Efeitos da recessão econômica na mortalidade por suicídio e riscos de ideação suicida no Brasil

Abstract

OBJECTIVE: to analyze the effects of the economic recession on suicide mortality and the risk of suicidal ideation in Brazil. MATERIAL AND METHODS: the study was developed in four stages, which followed specific methodological procedures. The first two steps consisted of a literature review, of the scope review type, to survey the variables identified in the studies that related the increase in suicide in periods of economic recession, and, thus, to assist in the construction of the theoretical framework. In the third stage, the correlation between national suicide rates and Internet search trends in Brazil in the population over 18 years of age, exposed by Google Trends based on search strategies, in the period before the economic recession (2010) was analyzed. to 2014) and after the beginning of the economic recession (2015 to 2019), using the Spearman correlation. The fourth stage was the analysis of interrupted time series on the effects of the economic recession on suicide mortality in the general population over 25 years of age, by sex, race and education, considering the time frame before and after the beginning of the study. of the economic recession in Brazil, using a quasi-Poisson regression model. Finally, in the fifth stage, a cross-sectional population-based study was carried out, with data from the National Health Survey, with the population over 18 years of age, having as a dependent, dichotomous categorical variable, the presence of suicidal thoughts or selfmutilation, and as independent variables the questions related to socioeconomic, behavioral, psychosocial, social support and access characteristics. The prevalence and their respective 95% confidence intervals (95%CI) were estimated, as well as the crude and adjusted odds ratios (OR) with their respective 95% confidence intervals were predicted through logistic regression. RESULTS: a strong positive correlation was identified, in the period after the beginning of the economic recession, between suicide rates and the search term “how to kill yourself” (rs = 0.64; p < 0.001) and a very strong positive correlation between the terms anxiety and borrowing (rs = 0.94; p < 0.001) and depression and anxiety (rs = 0.90; p < 0.001). In the analysis of interrupted time series, the results suggest that, after the beginning of the economic recession, there was an abrupt increase in populations with up to elementary school and in the southern region of the country, which showed, respectively, an increase of 12.5% (RR = 1.125; 95% CI: 1.027; 1.232) and 17.7% (RR = 1.177; 95% CI: 1.044; 1.328) in the risk of suicide mortality after the onset of economic recession. As for suicidal thoughts, the highest chances of suicidal thoughts were identified in the male population with less education (OR= 3.58; 95%CI: 1.26; 10.20), who reported consumption of more than five doses of alcoholic beverages ( OR= 1.82; 95% CI: 1.08; 3.05), victims of violence in the last 12 months (OR= 4.07; 95% CI: 2.12; 7.81), diagnosed with depression (OR = 5.69; 95% CI: 2.77; 11.67) and in the female population, higher than the male population, self-perception of health as poor or very poor (OR= 5.37; 95% CI: 2.83; 10.19). CONCLUSION: the economic recession produced different effects on suicide rates, considering different social strata. In addition, possible late effects of the economic recession were observed in relation to suicidal thoughts. The results found indicate the need for comprehensive and multidisciplinary care, inclusion of factors that increase risk in the health approach, development of new surveillance strategies and implementation of more effective policies that consider the different vulnerabilities, needs and opportunities for interventions for different groups. social.