Psychosocial factors associated with repeated suicide attempts in patients with mental illness treated at Hospital Mental de Antioquia, Colombia, 2014-2016
DOI:
https://doi.org/10.17533/udea.rfnsp.e344793Keywords:
Mental hospital, suicide attempt, risk factors, recurrence, suicide, mental disordersAbstract
Objective: This study sought to analyze psychosocial factors (sociodemographic characteristics, primary diagnosis, method of the attempt, cognition, and behavior) in relation to the number of suicide attempts in patients with a diagnosed mental illness who received care at Hospital Mental de Antioquia, from 2014 to 2016. We also had the objective of evaluating the associative relationship of such factors in recurrence per attempt.
Methodology: Cross-sectional study that analyzes the abovementioned association in 248 people with diagnosed mental disorders. To this end, we first describe the sociodemographic and clinical profile; then, a multivariate logistic regression model is constructed to assess the association of psychosocial factors with the risk of recurrence per attempt.
Results: The population was mainly young (12-20 years old) and female (62.9%), with a recurrence rate of 40%. Among the most relevant findings, there is a higher proportion of psychoactive substance use and low family/social support in patients with four episodes compared to those with one attempt. Predictors explaining the risk of suicide attempt recurrence were recurrent depression, little psychiatric follow-up, and the use of less lethal methods (wrist cutting).
Conclusion: These results are key in the context of suicide prevention, as they identify factors that contribute to an increased number of suicide attempts and their recurrence, and they coincide with the time window for beginning surveillance of events in the Colombian system.
Downloads
References
World Health Organization. Suicide. Ginebra [internet]; 2019 [ci¬tado 2021 may. 26]. Disponible en: https://www.who.int/news-room/fact-sheets/detail/suicide
Posada J. A. La salud mental en Colombia. Biomédica [inter¬net]. 2013 [citado 2019 feb. 19]; 33(4):497-8. Disponible en: http://www.revistabiomedica.org/index.php/biomedica/article/ view/2214/2317
Medina M, Velásquez AV, et al. Costos médicos directos por in¬tento de suicidio en pacientes del hospital mental de Antioquia, Colombia. Rev Panam Salud Publica [internet]. 2018 [citado 2021 may. 26]; 42(29). Disponible en: https://aplicacionesbiblioteca. udea.edu.co:2598/31093157/
Organización para la Cooperación y el Desarrollo Económico. Sui¬cide rates. Paris [internet]; 2015 [citado 2016 ago. 10]. Disponible en: https://www.oecd-ilibrary.org/social-issues-migration-health/ suicide-rates/indicator/english_a82f3459-en
Organización Panamericana de la Salud. Situación de salud en las Américas. Washington [internet]; 2018 [citado 2019 feb. 19]. Disponible en: http://iris.paho.org/xmlui/bitstream/ handle/123456789/49511/IndicadoresBasicos2018_spa. pdf?sequence=2&isAllowed=y
Instituto Nacional de Salud. Intento de suicidio. Colombia [inter¬net]; 2018 [citado 2021 may. 26]. Disponible en: https://www. ins.gov.co/buscador-eventos/Informesdeevento/INTENTO%20 DE%20SUICIDIO_2018.pdf
Colombia, Ministerio de Salud y de Protección Social. Boletín de salud mental. Conducta suicida [internet]; 2018 [citado 2021 may. 26]. Disponible en: https://www.minsalud.gov.co/sites/rid/ Lists/BibliotecaDigital/RIDE/VS/PP/ENT/boletin-conducta-sui¬cida.pdf
Jafari H, Heidari M, et al. Risk factors for suicidal behaviours after natural disasters: A systematic review. Malays J Med Sci. [inter¬net]. 2020 [citado 2021 may. 26]; 27(3):20-33. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7337952/
Tondo L, Vázquez GH, Baldessarini RJ. Prevention of suicidal be¬havior in bipolar disorder. Bipolar Disord. 2021;23(1):14-23. doi: https://doi.org/10.1111/bdi.13017
Coronado O. Características clínico-epidemiológicas y abordaje terapéutico de pacientes que acuden por intento suicida al Hos¬pital General San José del Callao, Perú. Rev Neuropsiquiatr [in¬ternet]. 2014 [citado 2019 feb. 19]; 77(4):242-9. Disponible en: http://www.scielo.org.pe/pdf/rnp/v77n4/a07v77n4.pdf
García JE, Quintanilla R, Sánchez LM, et al. Consenso cultural sobre el intento de suicidio en adolescentes. Rev. Colomb. Psicol. [internet]. 2011; 20(2) [citado 2021 jun. 1]. Disponible en: https:// www.redalyc.org/pdf/804/80421265002.pdf
Walsh C. G, Ribeiro J. D, Franklin J. C. Predicting risk of suicide attempts over time through machine learning. Clin. Psychol. Sci. 2017;5(3):457-69. doi: https://doi. org/10.1177/2167702617691560
Ursano RJ, Kessler RC, Naifeh JA, et al. Suicide attempts in U.S. Army combat arms, special forces and combat medics. bmc Psychiatry [internet]. 2017;17(1):1-10 [citado 2021 may. 26]. Disponible en: https://bmcpsychiatry.biomedcentral.com/arti¬cles/10.1186/s12888-017-1350-y
Gates M. L, Turney A, Ferguson E, et al. Associations among subs¬tance use, mental health disorders, and self-harm in a prison po-pulation: Examining group risk for suicide attempt. Int J Environ Res Public Health. 2017;14(3):317. doi: https://doi.org/10.3390/ ijerph14030317
Parra-Uribe I, Blasco-Fontecilla H, Garcia-Parés G, et al. Risk of re-attempts and suicide death after a suicide attempt: A sur¬vival analysis. bmc Psychiatry. 2017;17(1):1-11. doi: https://doi. org/10.1186/s12888-017-1317-z
Gobierno de Colombia, Instituto Colombiano de Bienestar Fami¬liar. Observatorio de bienestar de la niñez. Una aproximación al suicidio de niñas, niños y adolescentes en Colombia. Colombia [internet]; 2018 [citado 2019 feb. 19]. Disponible en: https:// www.icbf.gov.co/sites/default/files/boletin_suicidio_25.07.2018. pdf
Bachmann, S. Epidemiology of suicide and the psychiatric pers¬pective. Int. J. Environ. Res. Public Health. 2018;15(7):1425. doi: https://doi.org/10.3390/ijerph15071425
Dong M, Lu L, Zhang L, et al. Prevalence of suicide attempts in bipolar disorder: A systematic review and meta-analysis of obser¬vational studies. Epidemiol. Psychiatr. Sci. 2020; 29, E63. doi: https://doi.org/10.1017/S2045796019000593
Bedoya E, Montaño L. Suicidio y trastorno mental. Rev ces Psicol. 2016;9(2):179-201. doi: http://dx.doi.org/10.21615/cesp.9.2.12
Colombia, Ministerio de Salud y Protección Social. Análisis de situación de salud (asis). Colombia; 2016 [internet]; 2016 [cita¬do 2019 feb. 19]. Disponible en: https://www.minsalud.gov.co/ sites/rid/Lists/BibliotecaDigital/RIDE/VS/ED/PSP/asis-colom¬bia-2016.pdf
Conus P, Macneil C, McGorry PD. Public health significance of bipolar disorder: Implications for early intervention and preven¬tion. Bipolar Disord. 2014;16(5):548-56. https://doi.org/10.1111/ bdi.12137
Onat M, İnal Emiroğlu N, Baykara B, et al. Executive functions and impulsivity in suicide attempter adolescents with major de¬pressive disorder. Psychiatry Clin. Psychopharm. 2018;29(3):332- 9. doi: https://doi.org/10.1080/24750573.2018.1541647
Gvion, Y. Aggression, impulsivity, and their predictive value on medical lethality of suicide attempts: A follow-up study on hospi¬talized patients. J Affect Disord. 2018;227:840-6. doi: https://doi. org/10.1016/j.jad.2017.11.033
Colombia, Ministerio de Salud y Protección Social. Plan Decenal de Salud Pública 2012-2021. Bogotá [internet]; 2013 [citado 2014 ago. 10]. Disponible en: https://www.minsalud.gov.co/plandece¬nal/Paginas/home2013.aspx
Taborda LC, Burgos C, et al. Principios de semiología psiquiátrica. Bogotá: Editorial Pinel; 1985.
García-Valencia J, Palacio-Acosta C, Arias S, et al. Caracterís¬ticas asociadas al riesgo de suicidio valorado clínicamente en personas con intento reciente. Rev. Colomb. Psiquiat [Internet] 2017;36(4):610-27 [citado 2019 feb. 19]. Disponible en: http:// www.scielo.org.co/pdf/rcp/v36n4/v36n4a03.pdf
Colombia, Ministerio de Salud y Protección Social. Resolución nú¬mero 8430, por la cual se establece las normas científicas, técnicas y administrativas para la investigación en salud (1993, octubre 4).
Manzini JL. Declaración de Helsinki: principios éticos para la investigación médica sobre sujetos humanos. Acta Bioethica [in¬ternet]. 2000 [citado 2019 feb. 19]; 6(2):321-34. Disponible en: https://scielo.conicyt.cl/pdf/abioeth/v6n2/art10.pdf
O’Sullivan M, Lawlor M, et al. The cost of hospital care in the year before and after parasuicide. Crisis. 1999;20(4):178-83. doi: https://doi.org/10.1027//0227-5910.20.4.178
Echeburúa E. Las múltiples caras del suicidio en la clínica psico¬lógica. Terapia Psicológica [internet]. 2015;33(2):117-26 [citado 2019 feb. 19]. Disponible en: https://scielo.conicyt.cl/pdf/terpsi¬col/v33n2/art06.pdf
García-Valencia J, Palacio-Acosta C, Vargas G, et al. Validación del inventario de razones para vivir (rfl) en sujetos con con¬ducta suicida de Colombia. Rev. Colomb. Psiquiatría [internet]. 2009;38(1):66-84 [citado 2019 feb. 19]. Disponible en: http:// www.redalyc.org/pdf/806/80615419006.pdf
Baader MT, Urra PE, et al. Algunas consideraciones sobre el inten¬to de suicidio y su enfrentamiento. Rev. Méd. Clín. Condes [inter¬net]. 2011;22(3):303-9 [citado 2019 feb. 19]. Disponible en: http:// www.clc.cl/clcprod/media/contenidos/pdf/MED_22_3/303- 309-dr-baader.pdf
Sanchez ML. Trastorno depresivo y suicidio [tesis doctoral]. [Sa¬lamanca]: Universidad de Salamanca [internet]; 2014 [citado 2019 feb. 19]. Disponible en: https://gredos.usal.es/jspui/bits-tream/10366/127378/1/DPPMMLHM_AguilarSanchez_Trast or¬nodepresivoL.pdf
Fava G, Ruini C, Sonino N. Tratamiento de la depresión recurren¬te. Enfoque psicoterapéutico y psicofarmacológico secuencial. siic [internet]. 2003 [citado 2019 feb. 19]; 17(15):1109-17. Dis¬ponible en: https://www.siicsalud.com/dato/resiic.php/66881
Posada-Villa J, Rodríguez M, et al. Prevalencia y factores de riesgo de comportamientos relacionados con suicidio en el Estudio Na¬cional de Salud Mental, Colombia 2003 (ensm). nova [internet]. 2003 [citado 2019 feb. 19]; 5(7):84-91. Disponible en: http://he¬meroteca.unad.edu.co/index.php/nova/article/view/378/1180
Nichols SD, McCarthy MC, Ekeh AP, et al. Outcome of cervical near-hanging injuries. J Trauma. 2009;66(1):174-8. doi: https:// doi.org/10.1097/TA.0b013e31817f2c57
Martin MJ, Weng J, et al. Patterns of injury and functional outco¬me after hanging: Analysis of the National Trauma Data Bank. Am J Surg. 2005;190(6):838-43. doi: https://doi.org/10.1016/j. amjsurg.2005.05.051
Chest Physicia. Near-hanging injuries: Critical care, psychiatric management [internet]. 2020 [citado 2021 may. 26]. Disponible en: https://www.mdedge.com/chestphysician/article/227407/cri¬tical-care/near-hanging-injuries-critical-care-psychiatric/page/0/1
Tuesca RM, Navarro EL. Factores de riesgo asociados al suicidio e intento de suicidio. Salud Uninorte [internet]. 2003 [citado 2019 feb. 19]; (17):19-28. Disponible en: https://rcientificas.uninorte. edu.co/index.php/salud/article/view/4165
Salim A, Martin M, Sangthong B, et al. Near-hanging injuries: A 10-year experience. Injury. 2006;37(5):435-9. doi: https://doi. org/10.1016/j.injury.2005.12.013
Czyz EK, King CA, Nahum-Shani I. Ecological assessment of daily suicidal thoughts and attempts among suicidal teens after psychiatric hospitalization: Lessons about feasibility and accepta¬bility. Psychiatry Res. 2018;267:566-74. https://doi.org/10.1016/j. psychres.2018.06.031
Nakagawa M, Kawanishi C, Yamada T, et al. Characteristics of suicide attempters with family history of suicide attempt: A retros¬pective chart review. bmc Psychiatry. 2009;9(1):32. doi: https:// doi.org/10.1186/1471-244X-9-32
Gómez C, Rodríguez N, Bohórquez PA, et al. Factores asociados al intento de suicidio en la población colombiana. Rev. Colomb. Psiquiat [internet]. 2002; 31(4):283-298 [citado 2019 feb. 19]. Disponible en: http://www.scielo.org.co/scielo.php?script=sci_ar ttext&pid=S0034-74502002000400002
Pacheco B, Peralta P. La conducta suicida en la adolescencia y sus condiciones de riesgo. ars medica Revista de Ciencias Mé¬dicas.. 2016;40(1):47-55 doi: http://dx.doi.org/10.11565/arsmed. v40i1.38
García-Resa E., Braquehais-Conesa D. El paciente suicida. En Manual de Urgencias Psiquiátricas 2.a ed. España: Elsevier [internet]; 2010, pp. 165-196 [citado 2019 feb. 19]. Dispo¬nible en: https://www.clinicalkey.es/#!/content/book/3-s2.0- B9788445820247500058
John A, Okolie C, Eyles E, et al. The impact of the covid-19 pan¬demic on self-harm and suicidal behaviour: A living systematic review. 2020;9:1097. doi: https://doi.org/10.12688/f1000re¬search.25522.2
Leaune E, Samuel M, Oh H, et al. Suicidal behaviors and idea¬tion during emerging viral disease outbreaks before the co-vid-19 pandemic: A systematic rapid review. Preventive Medicine. 2020;141:106264. doi: https://doi.org/10.1016/j.yp-med.2020.106264
Tanaka T, Okamoto S. Increase in suicide following an initial decline during the covid-19 pandemic in Japan. Nat. Hum. Behav. 2021;5(2):229-38. doi: https://doi.org/10.1038/s41562-020- 01042-z
Published
How to Cite
Issue
Section
Categories
License
Copyright (c) 2022 Universidad de Antioquia

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The contents of the articles are the responsibility of the authors
The editorial committee has editorial independence from the National School of Public Health "Héctor Abad Gómez" of the University of Antioquia.
The editorial committee is not responsible for aspects related to copying, plagiarism or fraud that may appear in the articles published in it.
When you are going to reproduce and disclose photographs or personal data in printed or digital format, informed consent is required. Therefore, this requirement is required of the author at the time of receipt of the manuscript.
Authors are responsible for obtaining the necessary permissions to reproduce any material protected by reproduction rights.
The authors preserve the moral rights and assign the economic rights that will correspond to the University of Antioquia, to publish it, distribute electronic copies, include them in indexing services, directories or national and international databases in Open Access, under the Creative Commons Attribution license -Not Commercial-Share Equal 4.0 International Commercial (CC BY-NC-SA) which allows others to distribute, remix, retouch, and create from the work in a non-commercial way, as long as the respective credit and license are granted. new creations under the same conditions.
The authors will sign the declaration of transfer of economic rights to the University of Antioquia, after the acceptance of the manuscript.
The editorial committee reserves the right to reject the articles whose authors do not offer satisfactory explanations about the contribution of each author, to meet the criteria of authorship in the submission letter. All authors must meet the four criteria of authorship according to ICMJE: "a) .- That there is a substantial contribution to the conception or design of the article or to the acquisition, analysis or interpretation of the data. b) That they have participated in the design of the research work or in the critical review of its intellectual content. c) .- That has been intervened in the approval of the final version that will be published.d). That they have the capacity to respond to all aspects of the article in order to ensure that issues related to the accuracy or integrity of any part of the work are adequately investigated and resolved. "