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      Analysis of suicide mortality in Brazil: spatial distribution and socioeconomic context

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          Abstract

          Objective:

          To perform a spatial analysis of suicide mortality and its correlation with socioeconomic indicators in Brazilian municipalities.

          Methods:

          This is an ecological study with Brazilian municipalities as a unit of analysis. Data on deaths from suicide and contextual variables were analyzed. The spatial distribution, intensity and significance of the clusters were analyzed with the global Moran index, MoranMap and local indicators of spatial association (LISA), seeking to identify patterns through geostatistical analysis.

          Results:

          A total of 50,664 deaths from suicide were registered in Brazil between 2010 and 2014. The average suicide mortality rate in Brazil was 5.23/100,000 population. The Brazilian municipalities presenting the highest rates were Taipas do Tocantins, state of Tocantins (79.68 deaths per 100,000 population), Itaporã, state of Mato Grosso do Sul (75.15 deaths per 100,000 population), Mampituba, state of Rio Grande do Sul (52.98 deaths per 100,000 population), Paranhos, state of Mato Grosso do Sul (52.41 deaths per 100,000 population), and Monjolos, state of Minas Gerais (52.08 deaths per 100,000 population). Although weak spatial autocorrelation was observed for suicide mortality (I = 0.2608), there was a formation of clusters in the South. In the bivariate spatial and classical analysis, no correlation was observed between suicide mortality and contextual variables.

          Conclusion:

          Suicide mortality in Brazil presents a weak spatial correlation and low or no spatial relationship with socioeconomic factors.

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          Most cited references20

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          Suicide risk in relation to socioeconomic, demographic, psychiatric, and familial factors: a national register-based study of all suicides in Denmark, 1981-1997.

          Suicide risk was addressed in relation to the joint effect of factors regarding family structure, socioeconomics, demographics, mental illness, and family history of suicide and mental illness, as well as gender differences in risk factors. Data were drawn from four national Danish longitudinal registers. Subjects were all 21,169 persons who committed suicide in 1981-1997 and 423,128 live comparison subjects matched for age, gender, and calendar time of suicide by using a nested case-control design. The effect of risk factors was estimated through conditional logistic regression. The interaction of gender with the risk factors was examined by using the log likelihood ratio test. The population attributable risk was calculated. Of the risk factors examined in the study, a history of hospitalization for psychiatric disorder was associated with the highest odds ratio and the highest attributable risk for suicide. Cohabiting or single marital status, unemployment, low income, retirement, disability, sickness-related absence from work, and a family history of suicide and/or psychiatric disorders were also significant risk factors for suicide. Moreover, these factors had different effects in male and female subjects. A psychiatric disorder was more likely to increase suicide risk in female than in male subjects. Being single was associated with higher suicide risk in male subjects, and having a young child with lower suicide risk in female subjects. Unemployment and low income had stronger effects on suicide in male subjects. Living in an urban area was associated with higher suicide risk in female subjects and a lower risk in male subjects. A family history of suicide raised suicide risk slightly more in female than in male subjects. Suicide risk is strongly associated with mental illness, unemployment, low income, marital status, and family history of suicide. The effect of most risk factors differs significantly by gender.
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            An Economic Theory of Suicide

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              Comportamento suicida: epidemiologia

              O Brasil encontra-se entre os dez países que registram os maiores números absolutos de suicídios, com 9.852 mortes em 2011. O coeficiente médio para o período 2004-2010 foi de 5,7%. Esse índice aumentou 29,5% nas duas últimas décadas e é mais elevado em homens, idosos, indígenas e em cidades de pequeno e de médio porte populacional. Transtornos mentais encontram-se presentes na maioria dos casos de suicídio, principalmente depressão, transtorno do humor bipolar e dependência de álcool e de outras drogas psicoativas. Um estudo populacional revelou que, ao longo da vida, 17,1% das pessoas tiveram ideação suicida, 4,8% chegaram a elaborar um plano para tanto, e 2,8% efetivamente tentaram o suicídio. Dar especial atenção à pessoa que tentou se suicidar é uma das principais estratégias de prevenção do suicídio.
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                Author and article information

                Journal
                Braz J Psychiatry
                Braz J Psychiatry
                bjp
                Brazilian Journal of Psychiatry
                Associação Brasileira de Psiquiatria
                1516-4446
                1809-452X
                21 August 2017
                2018
                : 40
                : 1
                : 12-18
                Affiliations
                [1 ]Departamento de Medicina Clínica, Universidade Federal do Rio Grande do Norte (UFRN), Natal, RN, Brazil
                [2 ]Programa de Pós-graduação em Saúde Coletiva, UFRN, Natal, RN, Brazil
                [3 ]Secretaria Municipal de Saúde de Natal, Natal, RN, Brazil
                [4 ]Faculdade de Ciências da Saúde do Trairi (FACISA), UFRN, Natal, RN, Brazil
                Author notes
                Correspondence: Isabelle Ribeiro Barbosa, Faculdade de Ciências da Saúde do Trairi, Universidade Federal do Rio Grande do Norte (UFRN), Rua Vila Trairi, s/n, Centro, CEP 59200-000, Santa Cruz, RN, Brazil. E-mail: isabelleribeiro@ 123456oi.com.br
                Article
                10.1590/1516-4446-2017-2241
                6899420
                28832751
                256438ef-7b72-490e-acf1-4189311dccbd

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 30 January 2017
                : 16 March 2017
                Categories
                Original Article

                suicide,epidemiology,social and political issues,community mental health,statistics

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