Prevalencia de factores de riesgo entre adolescentes que intentaron suicidarse: estudio transversal

Souza, Danton Matheus de; Treichel, Carlos Alberto dos Santos; Ribeiro, Lucca Garcia Moreira; Ferrer, Ana Paula Scoleze; Rossato, Lisabelle Mariano

doi:10.1590/1980-220X-REEUSP-2024-0197en

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Original Article • Rev. esc. enferm. USP 58 • 2024 • https://doi.org/10.1590/1980-220X-REEUSP-2024-0197en linkcopiar

Prevalencia de factores de riesgo entre adolescentes que intentaron suicidarse: estudio transversal

Autoría SCIMAGO INSTITUTIONS RANKINGS

Objetivo: Analizar la prevalencia de factores de riesgo entre adolescentes atendidos en un servicio de urgencias por intento de suicidio.

Método: Estudio transversal, documental y retrospectivo, realizado a través del análisis de historias clínicas de adolescentes atendidos en un servicio de urgencia y emergencia de un hospital universitario brasileño, de enero de 2015 a mayo de 2023. Los factores de riesgo se dividieron en comportamentales, de salud, de violencia, conflicto y estrés. Los datos fueron sometidos a análisis descriptivo e inferencial.

Resultados: Se analizaron 140 expedientes de adolescentes. Los conflictos familiares (47,8%), el intento previo de suicidio (47,1%) y la automutilación (30,7%) fueron los factores de riesgo más prevalentes. Los factores de riesgo se asociaron con edad, sexo, color, educación, trastorno mental previo y uso de medicación psicotrópica (p < 0,05).

Conclusión: Se observó alta prevalencia de factores de riesgo para intento de suicidio en adolescentes, lo que se asoció con la caracterización sociodemográfica. Se espera que este estudio promueva reflexiones sobre la traducción de las políticas públicas brasileñas en asistencia, especialmente en promoción de la salud, con intervenciones que tengan como objetivo reducir los factores de riesgo y mejorar los factores protectores.

DESCRIPTORES
Adolescente; Factores de Riesgo; Intento de Suicidio; Salud del Adolescente; Salud Mental; Servicios Médicos de Urgencia

Participant characterization
Variables	Mean (+SD*)	Min-Max
Age (years)	16.3 (+2.2)	10–19
	N*	Prevalence (%)
Sex
Female	113	80.7%
Male	27	19.3%
Color
White	113	80.7%
Non-white	27	19.3%
Age
10 to 14 incomplete years	35	25.0%
15 to 19 incomplete years	105	75.0%
Education
Up to ES‡	44	31.4%
Up to HS§	76	54.3%
Up to HE\|\|	20	14.3%
Mental disorders	73	52.1%
Current use of psychotropic medications	51	36.4%
Risk factors
	N*	Prevalence (%)
Behavioral risk factors
Previous suicide attempt	66	47.1%
Self-harm	43	30.7%
LGBTQIA+¶	13	9.3%
Previous or current use of PAS**	21	15.0%
History of dropping out of school	4	2.8%
Poor academic performance	19	13.8%
Health risk factors
Grief	6	4.3%
Previous psychiatric hospitalization	2	1.4%
Changes in body image perception	8	5.7%
Lack of support in RAPS††	1	0.7%
Bullying	15	10.7%
Violence, conflict and stress risk factors
Physical violence	5	3.8%
Psychological violence	21	15.0%
Sexual violence	10	7.1%
Family conflict	67	47.8%
Love conflict	24	17.1%
Divorced parents	16	11.4%
SA‡‡ in someone close	5	3.6%

	Previous SA†	p‡	Self-mutilation	p‡	LGBTQIA+§	p‡	Use of PAS\|\|	p‡	School dropout	p‡	Low academic performance	p‡
Sex
Female	52 (46.0%)	0.585	37 (32.7%)	0.287	9 (7.9%)	0.271	13 (11.5%)	0.018	2 (1.7%)	0.114	14 (12.4%)	0.403
Male	14 (51.8%)	0.585	6 (22.2%)	0.287	4 (14.8%)	0.271	8 (29.6%)	2 (7.4%)	5 (18.5%)	0.114		0.403
Color
White	50 (44.2%)	0.160	36 (31.8%)	0.548	12 (10.6%)	0.266	14 (12.4%)	0.077	0 (0)	<0.001	17 (15.0%)	0.298
Non-white	16 (59.3%)	0.160	7 (25.9%)	0.548	1 (3.7%)	0.266	7 (25.9%)	0.077	4 (14.8%)	<0.001	2 (7.4%)	0.298
Age
10–14 years	12 (34.3%)	0.078	14 (40.0%)	0.169	2 (5.7%)	0.401	4 (11.4%)	0.494	2 (5.7%)	0.241	5 (14.3%)	0.887
15–19 years	54 (51.4%)	0.078	29 (27.2%)	0.169	11 (10.5%)	0.401	17 (16.2%)	0.494	2 (1.9%)	0.241	14 (13.3%)	0.887
Education
Up to ES¶	15 (34.1%)	0.106	15 (35.1%)	0.839	3 (6.8%)	0.791	7 (15.9%)	0.795	2 (4.5%)	0.590	7 (15.9%)	0.160
Up to HS**	41 (53.9%)		22 (28.9%)		8 (10.5%)		12 (15.8%)		2 (2.6%)		7 (9.2%)
Up to HE††	10 (50.0%)		6 (30.0%)		2 (10.0%)		2 (10.0%)		0 (0)		5 (25.0%)
Mental disorders
Yes	45 (61.6%)	<0.001	25 (34.2%)	0.344	11 (15.1%)	0.014	11 (15.1%)	0.981	3 (4.1%)	0.353	11 (15.1%)	0.589
No	21 (31.3%)	<0.001	18 (26.8%)	0.344	2 (2.9%)	0.014	10 (14.9%)	0.981	1 (1.5%)	0.353	8 (11.9%)	0.589
Continuous medication
Yes	32 (62.7%)	0.005	20 (39.2%)	0.099	8 (15.7%)	0.048	7 (13.7%)	0.749	3 (5.8%)	0.104	9 (17.6%)	0.286
No	34 (38.2%)	0.005	23 (25.8%)	0.099	5 (5.6%)	0.048	14 (15.7%)	0.749	1 (1.1%)	0.104	10 (11.2%)	0.286

	Grief	p†	Previous psychiatric hospitalization	p†	Change in body image	p†	Lack of welcoming	p†	Bullying	p†
Sex
Female	3 (2.6%)	0.05	1 (0.8%)	0.267	7 (6.2%)	0.616	1 (0.8%)	0.667	14(12.4%)	0.190
Male	3 (11.1%)	0.05	1 (3.7%)	0.267	1 (3.7%)	0.616	0 (0)	0.667	1 (3.7%)	0.190
Color
White	5 (4.4%)	0.868	1 (0.8%)	0.267	7 (6.2%)	0.616	1 (0.8%)	0.667	14 (12.4%)	0.190
Non-white	1 (3.7%)	0.868	1 (3.7%)	0.267	1 (3.7%)	0.616	0 (0)	0.667	1 (3.7%)	0.190
Age
10–14 years	2 (5.7%)	0.630	0 (0)	0.411	3 (8.6%)	0.4	0 (0)	0.837	8 (22.8%)	0.007
15–19 years	4 (3.8%)	0.630	2 (1.9%)	0.411	5 (4.7%)	0.4	1 (0.9%)	0.837	7 (6.8%)	0.007
Education
Up to ES‡	3 (6.8%)	0.543	1 (2.3%)	0.771	1 (2.8%)	0.416	0 (0)	0.002	7 (15.9%)	0.162
Up to HS§	2 (2.6%)		1 (1.3%)		5 (6.9%)		1 (1.3%)		8 (10.5%)
Up to HE\|\|	1 (5.0%)		0 (0)		2 (10.0%)		0 (0)		0 (0)
Mental disorders
Yes	2 (2.7%)	0.346	1 (1.4%)	0.951	8 (10.9%)	0.005	1 (1.4%)	0.002	6 (8.2%)	0.319
No	4 (5.9%)	0.346	1 (1.5%)	0.951	0 (0)	0.005	0 (0)	0.002	9 (13.4%)	0.319
Continuous medication
Yes	1 (1.9%)	0.304	1 (1.9%)	0.688	6 (11.7%)	0.02	0 (0)	0.098	5 (9.8%)	0.792
No	5 (5.6%)	0.304	1 (1.2%)	0.688	2 (2.2%)	0.02	1 (1.1%)	0.098	10 (11.2%)	0.792

	Physical violence	p*	Psychological violence	p*	Sexual violence	p*	Family conflict	p*	Love conflict	p*	Divorced parents	p*	SA† close	p*
Sex
Female	4 (3.5%)	0.967	19 (16.8%)	0.219	7 (6.2%)	0.373	54 (47.8%)	0.973	19(16.8%)	0.833	14 (12.4%)	0.465	4 (3.5%)	0.967
Male	1 (3.7%)	0.967	2 (7.4%)	0.219	3 (11.1%)	0.373	13 (48.1%)	0.973	5 (18.5%)	0.833	2 (7.4%)	0.465	1 (3.7%)	0.967
Color
White	4 (3.5%)	0.967	15 (13.3%)	0.242	5 (4.4%)	0.011	55 (48.7%)	0.693	20 (17.7%)	0.721	13 (11.5%)	0.954	4 (3.5%)	0.967
Non-white	1 (3.7%)	0.967	6 (22.2%)	0.242	5 (18.5%)	0.011	12 (44.4%)	0.693	4 (14.8%)	0.721	3 (11.1%)	0.954	1 (3.7%)	0.967
Age
10–14 years	4 (11.4%)	0.004	11 (31.4%)	0.002	4 (11.4%)	0.256	27 (77.1%)	<0.001	3 (8.6%)	0.12	9 (25.7%)	0.002	2 (5.7%)	0.430
15–19 years	1 (0.9%)	0.004	10 (9.5%)	0.002	6 (5.7%)	0.256	40 (38.1%)	<0.001	21 (20.0%)	0.12	7 (6.6%)	0.002	3 (2.8%)	0.430
Education
Up to ES‡	3 (6.8%)	0.319	6 (13.6%)	0.085	4 (9.1%)	0.808	27 (61.3%)	0.001	8 (18.2%)	0.952	9 (20.4%)	0.071	4 (9.1%)	0.05
Up to HS§	2 (2.6%)		15 (19.7%)		5 (6.6%)		38 (50.0%)		13 (17.1%)		6 (7.8%)		1 (1.3%)
Up to HE\|\|	0 (0)		0 (0)		1 (5.0%)		2 (10.0%)		3 (15.0%)		1 (5.0%)		0 (0)
Mental disorders
Yes	2 (2.7%)	0.580	12 (16.4%)	0.619	5 (6.8%)	0.888	35 (47.9%)	0.983	10 (13.7%)	0.259	9 (12.3%)	0.727	3 (4.1%)	0.720
No	3 (4.5%)	0.580	9 (13.4%)	0.619	5 (7.4%)	0.888	32 (47.7%)	0.983	14 (20.9%)	0.259	7 (10.4%)	0.727	2 (2.9%)	0.720
Continuous medication
Yes	2 (3.9%)	0.866	9 (17.6%)	0.507	5 (9.8%)	0.355	24 (47.1%)	0.886	6 (11.7%)	0.201	8 (15.7%)	0.231	3 (5.8%)	0.265
No	3 (3.4%)	0.866	12 (13.5%)	0.507	5 (5.6%)	0.355	43 (48.3%)	0.886	18 (20.2%)	0.201	8 (8.9%)	0.231	2 (2.2%)	0.265

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[T1FN1] Note: *N = number of adolescents;

[T1FN2] ^†SD = standard deviation;

[T1FN3] ^‡ES = elementary school;

[T1FN4] ^§HS = high school;

[T1FN5] ^||HE = higher education;

[T1FN6] ^¶LGBTQIA+ = lesbian, gay, bisexual, transgender, queer, intersex, asexual and others;

[T1FN7] **PAS = psychoactive substances;

[T1FN8] ^††RAPS = Psychosocial Care Network;

[T1FN9] ^‡‡SA = suicide attempt.