1980年至2019年巴西女性的自杀方式：年龄、时期和队列的影响。

Suicide methods among Brazilian women from 1980 to 2019: Influence of age, period, and cohort.

作者信息

Meira Karina Cardoso, Guimarães Raphael Mendonça, Silva Glauber Weder Santos, Jomar Rafael Tavares, Dantas Eder Samuel Oliveira

机构信息

Department of Collective Health at Escola Paulista de Enfermagem, Federal University of São Paulo, São Paulo, Brazil.

Sergio Arouca National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.

出版信息

PLoS One. 2024 Dec 13;19(12):e0311360. doi: 10.1371/journal.pone.0311360. eCollection 2024.

DOI:10.1371/journal.pone.0311360

PMID:39671434

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11642912/

Abstract

OBJECTIVE

To analyze the effect of age, period, and cohort on suicides among women by hanging, strangulation, suffocation, firearms, and autointoxication in different Brazilian regions from 1980 to 2019.

METHODS

Ecological time-trend study employing estimable functions to estimate APC models, facilitated through the Epi library of the R statistical program, version 4.2.1. Specific rates by age group per 100,00 women and relative risks by period and cohort were estimated using this method.

RESULTS

Between 1980 and 2019, 49,997 suicides among women were reported using the methods under study. Higher suicide rates per 100,000 women were observed in the South using strangulation and suffocation (2.42), while lower firearm suicide rates were observed in the Northeast (0.13). After adjusting the APC model, there was an increase in age-specific rates with advancing age across all regions for suicides by hanging, strangulation, and suffocation. In contrast, suicides by firearms and autointoxication showed a decrease in rates with advancing age. The period effect indicated an increased risk of suicides by hanging, strangulation (RR >1 and p<0.05) in the five-year intervals of the 2000s in the North, Southeast, and South regions. During the same period, there was an increased risk of suicides by autointoxication in the Southeast, South, and Northeast (RR>1, p<0.05). Suicides by firearms exhibited a statistically significant reduction in the risk of death from 2005 to 2019 in the Southeast and South regions, and from 2005 to 2014 in the Northeast and Midwest. The observed increase in the North region was not statistically significant (RR>1, p>0.05). The cohort effect demonstrated an increased risk of suicides by hanging, strangulation in younger cohorts (RR>1, p<0.05), whereas other methods showed an elevated risk in older cohorts relative to the 1950-1954 generation.

CONCLUSION

The results presented here may suggest changes in suicide method preferences between 1980 and 2019.

摘要

目的

分析1980年至2019年不同巴西地区年龄、时期和队列对女性通过上吊、勒颈、窒息、火器和自我中毒自杀的影响。

方法

采用可估计函数估计APC模型的生态时间趋势研究，通过R统计程序（版本4.2.1）的Epi库实现。使用该方法估计每10万名女性按年龄组划分的特定比率以及按时期和队列划分的相对风险。

结果

1980年至2019年期间，报告了使用所研究方法的49997例女性自杀事件。在南部地区，使用勒颈和窒息的自杀率较高（每10万人中有2.42例），而在东北部地区，火器自杀率较低（0.13例）。调整APC模型后，所有地区上吊、勒颈和窒息自杀的年龄特异性比率随年龄增长而增加。相比之下，火器和自我中毒自杀率随年龄增长而下降。时期效应表明，在2000年代的五年间隔中，北部、东南部和南部地区上吊、勒颈自杀的风险增加（RR>1且p<0.05）。同一时期，东南部、南部和东北部自我中毒自杀的风险增加（RR>1，p<0.05）。在东南部和南部地区，2005年至2019年以及在东北部和中西部地区2005年至2014年期间，火器自杀的死亡风险有统计学显著降低。北部地区观察到的增加无统计学显著性（RR>1，p>0.05）。队列效应表明，年轻队列中上吊、勒颈自杀的风险增加（RR>1，p<0.05），而其他方法显示，相对于1950 - 1954代，老年队列中的风险升高。