9.95	9.78	10.48	10.44	10.07	10.71
Midwest
Male	14.10	13.20	14.65	13.71	12.87	12.35	12.45	12.09	13.85	12.73	11.54	11.97	12.92	13.39	12.99	11.99
Female	3.30	3.41	3.91	3.01	3.87	3.37	3.20	3.25	3.21	3.14	3.64	2.90	3.39	3.55	3.48	3.26
Both	8.70	8.30	9.26	8.34	8.35	7.83	7.80	7.64	8.49	7.90	7.56	7.40	8.11	8.43	8.19	7.59
Brazil
Male	9.59	10.55	10.19	10.32	10.17	10.65	10.66	10.59	11.09	11.12	10.63	11.03	11.16	11.43	11.40	11.57
Female	2.16	2.38	2.59	2.39	2.50	2.64	2.60	2.71	2.71	2.64	2.84	2.79	2.99	2.87	2.82	3.00
Both	5.84	6.42	6.34	6.31	6.29	6.59	6.58	6.60	6.85	6.82	6.69	6.86	7.02	7.10	7.06	7.23

Macroregions	Average annual change (95%CI)	Trend	p value	Adjusted R ²
North
Male	0.26 (0.17 to 0.34)	Increase	<0.001	0.73
Female	0.01 (-0.00 to 0.04)	Oscillation	0.157	0.07
Both	0.13 (0.09 to 0.18)	Increase	<0.001	0.74
Northeast
Male	0.21 (0.14 to 0.28)	Increase	<0.001	0.71
Female	0.03 (0.01 to 0.06)	Increase	0.003	0.44
Both	0.12 (0.08 to 0.16)	Increase	<0.001	0.70
Southeast
Male	0.14 (0.11 to 0.18)	Increase	<0.001	0.84
Female	0.06 (0.05 to 0.07)	Increase	<0.001	0.90
Both	0.10 (0.08 to 0.12)	Increase	<0.001	0.90
South
Male	-0.18 (-0.27 to -0.01)	Decrease	<0.001	0.61
Female	0.04(0.01 to 0.06)	Increase	0.002	0.45
Both	-0.07 (-0.11 to -0.02)	Decrease	0.003	0.45
Midwest
Male	-0.09 (-0.18 to 0.00)	Decrease	0.042	0.21
Female	-0.00 (-0.04 to 0.02)	Oscillation	0.582	-0.04
Both	-0.05 (-0.10 to -0.00)	Decrease	0.040	0.21
Brazil
Male	0.10 (0.07 to 0.12)	Increase	<0.001	0.81
Female	0.04 (0.03 to 0.05)	Increase	<0.001	0.82
Both	0.07 (0.05 to 0.08)	Increase	<0.001	0.88

Associação de Psiquiatria do Rio Grande do Sul Av. Ipiranga, 5311/202, 90610-001 Porto Alegre RS/ Brasil, Tel./Fax: (55 51) 3024 4846 - Porto Alegre - RS - Brazil
E-mail: trends@aprs.org.br

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[1] Correspondence: Danúbia Hillesheim Rua Eng. Agronômico Andrei Cristian Ferreira, s/nº, Trindade 88040-900 - Florianópolis, SC - Brazil Tel.: +5548999825726 E-mail: nubiah12@yahoo.com.br