Forensic Institute, Civil Police of the Brazilian Federal District (PCDF), Brasilia, DF, Brazil.
Division of Psychiatry, School of Medical Sciences, University of Campinas (Unicamp), Campinas, SP, Brazil.
BMC Psychiatry. 2022 Jul 14;22(1):467. doi: 10.1186/s12888-022-04082-z.
Psychoactive substances (PASs) are an important risk factor for suicide. This study investigated the sociodemographic characteristics, data related to the suicidal behavior, the methods employed, the circumstances of the events, and the use of PASs before dying in all suicides that occurred between 2005-2014 in the Brazilian Federal District, comparing cases with positive and negative detection for PASs in the post-mortem analysis to identify groups at greatest risk.
A population-based, observational, cross-sectional study with an analytical aspect was conducted with suicides cases collected from local police, which toxicological examination was performed (headspace gas chromatographic-mass spectrometry-HS-GC/MS) for detection of ethanol and methanol in blood samples; immunoassay for other substances (cocaine, marijuana, benzodiazepine).
The results showed that the increase in the suicide rate was 10 × greater than the population growth, and 44% of the individuals used PASs before suicide. Individuals are more likely to die by suicide at home, be male, have tried before, and change their behavior days before death; they choose to hang as the method and are influenced by alcohol.
Identifying what sociodemographic characteristics are associated with a fatal suicide attempt among individuals who use PASs and those who do not use and those who have/do not have mental disorders and what methods are employed could be employed as a path to better interventions. Thus, prevention actions could be planned and directed to individuals with greater risk.
精神活性物质（PASs）是自杀的一个重要危险因素。本研究调查了 2005-2014 年期间在巴西联邦区发生的所有自杀事件中的社会人口学特征、与自杀行为相关的数据、采用的方法、事件发生的情况以及死前使用 PASs 的情况，并将死后分析中 PASs 检测呈阳性和阴性的病例进行了比较，以确定风险最大的人群。
本研究采用基于人群的、观察性的、横断面研究方法，并具有分析性，对当地警方收集的自杀案件进行了研究，对这些案件进行了毒理学检查（顶空气相色谱-质谱法-HS-GC/MS），以检测血液样本中的乙醇和甲醇；免疫测定法用于检测其他物质（可卡因、大麻、苯二氮䓬类）。
结果显示，自杀率的增长是人口增长的 10 倍，44%的自杀者在自杀前使用过 PASs。自杀者更有可能在家中自杀，是男性，有过自杀未遂史，并且在死前几天会改变行为；他们选择上吊作为自杀方法，并受到酒精的影响。
确定在使用 PASs 和不使用 PASs 的自杀未遂者、有/无精神障碍者中，哪些社会人口学特征与致命自杀企图相关，以及采用哪些方法，可作为更好干预措施的途径。因此，可以计划和针对风险较高的个体采取预防措施。
