Ecological study of isolation and suicide in Tuscany (Italy)

Martiello, Michele Arcangelo; Giacchi, Mariano Vincenzo

doi:10.1016/j.psychres.2011.11.013

Cited by 10 publications

(5 citation statements)

References 24 publications

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“…More than half of the elderly who committed suicide were living alone (1)(2)(3)6,11,13,21,23,37,41,43,(48)(49)55,57,(59)(60)(61)67,79) . Feelings of solitude and lack of connectivity with the society are predictive of suicide (1,12,26,30,37,39,43,57,63,74,83) .…”

Section: Discussionmentioning

confidence: 99%

Diagnóstico de enfermagem Risco de Suicídio em idosos: revisão integrativa

Sousa

Perrelli

Botelho

2018

Rev. Gaúcha Enferm.

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Objective: To analyze the specialized literature regarding the risk factors in nursing diagnosis for suicide risks in elderly. Method: This is an integrative literature review carried out during June 2015 in the following databases with no time limit: MEDLINE, PsycINFO and CINAHL.Results: A total of 80 full papers were analyzed. It was suggested the inclusion of 23 risk factors in NANDA-I taxonomy: apathy; unrest; low self esteem; carelessness with medication; Inability to ask for help; Inability to express feelings; suicidal plan; rigidity; functional disability; visual problems; sadness; hostility; anxiety; failure; frustration; unhappiness; dishonor; frequent visits to a physician with unclear symptoms; social deprivation; social devaluation; psychological violence; Interfamilial violence; and financial violence. Conclusion:The risks for suicide presented in NANDA-I taxonomy need to be refined and adapted to the elderly reality. Furthermore, a review is also recommended for the risk factors not included in this classification.Keywords: Nursing diagnosis. Suicide. Aged. Review. RESUMOObjetivo: Analisar a literatura específica acerca dos fatores de risco do diagnóstico de enfermagem Risco de Suicídio de idosos. Método: Trata-se de uma revisão integrativa da literatura realizada em junho de 2015 nas bases de dados MEDLINE, PsycINFO e CINAHL, sem limite temporal.Resultados: Foram analisados 80 artigos. Sugere-se a inclusão de 23 fatores de risco na taxonomia da NANDA-I: apatia; agitação; baixa autoestima; descuido com a medicação; incapacidade de pedir ajuda; incapacidade de expressar sentimentos; plano suicida; rigidez; incapacidade funcional; problemas visuais; tristeza; hostilidade; ansiedade; fracasso; frustração; infelicidade; desonra; frequentes visitas a médico com sintomas vagos; privação social; desvalorização social; violência psicológica; violência intrafamiliar e violência financeira.Conclusão: O risco de suicídio apresentado na taxonomia da NANDA -I necessita de refinamento e adaptação ao contexto de idosos, sobretudo para averiguação dos fatores de risco que não estão contidos na referida classificação.Palavras-chave: Diagnóstico de enfermagem. Suicídio. Idoso. Revisão. RESUMENObjetivo: Analizar la literatura específica acerca de los factores de riesgo en el diagnóstico de enfermería sobre los riesgos de suicidio en ancianos.Método: Revisión completa en la literatura, realizada en junio del 2015, sobre la base de datos MEDLINE, PsycINFO y CINAHL, sin límite de tiempo.Resultados: Se analizaron 80 artículos. Se sugiere la introducción de 23 factores de riesgo en la Taxonomía de NANDA-I: apatía, agitación, autoestima baja, descuido con la medicación, incapacidad de pedir ayuda, incapacidad de expresar sentimientos, pensamientos suicidas, incapacidad funcional, problemas visuales, tristeza, hostilidad, ansiedad, fracaso, frustración, infelicidad, deshonor, visitas frecuentes al médico con síntomas vagos, comportamientos antisociales, violencia psicológica, actitudes violentas dentro del seno fam...

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Section: Discussionmentioning

confidence: 99%

Diagnóstico de enfermagem Risco de Suicídio em idosos: revisão integrativa

Sousa

Perrelli

Botelho

2018

Rev. Gaúcha Enferm.

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“…Another study using World Health Organization (WHO) data focused on countries with a medium Human Development Index (HDI) and found that education and telephone density were directly related to suicide while a high Gini index was inversely related to suicide [ 29 ]. Other recent ecological studies performed in the United States [ 50 ], Japan [ 51 ], Australia [ 52 ], Northern England [ 53 ], Finland [ 54 , 55 ] and Tuscany (Italy) [ 56 ] identified an inverse relationship between income and suicide. Another study carried out in Italy suggested that regions with higher economic status have the highest suicide rates [ 57 ].…”

Section: Discussionmentioning

confidence: 99%

Spatial clusters of suicide in the municipality of São Paulo 1996–2005: an ecological study

et al. 2012

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BackgroundIn a classical study, Durkheim mapped suicide rates, wealth, and low family density and realized that they clustered in northern France. Assessing others variables, such as religious society, he constructed a framework for the analysis of the suicide, which still allows international comparisons using the same basic methodology. The present study aims to identify possible significantly clusters of suicide in the city of São Paulo, and then, verify their statistical associations with socio-economic and cultural characteristics.MethodsA spatial scan statistical test was performed to analyze the geographical pattern of suicide deaths of residents in the city of São Paulo by Administrative District, from 1996 to 2005. Relative risks and high and/or low clusters were calculated accounting for gender and age as co-variates, were analyzed using spatial scan statistics to identify geographical patterns. Logistic regression was used to estimate associations with socioeconomic variables, considering, the spatial cluster of high suicide rates as the response variable. Drawing from Durkheim’s original work, current World Health Organization (WHO) reports and recent reviews, the following independent variables were considered: marital status, income, education, religion, and migration.ResultsThe mean suicide rate was 4.1/100,000 inhabitant-years. Against this baseline, two clusters were identified: the first, of increased risk (RR = 1.66), comprising 18 districts in the central region; the second, of decreased risk (RR = 0.78), including 14 districts in the southern region. The downtown area toward the southwestern region of the city displayed the highest risk for suicide, and though the overall risk may be considered low, the rate climbs up to an intermediate level in this region. One logistic regression analysis contrasted the risk cluster (18 districts) against the other remaining 78 districts, testing the effects of socioeconomic-cultural variables. The following categories of proportion of persons within the clusters were identified as risk factors: singles (OR = 2.36), migrants (OR = 1.50), Catholics (OR = 1.37) and higher income (OR = 1.06). In a second logistic model, likewise conceived, the following categories of proportion of persons were identified as protective factors: married (OR = 0.49) and Evangelical (OR = 0.60).ConclusionsThis risk/ protection profile is in accordance with the interpretation that, as a social phenomenon, suicide is related to social isolation. Thus, the classical framework put forward by Durkheim seems to still hold, even though its categorical expression requires re-interpretation.

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“…Other recent ecological studies performed in the United States [17], Japan [18], Taiwan [19], Australia [20], England [21], Finland [22,23] and Italy [24] also demonstrated an inverse relationship. Moreover, an ecological study that grouped data from the G7 countries in 2007 observed an inverse relation between income and male suicides [25].…”

Section: Introductionmentioning

confidence: 93%

“…A systematic review of ecological studies in North America, Europe, Australia, and New Zealand, dating from 1897 to 2004, reported an inverse relation between socioeconomic characteristics and suicide [ 16 ]. Other recent ecological studies performed in the United States [ 17 ], Japan [ 18 ], Taiwan [ 19 ], Australia [ 20 ], England [ 21 ], Finland [ 22 , 23 ] and Italy [ 24 ] also demonstrated an inverse relationship. Moreover, an ecological study that grouped data from the G7 countries in 2007 observed an inverse relation between income and male suicides [ 25 ].…”

Section: Introductionmentioning

confidence: 93%

Suicide rates and income in São Paulo and Brazil: a temporal and spatial epidemiologic analysis from 1996 to 2008

et al. 2012

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BackgroundIn a classical study, Durkheim noted a direct relation between suicide rates and wealth in the XIX century France. Since that time, several studies have verified this relationship. It is known that suicide rates are associated with income, although the direction of this association varies worldwide. Brazil presents a heterogeneous distribution of income and suicide across its territory; however, evaluation for an association between these variables has shown mixed results. We aimed to evaluate the relationship between suicide rates and income in Brazil, State of São Paulo (SP), and City of SP, considering geographical area and temporal trends.MethodsData were extracted from the National and State official statistics departments. Three socioeconomic areas were considered according to income, from the wealthiest (area 1) to the poorest (area 3). We also considered three regions: country-wide (27 Brazilian States and 558 Brazilian micro-regions), state-wide (645 counties of SP State), and city-wide (96 districts of SP city). Relative risks (RR) were calculated among areas 1, 2, and 3 for all regions, in a cross-sectional approach. Then, we used Joinpoint analysis to explore the temporal trends of suicide rates and SaTScan to investigate geographical clusters of high/low suicide rates across the territory.ResultsSuicide rates in Brazil, the State of SP, and the city of SP were 6.2, 6.6, and 5.4 per 100,000, respectively. Taking suicide rates of the poorest area (3) as reference, the RR for the wealthiest area was 1.64, 0.88, and 1.65 for Brazil, State of SP, and city of SP, respectively (p for trend <0.05 for all analyses). Spatial cluster of high suicide rates were identified at Brazilian southern (RR = 2.37), state of SP western (RR = 1.32), and city of SP central (RR = 1.65) regions. A direct association between income and suicide were found for Brazil (OR = 2.59) and the city of SP (OR = 1.07), and an inverse association for the state of SP (OR = 0.49).ConclusionsTemporospatial analyses revealed higher suicide rates in wealthier areas in Brazil and the city of SP and in poorer areas in the State of SP. We further discuss the role of socioeconomic characteristics for explaining these discrepancies and the importance of our findings in public health policies. Similar studies in other Brazilian States and developing countries are warranted.

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Ecological study of isolation and suicide in Tuscany (Italy)

Cited by 10 publications

References 24 publications

Diagnóstico de enfermagem Risco de Suicídio em idosos: revisão integrativa

Diagnóstico de enfermagem Risco de Suicídio em idosos: revisão integrativa

Spatial clusters of suicide in the municipality of São Paulo 1996–2005: an ecological study

Suicide rates and income in São Paulo and Brazil: a temporal and spatial epidemiologic analysis from 1996 to 2008

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