Risk and protective factors for suicide: a populational case-control study, Brazil, 2019

ABSTRACT OBJETIVE To estimate risk and protection factors associated with suicide in Campinas, Brazil, in 2019. METHODS This is a populational case-control study analyzing 83 cases of suicide that occurred in 2019 in Campinas, a Brazilian city with about 1.2 million inhabitants. Controls were composed of 716 inhabitants. An adjusted multiple logistic regression was used. Cases and controls were the dichotomous response variables. Sociodemographic and behavioral variables were the predictor variables. RESULTS The categories which presented higher risk of suicide were: males [OR = 5.26 (p < 0.001)]; people aged 10–29 years [OR = 5.88 (p = 0.002)]; individuals without paid work [OR = 3.06 (p = 0.013)]; individuals presenting problematic use of alcohol [OR = 33.12 (p < 0.001)] and cocaine [14.59 (p < 0.007)]; and people with disabilities [OR = 3.72 (p < 0.001)]. Moreover, the perception of fear was associated with reduced suicide risk [OR = 0.19 (p = 0.015)]. Higher district HDI levels also showed a 4% decrease in risk for each 0.01 increase in district HDI levels [OR = 0.02 (p = 0.008)]. CONCLUSIONS This study evidenced the association between sociodemographic and behavioral variables and suicide. It also emphasized the complexity in the dynamics between personal, social, and economic factors to this external cause of death.

【研究目的】评估2019年巴西坎皮纳斯市自杀相关的风险因素与保护因素。

## 研究方法
本研究为人群病例对照研究，分析了巴西常住人口约120万的坎皮纳斯市2019年发生的83例自杀病例，对照组由716名当地居民组成。本研究采用校正后的多因素logistic回归分析，以病例与对照作为二分类响应变量，以社会人口学特征及行为学变量作为预测变量。

## 研究结果
自杀风险显著升高的类别包括：男性[比值比（OR）=5.26，p<0.001]；10~29岁人群[OR=5.88，p=0.002]；无有偿工作的个体[OR=3.06，p=0.013]；存在酒精问题性使用行为的个体[OR=33.12，p<0.001]及存在可卡因使用问题的个体[OR=14.59，p<0.007]；以及残障人士[OR=3.72，p<0.001]。此外，恐惧感知与自杀风险降低存在关联[OR=0.19，p=0.015]。辖区人类发展指数（HDI，Human Development Index）每升高0.01，自杀风险降低4%[OR=0.02，p=0.008]。

## 研究结论
本研究证实了社会人口学特征与行为学变量与自杀行为之间存在关联，同时强调了个人、社会及经济因素在这一外部死亡原因的动态机制中的复杂性。