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巴西青少年自杀趋势(2000 - 2022年):按性别、年龄和自杀方式进行的生态分析

Adolescent suicide trends in Brazil (2000-2022): An ecological analysis by sex, age, and suicide methods.

作者信息

Corassa Rafael Bello, Souto Rayone Moreira Costa Veloso, Viana Maria Carmen, Morais Neto Otaliba Libânio

机构信息

Instituto de Patologia Tropical e Saúde Pública, Universidade Federal de Goiás (UFG), Setor Universitário, Goiânia/GO, Brasil.

Departamento de Medicina Social, Universidade Federal do Espírito Santo (UFES), Bonfim, Vitória/ES, Brasil.

出版信息

PLoS One. 2025 Jul 18;20(7):e0309505. doi: 10.1371/journal.pone.0309505. eCollection 2025.


DOI:10.1371/journal.pone.0309505
PMID:40679955
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12273947/
Abstract

INTRODUCTION: Suicide is the 3rd leading cause of death among Brazilian adolescents. Despite the rising rates, national studies on suicide trends still face methodological limitations and data quality issues. This study aimed to investigate adolescent suicide trends in Brazil. METHODS: An ecological time-series study was conducted to analyse suicide (ICD-10: X60-X84, Y87.0) trends among 10-19-year-old adolescents from 2000 to 2022, stratified by sex, age group, and self-harm method. Garbage code redistribution was applied to correct misclassified underlying causes of death. Corrected suicide rates were estimated and time trend analysis was performed using joinpoint regression. RESULTS: After the redistribution, 22,591 adolescent suicides were identified. Rates increased by 120% over the period, with a sharp rise starting in 2013 (APC: 7.7%; 95%CI: 6.2-9.3), particularly among 10-14-year-old girls after 2011 (APC: 10.6%; 95%CI: 8.2-13.0). Male rates were nearly twice as high than female rates, but 10-14-year-old female rates surpassed males after 2018. Hanging was the most frequent method (65.9%), followed by poisoning (15.7%) and firearms (10.8%). Hanging-related deaths increased across all subgroups, and the downward trend in firearm-related suicides reversed after 2010 (APC: 3.0%; 95%CI: 0.6-5.4). CONCLUSIONS: The increasing trend of adolescent suicides in Brazil, notably among young females and through more lethal methods, suggests a deterioration of adolescents' mental health and well-being. The findings underscore the need for comprehensive suicide prevention strategies addressing individual, social, and environmental factors, and the importance of accurate data for policymaking. The study calls for urgent action to tackle the growing problem of adolescent suicides in Brazil.

摘要

引言:自杀是巴西青少年的第三大死因。尽管自杀率不断上升,但关于自杀趋势的全国性研究仍面临方法学上的局限性和数据质量问题。本研究旨在调查巴西青少年自杀趋势。 方法:开展了一项生态时间序列研究,以分析2000年至2022年10至19岁青少年的自杀(国际疾病分类第十版:X60 - X84,Y87.0)趋势,按性别、年龄组和自我伤害方法进行分层。应用垃圾代码重新分配来纠正潜在死因的错误分类。估计校正后的自杀率,并使用连接点回归进行时间趋势分析。 结果:重新分配后,共识别出22591例青少年自杀案例。在此期间,自杀率上升了120%,自2013年起急剧上升(年度百分比变化:7.7%;95%置信区间:6.2 - 9.3),特别是2011年后10至14岁女孩中(年度百分比变化:10.6%;95%置信区间:8.2 - 13.0)。男性自杀率几乎是女性的两倍,但2018年后10至14岁女性自杀率超过了男性。上吊是最常见的方法(65.9%),其次是中毒(15.7%)和枪支(10.8%)。所有亚组中与上吊相关的死亡均增加,2010年后与枪支相关的自杀下降趋势逆转(年度百分比变化:3.0%;95%置信区间:0.6 - 5.4)。 结论:巴西青少年自杀呈上升趋势,尤其是年轻女性且采用更致命的方法,这表明青少年的心理健康和幸福感在恶化。研究结果强调需要制定综合自杀预防策略,解决个人、社会和环境因素,以及准确数据对决策的重要性。该研究呼吁采取紧急行动应对巴西日益严重的青少年自杀问题。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5cdb/12273947/3432528a8248/pone.0309505.g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5cdb/12273947/d1876f7ec271/pone.0309505.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5cdb/12273947/3432528a8248/pone.0309505.g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5cdb/12273947/d1876f7ec271/pone.0309505.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5cdb/12273947/3432528a8248/pone.0309505.g002.jpg

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本文引用的文献

[1]
[Estimates of mortality from external causes in Brazil, 2010-2019: methodology for redistribution of garbage causes].

Cad Saude Publica. 2024-11-22

[2]
Trends in Suicide Among Black Women in the United States, 1999-2020.

Am J Psychiatry. 2023-12-1

[3]
The Influence of the Great Recession on Adolescent Major Depressive Episodes and Treatment in the United States: An Interrupted Time Series Analysis.

J Adolesc Health. 2024-1

[4]
Suicide before and during the COVID-19 Pandemic: A Systematic Review with Meta-Analysis.

Int J Environ Res Public Health. 2023-2-14

[5]
Association Between Means Restriction of Poison and Method-Specific Suicide Rates: A Systematic Review.

JAMA Health Forum. 2021-10

[6]
Global, regional, and national burden of 12 mental disorders in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019.

Lancet Psychiatry. 2022-2

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Emergency Department Visits for Suspected Suicide Attempts Among Persons Aged 12-25 Years Before and During the COVID-19 Pandemic - United States, January 2019-May 2021.

MMWR Morb Mortal Wkly Rep. 2021-6-18

[8]
What are the risk factors and protective factors of suicidal behavior in adolescents? A systematic review.

J Child Adolesc Psychiatr Nurs. 2021-2

[9]
Emotion Regulation as a Risk Factor for Suicide Ideation among Adolescents and Young Adults: The Mediating Role of Belongingness.

J Youth Adolesc. 2020-8-9

[10]
Data for health: impact on improving the quality of cause-of-death information in Brazil.

Rev Bras Epidemiol. 2019-11-28

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