Multidimensional Analysis of Clinical, Demographic, and Cultural Factors in Suicidal Ideation and Behavior in a Psychiatric Inpatient Ward
DOI:
https://doi.org/10.51987/revhospitalbaires.v44i2.290Keywords:
suicide, epidemiology, isolation, women, culture, ideographicAbstract
Introduction: Suicide is responsible for 1.5% of deaths worldwide, totaling approximately 800,000
deaths per year. Estimates suggest that it will become one of the leading contributors to the global
burden of morbidity in the next two decades. Proper clinical training in the field of suicidology and the
prevention of suicidal behavior is particularly relevant in the context of the psychiatric inpatient ward.
This study aims to analyze the factors that contribute to suicidal ideation and behavior in patients
hospitalized in the psychiatric inpatient ward of a general university hospital.
Materials and Methods: We conducted a cross-sectional study of hospitalized patients over one year
(October 2018 to September 2019, n=254). We examined sociodemographic, cultural, and clinical
variables related to suicide.
Results: Of the patients admitted during the study period, 39.4% reported suicidal ideation, 13.4% had
a suicidal plan, and 10.6% had attempted suicide. Women had a higher chance of hospitalization due
to suicidal ideation (OR=2.22, 95% CI [1.28-3.77]), suicidal plan (OR=2.77, 95% CI [1.15-6.62]), and
suicide attempt (OR=3.12, 95% CI [1.13-8.47]). Seventy percent of patients over 65 years old with a
suicidal plan lived alone, while this percentage was 80% for those admitted after a suicide attempt.
Conclusions: Most epidemiological data on suicidal behavior come from developed countries.
Considering the complexity of this phenomenon, we believe it is necessary to incorporate social, politicaleconomic, cultural, and gender perspectives into the analysis. Application of the idiographic method could provide a useful tool to advance our understanding of suicidology by proposing an approach that draws on quantitative and qualitative information centered on the individual in an iterative process that starts with the individual and then seeks contextualized common elements.
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References
Naghavi M; Global Burden of Disease Self-Harm Collaborators. Global, regional, and national burden of suicide mortality 1990 to 2016: systematic analysis for the Global Burden of Disease Study 2016. BMJ. 2019;364:l94. https://doi.org/10.1136/bmj.l94. DOI: https://doi.org/10.1136/bmj.l94
World Health Organization. Preventing suicide: a global imperative [Internet]. Geneva: WHO; 2014 [citado 2023 ago 20]. Disponible en: https://www.who.int/publications/i/item/9789241564779.
Mathers CD, Loncar D. Projections of global mortality and burden of disease from 2002 to 2030. PLoS Med. 2006;3(11):e442. https://doi.org/10.1371/journal.pmed.0030442. DOI: https://doi.org/10.1371/journal.pmed.0030442
World Health Organization. The Global Health Observatory. Age standardized suicide rates (per 100 000 population) [Internet]. Geneva: WHO; 2019 [citado 2023 ago 20]. Disponible en: https://www.who.int/data/gho/data/indicators/indicator-details/GHO/age-standardized-suicide-rates-(per-100-000-population).
Olfson M, Wall M, Wang S, et al. Suicide following deliberate self-harm. Am J Psychiatry. 2017;174(8):765-774. https://doi.org/10.1176/appi.ajp.2017.16111288. DOI: https://doi.org/10.1176/appi.ajp.2017.16111288
Sewall CJR, Wright AGC. Personalizing suicidology. Crisis. 2021;42(6):405-410. https://doi.org/10.1027/0227-5910/a000834. DOI: https://doi.org/10.1027/0227-5910/a000834
Shneidman ES. The suicidal mind. Oxford: Oxford University Press; 1998. 187 p.
Strejilevich SA, Vallejos F, Bustin J. How Argentina is training their mental health residents to face its Silver Tsunami? Int Psychogeriatr. 2018;30(10):1573-1574. https://doi.org/10.1017/S1041610218000182. DOI: https://doi.org/10.1017/S1041610218000182
Matusevich D. Aplicación de los siete principios del aprendizaje pleno en una sala de internación de psiquiatría en el entrenamiento médico. Rev Hosp Ital B. Aires (2004). 2016;32(6):50-52. DOI: https://doi.org/10.51987/Rev.Hosp.Ital.B.Aires.v36i2.673
Malleza S, Abudarham T, Bertolani FC, et al. Análisis epidemiológico de la sala de internación de psiquiatría de un hospital general metropolitano de comunidad de la Ciudad de Buenos Aires, Argentina. Vertex. 2022;33(158, oct.-dic.):6-19. https://doi.org/10.53680/vertex.v33i158.314. DOI: https://doi.org/10.53680/vertex.v33i158.314
Oquendo MA, Halberstam B, Mann JJ. Risk factors for suicidal behavior. En: First MB, ed. Standardized evaluation in clinical practice. Washington, DC: American Psychiatric Pub; 2003. p.103-129. DOI: https://doi.org/10.1176/appi.books.9781615377268.lg04
Posner K, Brent D, Lucas C, et al. Columbia-suicide severity rating scale (C-SSRS): version 6/23/10 [Internet]. New York, NY: Columbia University Medical Center; 2008 [citado 2023 ago 20]. Disponible en: https://cssrs.columbia.edu/wp-content/uploads/C-SSRS_Pediatric-SLC_11.14.16.pdf.
Fazel S, Runeson B. Suicide. N Engl J Med. 2020;382(3):266-274. https://doi.org/10.1056/NEJMra1902944. Errata en: N Engl J Med. 2020;382(11):1078. https://doi.org/10.1056/NEJMx200005. DOI: https://doi.org/10.1056/NEJMra1902944
Iribarren C, Sidney S, Jacobs DR Jr, et al. Hospitalization for suicide attempt and completed suicide: epidemiological features in a managed care population. Soc Psychiatry Psychiatr Epidemiol. 2000;35(7):288-296. https://doi.org/10.1007/s001270050241. DOI: https://doi.org/10.1007/s001270050241
García de la Garza Á, Blanco C, Olfson M, et al. Identification of suicide attempt risk factors in a national US survey using machine learning. JAMA Psychiatry. 2021;78(4):398-406. https://doi.org/10.1001/jamapsychiatry.2020.4165. DOI: https://doi.org/10.1001/jamapsychiatry.2020.4165
Bostwick JM, Pabbati C, Geske JR, et al. Suicide attempt as a risk factor for completed suicide: even more lethal than we knew. Am J Psychiatry. 2016;173(11):1094-1100. https://doi.org/10.1176/appi.ajp.2016.15070854. DOI: https://doi.org/10.1176/appi.ajp.2016.15070854
Wasserman D, Wasserman C. Oxford textbook of suicidology and suicide prevention. Oxford: Oxford University Press; 2020. 760 p. DOI: https://doi.org/10.1093/med/9780198834441.001.0001
Canetto SS. Women and suicidal behavior: a cultural analysis. Am J Orthopsychiatry. 2008;78(2):259-266. https://doi.org/10.1037/a0013973. DOI: https://doi.org/10.1037/a0013973
Kleinman A, Good BJ, eds. Culture and depression: studies in the anthropology and cross-cultural psychiatry of affect and disorder. Berkeley: University of California Press; 1985. 535 p. DOI: https://doi.org/10.1525/9780520340923
González RMS, Segura IP. Impacto diferencial del estrés entre hombres y mujeres: una aproximación desde el género. Revistas Alternativas en Psicología. 2016;36:112-120.
ergman B, Brismar B. Suicide attempts by battered wives. Acta Psychiatr Scand. 1991;83(5):380-384. https://doi.org/10.1111/j.1600-0447.1991.tb05560.x. DOI: https://doi.org/10.1111/j.1600-0447.1991.tb05560.x
Havens B, Hall M, Sylvestre G, et al. Social isolation and loneliness: differences between older rural and urban Manitobans. Can J Aging. 2004;23(2):129-140. https://doi.org/10.1353/cja.2004.0022. DOI: https://doi.org/10.1353/cja.2004.0022
Clare Wenger G, Davies R, Shahtahmasebi S, et al. Social isolation and loneliness in old age: review and model refinement. Ageing & Society. 1996;16(3):333-358. https://doi.org/10.1017/S0144686X00003457. DOI: https://doi.org/10.1017/S0144686X00003457
Peplau LA, Perlman D. Blueprint for a social psychological theory of loneliness. En: Cook M, Wilson G, eds. Love and attraction: an international conference [Internet]. Oxford: Pergamon; 1979 [citado 2023 ago 20]. p. 101-109. Disponible en: https://books.google.com.ar/books?hl=en&lr=&id=rfRFBQAAQBAJ&oi=fnd&pg=PA101&dq=blueprint+for+a+social+psychological+theory&ots=8viOqbTu3x&sig=aQGRIO7zwSyZ5c1CJGzC3KL8KeI&redir_esc=y#v=onepage&q=blueprint%20for%20a%20social%20psychological%20theory&f=false.
Heuser C, Howe J. The relation between social isolation and increasing suicide rates in the elderly. Qual Ageing Older Adults. 2018;20(1):2-9. https://doi.org/10.1108/QAOA-06-2018-0026. DOI: https://doi.org/10.1108/QAOA-06-2018-0026
Dury R. Social isolation and loneliness in the elderly: an exploration of some of the issues. Br J Community Nurs. 2014;19(3):125-128. https://doi.org/10.12968/bjcn.2014.19.3.125. DOI: https://doi.org/10.12968/bjcn.2014.19.3.125
Matusevich LD, Vega AL, Donadio PD. Viejo por accidente: identidad, narcisismo y tentativa de suicidio en la vejez. Rev Hosp Ital B.Aires (2004). 2018;38(1):19-24. DOI: https://doi.org/10.51987/Rev.Hosp.Ital.B.Aires.v38i1.588
Matusevich D. Suicidio en la vejez: análisis de "La Humillación" de Philip Roth. Vertex. 2010;21(92):306-313.
Berardi F. Heroes: mass murder and suicide. London: Verso Books; 2015. 224 p.
Nesselroade JR. Interindividual differences in intraindividual change. In: Collins LM, Horn JL, eds. Best methods for the analysis of change: recent advances, unanswered questions, future directions. Washington, DC: American Psychological Association; 1991. p. 92-105. DOI: https://doi.org/10.1037/10099-006
erman AL. An idiographic approach to understanding suicide in the young. En: King RA, Apter A, eds. Suicide in children and adolescents. Cambridge, UK: Cambridge University Press; 2003. p. 198-210. DOI: https://doi.org/10.1017/CBO9780511550423.009
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