2003, Number 6
Análisis de muertes por suicidio en el Estado de Querétaro
Espinosa FLF, Almeida MLG, Cortés SF, Leo AGE
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Language: Spanish
References: 23
Page: 47-54
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ABSTRACT
Suicidal behavior is a complex event. Neurobiological, psychological and sociodemographic factors are involved. Suicide is a health problem which accounts for 0.9% of all worldwide deaths.In Mexico, the suicide mortality rate in males was 5.9 x 100,000 inhabitants in 2000, and was the 17th cause of death among males in the same year.
In the USA, the death rate due to suicide has remained stable for last 15 years. In contrast, in México this phenomenon has increased.
In 1970 the rate death by suicide was 1.01 per 100,000 inhabitants and in 2000 increased to 5.9. In Mexico, there are many different report sources related to suicide incidence, but unfortunately the information is incongruous. Recent research shows that some of these report sources are not reliable. Additionally, there is no information about sociodemographic factors such as age, gender, or place of residence linked to suicide behavior.
According to Mexican laws, all death by suicide requires an autopsy to be practiced. For this reason, we consider the registration at the SEMEFO (Medical Forensic Services)of the state of Queretaro, to be optimum for this analysis.
The objective of the present study is to know the suicide rate in population older than 10 years in the state of Queretaro, Mexico, during the last seven years and, in addition, to find out some factors related to death by suicide.
We computed the rate of suicide in subjects older than 10 years from 1996 to 2002. Additionally, a retrospective analysis was made from the data base which included social and demographic information such as age, gender, place of residence, hour and month of death from the diseases registered at the SEMEFO in Queretaro from January 1999 to December 2001. A descriptive statistic was made of the suicide deaths and other different causes. A logistic regression and structural analysis model was applied to identify the social and demographic variables associated with the suicide behavior.
The retrospective cohort was integrated for the deaths registered at SEMEFO from 1996 to 2003 in Queretaro, which contains all deaths that required a forensic intervention in the state. This included the information reported by the four SEMEFO ubicated in the state: Queretaro, Cadereyta, San Juan del Río, and Jalpan counties.
The death cause was determinated in the following way: once authorities were informed about the ocurrence of a death, a team conformed by a forensic medical doctor, photographer, criminalistic expert, chemist expert, and dactiloscopist expert, collected the evidences and the body was transfered to the correspondig SEMEFO in order to practice the autopsy.
All the information was reported to the police in order to proceed with the death cause investigation. Together with the authorities, the police and the SEMEFO defined if the death was secondary to suicide, illness, homicide or accident.
The three SEMEFO ubicated across the State reported directly to SEMEFO at Queretaro city. We used the total number of suicide deaths registered at the SEMEFO each year, and the annual projections for the number of inhabitants older than 10 years provided from CONAPO (National Council of Population) from 1996 to 2002, to estimate the mortality ratio by year and per 100,000 inhabitants.
The social and demographic characteristics of a total of 2,396 deaths which occurred due to different causes were analyzed. The rate of suicide in subjects older than 10 years was 2.49 in 1996, 4.74 in 1997, 4.05 in 1998, 4.39 in 1999, 4.39 in 2000, 6.04 in 2001, and 3.43 in 2002. All rates are per 100,000 inhabitants. The rate of suicide per year and per age group was the highest for those subjects in the 20-29 years old age group and those older than 50 years. The risk of suicide showed an inverse relationship to the age.
The relative risk to commit suicide by each year of age was 1.033 (CI 96% 1.022-1.043) (X2w [1] = 38.59; p‹ 0.001). Living in a place with more than 179,000 inhabitants increased the risk 1.46 times (CI 95% 1.0504-2.0418)(X2w [1] = 5.06; p = 0.024). When the age effect was controlled, the risk of dying by suicide in those who lived in a place with more than 179,000 increased to 1.52 (CI 95% 1.0859-2.1240) (X2w [1] = 5.96; p = 0.01). In the structural analysis, the age and place of residence were the factors directly related to suicide behavior.
The main method used to commit suicide were hanging (107 cases), shooting with fire arm (37 cases), and overdose medication (15 cases).
Conclusion: Suicidal behavior has increased in the last seven years in Querétaro. Males in an age range between 20 and 29 years and those older than 50 years old, showed the highest risk of dying by suicide.
REFERENCES