A 10-year ecological study of the methods of suicide used by Brazilian adolescents

Abstract: Suicide among adolescents has become a major public health problem worldwide. Our study sought to describe the most commonly used methods of suicide among adolescents aged 10 to 19 years in Brazil between 2006 and 2015. Complete data were obtained from the Brazilian Health Informatics Department (DATASUS) and coded into seven categories of suicide methods. The following statistical analyzes were performed: chi-square (χ2) tests to examine the association between the frequency of each suicide method and the year; odds ratios (OR) and 95% confidence intervals (95%CI) compared the relative chances of each suicide method occurring between boys and girls. In total, 8,026 suicides among Brazilian adolescents were registered over the analyzed period. The most commonly used method of suicide by both sexes was hanging (2015 = 70.3%), and the most significant increase was observed in girls (2015 = 65.82%). The proportional use of arms (2006 = 14.2%; 2015 = 9.1%) and poisoning (2006 = 13.3%; 2015 = 9.2%) decreased over the period. The increase in hanging is worrisome, mostly due to difficulties to impose access barriers and to 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 need to be further investigated.

摘要：青少年自杀已成为全球范围内的重大公共卫生问题。本研究旨在描述2006至2015年间巴西10至19岁青少年最常采用的自杀方式。研究数据取自巴西卫生信息部（DATASUS），并被编码为7类自杀方法。本研究开展了以下统计分析：采用卡方（χ²）检验，以考察每种自杀方法的使用频率与年份之间的关联；通过比值比（OR）及95%置信区间（95%CI），比较男、女青少年各类自杀方法发生的相对风险。本分析周期内，巴西青少年自杀登记案例共计8026例。男女青少年最常用的自杀方式均为缢吊（2015年占比达70.3%），其中女性群体的缢吊自杀占比增幅最为显著（2015年为65.82%）。同期，枪支自杀与中毒自杀的使用占比均呈下降趋势：枪支自杀占比从2006年的14.2%降至2015年的9.1%，中毒自杀占比则从2006年的13.3%降至2015年的9.2%。缢吊自杀占比的上升令人担忧，这主要归因于难以对该方式设置访问障碍，且其致死率极高。在此背景下，需全面解析巴西青少年的自杀行为特征，为通用预防措施制定提供参考；同时，应进一步探究缢吊自杀占比上升的具体原因。